Walk in their shoes

5 ways to connect with patients when recommending orthotics.

Compelled by clinical evidence and the value that ancillary products offer their practices, over half (52 percent) of the nation’s DCs offer orthotics to their patients, according to chiropractic economics’ 2015 salary and expense survey. Yet while some doctors excel at recommending custom orthotics—with sales adding 30 percent or more to annual revenue—others struggle with it.

Anecdotally you’ll hear many reasons for this, including:

• “I don’t feel comfortable selling,”
• “I don’t know how to explain to patients why orthotics can help them,” and
• “It’s hard to recommend services that aren’t covered by insurance.”

If you’re among those who feel you’re lacking the right skills in this area, or if you’re currently recommending orthotics but want to improve your communication with patients, here are a few helpful tips:

1. Let your experience give you confidence. If you want to genuinely convey the value of orthotics, wear a pair yourself. Indeed, research shows orthotics can help with low-back pain, among other ailments.1-4 One study showed that chiropractic adjustments in addition to wearing orthotics helped reduce the symptoms of workers standing six hours daily, and more so than adjustments alone.⁵

This is important knowledge to have in your back pocket, but getting through to patients may require feeling the results yourself and speaking from experience. And, as a DC, you spend a lot of time on your feet.

2. Evaluate the feet of every new patient. Adding this step to your intake protocol may lead to increased sales, and it can also help you build confidence in your knowledge of pedal foundation dysfunction and how it can affect the entire body. Most of the pain syndromes you see are the result of postural stresses over time, and the feet are often a contributing factor.

Look for simple-but-obvious signs that your patient’s foundation may be compromised, including asymmetrical foot flare, internal knee rotation, uneven shoe wear, pelvic tilting, and forward head carriage.

3. Educate, don’t sell. Don’t like selling? Well that’s great—because you should be doing no such thing. The objective is to have patients choose your services because they want to, based on the clinical information you present.

Change your mindset from one of selling to a service-based approach. Ask questions. Determine the problem. Create a clear, well-defined plan of how you can help solve it, and why orthotics will be a vital treatment component.

Compare and contrast the benefits of using your services and what will happen if patients choose to ignore or mask the problem. If you’ve already scanned or assessed the feet, your report of findings can be an invaluable visual aid in this educational discussion.

4. Keep the conversation simple. When speaking with patients, use analogies. Avoid industry jargon. Remind them that the feet serve as the foundation of the body.

Tell patients to think of their body as a building, emphasizing that the foundation determines how well it will hold up to stress and age. When cracks emerge in the walls or ceiling—or the body experiences pain—problems in the foundation may be the culprit.

Remind patients that just because their feet feel OK, they aren’t necessarily free from problems or dysfunction. Foot issues can have ripple effects, transferring pain to the legs, knees, hips, spine, shoulders, and even the skull (headaches).

5. Make it easy (for you and for them). Make sure your CA understands the benefits of orthotics, so he or she can speak knowledgably to patients about the benefits. And get all your team members on board with orthotics so they too experience the benefits firsthand.

Finally, make orthotics accessible and affordable to patients. Enlist your CA during the intake process to handle foot scans, if possible. When your CA draws up a payment plan, include orthotics in the cost as an integral part of treatment rather than extra fees. Most insurance companies will pay for ancillary services that go with functional orthotics, even if they don’t pay for the orthotics themselves.

As compliance expert Kathy Mills Chang, MCS-P, advises: “If the patient chooses to wait and not order functional orthotics up front, make a note in the record so that you can remember to bring it up again. Scan the patient again at re-evaluations. Bring up the issue if the patient is not progressing as he or she should. Perhaps the functional orthotics would be the X factor to help the patient improve more quickly.”

Overall, orthotics can boost your bottom line, engage your staff, and help your patients improve their performance. Once patients start to see results, they feel empowered, and their trust in your care grows.

 

KEVIN WONG, DC, is an expert on foot analysis, walking and standing postures, and orthotics. He discusses spinal and extremity adjusting at speaking engagements. He can be contacted through orindachiropractic.com.

 

 

References

1 Chuter V, Spink M, Searle A, Ho A. The effectiveness of shoe insoles for the prevention and treatment of low back pain: a systematic review and meta-analysis of randomised controlled trials. BMC Musculoskelet Disord. 2014;15:140.

2 Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology (Oxford). 2013;52(12):2275-82.

3 Cambron JA, Duarte M, Dexheimer J, Solecki T. Shoe orthotics for the treatment of chronic low back pain: a randomized controlled pilot study. J Manipulative Phys Ther. 2011;34(4):254-260.

4 Castro-Mendez A, Munuera PV, Albomoz-Cabello M. The short-term effect of custom-made foot orthoses in subjects with excessive foot pronation and lower back pain: a randomized, double-blinded, clinical trial. Prothet Orthot Int. 2013;37(5):384-90.

5 Zhang, J. Chiropractic adjustments and orthotics reduced symptoms for standing workers. J Chiropr Med. 2005;4(4):177-181.