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Patient Education

patient-education.jpgThe number one chiropractic marketing strategy is to educate patients. Educated patients get well faster, ask better questions, have greater respect for their chiropractor and are more likely to refer others of the same ilk. After almost 30 years of being immersed in the patient education realm, this so obvious I feel a bit self-conscious even writing about it. Yet, most chiropractors rely on the least effective way of educating patients.

I’m NOT talking about which educational videos to use or what chiropractic brochures to hang on the wall! Those are convenient distractions that keep many chiropractors from a far more relevant and productive debate. The fact is, brochures, videos, health care classes and most of the other techniques or procedures for “educating” patients are merely forms of patient “teaching.” (Teaching is outside-in. Education is inside-out.)

After dedicating most of my adult life to patient communications, I only know of three ways to educate patients. Here they are, from least effective to most effective.

The Ah-Ha! Experience

Most chiropractors are compelled to yak at patients. Especially new ones during the first visit or two. The report of findings, accompanied by X-rays and the results of other diagnostics, is the centerpiece of this approach. Later, ear-raping, while the patient is lying face down on the adjusting table is justified as enlightening patients who, it is assumed, are interested in being enlightened. And while the self-righteousness is justified, the effect is underwhelming. Few patients have been saved by the words spoken by chiropractors.

Sorry.

I know it feels like you’re doing something important, even significant. Yet, few patients change their ways. This is the “connect-the-dots” theory; in other words, the truth has been withheld from patients and all they need to do is hear the health care gospel and they can be saved.

I doubt it.

Oh, patients will humor you and even feign interest, but remember, they brought with them a lifetime of symptom treating: “Here’s my headache doctor. Please fix it,” attitude. Your well-intentioned words are unlikely to change that. (I’ll explain what can, in a moment.)

Patient teaching, while thought to be patient education, assumes 1) that patients make health care decisions rationally and objectively, 2) that patients are even interested in changing their wrongheaded beliefs about the nature of true health, and 3) that giving them information, advice or coaching will fill in the blanks and get patients to empty their medicine cabinet and swear off vaccinations, fast food and ibuprofen.

The Socratic Method

Turns out that if there’s going to be any patient “education” (or healing for that matter), it’s going to come from the inside-out. Socrates was quoted by Plato as observing that “…the effective educator serves as the midwife to the process of the student becoming self-aware of the truth in them.”

How do you do that? Ask questions. Turns out, new synaptic connections are more likely made by trying to form the answer to a question, then connecting the dots because of some well-intentioned data dump.

A prerequisite to effectively implementing Socratic patient education in your practice is to show up curious. Few chiropractors are actually interested in what patients believe or how they see the world. Without this curiosity, asking questions becomes a “technique” and, well, manipulative. Chiropractors who see the value of asking questions, but who aren’t actually curious, will often ask me for a list of questions they can ask their patients. They miss the point. Because if you’re not curious, you won’t know what to do with the ignorant, misguided answers that patients provide you!

Maybe this will help. What patients believe controls their behaviors. In fact, regardless of what comes out of their mouth, all behavior is congruent with one’s beliefs. If you have any hope of changing the software (beliefs, programming and habits) that controls the hardware (body) you’d want to uncover their current beliefs. What do they believe? Why do they think their beliefs are true? How did they acquire them? How has (or hasn’t) it served them? That sort of thing. Start there. Most patients don’t live consciously and are oblivious to what guides their decisions. Coaxing it out of them may be frustrating. But potentially entertaining.

“I’ll-Never-Do-That-Again!”

The most effective form of education, patient or otherwise, is good, old-fashioned failure. The more expensive it is (financially, socially or physically) the more powerful and long lasting the lesson. However, in the same way we’re inclined to protect our children from the pain of failure, many chiropractors attempt to protect their patients.

Big mistake.

If you have any hope of educating patients and inspiring them to avail themselves of periodic chiropractic checkups and embrace what is often referred to as the “chiropractic lifestyle,” creating a safe place to fail is essential. “Safe,” meaning that there isn’t a shred of shame or guilt dispersed when patients choose to discontinue their care after achieving the symptomatic relief they originally sought. If patients get even a whiff of this toxic judgmentalism, kiss the possibility of a reactivation goodbye and get ready to do more advertising and screenings to snag new patients.

Take an inventory of your once-a-monthers and you’ll discover that most of them have had three, four, five or more brushes with chiropractic before embracing it as a lifestyle adjunct. Yet, if you mistrust patients, can’t tolerate the thought of patients “giving up on themselves,” or it’s simply economics because you need the income, you’re unlikely to cultivate many of these stabilizing, cash-paying patients.

Talk about discontinuing care once they feel better. Reveal to patients that you don’t have any emotional charge linked to their behavior. Explain the likelihood of a relapse. Assure them there won’t be even a hint of an “I-told-you-so” when they return.


Think of the eternal relationship—not merely the short-term diet of care that satisfies most patients. Lighten up. What patients do or don’t do isn’t ANY of your business. And it certainly isn’t a reflection of you or your career choice.

Comments (1)

Steven Krauza DC:

What? You mean if I don't get a patient to sign up for 34 visits, pre-pay for their visits, and get them to bring a family member with them I'm not a failure? (Scanning for sarcasm...DETECTED!)
I don't know where the profession got off track over the years in regards to care plans, but I know of no other profession that REQUIRES patients to adopt health care practices that may be against their wishes. Look, I'm all for lifetime care. I'm all for getting adjusted with or without Sx. I would love a practice to be full of wellness minded individuals and families, ones that take a proactive approach to their health habits. The key, though, is that they CHOOSE to be in the practice for that reason not because they are under contract. I will continue to educate practice members about the need for getting their spines checked for subluxation. I will continue to educate them on how to make better lifestyle choices so they subluxate less often. I will also continue to not base my success on another person's actions or choices. I can't and don't want to control someone's actions. If what I say and offer to a practice member is in tune with their beliefs and needs, then we will have a mutually beneficial relationship. If what I offer does not sync up with what they want or need, then I did not fail. Chiropractors need to learn to not judge their success or self-worth based upon what someone says or does. We have the best profession in the world, we just need to believe in ourselves. As I learned at Total Solution: "Some will, some won't, so what? NEXT!"

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From May 18, 2010 8:26 AM

This page contains a single entry from the blog posted on May 18, 2010 8:26 AM.

The previous post in this blog was Monday Morning Motivation.

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