Hi Dr. Margolies, I wanted to touch base with you and see if you would be interested in sending an article for the upcoming issue of ICA Review which will focus on public relations. We would like to have an article from you which discusses patient education issues--but we don't have too much time to play with--we're looking at a deadline of May 2nd. Thanks! Karen Cercone - karenjc@chiropractic.org 1-800-423-4690, ext. 113 ICA Review Thank you for offering me this opportunity to provide this article. You asked for public relations with an emphasis on patient education. Below is a combination of both via the evolution of a new patient. Feel free to edit at will. I appreciate this and am always available to write on various subject in the future. PLEASE PLACE THE BIO AND INFORMATION ABOUT MY FREE WEEKLY E- MAIL AT THE BOTTOM Educating Our Patients By: Joel E. Margolies, DC We often equate volatility with the stock market, but just as volatile is the healthcare industry. Every aspect of healthcare from the huge pharmaceuticals to the halls of local hospitals are being scrutinized and downsized daily. Managed care has literally provided the impetus of change that was demanded by conservative and conscientious consumers for decades. Your only solution to avoid being a statistic is patient education and compliance. Therefore, there is no greater purpose for Public Relations than educating your patients and community of our great gift .. Chiropractic. Rather than dwelling on finding new patients, why not manage those you presently have and grow from within. The format for this is simple .. tell the Chiropractic story. Let others share with you your understanding and enthusiasm. Share your goals and commitment to community Health and Wellness and allow them to ignite with your inner spark of excitement. Explain your concern about the hidden dangers of minimal healthcare and excessive crisis disease care. Show and tell via workshops, postural screenings, health fairs, lectures and safety advisor positions the reality of conservative chiropractic care. Do this and you shall prosper. Let us explore the evolution and education of a new patient: A referred patient makes our professional life much easier. They understand the mechanics of our office, fee structure, scheduling, workshop demands and referral concepts. Somewhere during their time as your patient, their friend or family member was offered a mission to do unto others as they would have hoped others would have done unto themselves .. the Golden Rule. If we get across the message of chiropractic to our patients and community the sky is the limit to patient volume and an increased community health potential. The average new patient may have doubts and concerns about chiropractic. They may fear it being a form of Wrestlemania or at best the movie Exorcist, as they visualize twisted necks and backs with loud pops here and there. Even if their friends express a positive experience, they still have concern. Although I grossly exaggerate, there is much truth to what I just wrote. People still have fear of chiropractic at best and total ignorance of what we can do and the ramification of the vertebral subluxation complex at worst. So the first and foremost step is to educate and replace fear and doubt with hope and the concept that chiropractic care is safe and the smart way to go. But, even if this is accomplished, you must still place a value of chiropractic as a stand alone Health and Wellness profession with a purpose and a goal to reach. Let me explore some areas. The first step towards patient compliance and referrals is knowledge. A patient with a comfortable understanding of why they chose chiropractic is more apt to share that with others. A patient with an understanding of the subluxation complex draws from a far more extensive base of people who may benefit, than just the understanding we can help only low back pain. Does this make sense? „Has any of our patient¼s referred you to our office?¾ Every new patient is plugged immediately into our service and educational mode. From the initial phone conversation with the CA, they realize you not only accept referrals but expect them with this simple question .. „has any of our patient¼s referred you to our office?¾ If you and your staff are committed to excellence and pride yourself in results the enthusiasm will be felt by others. Therefore begin the basics of patient management by scripting the initial phone conversations and be sure to reach a caring and supportive tone by the CA and supportive staff. Family Health History: Case history forms should reflect an exploratory nature. Obvious questions concerning their immediate problem is a given but also explore a familial trail, a family tendency for their structural and lifestyle irritation. I hope you have similar questions on your forms, or request your new patients complete a Family Health History within a day or two, but is it used wisely to actually capture new patients who may need our care? Concern is the greatest asset of service, and displaying a genuine interest in their family and work or social health and wellness habits begins this process from the start. Touch and tell examinations: New patients should leave your office with a sense of hope and continuity. They should have no doubt that chiropractic is different and therefore offers a new approach to their concerns .. and possibly the health and wellness concerns of others. Touch and tell should be the hallmark of your evaluation. Explain the