MANAGED-CARE SUCCESS Change your patients' perceptions


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MANAGED-CARE SUCCESS
Change your patients' perceptions
By Mark Mandell, DC

Most patients harbor the false assumption that healthcare coverage covers healthcare. And most patients have the perception that their healthcare coverage for chiropractic services covers all the chiropractic services they need.

This perception is fueled by the traditional biomedical (injury/illness) model on which healthcare insurance has been built: A patient has symptoms; you treat the condition to remove the symptoms; then you release the patient. The cycle begins again when a new injury or illness causes the patient to return for more care.

The key to developing a successful managed-care practice is to understand the diverging healthcare models and employ techniques to shift your patient's perceptions from a biomedical model to a wellness model.

When you do this, patients understand the limitations of their healthcare coverage and do not let those limitations drive their healthcare decisions.

CHANGE THE PERCEPTION

The change of perception begins with your initial patient interaction. During the initial consultation, focus on two things: the patient's complaints and his perceptions and/or expectations.

• Listen and ask. Listen to your patients and begin the education process by asking them what their expectations are. "Why did you seek chiropractic care?" Most will answer, "To make the pain go away." By having patients articulate their expectations, you create the opportunity to change their beliefs.

You cannot change behaviors unless you change beliefs.

• Discuss the three aspects of treatment. Treatment is designed to reduce and remove the spinal subluxations so their body can heal their condition, and reduce the risk for future episodes. Discuss with your patient the three primary treatment protocols for correction of subluxations.

Back to basics

How do we educate our patients? Get back to the basics. Instead of letting managed care dictate your treatment models, get back to a core practice model.
From a business standpoint, this means managed care is a market segment that cannot be ignored. Use managed care as an access to a flow of patients. What you do with those patients is your responsibility — and your opportunity.
Look at every aspect of your practice — initial consultation, report of findings, and the interaction between your insurance department and your patient.
For example:
• Are most conversations between staff members and patients centered on coverage, benefit limitations, and visit approvals?
• Is your patient interaction driven by what services are deemed reimbursable by their insurance company?
There are subtle, but significant differences between informing your patient of their coverage, visit approvals, and denials, and letting that interaction drive whether they schedule appointments.
The focus should be on getting well and maintaining health — not on "You have exhausted your insurance benefits."

Protocol 1. A regular series of spinal adjustments. Explain the incremental effectiveness of chiropractic adjustments. If your patient expects adjustments to have any substantial effect on the structure and function of his spine, he must receive a sequence of adjustments at intervals varying between one and three days.

Explain that at each reassessment, you will demonstrate his progress and adjust the dosage appropriately, not in terms of his symptoms, but in terms of spinal correction. It can take between six and nine months to make lasting structural changes. Emphasize that he will feel better much sooner, but it takes longer to correct subluxations.

Protocol 2. Biomechanical analysis of the lower extremities. Assess the stability of the arches of your patient's foot and explain the relationship between spinal structure and her foundation.

If you find any substantial drop in the arch in the weight-bearing position, that patient is a candidate for orthotics. Fit athletes, runners, or anyone involved with a regular exercise program with custom-made orthotics, whether or not they have already developed abnormal foot mechanics.

Protocol 3. Customized exercise program. The third component of a spinal corrective care program is an exercise program.

Identify postural faults and provide specific exercise protocols to change from a spinal pathological state to a state of spinal wellness.

• Communicate your plan of care. Use the report of findings to communicate your plan of care, including a specific number of treatments over a specific period of time.

Establish a general expectation of time and number of treatments so your patient can make a value judgment about the cost and benefit of care.

Remember that people make purchasing decisions by weighing the answers to two questions: What is the benefit? What is the cost?

Identify your patients' perceptions and expectations of their condition, health, and chiropractic care. Educate them about the causes of spinal pain, and the correlation between spinal health and wellness.

Integrate the three components of spinal correction in your treatment protocols: chiropractic adjustments, the use of custom-made spinal pelvic stabilizers, and customized postural rehabilitation exercise programs. These components should make up routine treatment protocols regardless of the diagnosis.

Those patients who choose to remain focused on symptoms will discontinue treatment when they feel better. If 30 percent of your practice "gets" it, you will thrive in this world of managed care.

Managed care can be viewed as a market opportunity to bring a flow of patients into your practice. What you do in terms of treatment and education with your patients is your choice and your responsibility. If you take time to educate your patients, your practice will not only survive, it will thrive.

Mark Mandell, DC, is the director of business development at Foot Levelers. He served as the chairman of the 1994 World Cup Opening Ceremonies Medical Staff, as president of BrainStorm Group, and has consulted with leading chiropractic and healthcare product companies around the globe. He can be reached at 800-553-4860.

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