It’s time to improve your communication and think about the receiver during new patient consultation, exam and report of findings
“Communication isn’t what you say, it’s what the other person hears.” Show more. Talk less. Keep it simple. Communication is both verbal and visual. Visual makes a better impact than verbal. Add “simple” to that and you now have the ingredients for very effective communication during new patient consultation, exam and report of findings.
Honesty in communication
There is no doubt that improved communication is going to produce a more successful practice outcome. Unfortunately, in chiropractic it sometimes takes years before we truly communicate honestly with ourselves.
Due to so many philosophies, techniques and protocols, many of us are busy searching for an identity, and that delays the confidence we need and the development of a good message. This certainly reduces our ability to communicate a message to patients.
So, the goal is to find something that is constant regardless of philosophy, technique or protocol. Find a message that is universally true and work to improve your vocabulary, belief and presentation. Patients know if their doctor is committed to their message or not. If a doctor isn’t committed to the message, if it’s more like a script in a play, and doesn’t convey a strong belief to the patient, lack of success will follow.
The human body hasn’t changed in thousands of years. Balance is better than imbalance. Mobility is better than fixation and no person on this planet is symmetrical. That leaves open the vast opportunity to detect asymmetry through whatever means an office chooses.
I’ve found that regardless of the differences we may have as chiropractors, if we focus on the asymmetries of a patient and the issues caused by these asymmetries, we’ll have a better opportunity for getting patients to understand our recommendations. This allows many visual graphics as well as verbal phrases to penetrate the patient’s brain barrier and get them to take positive action. Analogies such as “All humans are architectural structures, so we need strength, symmetry and balance from the ground up,” will give the patient a visual and a better understanding of how the body works.
I begin this “message” in my new patient consultation or general consultation. I really enjoy meeting new patients, as I love the study of human nature. What makes people tick? When I first meet the patient, my initial question is always “So, what brings you in today?” Everyone is different, and many people have such a wrong understanding of how the body works; it’s enjoyable hearing the many beliefs, complaints and ideas as to how the patient can fix their own problem. But they are in your office, ready and willing to pay you, so the evident truth is, they have no clue. And the conversation is always fun to have. I let them talk until they demonstrate a lack of organization or good communication. I’ll stop them and tell them to let me ask questions to make sure I get everything I need.
Once we’ve completed the consult about why they’re at my office and what their goals are, I then give my “message.” I use the graphic Crooked Man (Fig. 1), which is on the wall directly in front of them and I point to it and say, “This is you. We’re all imbalanced from the ground up and these imbalances are what cause the majority of problems.” Their response is very often, “That’s me. That’s what I feel like.”
The initial exam
I tell the patient I’m looking for imbalances, during a new patient consultation or returning patient exam. Whether it’s a difference in the collapse in one or all of the three arches in the feet, found on palpation of the medial arches or seen on the digital laser foot scan, an increased Q angle of the knee or a difference in the range of motion while doing the Patrick-FABER test, these are all by-products of the body’s adaptation to asymmetries. These lead to muscle tightness, joint stress, bone stress, neurological interference, inflammatory responses (bone and soft tissue) and pain. Imbalances lead to injuries and premature degeneration.
I then perform a digital laser foot scan (Fig. 2), which shows the collapse of the patient’s feet compared with optimal feet. It produces a number representing the arch height difference and it shows the percentage of body weight on the right vs. the left side of the body. We then perform two standing lumbo-sacral X-rays and two cervical X-rays while barefoot. There are usually many biomechanical imbalances found on X-rays.
Most people are not aware that the plantar vault comprises three arches rather than just one. Since each arch has its own role in aligning the body, it’s crucial that all of them have the proper support and stabilization needed to function properly.
The key to the report of findings
Many doctors hate to give a report of findings as they feel like it’s selling, and they have to get the patient to say “yes.” A report of findings is everything but that.
It’s a combination of the doctor’s knowledge, experience, empathy and communication skills. You want this to resonate with the patient, so it’s important to adapt your communication style to their personality. Some are loud; some are gentle. Some are brief; some require more time. The more you mirror the patient’s personality during your report of findings, the more successful you’ll be. The simpler you keep your report of findings, the more successful you’ll be.
Talk about the normal vs. the patient’s abnormal while including visuals. For example, if the patient has an 8-mm difference in femoral head height, show that to the patient and tell them that’s probably a contributor to their low-back pain. Then show them the collapse of the feet along with a picture of Crooked Man. You are now ready to make the patient understand why they need custom orthotics with three-arch correction to help restore optimal foot function and balance and stabilize their entire body from the ground up.
When justifying the need for chiropractic care, I tell the patient that joint mobility is critical for joint health. Whether it’s spinal or extremity, joints fixate due to many different types of stresses we are subjected to every day. A mobile joint can tolerate much more than a fixated joint. A fixated joint will be more vulnerable to injury and degenerate prematurely; therefore, you need to have your joints mobilized on a regular basis. That’s what chiropractors do. We adjust joints of the body to insure mobility.
Teach the patient not to associate getting adjusted with the relief of pain only. Adjustments should be performed on a regular basis to the patient who wants to preserve their structure and have a healthier and more productive future.
New patient consultation: make your communication resonate
I have a scripted report of findings that includes graphics, scans, X-rays, both normal and abnormal and personalized to the given patient. It lasts approximately 15 minutes but has proven to be very effective.
I sell 40-50 pairs of custom orthotics a month, and 50% of my patients also include spinal decompression with their treatment program, which is an out-of-pocket expense. But it’s all because my new patient consultation communication resonates with their needs, goals and wishes. And, when you can achieve that with your communication, you will have a much greater impact on your community.
TIM MAGGS, DC, is a graduate of the National College of Chiropractic and has been in private practice for 42 years. He has specialized in the diagnosis and treatment of sports injuries throughout his entire career. He is the president of Dr. Tim Maggs Sports Chiropractic and Health Center in Schenectady, N.Y. He is the author of numerous books and articles on chiropractic care and established the Concerned Parents of Young AthletesTM (CPOYA) Program and the Biomechanical Analytics™ Certification Program. He partnered with Foot Levelers to develop their CPOYA custom orthotic. He is the owner of the Albany Patroons basketball team, the first professional U.S. team totally under the Structural Management® Program, and he can be reached at DrT@DrTimMaggs.com.