One of the keys to patient retention is to create and develop the well-educated patient.
More times than not, the patient who understands chiropractic care is the one who refers and remains under long-term care. Patient education allows you to cast a broader net to a larger audience. It is demonstrably a key element of a successful practice.
The general public as a whole is not well educated about chiropractic, and it is up to you to help people understand the benefits of chiropractic care. There are many potential patients who need what you have to offer and would be willing to invest in its benefits. If you do a good job teaching your current patients, you can empower them to deliver the message to future referrals.
But chiropractors often struggle with effective communication. In a survey of 150 randomly selected chiropractic patients, more than 90 percent rated their chiropractors “excellent” in personal manner, and about 80 percent thought their technical skills were excellent, too. But only about 75 percent felt that the doctor’s explanation of procedures was excellent, leaving room for improvement in doctor-patient communication.1
Mix it up
Understanding how people learn and applying that information will enhance your success in practice. Essentially, there are three general styles of learning: visual, auditory, and experiential.2-3 In practice, combining learning styles is frequently the most effective approach. Tell your patients about their condition; show your patients a visual aid that supports the discussion; and, whenever possible, have them physically participate in a demonstration that reinforces your message even further.
Helpful patient demonstrations Encouraging meaningful patient education can be as simple as conducting demonstrations. Because the patient will be hearing your voice as you demonstrate, seeing you as you show how to place the finger pads or move the feet, and feeling the motion of the demonstration, all three styles of learning will be employed.
Foot flare and knock-knee or bow-legged demo: I have had great success in making patients aware of “foot flare” or toeing out (point it out on your patient for a visual learning experience). It is generally asymmetrical so it is easy to see one foot toeing out more than the other; make your patient take a few steps for experiential learning. Using the “feet are the foundation of the body” truism, explain how asymmetries in the foundation have ripple effects through the body—just like problems in the foundation of a house can lead to cracks, imbalance, and instability throughout a building.
Pronation and supination demo:
- Have the patient stand with feet shoulder-width apart. Place the flat finger pads on the boney prominences of the greater trochanters bilaterally as shown. [Figure 1]
- Have the patient roll the feet inward, “knocking” the knees. [Figure 2] Then have the patient roll the feet outward, for a “bow-legged” appearance. [Figure 3] Repeat this two or three times.
- Show the patient that, as they roll their feet in and out, they can feel with their finger pads on the greater trochanters that their hip bones are moving. First, have the patient perform this motion in an exaggerated way, then have them perform it with minimal motion. It only takes small motions of the feet to create abnormal motion at the greater trochanter.
This demonstration can also be done unilaterally by having the patient contact only one trochanter with the finger pads. [Figure 4]
Forward head-carriage demo: Another simple but effective patient education tip is asking your patient if he or she knows anyone whose ear is in front of the tip of the shoulder when looking at the person from the side.
Have a photo on your wall and point to it for visual emphasis. As you know, this is a classic postural distortion that is often associated with common symptoms of upper back, neck, or headache problems. More likely than not, X-rays of your patient will show some level of this condition.
With these demonstrations, favor common terms over clinical ones. For example, hip bones versus trochanters. Sprinkle metaphors and comparisons throughout. A house is often a great example because it’s clear and relatable, and speaking in such terms makes the lesson even more understandable.
For every inch the head moves forward, it gains 10 pounds in weight, straining the neck and spine.4 Have a 10-pound weight handy for a patient to hold and give them an immediate sense of the impact of this degenerative posture on the rest of their body. Then explain how chiropractic care can help reverse this condition.
Technology has an important role in the see-hear-feel learning experience. Patients notice if you are up on current technology. A-plus digital X-ray machines, 3-D foot scanners, and other innovations can make your job easier.
By using a 3-D digital foot scanner, for example, you can show a patient color pictures and indicators of how
flat their arches are. You can then explain how this relates to the other joints of the body all the way up to the neck and head. The pictures and graphics help you educate and report your findings in ways that patients understand.
Review your findings with your patients to make sure they understand, but don’t stop there. Send each patient home with information such as a digital foot scan report of findings to help underscore the long-term consequences of not taking care of the situation. You can also include copies of your patient’s X-rays and your own customized material that represents your approach and practice brand.
The proper approach
These are just a few ideas you can incorporate to make the educational component of your care more powerful. Add see-hear-feel experiences of your own, mixing the three learning styles for maximum impact. Also, ask your colleagues what they’re doing with their patients.
Experiment with different approaches until you find ones that work for you.
When educating patients, give them the big picture first, and then start them on the small steps to get there. The same is true for your practice. Set a goal and then take small steps to achieve it. The main purpose of any chiropractor is to help people and that starts with proper patient education. Education is an investment that will pay off through a more successful practice and healthier patients.
Mark N. Charrette, DC, is a 1980 summa cum laude graduate of Palmer College. He is a frequent guest speaker at chiropractic colleges worldwide and has taught more than 1,400 seminars on extremity adjusting, biomechanics, and spinal adjusting techniques. He can be contacted at firstname.lastname@example.org.
1 Gemmell HA, Hayes BM. Patient satisfaction with chiropractic physicians in an independent physicians’ association. Journal of Manipulative and Physiological Therapeutics. 2001:24(9):556- 559.
2 Rajaratnam N, D’cruz SM. Learning styles and learning approaches -Are they different? Educ Health. 2016 Jan-Apr;29(1):59-60.
3 Dirette DP, Anderson MA. The Relationship between Learning Style Preferences and Memory Strategy use in Adults. Occup Ther Health Care. 2016 Mar 16:1-10.
4 Kapanji I. (2008). The Physiology of the Joints, Volume III. (6th ed.). London: Churchill Livingstone.