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Dear Bill

choices.jpgI find it hard to present choices in an objective way when I obviously want them to choose the healthiest path.

I sometimes feel my ROF comes across as, "Here's a choice, or if you’re a total idiot you can choose this.”

So I get a lot of acceptance at the ROF, but then I have a dropout rate the same as others. How would you suggest making patients feel comfortable choosing short-term relief or corrective care. Or lifetime care for that matter?


Dr. Dropout

Dear Dr. Dropout,

Patients already feel comfortable choosing short-term relief. In fact, that’s what they’ve learned (and expected) from consulting allopaths their entire life.

Even on the admitting paperwork, most patients pick up on the idea that “fix” care is for intelligent, attractive and enlightened patients, and that “patch” care is for well, idiots, as you so eloquently observe.

Patients don’t have the problem. You do.

Here’s what’s happening. Most patients fail to recognize that there are actually two types of care. There’s Sick Care, which is largely symptom-treating (euphemistically called “Health” Care in most conversations) and it’s what most patients are looking for when consulting a chiropractor. They want a short-term “diet” of chiropractic to get them out of pain.

Naturally, this is at odds with the way many chiropractors use chiropractic. Chiropractors think highly of Life Care. Its purpose is to optimize our performance and help us be all that we can be. Examples would be brushing and flossing our teeth, getting enough exercise, high quality rest, personal hygiene; that sort of thing. Interestingly, insurance doesn’t pay for Life Care.

Ignore for the moment that most chiropractors enjoy Life Care without having to reach into their pocket or purse and give up something else. Trying to sell patients corrective or lifetime care, at a time in the relationship when you haven’t yet helped them with their admitting complaint, is like talking marriage and children on the first date. You seem excited by the possibility, but they’re not even sure you can help them with their headaches.

Do you have an obligation to explain the various choices they have and the consequences of their decision? Of course. But the way to make patients feel comfortable with their choice is to first make sure you’re comfortable! Practitioners who assume a healthy detachment and show up as a humble servant may not have patients who stay long, but they don’t feel the guilt or shame of “letting the doctor down” and go down the street when they have their inevitable relapse months or years later. At which time, you are more valid and get another shot at enlightening the patient.

If more chiropractors would look 5-, 10- and 20-years down the road, instead of trying to overpower the patient, using their limited social authority to get patients to do the “right” thing, they would enjoy more reactivations, more referrals and in time no longer have such a voracious appetite for new patients.

Comments (1)

Tony Russo:

After 15 humble years of practice, I have noticed, and you might agree, that patients listen to very little of what we say. They come into my Office with all kinds of conceptions and misconceptions about what you can actually do for them. I find that if what I say is congruent with their way of thinking, then they might give me a few minutes at best of their attention. So I spend a lot of my time trying to find what will "congru" with their psychie. Then, if I get some result, I've established a relationship. If I haven't, then they are at least satisfied that I've tried my best to help them. It works for me. I'm seeing patients coming back almost weekly who haven't seen me for up to 10 years. And some patients who are still coming in once per month for 10 years. Yes they've gotten off the bus for a couple of years in between. So you're right when you say that presenting yourself as a humble servent is indeed the tried and true way to a stably successful practice. But I enjoy 15 years of "practice" at this to enjoy what I enjoy. What's the new kid gonna do?

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From July 15, 2009 6:13 PM

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