purpose of the exam and the difference between your chiropractic and their previous medical evaluation, and how we differ in approach and outcome. While medical examinations attempt to provide answers towards eventual treatment, ours are cause and correction related. Does your examination offer this and do new patients leave your office with answers towards these basic questions .. what is wrong and can you help me and why chiropractic care when other attempts have failed? To accomplish this have a number of wall charts or hand held displays of the spine and paravertebral soft tissue. Our professional suppliers have various educational items from pamphlets to colorful electronic wall charts. Check this website: http://www.chirostore.com. Whatever you use, be sure to relate their specific concern with the matrix of spinal structures and relating biomechanical issues. If the patient leaves the examination room with a clear understanding of the mechanics of their condition and the role that chiropractic plays assisting them towards relief and correction, you are on your way to an educated and referral patient. Gather patient e-mail.addresses: Let me return to the case history form. Include a separate line for the patient¼s e-mail address, both at home and work. Probably the least expensive approach towards patient communications, especially those who have not been in for awhile is via monthly e-mail newsletters. These can be tailored towards wellness concepts for their home or ergonomics if sent to their business. There are various companies within our profession that offer e- mail newsletters and the list is growing. But, if you wish to create your own, just use a word processing program to write specific office news and chiropractic or health oriented topics of interest. If you are not creative, visit my webpage: http://www.mindspring.com/~chirosmart and search under General Newsletters. I place various chiropractic and health oriented newsletters sent to me in this section. Just cut and paste the various articles and send these regularly. For the truly computer novice .. you can generate an e-mail address book and send the newsletters to a large group as one. As a matter of confidentiality and courtesy .. be sure to send them as a blind copy. If you desire your patients to be an advocate for you at their workplace, have them copy the e-mail sent to their office and post it around the office break rooms. These newsletters would be geared towards ergonomic issues. If you lack information concerning ergonomics (fitting the employee to their workstations), check my webpage under Weblinks and click under Ergonomics .. there are numerous sites there for you to gather data necessary to make your e-mails worthwhile. You will also find: http://www.chiroweb.com a great resource. Additional educational tools: As the new patient leaves the examination room, they should be aware that you will be compiling data necessary to begin a care plan and assist them in returning to health. They may still have many questions concerning chiropractic and your specific method of care. This includes your criteria prior to each adjustment, when their care is complete and when maintenance begins. These concepts can be easily explained with video. Again, there are many professional videos explaining chiropractic and various technics. If you are handy with the camcorder you can probably create your own homemade videos. If you are really creative and have a clear voice make audio tapes that can be played in their car which explains your practice and chiropractic. Many doctors has specific pamphlets and booklets that welcome new patients to their office. These can be tailored to specific topical wellness concerns with your chiropractic answer, insurance concerns, staff and doctor bios, etc. Whatever you do, don¼t let them leave their first day either empty handed or dumbfounded. Mini-reports and patient homework: Nothing replaces a one on one or knee to knee discussion and report. I recommend after the initial examination you share with them a peripheral explanation of your findings and some solution of their problem and give them some homework. I may ask them to begin gentle stretch exercises and either give them a handout or show them. I also request they bring their pillow their next visit and use muscle testing to see if it supports their spine. I also have a contoured pillow which I test as well. You¼ll be surprised how accurate this test is. Some doctors have created lifestyle surveys which they have new patients complete. Also, ask them to share their new knowledge with those that will support them getting well, this includes both friends and family. Spouses should be encouraged to return for your report of findings and everyone should be encouraged to attend your weekly New Patient Orientation or Healthcare Class. If you own a digital camera, take a picture of their x-ray and print it small enough to place on your business card. If you have access to a laminator, laminate your card with their individual x-ray .. talk about a promotional tool. Before they leave you and see the CA for their next visit appointment, be sure to give them positive expression that you will do all you can to assist them and you¼ll discuss more of your finding on their next visit. A satisfied consumer and patient refers: To this point we are attempting to create a satisfied consumer and patient. Our consumer oriented society demands ultimate service and when provided rewards the business with more. Don¼t delude yourself .. we are part of the healthcare business and as such the perception of many is „take a number and wait.