From: Dr. Margolies

Find these new items on my webpage this week December 8, 1997:       
                                       http://www.mindspring.com/~chirosmart

Under Office Newsletters, I scanned my four page homemade newsletter. The time 
honored Chiropractic "Twas the night before Christmas," is on page 4.  Under class notes 
you'll find my class handouts from each Chapter of my book. Under Practice Management 
Tips you'll find Personal Injury Financial Protection forms, letters for referrals, a Welcome 
Letter, flyers for workshops (which you'll have to play with) a Patient Care Completion 
letter and more. Under weblinks look for other chiropractic pages as well as a link to the 
CDC for their ergonomic and other websites, Small Business advice, Financial 
Management advice and much more .. spend a few moments and copy these sharings. If 
you know of any weblinks that I should add .. please let me know. Now to this weeks e-
mail message.

 Communicating:

I receive a telephone call at home from a friend. She is an avid runner, just completing the 
New York Marathon. I影e seen her suffer the perils of physical wear and tear and from one 
episode of sciatica to the next she has not listened to my advice. In fact, a week prior to her 
recent run in New York, she went to her orthopedist and was given an injection to reduce 
pain. Yes, I told her about chiropractic and offered my services but she never listened. So 
.. the other day to my surprise, I answered the phone and it was she questioning me about 
her chiropractic care. Yes .. she finally (she must have been  desperate to succumb to 
chiropractic after all these years of suffering) decided to seek chiropractic care close to 
where she works. Her question was ... "is it normal to feel worse after two visits to a 
chiropractor?" I asked her to describe what the doctor does during an adjustment  (by the 
way .. it廣 a revelation to hear your patient廣 discuss the type of care and caring they 
receive from your office). Her reply was "he cracks me here and there, twists my back." I 
asked her if the doctor spent time explaining what he was doing and why .. did she or he 
communicate with each other? She told me that the doctor said she had bone rubbing on 
bone and that her lower back was twisted (I took that with a grain of salt .. please realize 
that your patient廣 may leave your office with no clue of what you said .. even with the best 
of attempts). My response was it may be a normal response of her body to initially be 
defensive as this is a physical method of healthcare, but it is very important she 
communicate any concerns with her doctor and be clear what he is attempting to do and 
why. Her next question to me was "how long should she go .. will this be long term care .. 
he want廣 to see my three times this week." You see .. in her haste to receive answers she 
called her cousin in another state to ask about her cousin's chiropractic care. Seems her 
cousin in just three visits was better. Her fellow employee went to a chiropractor and her 
experience was different, she felt better but the doctor asked her to keep coming back for 
more. Then she called me. How often is this scenario replayed? In reality .. the person she 
needed to call or touch base with was her chiropractor.

Well, I knew who he was and he is a fine and experienced DC. I called him early the next 
morning and told him of the conversation. As a matter of courtesy, I told him he廣 about to 
lose a patient and prevent a fine individual from receiving the care she needs. They needed 
to communicate .. no matter how busy the office is when she comes. 


Communications may be as helpful and caring as a phone call after the patient's first visit to 
answer any questions. "Mrs. Smith, this is Dr. Margolies, the chiropractor. I幟 calling to 
see if you have any questions and ask how you廝e doing after your first adjustment today. 
Great .. do you have any questions?" Now is the time to answer any lingering questions. 
Your caring call will go a long way in terms of this patient廣 management and her potential 
referrals. Communications may also be a handout or prepared booklet with chiropractic 
answers to their lingering questions. Communications may be your CA sizing up the tone 
of the patients when they come in and advise the doctor that a patient here and there may 
need more TLC or has a questionable look on them. In other words review your level of 
patient and staff communicating. 

For example ... have you ever audio or video taped your consultation or report of findings? 
Listened to your consultation and report of findings?  Did they make sense .. were your 
explanations clear .. did your patient leave with a simple answer to their complex problem 
.. would you be able to tell someone what you said an hour later .. were there gaps of 
advice leaving holes of questions and reasons for them to stop care .. did you express the 
difference between traditional medical care and chiropractic .. was your explanation of the 
adjustment clear leaving them without fear of an unknown .. was any schedule of care 
given and any financial concerns answered .. how was your tone .. was it complacent .. 
adversarial .. would your patient be calling their cousin to find out about chiropractic or 
question any component of your care and their healing? Could you have used props and 
other visual aids? These are all questions concerning aspects of office communications.

In conclusion .. practice management starts from their first phone call to your office to their 
last scheduled. It never stops. But .. it should start with sound judgment and meaning. 
Review all aspects of patient communications .. be aware of complacency and redundancy 
.. review what is told and given .. can they be updated and made more visual .. less verbal 
.. are there handouts that can be created or purchased .. the new edition of the Koren New 
Patient Booklet is very visual and educational. Marking pages within this booklet for the 
new patient to read is a great and easy way to educate. The latest edition of videos from 
BackTalk for the new patient as an introduction and then their report of findings is a great 
visual and easy way to get your message across. And .. don廠 forget your workshops .. 
Chapter seven in my Smart Start Book has a number of workshops you can use. If you 
don't have the book and wish a copy of these worrkshops e-mail me and I'll send a 
Wellness into thew 21st Century and Stress workshop to you. maybe I'll put it on my 
webpage.

Have a Happy Holiday

Dr. M