When you present your report of findings (ROF), do you ever wonder if you’re actually reaching your patients and motivating them to accept your treatment plan?
This 5- to 10-minute one-on-one session with the patient is absolutely critical to your success. The report of findings is your opportunity to further establish rapport and credibility, answer questions, and inspire people to want your help.
Once you have determined the causes of the patient’s concerns and presented your treatment plan, your next steps should involve setting up appointments and putting the plan in motion. Every interaction you have with the patient should build up to this short meeting, where you communicate how you can help.
Of course, there are some critical points that influence whether your plan motivates the patient. If your patients are complaining about expenses, not referring, or leaving care prematurely, you may want to consider the following ways to improve your ROF.
The First Exam
Most of us begin our first exam by saying something like: “I provide corrections to unhealthy joints and nerves. Additionally, I support this care with specific nutrition, specific orthotic support, and specific rehabilitative exercises. Each one of these aspects of care will be based on your needs, which I will establish by performing a thorough exam.”
After making this kind of statement, you should ask the individual questions that will reveal any obstacles to overcome before the patient will initiate care. Make sure to ask your patients, if it is determined they can benefit from chiropractic care, is there anything that would stop them from letting you help them? Remember that the ROF is not the time to discuss prices, policies, or patients’ motivations. These topics should have already been discussed before you begin your investment in their health.
At the first exam, you should demonstrate an interest in the patient’s daily activities, such as work environment, posture, exercise, and diet. While taking X-rays, or prior to taking them, you should explain to how valuable it is to have a picture of the area(s) of complaint. Over the course of the exam, patients will begin to realize that you leave very few rocks unturned when it comes to improving their health.
By the time you meet for the ROF, your communications with the patients will have reinforced the idea that chiropractic care improves the relationships between structure, function and health.
Reporting Your Findings
When it comes to presenting your ROF, keep it short! The average person absorbs only 5-10 minutes of new information before starting to “tune out,” so it is important that you keep your ROF short and to the point.
There are only three basic learning styles – visual, auditory, and kinesthetic, and the best way to communicate with patients is by using all three.
When you are presenting your ROF to the patient, stand in front of a poster, view box, or exam table so you can point and demonstrate (visual and kinesthetic) as you ask and answer questions (auditory). By now, you should have a basic idea about the patient’s job, family, or hobbies. Adapt your report to include word pictures that relate to one of these areas.
Chiropractic terms will make more sense when patients can see how the vertebral subluxation complex relates to them personally.
When patients see an X-ray of their spine, three of the most common questions they may ask include:
- Is there any cancer?
- Are there any fractures (especially after recent trauma)?
- How bad is the arthritis?
Until you answer any of these “Big Three” questions that your patients might ask, you will not have their full attention to cover other topics, such as the stages of spinal degeneration and subluxations. After answering any pressing questions your patients might have, it’s your job to get and keep their attention to present the rest of your ROF.
If you ask your patients what they see when you put up their films, the most consistent answer you’ll probably receive is, “Something in the spine doesn’t look straight.” Everyone knows the difference between a straight and a curved line. You can use that opportunity to draw a line connecting the femur heads, or a vertical line connecting the spinous processes. This draws attention to pelvic unleveling and lateral spinal curvatures. You can simply point to the lines and correlate the crooked lines with their complaints. At the same time, you can remind the patient that the problems you may have found in their feet, or the way they sleep, or a variety of other factors, may directly contribute to the crooked lines.
Seizing Opportunity
Have you ever finished your report and had your patient say something like, “I’m glad that’s all it is. I thought it was something serious.”
If you have, then feel lucky if the patient lets you make even one adjustment. Once the primary concerns are answered and patients know they will live to see tomorrow, you have an opportunity (and an obligation) to honestly warn them of the seriousness of their particular level of “spinal damage.”
As doctors, it is our duty to inform our patients about the degenerative nature of subluxations and their effect on health in general. We must leave it up to the patients to decide how much care they will accept.
To determine your patients’ level of understanding and to solidify their commitment to improving their health, ask these two important questions as you summarize your report:
- Now that we have had the opportunity to review the results of your exam, what do you think is causing your pain (numbness, dizziness, fatigue, swelling, etc.)?
- Once we take care of your spinal problems, how do you expect that will affect your job (golf game, ability to interact with your kids, etc)?
The answers you will get to these questions will be all you need to determine how effective your report was. If there are still concerns, they should now be more obvious and easier to resolve.
Commit the Patient
Finally, outline your treatment schedule and commit the patient to follow through with care. Whether it’s adjustments and orthotics, cervical pillows, rehabilitative exercises, or nutritional support, patients expect to be told what they need to do to improve their health. One of the most important things you will have done during your report of findings is demonstrated your genuine concern and your confidence in providing answers and relief.
For an unbiased review of your report, consider videotaping an actual or “role play” encounter with a patient or staff member. You can learn a great deal by watching yourself in action. You should refine a powerful and convincing presentation that can be tailored to each patient without sounding scripted.
Pay close attention to words and body language that weaken your presentation. Do you frequently say “maybe,” “might,” “possibly,” “minimal” or “minor”? Spending time improving your ROF may be the best and least expensive way to dramatically increase the number of patients accepting your care. It will also give you more opportunities to help more people through chiropractic.
Examine your current report of findings. Have you made it short and interesting? Are you answering your patients’ questions and alleviating their fears? Are you presenting a consistent message from your first contact to your first adjustment?
If there are areas where you could make improvements, I will ask you the same thing I ask all my patients at the end of my report of findings: “Ready to get better?”
