Have you mistreated patients for the last couple of decades, using manipulative techniques that were justified as “being for the patient’s own good.”
Relying on fear tactics, using your limited social authority or imposing financial policies in an attempt to get patients to do the “right” thing (according to you) has prompted hundreds of inactive patients to avoid your office. They shun your practice when they experience their inevitable relapse. They fail to recommend you to their friends at work, saving them from your heavy-handed interpersonal skills.
What’s worse, you don’t see how parental and manipulative your tactics actually are!
Due to the inbreeding within chiropractic (chiropractors teaching chiropractors about what patients should do), many chiropractors are oblivious to the damage they’re doing in their efforts to save patients from themselves. Acting on the advice of highly-paid practice consultants, many chiropractors rely on artful bluffing, trickery and deliberate scare tactics.
Here are some of the most revealing, self-sabotaging examples that dry up reactivations and suppress referrals from what otherwise would have been delighted patients:
Three times a week. “…so we’ll be seeing you three times a week for the first four weeks, then twice a week for the following four weeks, yada, yada, yada.” It rolls off your tongue with practiced precision as if you had a crystal ball that can accurately predict the future! The intent is to impose a care plan that will prolong their care for as long as possible. Why three times a week? Why not three times a day? Why not once a day? To offer what is apparently a canned, one-size-fits-all set of recommendations is mindless, robotic and ignores the individuality of each patient and how much (or little) the patient will do to support their adjustments.
Instead, how about something like this? “…so in the beginning, to create enough momentum to overcome the established pattern in your spine, I recommend three visits a week for the first four weeks. And since you and I have no idea how your body will respond to chiropractic care, on the 12th visit you and I will get together and conduct some of the same tests we did yesterday. By then, we can objectively compare where you are, with where you were, and together chart a course for the future that makes sense for you and your health goals. Do you see anything standing in the way of making that commitment?”
Fix care or patch care. For some reason, many chiropractors need to know whether the patient is going to opt for “fix” care that intelligent, enlightened, attractive patients choose, or “patch” care that stupid, ugly patients choose. “Don’t tell me! I know the right answer to this question,” patients think to themselves. “Fix care please.” Asking this question at the beginning of the relationship before you’ve proven yourself for the problem that prompted them to consult your office in the first place is the height of hubris. Regardless of their choice, it won’t change your recommendations for the first month’s of care anyway! Asking this question on the first visit or two practically forces patients to lie—not exactly the best way to begin a new relationship. (Just so you know, when the symptoms subside they believe they’re fixed!)
Instead, how about something like this? At the consultation explain “…there are five ways patients use chiropractic care in our practice. Most start with the desire for Relief of their presenting ache or pain. Chiropractic can be quite effective for this. However, discontinuing care once the symptoms subside will often produce a relapse because underlying muscles and soft tissues haven’t been retrained to healthier patterns. That’s the purpose of Corrective Care. The third way to use chiropractic care is what we call Maintenance Care. Here the intention is to maintain the progress that’s already been made. Then, there’s Preventive Care, with the purpose detecting little problems early before they become serious. And finally there’s Wellness Care with the goal of optimizing your total health and well-being. You don’t have to tell me now, but be thinking about how far you want to take your care and we’ll discuss it on a future visit.” (Many chiropractors rely on the graphics of our How Far chart to make this explanation more powerful.)
Annual care plans. Annual care plans are great for patients who “get” the idea that chiropractic is a lifestyle decision, not merely a short-term diet for pain relief. That’s a distinction lost on patients who are having their first chiropractic encounter after a lifetime of symptom treating. Chiropractors who overlook this little detail go to extraordinary lengths to “sell” chiropractic as a long-term investment. Using your financial policy to seduce patients into making the “right” decisions about their health is manipulative and demonstrates a profound mistrust of a patient’s judgment. Most patients will need to start care and stop care several times before they see chiropractic as a lifestyle decision. And perhaps not even then. Luring patients with a lower-per-visit-fee is right out of “the-ends-justify-the-means” playbook.
Instead, how about something like this? Sure, have an annual care plan. Announce it on that first or second visit when you discuss the financial implications of your care recommendations. But let patients know that they aren’t eligible for it until after their first progress examination. If that sounds unattractive or you fear few patients would choose it after obtaining relief, it’s proof you’re offering an annual care plan for the wrong reason.
How to say goodbye. Virtually every patient who enters your practice has heard the old adage that “once you go to a chiropractor you have to go for the rest of your life.” Most chiropractors do little if anything to convince the patient otherwise. Rather than an error of commission, this is an error of omission. This oversight leaves a wake of guilt and shame when the patients try to extricate themselves when they’re feeling better. The fear of letting you down and having to explain their decision, pales in comparison with how they imagine you’ll react to sell them on care they don’t want. Instead, they force your staff to break the news by making appointments and then repeatedly canceling them. Ending in this way, what would have otherwise been a wonderful relationship, costs many chiropractors the steady stream of reactivations and referrals they deserve.
Instead, how about something like this? Acknowledge the myth! Recognize that failing to mention this unmentionable prompts the patient to keep their eye on the door. The fact that you intend to use chiropractic for the rest of your life, and that you recommend everyone do so, isn’t the point. By failing to explain how to leave; how to say goodbye, you force the patient to be evasive and distant at the very moment when they should be most delighted with their decision to consult your office! “…and when you've had enough chiropractic care, be sure to let me know so we can celebrate your success.” By avoiding this simple conversation you needlessly doom the relationship and cause patients to select a different practitioner when they have their inevitable relapse months or years later. Making it difficult for patients to leave probably extracts an additional visit or two, but significantly reduces the chance of a long-term relationship.
I know. Many of these recommendations fly in the face of what you’ve paid good money to receive from practice consultants. Your instinct at the time was to reject this poor advice, but the desire to be “successful” blinded your better judgment. Turns out, they used the same techniques on you. Two-year contracts. Accusations of a “poverty consciousness.” And don’t forget the sure-fire observation that “…even Tiger Woods has a coach.”
How many of your peers have you referred to your most recent practice management consultant? Which consultants would you sign up with again? Unlikely, right? How come? Why is it so surprising that when a so-called practice coach is manipulative, seductive and over-bearing with you, that they would offer anything else but the same for use with your patients?