Professional Patient Procedures By W. Karl Parker, B.A., D.C., F.I.C.C., F.A.C.C. In most cases the new patient's impression (favorable or unfavorable) of chiropractic and the chiropractor is made by the CA's voice, attitude and words during the initial appointment making phone call. The physical appearance of the office, the outside of the building, and the reception area, make the second impression. The CA's personal contact with the patient along with Professional Patient Procedures (PPP) is your third chance to make a favorable impression. Professional Patient Procedures (PPP) include: doctor-patient relationships; assistant-patient relationships; telephone communication; consultation; examination; report of findings; and the things to say and do during patients' ongoing visits, including the proper use of the appropriate forms, charts, pamphlets, and brochures. To understand the purpose of PPP, you need to understand something about some of the various types of patients. There are generally three types of patients based on what the patients want: 1 . Those who only want relief of pain--approx. 70% 2. Those who want restoration of health--approx. 20% 3. Those who want to prolong their lives--approx. 10% There are generally three categories of patients based on patient response and follow-through to your recommendations: 1. Those who take a few adjustments, respond quickly, feel they are well and discontinue care. 2. Those who take a few adjustments, do not respond quickly, feel you can't help them and quit. 3. Those who will follow your recommendations closely, get well, pay for their service, refer others for care and return if old conditions re-appear or new conditions develop. The purpose of PPP is to ATTRACT and PLACE as many of your patients as possible into the third type and the third category described above. One of the major ways PPP accomplishes this is by changing the patient's Functional-State (F-S) and the doctor's Functional State (F-S). When a new patient contacts your office they are in a certain State- mental, emotional and physical. This State includes their voice (pitch, tone, volume etc.), their muscle tension and tone, their blood pressure, their breathing and the rest of their physiology, This State is referred to as their Functional-State (F-S). F-S is the "what you are" in the statement what you are speaks so loud I can't hear what you say." Generally the patients' F-S when they enter your office is one of "I know where I hurt; I want someone to listen to me; I want someone to be interested in me; I want a doctor who is understanding and caring; I want a doctor who is honest and competent;" and the patient may have suspicion and doubt. If the doctor is to favorably impress new patients and erase their suspicion and doubt, the doctor must be in a F-S of- "I want to know; I want to listen; I am interested; I want to understand your problem; I do care about you; I am competent; I am honest." In other words the doctor's F-S should compliment the patient's F-S. If the doctor wants to project a F-S to the patient that they want to know about the patient's problem--WANT TO KNOW! If the doctor wants to project caring--CARE. If you want to project honesty--BE HONEST. ETC. It is easy. If you want to have a certain F-S and project that to the patient--BE THAT WAY, and you will project that to the patient. PPPs are designed to change the patients' F-S from "knowing about their problem and wanting the doctor to listen." to "wanting to know what the doctor has found." The doctor's F-S then must change from "wanting to listen and know." to "knowing authority." In other words, PPPs help reverse the F-S of the doctor and patient. The doctor starts the consultation in a F-S -of wanting to know and the patients¼ F-S is one of knowing. The consultation starts the change of F-S and it is continued in the examination. If PPPs are followed correctly, when it is time to give a report of findings, the doctor¼s F-S and the patient's F- S have been reversed. The patient now has questions--can you help me? How long will it take? How much will it cost? The doctor now knows the answer to the patient's questionss. Each aspect of PPP has an appropriate F-S that is unique and necessary to perform that procedure optimally. If PPPs are followed, most will be examined properly, informed adequately, and will follow your recommendations closely. This group will make your acceptance of patients worthwhile from both a professional and financial point of view. This group will be the ones who do the following: a. Stay. b. Pay. c. Get well. d. Refer e. Maintain, or at least return if old conditions re-appear or new conditions develop. Another way that PPP accomplishes attracting and placing most, if not all, of your patients to this group of those who stay, pay, get well, refer, and maintain, is by understanding and living up to your degree of DC. In this case, DC is referring to the initials for the words, "Doctor of Chronics." In other words, fully understand the fact that most, if not all, patients are actually chronic. Understand that all your patients actually have chronic conditions and that most acute patients are actually a chronic patient in an acute phase of their chronic condition. Developing this understanding and a belief system in it,' plus a sincere desire to serve the sick to your utmost, results in caringly motivating patients to also understand that their condition of having a Vertebral Subluxation Complex (VSC) is a chronic situation that requires long-term care. They will also understand that when the symptoms, and even the signs that the doctor evaluates that indicates the presence of VSC, are no longer present, that a maintenance or preventive check-up should still be performed to avert this problem as it tends to be recreated. It has been found to be very beneficial to the practice and to the patients when a doctor who is not fully busy becomes a "Doctor of Chronics". It fills the practice with improved retention, higher Patient Visit Averages (PVA), and patients that are having a healthier and a fuller life. The adoption of this concept is beneficial to most doctors except in unusual circumstances. For example, in Europe, there are many doctors who are fully busy with PVAs of 6 or less. This is because the per-capita ratio to chiropractors is so great and the new patient load is so high that the doctors must make as much and as quick a causal correction as possible to relieve the symptoms of the patient and as much of the signs of the VSCs as possible in as few visits as possible in order to have room to take care of more sick people. Of course, this situation does occur in all parts of the world, although it is the exception. As we continue this series of "Impressions" articles, we will set forth some of the basic methodologies of achieving the primary objectives of PPP of which there are 6: 1. Set an appointment. 2. Perform a thorough examination. 3. Give an official acceptance. 4. Provide improvement. 5. Make a favorable professional impression. 6. Motivate into lifelong referral-type patient. By using PPP to achieve these objectives with each patient, you can render a much higher quality health care service, and as a result have a larger practice.