Patient Education For the 1990s
by William D. Esteb
Educated patients are more likely to comply with your recommendations, get well faster, remain under maintenance care, and be better equipped to tell others about chiropractic. At a time when insurance coverage is dwindling and advertising has become less effective, helping your current patients understand and vouch for their decision to seek care in your office is more important than ever. After all, if they knew what you knew, they'd do what you do. They would adopt a chiropractic lifestyle, bring their kids in for care, and tell everyone they know about chiropractic. But they don't. Even patients for whom you've worked a "miracle cure" seem unwilling to tell others.
It takes more than great results to have a great practice.
Walking into most offices these days are members of the baby boom generation. A generation raised by television. A generation that grew up with Howdy Doody, Ben Casey, Marcus Welby, and Walter Cronkite. This is a generation accustomed to getting information spoon fed by captivating visuals. We didn't read about the Kennedy assassination, we watched it on television. We didn't read about Neil Armstrong's first steps on the moon, we watched it on television. And we still don't rush home to read the newspaper. The "fireside chat" days of radio are gone. Today we turn on the tube.
Unfortunately, the communication efforts in most chiropractic offices are out of step with the new generation of chiropractic patient. It means you need to be more visual in your patient education. It almost certainly suggests the need to use video. It means modifying your report of findings. It means change!
Video-based patient education has been around since the very early 1980s. Today, you can choose from dozens of video programs. If you've tried video before and were disappointed, or you're contemplating embracing the Information Age by adding a VCR to your patient education arsenal, here are some considerations when previewing the countless patient education videos available for your office.
The video(s) must be short. Common sense suggests that you should avoid showing videos to patients in pain. Patients who are not distracted by their symptoms should be shown a video on their first visit. The purpose of this introductory video should be to orient them to a chiropractic perspective and anticipate their concerns. Moreover, it should be short. Avoid documentary length videos or presentations that are too philosophical or longer than 10 minutes. Longer than 10 minutes and your imposition may preclude their willingness to see subsequent videos. Select a first visit video that anticipates a typical patient's concerns and puts them at ease. Save the chiropractic science and philosophy for future visits.
The videos must be relevant. Patient education videos shouldn't overload the patient by numbing them with too much information. They should present relevant information as it is needed by the patient. It's inappropriate to explain the value or necessity of maintenance or wellness care on the first couple of visits. You haven't earned the right to broach this topic until you've proven you can help them with the complaint they've originally presented. Help put the common myths and misconceptions about chiropractic to rest. Deal with the doctor's education, X-rays, what an adjustment is, and their other concerns in a positive, non-defensive way.
The videos must avoid scare tactics. A previous generation could be "managed" into compliance or "scared" into compliance. Not today. The baby boom generation wants understandable information so they can make an informed decision. Recognize that ultimately patients control compliance. Their own "internal doctor" decides whether they trust you and if their condition is worth the time and money required to follow your recommendations. Present the facts clearly and without bias, honoring the patient regardless of their decision. Take a purely informational approach and anticipate their "why?" questions. Why does it hurt? Why will it take time? Why should children seek chiropractic care? Why does it take more than one adjustment?
The videos must be highly visual. Avoid what television specialists call the "talking head" at all cost! This is the major flaw with most patient education videos, whether produced professionally with a Hollywood star or done on a shoestring by the doctor. You might as well create an audio cassette! Putting a talking head on television is like using a highly-complex computer as a simple adding machine. It doesn't take full advantage of the compelling power of video. Patient education video should show patients things they couldn't see in any other way. We are visual animals and we get most of our information through our eyes. We remember images much longer than words. Hardly anyone remembers the words spoken by evangelist Jimmy Swagart--we remember the anguish on his tearful face.
The videos must be contemporary. Videos for patients must embrace the latest model of chiropractic and give them a complete understanding of the full nature and severity of their condition. Explaining the Vertebral Subluxation Complex is a good start. When patients understand their problem is more serious than a bone out of place (one or two visits) or a pinched nerve (discontinue care when symptoms improve), their willingness to follow through is increased. Patients are more responsive and have a greater respect for the doctor when they can visualize the seriousness of their condition. Without this understanding they can only depend on how they feel.
The videos must be part of a system. Besides making chiropractic information more visual and memorable, patient education videos should help avoid repetitious explanations. Videos should impart basic information that every patient should know, regardless of their condition. Moreover, video should be part of a multi-media effort that includes written and aural messages to allow for differing learning styles. This coordinated "systematic" approach makes patient education efforts consistent. Advertisers have long known the importance of a single, consistent message in print and broadcast media. The total impact is greater than its parts.
The videos must be supported by the staff. When patients enter a strange new environment like your office, they are extremely sensitive to the subtle, non-verbal communication of the staff. Not only should the staff see and understand every visual and every word of your video system, they must totally agree with the importance of exposing every patient to it. If staff members expect resistance when explaining to patients that "The doctor would like you to see a short video..." then they will almost certainly get it. This is the same self-fulfilling prophecy that affects patient compliance, collections, and other aspects of the doctor/patient relationship.
Video will never be a substitute or replace good old-fashioned low tech talking with patients. However, it is excellent at reducing repetitious explanations and dramatically conveying bulk amounts of basic information quickly and consistently. It can free up the doctor and staff so they can be more productive and provide better patient care. The key is to build on the information presented in your video. Reference scenes or important phrases on subsequent patient visits. Avoid the patient perception that you used the video as a momentary "babysitter." Make sure patients know the importance that you place on the video by correlating pertinent information to each patient's case.
The fact is, at the helm of the most successful practices is a doctor who is a great communicator. Regardless of adjusting technique, what school you graduated from, whether you were the oldest son or the youngest daughter, tall or thin, practice in a big city or a small town, the better your communication skills--the better your practice.
There was a time when brochures, lectures, and a monologue in front of the X-ray view box was enough. These communication technologies worked for a generation that grew up on radio and put doctors (and others with college educations) on a pedestal. Today, mere words are not the most effective way to communicate effectively with patients. Memorizing a super-duper-this-will-convince-them report of findings isn't the answer either. Better pictures are the answer. The doctor with the best pictures wins. And that most assuredly means some type of video.
Buy the book
My Report of Findings
Originally published in 1993
240 Pages
US $24.95
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