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Chiropractic News

November 2011

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3 steps to improving patient compliance

macdonaldChiropractic is about creating a relationship. That means you need to have the commitment of both parties involved.

By Don MacDonald, DC

Patient compliance means different things to different chiropractors.

Some only want patients to come in after they feel pain, which ultimately eliminates the need for patient compliance because they will tell you when they need care.

However, other chiropractors offer their patients treatment plans designed to improve neurological function. This is usually measured through neurologically based functional tests.

These are typically completed on the first visit and then again on subsequent reevaluations to measure progress.

For these individuals, you can offer three smart steps to help support them along their journey to improved health and function.

1. Find out what the patient wants. When patients first come into your office, they might list pain or an ailment as the reason for their visit, but there is often more to it.

They usually come to you because their condition is restricting their ability to do things that they value and enjoy.

For example: You might see a grandmother who comes in with low-back pain that she’s had for years, but is now seeking treatment because she wants to play more actively with her grandchild.

Finding out what is important to your patients is the first thing you should do when recording history. Most people aren’t truly interested in chiropractic until they understand how it is going to improve what matters to them.

2. Give your ideal recommendation and explain how it will benefit them. When you present your report of findings, make sure you link how following through with care will help improve your patients’ spinal function and help them do what is important to them.

Not all patients will have given much thought to how this problem could affect the rest of their life and what will happen if it is not treated.

As motivational speaker Tony Robbins says, people are motivated by two things: avoiding pain or gaining pleasure. When you review your results and recommendations with your patients, give them the pros and cons of following through with care and as well as with not following through. This rule is the same for the wellness phase of their care as well.

3. Have your patients decide what type of care they would like and then support them. Once you have fully explained the issue and your recommendations for care, your

patient needs to make the decision.

When patients make an informed decision to follow through with care, let them know that your office procedures are designed to help them achieve their goals. Tell them in advance about making up missed appointments, reminder calls, and the importance of pre-booking appointments.

Let them know that your office works as a support network to help them follow through with and achieve their goals.

For example: When you decide you want to commit to a workout schedule, wouldn’t it be nice if the gym had you pre-book and prepay your workouts and called you if you didn’t show up for a workout  to reschedule it before the end of the week?

Many people would be much more successful in following through on their commitments if they had a support network to help them.

Continually give the patient more information and stay connected. This is where in-office classes (such as healthcare, nutrition, exercise, and stress management classes), reevaluations, and patient education materials come into play.

Some DCs and CAs dislike reminder calls, missed appointment calls, and reactivation calls as part of patient compliance. The problem might be a lack of agreement from the very start.

If a patient didn’t commit to care or wasn’t given a plan to follow, then you won’t need reactivation procedures in your office. The main part of patient compliance is being very clear with your patients up front. Many chiropractors lack this initial clarity and end up implementing all the compliance procedures afterward, which can make patients feel like they are being harassed.

Chiropractic is about creating a relationship, and when you create a relationship, you need to have the commitment of both parties involved. Once that agreement has been reached, all the other procedures around patient compliance simply become support for the success of the patient.

When the main goal is to help improve the patient’s health and neurological function, the key to patient compliance is good communication and having the patient make a commitment.

After that, ensure that your office procedures support and nurture that relationship while helping your patients succeed.

DonMacDonaldDon MacDondald, DC, owner of South Side Chiropractic in Edmonton, Alberta, Canada, runs a high-volume, wellness-based practice and operates Personal Chiropractic Coaching. He can be reached at or through

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