Those first 5- to 10-minute sessions with your patients are crucial to your success

Are you currently giving your patients a report of your examination findings? Have you ever wondered if you are actually getting their attention and motivating them to accept your treatment plan? Realize that this 5- to 10-minute one-on-one session with the patient is critical to your success. The report of findings (ROF) 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 problems, your next steps are presenting a treatment plan and discovering the patient’s motivations. Knowing your patients’ motivations will help you tailor the ROFs to their needs. Every interaction you have with the patient should emphasize how you and chiropractic care can help them.

ROFs do not have to be limited to new patients. If your patients are complaining about expenses, not referring, or leaving care prematurely, you can use ideas from the ROF to show them how valuable chiropractic care is. If you do not answer the patient’s question, “What will I get out of this?” and if you do not continue to emphasize the value of your care, you will not achieve the success that you could have.

The First Examination
Most of us begin our first examination by saying something like: “I provide corrections to unhealthy joints and nerves. Additionally, I support this care with specific nutrition, postural support, and rehabilitative exercises. Each one of these aspects of care will be based on your needs, which I will establish by performing a thorough exam.”

At the first examination, you should demonstrate an interest in the patient’s daily activities, such as work environment, posture, exercise, and diet. You should ask them questions that will reveal their motivations for seeking care. Over the course of the examination, patients will begin to realize that you leave very few rocks unturned when it comes to improving their health.

Many patients tend to be concerned about the cost of care. Before you do the ROF, your office manager or CA can tell the patient, “During the report of findings, the doctor will be going over what he or she found during your examination. I would like to outline a range of costs associated with the doctor’s recommended treatment plan.” It is important to answer your patients’ concerns about cost before the ROF, so they can focus fully on the information on their health that you will be giving them.

Reporting Your Findings
Keep it short! The average person absorbs only 5 to 10 minutes of new information before they start tuning 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 I have discovered that 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 examination 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 words or pictures that relate to one of these areas. Chiropractic terms will make better sense when patients can see how vertebral subluxation complex relates to them personally.

Answer Your Patients’ Concerns
Many times, patients fear that their problem will be a worst-case scenario—that they will wind up permanently disabled or in constant pain. It is important for you to reassure the patient while still stressing the need for care. Chiropractic cases are generally self-limited. “In the absence of signs of dangerous conditions, 90% of patients (suffering from low back pain) will recover spontaneously within 4 weeks”¹; however, the pain that the patient is experiencing indicates that there is probably an underlying problem that chiropractic care can remedy.

Unfortunately, once some patients realize that their problem will not disable them, they think there is no need for care. 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 one adjustment. Once the primary concerns are answered and patients know they will live to see tomorrow, we must 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. Discuss with your patients the consequences of accepting care and the consequences of not accepting care. We must leave it up to them to decide how much care they will accept.

Patients often want to know what they can do at home to get better faster. During the ROF, you can make recommendations that will help the patient improve, such as stretching, exercising, changing their pillow, heating or icing, or restricting their activities at work. It is important to let patients know what all of their options are during the ROFs.

At the end of your ROFs, ask your patients the following two important questions to determine their level of understanding and to solidify their commitment to improving their health:

1) Now that we have had the opportunity to review the results of your examination, what do you think is causing your pain (numbness, dizziness, fatigue, or swelling)?

2) Once we take care of your spinal problems, how do you expect that will affect your job (such as your golf game or your ability to watch your kids)?

Finally, outline your treatment schedule and commit the patient to follow through with care. Whether it is adjustments and custom-made stabilizing orthotics, cervical pillows, rehabilitative exercises, or nutritional support, patients expect to be told what they need to do to improve their health. The most important thing you will have done during your ROFs is demonstrate your genuine concern and your confidence in providing answers and relief.

Lifetime ROFs
Traditionally, chiropractors give the ROFs only once to new patients. But is one 5- to 10-minute session enough to answer all of your patients’ questions about chiropractic care? You can educate them by incorporating ideas from the ROFs into a continuous dialogue that you give to all your existing patients. When we are adjusting our patients, we are usually talking about the weather or how their kids are doing. We are missing the perfect opportunity to talk to patients about chiropractic.

Instead of chatting with patients about trivial things, we can have intentional conversations about chiropractic with them. You can take hundreds of hours of patient education and give it to patients in small doses. Pick a theme for the day, and discuss it with every patient that comes in. For example, Monday—proper bending, Tuesday—vitamins, Wednesday—exercise, Thursday—whiplash, and Friday—orthotics.

Talking to patients about chiropractic does not mean that you have to bore or lecture them. You should continue to keep your patients’ needs and motivations in mind. This does not have to be time-consuming or difficult for you. Instead of talking to “Bob” about how his golf game was on Saturday, talk to him about how custom-made orthotics could help improve his golf game.

Giving patients these lifetime ROFs helps create more value for patients. If you are always talking to patients about how chiropractic care can help them, they will know that you are more than just a back cracker. They will know that their chiropractor knows a lot about many different subjects, and this will help you increase patient retention and referrals. For example, if you helped “Jane” with her back pain, she might not think of you when her husband has neck pain or if her daughter has headaches because in her mind, you only treat back pain. But if you have been talking to her about chiropractic, she will know that you can help neck pain and headaches.

Educating your patients about their conditions and how chiropractic can help them should begin with your ROFs and continue until the day the patient leaves your care. CP

Jeffrey D. Olsen, DC, has been in private practice in Roanoke, Va, with his two partners/brothers since 1997. Olsen has also instructed as an adjunct faculty member at the College of Health Sciences in Roanoke, teaching anatomy and physiology in the Physician Assistant Department. He can be reached at (800) 553-4860.

Reference
1. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline, Quick Reference Guide Number 14. Rockville, MD: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, AHCPR Pub. No. 95-0643. December 1994:1.