BACK TALK SYSTEMS, INC. 14998 W. 6th Avenue, Suite E-500 Golden, CO USA 80904-5025 USA 1/800/937-3113 CANADA 1/800/461-0100 UNITED KINGDOM 44(0)1202-534-986 AUSTRALIA 1/800-800-963 www.backtalksystems.com Team Tip #70 SCRIPTS (part 2) by Susan Hoy THE INITIAL VISIT In Team Tip 69, I gave scripts that will help potential patients come to your office, at least for a consultation. I've found that once new patients enter our office, most will stay for care. The reason is simple...our office is a patient magnet! I believe this with all my heart and so do our staff members. In fact, we are so proud of our office, we just can't fathom any patient not wanting to stay for care. A sense of pride is a great beginning. The moment our patients open our door they are greeted by a smiling face. Robbi, our front desk manager, takes her responsibilities very seriously. In fact, Dr. _________ and I are usually the last ones to enter our office in the morning because our commutes are so long. Robbi is always at her post, giving us a big smile and a hearty "good morning". I miss that greeting if Robbi is somewhere else when we arrive. It is a great beginning! Why would patients feel any differently? I can promise you if your patients are greeted with a warm smile, and with a sense of sincerity, it will be the beginning of a great relationship The new patient experience starts with the greeting. Robbi always keeps a clipboard by her side that holds new patient forms, and a sticky note with the patient's name on it. Her greeting goes like this: "Hello, you must be Mr. Smith. My name is Robbi. Welcome to our office (we find it very effective when greeting a patient for the first time, to shake his or her hand). Please sign your name right here. First, I will need a picture ID and your insurance card. If you'll take a seat in the reception room, we'll copy them and give them back to you in a few minutes." When the cards are copied, I, as the office manager, will personally introduce myself and welcome him to our office. We make it a policy to request a picture ID. It proves that the person in front of you is actually the same person on the insurance card. Also, it helps us identify the patient when we go over the patient file at our staff meetings. A picture of the new patient really helps us get to know the new patient. All requests of the new patient should be short and to the point. Remember, when they arrive at your office, they feel anxious and out of their comfort zone. We must make them feel comfortable immediately and tell him ahead of time exactly what to expect. Lead them all the way so they don't feel lost or confused. Robbi continues, "As you may have expected, we have a few forms to fill out. They are all on this clipboard. Please fill them out entirely. You may sit in our reception room at the desk, if you like. As soon as you are finished, please return them to me." Be aware of any on the part of the patient. "I forgot my glasses" could possibly mean, "I "can't read." Help them through uncomfortable situations. Possibly they can't sit or can't stand because of pain. Patients who are obviously distressed should be taken to a treatment room immediately. Do whatever it takes to make them comfortable and fill out the forms for them. If you show a video on the first visit, remember that when the patient is in pain the video is ineffective! It will cause more resentment than education. The point I am making is every patient should be treated as an individual. We are not running an assembly line. These are good folks we're working with. Policies and procedures were meant to be a guide, not a hard rule! When I return to the patient with their cards, I say, "Mr. Smith, my name is Susan. I'm the office manager. Welcome to our office. Here are your cards. Do you have any questions? As soon as you are finished with your paperwork, hand them to Robbi and we'll come and get you immediately." It is a policy in our office to have one person hand the new patient off to another. We have a patient advocate (me) who leads the patient through the office every step of the way. When the patient hands the paperwork to Robbi, she says, "Thank you. Just be seated for a moment and Susan will be right out to get you." Now the patient knows exactly what to do. I say, "Mr. Smith, come with me. I'm going to take you to our consultation room. Please sit in this chair right here." No direction is too small. If you show a video, it is important to present it properly. Most patients don't want to take time for the video. Make it the doctor's wishes. "While we are making up your file. Dr. __________ asks that you view a short video that will explain the benefits of chiropractic care and what you can expect today. Have you ever been to a chiropractor?" If the patient says, "Yes", do not assume that his last chiropractor educated him. We have found that patient education is sadly lacking in most offices. If the patient says he doesn't want to watch the video, use the following script. "It will take a few minutes to make up your file. You can either watch it while we are doing that or you can just sit quietly for a few minutes, whatever you would like." Almost always, they opt to watch it. If they still refuse, use the following script. "O.K., I'll let Dr. ________ know and he'll be with you in a few minutes." It is always very effective when the patient is not compliant to say, "I'll let the doctor know", for no other reason than that the doctor needs to know if the new patient or existing patient does not follow through with recommended care If anyone, other than the doctor, takes the patient's medical history, the first video can be shown after the history taking. If this is the case, the video presentation should be as follows: "Now that I have all your medical history, the doctor will want to take some time to read it. While you are waiting, he asks that you view this short video that will explain the benefits of chiropractic care and what you can expect today." I like to "pre-frame" new patients. If they tell me they've never seen a chiropractor, I say, "Well, you're in for a treat! Are you a little anxious about getting adjusted?" Allow them to verbalize their fears. Almost all have some anxiety. Usually, they will address them to the staff before they will tell the doctor. If they tell you they are afraid to be adjusted, tell them, "There are so many ways to adjust, and most are extremely gentle. Most patients are a little anxious at first, but once they begin to see results, they love getting adjusted. Don't be afraid to talk to the doctor about your anxiety and he'll appreciate your honesty. He's very easy to communicate with and very understanding. Trust me, you won't be any different than anyone else who begins care. Dr.