Patient Follow Through From Dr. Margolies Having the Patient Follow Through: A student asked me the other day how to retain clinic patients. She said people come for a few visits and after that itžs like pulling teeth to have them return. As mentioned in class and what Ižve written in Chapter Two of the Smart Start book, you have to set the stage correctly. This is true whether you are in active practice or creating an awareness while in the school clinic. The stage is prepped via your consultation and set during your report of findings. Remember the most important step is the consultation and your valiant attempt to change their point of view and motivating factor. If they are coming to a school clinic .. their attitude towards you may be less serious than if you were in active practice charging a higher fee and setting your own rules (policies) .. if you are in active practice .. they may consider your care based on the medical model .. once feeling better their gone. In either case .. you must get to their level of understanding .. usually little to none (even if a previous patient of chiropractic), and reach for more to set the stage correctly. Once that is done, the next visit is ready for your report and your recommendations. Again, if there was value presented and the patient can understand the need, they will follow through. Consultation: If in the school clinic setting .. or if you are a new practitioner .. donžt take the apologetic defensive posture and say „... Ižm a tenth quarter student and Ižve been in the clinic for three quarters .. etc.ū There is no need to dwell on this ..they assume you know what youžre doing or the school wouldnžt allow you to work with them. Being defensive creates their natural reaction to be defensive and everything you say will be weighed accordingly .. including your report and recommendations. If a new practitioner.. donžt take the position of being apologetic that the office isnžt full. Be reactive by showing enthusiasm for their allowing you to turn on the power .. let them know that your purpose is to create wellness throughout your community .. which includes their friends, family, fellow employees, church and civic club members, as well as asking them to assist you in this effort. Too much to ask at once .. you bet .. but the successful doctor .. or businessperson .. doesnžt have to say a word .. it comes from their being .. their desire ..their purpose .. with experience itžs just there. You know .. being in the zone. Student to clinic patient at the first visit: „Hi, my name is Fred Simmons and Ižm so glad you came to the school clinic. First, let me tell you that youžll be having an extensive biomechanical and physical examination that will assist us in determining why you have this problem and most important how to correct it. Best yet, since you are here in the school clinic we have the advantage of using the experience of the supervisory doctors and the research center here on campus. (Might be a stretch .. but perception is everything). At your next visit, I will go over our findings and wežll discuss how best to correct your problem and get to the cause of it.ū Report: „Mrs. Smith, after reviewing my findings with the staff here, Ižm going to go over my findings and recommend the best approach to correct it. Does this make sense?ū (get their nod .. go over your findings .. donžt dwell on specific tests .. they can care less .. but dwell on how it impairs their function ... how it has developed into a chronic condition with years of wear and tear .. how chronic irritation to the nervous system results in our important subject the Subluxation .. (make the subluxation real .. demonstrate it .. use a rubber band around a finger .. squeeze their wrist .. practice with others .. as shown in my class during chapter seven). Never come from a place of distrust .. or their perceived feelings that you are exaggerating .. always tell the truth and in so doing they sense your concern. It may seemed „cannedū and a practiced approach in the beginning .. allowing you the room to grow with your ability to get the message across .. but this will come naturally as time evolves. Therefore, you must practice your report and your recommendations including overcoming objections. Important step: (When you present your report be powerful and look them in the eye. Use analogies and give them the why and because as part of your recommendations and solutions) .. „Mrs. Smith, chiropractic care is a physical method of health care .. not just taking medication three times a day. (Use an analogy) It is similar to going to the gym .. we attempt to make a physical change .. just like the gym it takes repetition and momentum. If you want to be fit and trim you start off three times a week at the gym and after awhile you can add an extra pound of weight or two or three more repetitions. It is the same with chiropractic.ū (now the why and because towards your solution .. make it real .. place a reason and need .. a value) „First step is to stabilize your spine (this would be the concerning factor for most people and is physiologically true). Therefore, wežll see you three times a week for at least a month .. thatžs twelve visits. (Be prepared to look them in the eye .. if you are antsy about giving numbers .. and twelve isnžt much in the lifetime of a human being .. practice to do it without gagging and hesitation). Is this a good time for you? Great. Please, if an emergency comes up and you are unable to make your appointment, would you be kind enough to call the clinic the night before or that day .. better yet, call my home and leave a message. What wežll do is see you the next day .. as momentum during this stage of care is most important.ū If you make it real to them .. and instability is real .. they will follow through. If there is an objection to these twelve visits .. which literally is not much .. you must go back and re-educate. You have no choice but to work with them visit by visit until they make the correct choice. In other words .. their reluctance is based on your reluctance of them saying yes. Practically speaking .. if you practice with your fellow students or if you are field DC with your spouse or staff .. you can gain this responsible demeanor and come across as caring and in authority. It takes practice. Any questions, or if you wish to download your report .. writing it down is part of practicing it .. Ižd be happy to review it and give you my opinion. Dr. M