This procedure reiterates the 3 education points you need to be giving to your patients at every visit. AND it helps you continue to build your patient relationships and retain them for ALL of their care!
Here is what you will do on EVERY visit:
1. ASK THE PATIENT HOW THEY ARE PROGRESSING #
Some consultants teach their clients not to ask the patient about their condition because it engages the doctor in conversation and slows the doctor down. This is a major mistake. You should ask patients how they are progressing. It improves the doctor-patient relationship, reduces malpractice risk and helps speed the patient healing. However, wait to ask the patient how they are progressing until you have positioned them so that you can work with them while the patient is responding. For instance, if you are using a heat sensitive instrument you can ask the patient how they are doing and take a heat reading while the patient is responding. Always ask the patient how they are progressing.
It is good to have a grading tool so you can immediately put some objectivity to the answers for purposes of documentation. But of course, we do want to be sure that the most basic connection is being met… that is, connecting to the patient. Asking “how are you” or “how’s the back today” or “how are you feeling” is engaging them and acknowledging their issues. It also says, “I’m concerned… genuinely concerned with how you are”. So although I do think it is ok to start more generic, it should be followed up with something like… “ok, so the back is better but not gone, you say? Good to hear. Rate the pain for me on a scale of 1-10…”.
2. TELL THE PATIENT HOW THEY APPEAR #
So, if Step number one is, “always ask the patient how they are progressing.” Step number two says, “Never ask them how they are progressing without immediately telling them how they appear to be doing.” After the patient responds to your question, “How are you doing?”, you should follow their response with a statement about how they appear. For example, you might say, “I am glad to hear you haven’t had any headaches for the last two weeks. I do notice when I palpate your back that you still have some sensitive areas and I also notice that your neck doesn’t move through its full range of motion as well as it should yet. I am glad you’re getting better, but we’ll need to keep working on that area.”
If you only ask the patient how they are doing and never tell them how they appear, they will draw the conclusion that you are symptom oriented and they should be also. Therefore, if it hurts a lot – keep coming in, but as soon as it is better – quit. By discussing how they are progressing or showing them objective findings, you will help them realize you are scheduling them according to their progress and not according to the presence or absence of symptoms.
Example: I am feeling how your low back & hips are moving and I am noticing some improvement so the joints are loosening up a bit, feels these muscles on the side, remember how they were rock hard before? Those are starting to ease up, that is perfect, that is what we want to see. You still have some tension & restriction we want to work through but it is looking very well so far.
3. EXPLAIN WHAT IS HAPPENING WHILE YOU ARE ADJUSTING THEM! #
Here’s where those 3 education points come in doctors… you can do this WHILE your adjust them. Let me say it now to you just like I would say it to a patient:
“I want to remind you of 3 things that are happening with your adjustment:
First, I am removing the nerve interference so that your body has 100% capacity to HEAL itself from your pain and even other sickness.
Second, this adjustment assures your body has 100% capacity to PREVENT future sickness and pain – so you don’t get so much sickness in the first place.
and third, I am removing the nerve interference for your Future PERFORMANCE so that your musculo-skeletal system doesn’t experience so much wear and tear from misalignment allowing you to have better mobility your WHOLE life.”
4. GRADE YOUR ADJUSTMENT #
You should grade each adjustment. By grading your adjustment you show the patient that you are happy with your results and their progress. Remember, perception is key. Lead your patient to have a good perception of their treatment each time. your grades are “good, better and best”. And doctors, as we all know, an adjustment can be a GREAT adjustment and still not have an audible “pop”. Don’t grade on the SOUND, grade on how you feel things went. Say: “oh yes, that was a really GOOD adjustment.” Or “Mary, that adjustment went even BETTER than last time.” or “John, that was the BEST adjustment you’ve had yet.”
Remember doctors, it is ALL about your excitement and enthusiasm. THEY don’t know what is good and what isn’t in an adjustment until you TELL them. So TELL them… TELL them EVERY time!!!! when you lead them to think it was a good treatment they have no reason to think otherwise!
5. OFFER ENCOURAGEMENT #
One of the best procedures for keeping a patient under care is to constantly encourage them regarding their progress. If a patient is progressing well a sufficient statement to use is: “You’re progressing just like I anticipated. That’s very encouraging,” however, only say this when it is true.
If they aren’t improving yet… or as quickly as you would like them to, address that in an encouraging way too. say: “I know you are still having pain but that is to be expected. It takes a while to get control of a problem that’s been going on as long as yours.” Or “you are improving slower than we hoped you would BUT you ARE improving. THAT is good. Your body is just going to make us work harder and longer than we expected to get you well. We need to keep at it.. this IS the right thing to do.”
6. CONFIRM THE NEXT APPOINTMENT #
After you have completed the adjustment, be sure to firm up the next appointment with the patient. THIS HELPS IMPROVE YOUR COMPLIANCE AND KEPT APPOINTMENT RATIO. Know the EXACT date and time of the next visit. Make SURE you get a confirmation from them (which of course means they must be AMS’ed in order to already have that next appointment). When you do this it lets them KNOW you think that keeping appointments is IMPORTANT. Again, remember, they don’t know what’s important until you TELL them what is important. Then, if they indicate they may not be coming or are uncommitted then address it RIGHT THERE AND THEN!!!!
Using this six point office visit procedure on every patient every visit greatly increases your chance of patient compliance and practice growth!