___________ is a wonderful chiropractor. You'll be in good hands. Also, if your problem turns out not to be a chiropractic problem, he will help you get to the correct medical doctor. He has a great relationship with many doctors. We get referrals from them also." This usually will give new patients confidence. They usually breathe a sigh of relief at this comment! We set a timer to beep when the video is over. We can immediately enter the room and rewind. This lets patients know how efficient we are. By the time our doctor enters the room, they are ready to give him respect and you have paved the way. Once the doctor gets the commitment of care from new patients, he tells them what to expect next. "Susan will be in to go over your insurance coverage and what will be expected of you today. Then she will get you ready for your exam. If you tell the patient up front, he will not be surprised when you tell him how much he will owe at the end of the visit. If you want to have a good collection record, then you must learn to make collecting a priority. If patients tell you they did not expect to pay today, you can work this out in advance, before treatment. If this happens, I immediately go to our staff member who booked the appointment and ask if they advised the patient about payment. There is a check-off area on our new patient form for advice of payment, so there should be no excuse. Our doctor does not discuss fees unless the patient specifically asks. He will usually refer them me. Most doctors, when confronted with money issues, will give too much away. The patient should know right from the beginning that the doctor has a specific job, patient care. Collections are handled by the office manager or by the staff. Dr. ___________ does not want to know who owes him money because he doesn't want to create a problem that will affect his care for the patient. Once the patient is advised of insurance and payment issues, I take him to his changing room. "OK, Mr. Smith, let's get you ready for your examination. Bring all of your things with you and follow me." Always lead the patient. Take control. Offer to help. Remember that he is probably in pain. "This is your changing room. Dr. __________ asks that you take off your jacket, shirt and tie, and your shoes and hang them up here. Everything will be safe here. Just step out of the room when you are finished and I will be waiting for you." Of course, for our women patients, they receive a gown. Be very explicit with directions. "Mrs. Smith, the doctor asks that you remove everything but your bra and panties. You may keep your pantyhose on if you wish. Please take your jewelry off. All of your things will be safe in your changing room, but if you feel more comfortable bringing your purse with you, that's OK." If the patient is getting an X-ray, she must also remove her bra. Obviously, you each have your own procedure for this. The point here is to tell the patient exactly what to expect, in short, easy to remember commands. I always tell our women patients that I will be right back to get them. They usually take more time and I don't want them to feel I am rushing them. Them must be led to the exam room with the following script. "This is our examination room. You can be seated right over here. Dr. _____________ is just finishing up with another patient and will be with you in a few minutes. In the meantime, possibly you would like to read this informational pamphlet about low back pain." This is a great educational tool. They will learn something about their condition, and be able to ask questions of the doctor. Having a rack of different chiropractic problems is a good thing to have in the exam room. Patients will identify other problems that the doctor might help with. They might even identify problems that their family members or friends are suffering with. It is a great referral tool, AND IT IS A VERY NON-THREATENING WAY TO EDUCATE! Having a CA present for the examination is a good idea, to record or hand write the exam findings, and also for liability reasons. One can never be too careful! Patients come to you for all different reasons and motives. They are very conditioned to make judgments, even if the are incorrect. It is always important to be as professional as possible. Also, take modesty into consideration. Some men want patient gowns too. Be careful not to have women and men passing each other in the hallway. Some men don't like to be viewed by women with their shirts off. Women especially don't like to be seen in those "lovely" patient gowns. And if you don't want to be embarrassed by a man emerging from his changing room with only his boxer shorts (Garfield pattern), be very sure he understands your instructions. Many women don't wear panties under their pantyhose, so address the issue. "If you're not wearing underpants, just leave your panty hose on. If you're uncomfortable, just leave your skirt or slacks on." Identifying with any qualms that patients might have will put them at ease and let them feel the caring, professional atmosphere of your office. You may order our new TEAM TRAINING AND PRACTICE MANAGEMENT MANUAL package, from which this article is taken, by calling 800/937-3113 today.