It is the entire chiropractic team’s responsibility to make sure each patient is given individual attention and encouragement. Each patient must be given the rules, the tools, the education, and encouragement needed to become wellness-oriented.
On the patient’s second visit, he will be presented with a report of findings (ROF). This visit is vital for the patient to understand the scope of the problem and the recommended treatment. The ROF is the beginning of the journey to wellness. This is the visit during which the patient is given needed information to make an informed choice about the type and level of care he will be receiving.
Additionally, the patient must know what his responsibilities are in the process. The man who shows up for the blind date with an engagement ring in his pocket is skipping a few steps, and so is the chiropractic team that automatically assumes the patient will become a lifelong patient of chiropractic starting with the second visit. The journey to wellness is a process, and no steps should be skipped along the way. The ROF visit is one of the most important steps in this journey.
When a patient enters your office for the second visit, she should be welcomed warmly. The front desk CA should say with sincerity, “Good Morning, Mrs. Smith, I’m glad you’re here.” The question, “How are you today?” is quite premature. The last thing you should want your patient to think is that she should already be feeling better by the second visit. At this point in care, she should have had very little treatment, if any.
You may want to consider that the patient view some type of ROF video to prepare for the consultation with the doctor. A very simple script such as, “Mrs. Smith, in a few minutes Dr. Taylor will be going over your X-rays and his findings from your examination. Dr. Taylor requests that you view this short video beforehand, which will explain some of the things he will be talking to you about today.” Never assume your patient knows anything about chiropractic, even if she has received chiropractic care in the past.
Following are a few tips that will help with compliance and retention:
- A ROF should include written materials presented professionally. Never assume a patient will remember what you tell him. A patient must be able to refer back to the information given.
- A ROF should be no longer than 15 or 20 minutes. Too much information is as damaging as not enough information. Plot out your ROF. Take five minutes to explain the function of the nervous system, five minutes to explain and show individual trouble areas, five minutes to explain solutions and types of care.
- A ROF should include simple explanations and a two-way dialogue. Simple questions will help your patient think about the importance of the nervous system. Some questions you might want to ask may include: “Do you know how the brain communicates with the body?” or, “Do you know what would happen if the brain’s communication power was cut off from the rest of the body?” Do not talk “at” the patient; talk “with” her.
Once the patient understands the chiropractic concept and the seriousness of his particular condition, he needs to choose the type of care desired. It is imperative to get a commitment from your patient. Many chiropractors stop short of asking for a commitment, even though this is crucial for retention.
Once you have explained the types of care you offer and the incentives for choosing wellness care, including your best recommendations, let the patient decide the type of care desired. The choice will reflect the patient’s personal commitment to health. You must sit back and let the patient decide, and then accept the decision your patient makes for now.
After the patient makes a choice, move on to the last part of the ROF, which includes the following (all of these areas can be explained by a trained chiropractic assistant):
- Patient Responsibility Form: This form should include your rules for patients, including: making up visits, arriving on time, missed appointments, payment expectations, advance appointments, importance of following through with chosen care, and insurance information. Each patient must understand that this is a partnership and each of you is responsible for the outcome. How will your patient know what is expected if you don’t tell her?
This form must be signed by the patient and a copy should be kept in her file. End your form with your patient care promise. Here’s a sample: “I promise to do everything in my power to help you return to health. I will do this by giving you the most effective care possible, in the least amount of time, and keep the cost for services at a reasonable level. I will respect your judgment and will become congruent with your quest for health. Thank you for your confidence in me.”
- Multiple Appointment Scheduling: An attempt should be made to schedule all appointments in advance. This will cut down on unnecessary phone calls to your clinic and will be convenient for your patient. Your CA can say: “Mr. Jones, we always recommend that you make your appointments in advance so you can get the times that are convenient for you.”
- Financial Obligations: For best retention results, encourage your patients to pay in advance. If you only collect from visit to visit, your patient may only see his commitment in terms of one visit at a time. You may be able to offer an incentive for payment in advance; check with your state board for advance payment rules. Obviously, the greatest advantage of advance payment is that once the patient has scheduled in advance and paid in advance, he will be more committed to care.
If you educate your patients from the beginning about the importance of wellness care and adhering to your practice’s “ground rules,” not only will your patients be thankful – you and your staff will be, too.