¾ Chiropractors usually excel in customer service and therefore reorient our patient¼s perception creating a referral attitude with a smile. Staff meetings should go over patient service as much as any aspect of patient and office management. Once patients are understanding of our mission and goals .. offering conservative Health and Wellness care rather than Sickness and Disease and specifically reducing the subluxation complex as a community epidemic .. they become a team player by introducing their family and friends to chiropractic. Report of Findings: The second visit is as important as the first. Many new patients are intimidated seeing a new doctor and may be concerned with any findings and reports, therefore this second visit should set them at ease while providing them another dimension of your thoroughness gathering their data and compiling their individual care plan. If you provide a written or verbal report of findings on this visit be sure to set aside enough time to get your point across. Time management dictates that quality far exceeds quantity and practicing your reports so that they provide specific information without being overwhelming will streamline your time and add quality information without the fluff. Again, have many illustrations to reach and exceed their level of understanding. If you use a professional booklet or multi page pamphlet as part of your written or take home report, be sure to outline and highlight specific pages or concepts tailored to their concerns. Be sure to look them in the eye when you discuss any recommendations or fees, as looking down or around lowers and reduces your recommendations and professional edge. Patch or Corrective Care: During this second or possibly third visit you will either make or break your patient¼s history with you and chiropractic. If your purpose is to increase the health and wellness potential of your community with conservative chiropractic care, you have one goal and that is to see many new patients and provide them ultimate quality care while you retain those you have. This being the case, be sure to lay a strong foundation of chiropractic within your recommendations and reports. Let the patient understand that the choice of care is theirs, but prior to making their choice here is the menu. Do they wish to just patch the problem or correct it? Do they want to feel better or go beyond this point and stabilize a potential structural and biomechanical problem that will continue with increased wear and tear? Being in practice for over 22 years, I personally know that chiropractic helps more than backaches. I have more than a peripheral understanding and belief. I have clinical experience and my ability as an adjuster is high enough for me to transfer this belief to others. Therefore, your recommendations must come from your heart, while your words are tempered with commitment and belief that you are part of their solution. Outline to them your recommendations over a course of time, and also provide the criteria you use per visit to see if progress is being made. Place a strong value on repetition and momentum. Chiropractic is physical healthcare and demands repetition over a period of time. Be sure to clear any questions and doubts before fees are discussed and the schedule is outlined. If the patient understands the value of chiropractic they will follow their schedule, attend your office workshops, and refer their family and friends. Workshop and others things: To complete the cycle of patient education it is imperative that you capture their enthusiasm within the first five or so visits. Repetition of care results in complacency both for the office and patient allowing just a short window of opportunity to enrich them. Therefore, invite them for a new patient orientation within the first week of care. If time allows, offer these classes both in the morning and evenings so everyone has an opportunity to attend including their guests as well. The initial workshop should focus on the benefits of chiropractic and how the subluxation complex affects all. Various professional charts and posters can be used or purchase an erasable chalk board to illustrate your points. Offer complimentary evaluations for their guests or people they feel should have attended and/or need chiropractic care. Keep in contact with these new patients. Send a welcome letter; survey them after a series of adjustments; answer any questions and clear any doubts, and focus on getting them well. Once they begin to appreciate our conservative mode of healthcare begin to acknowledge their positive results and discuss how others may benefit as well .. this is when you ask for referrals. Have them also complete a testimonial page to place in your „Our Patient¼s Speak¾ book which is placed throughout the reception area. Just be sure to tell them the whole story .. they deserve no less. Dr. Joel E. Margolies has been practicing for 22 years in Atlanta, Georgia. He was a part time instructor at Life University from 1995 until 1999, and has published a number of chiropractic practice management books. He presently sends a free weekly chiropractic e- mail concerning public relations, marketing and philosophy that presently is sent to over 4700 DC¼s in 30 countries. If you would like to receive these e-mails contact him at: joel3639@aol.com and/or visit his webpage: http://www.mindspring.com/~chirosmart