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 #75 SCRIPTS (part 7) by Susan Hoy SCRIPTS TO ENCOURAGE PATIENTS TO FOLLOW THROUGH WITH CARE In the past several articles, I have been writing about the presentation of our offices through specific scripts that inspire confidence and belief. Knowing how to present chiropractic throughout the many different phases of care is imperative in helping the patient understand the need for, and have the desire to become a wellness patient. I have talked about enthusiasm, positive energy, believing in your chiropractor and the importance of transferring that belief to patients. With a lot of TLC and hard work, the patient finally "settles in" and becomes a regular patient. Those first few visits are so important as confidence-builders for the patient. We literally have to prove ourselves to them, gaining their confidence that they must have in order to begin the long process of healing. This is no easy feat. We must pay the price for every rumor our patients have heard about chiropractic, and be able to overcome the preconceived ideas that many of our patients come to us with. Gradually, they begin to relax. Beware of the settling in period, as it is a dangerous time in the patient's treatment plan. It is when we get complacent that the patient needs the most encouragement. A WELLNESS PRACTICE DOES NOT HAPPEN BY ACCIDENT. IT TAKES BELIEF, ENTHUSIASM, EDUCATION, FOCUS, AND A LARGE AMOUNT OF ENCOURAGEMENT TO MAKE A WELLNESS PATIENT. We have managed to create excitement and enthusiasm in our new patients, but now comes the hard part... perpetuating the feeling. We have given them hope, but there is still some degree of uncertainty. They are wondering if we can walk our talk. It is the responsibility of every staff member to keep encouraging them through the ups and downs of treatment. I have found that once a new patient is established, there is some degree of "let down". It seems like we used up all of our enthusiasm on the first few visits and then we begin to take them for granted. It is vitally important to keep track of each of them throughout the first phase of care, making sure we recognize the signs of discouragement and the possibility of dropping out. Remember that while some patients improve immediately, others actually get worse before getting better. Still others begin to notice pain in other areas of the spine that wasn't evident when they began care. This is where our challenge begins, not ends! We know that all of these scenarios are quite normal, but our new patients don't, and it is our responsibility to recognize the red flags of possible dropouts, and bring them to the attention of our chiropractor. A patient needs to be continually encouraged, reassured, and educated about chiropractic care continually. Chiropractic care takes time. We know that, but patients must know it too! Often, patients often will direct their frustrations and disillusionment to the staff instead of the doctor. They feel more comfortable addressing the staff but they don't want the doctor to know they are getting discouraged. When start feeling the patient is getting discouraged, you must tell the doctor and write a note in the patient file. A good system of communication between the staff and the doctor is crucial in bringing the patient through the phases of chiropractic care along the path to wellness. The important thing to remember is that we should not expect our patients to get immediate improvement. Too often, we pass on unrealistic expectations to them. Questions like, "Are you feeling better?" or "How are you feeling today" gives them idea that we are expecting immediate improvement. Giving them the idea that we are anticipating quick, positive results will set them up for disappointment. More realistically, we should be expecting patients to progress slowly, especially those that have had a chronic condition over a longer period of time. Our body language, facial expressions, and specific scripts to encourage patients along the road to recovery will help them understand that chiropractic care is a process of slow improvement with applied patient involvement. When a patient communicates discouragement and disillusionment, we should act as if that is exactly what we were expecting and react accordingly. If a patient does get immediate results, our reaction should be one of cautious optimism, letting him know that there may be setbacks along the way. Pre-framing the patient about what to expect will help him or her deal with the possibility of a more difficult recovery. When we are able to give our patients a more realistic approach to their care, they will be more apt to persevere and follow through and not get discouraged. Cautious optimism is a far better approach to bringing the patient through all stages of chiropractic care and will ultimately make them a wellness patient. Following are some scripts that will help with patient follow- through and encouragement. "How long does it take to begin feeling better?" "That depends on you. First, it is important that you are following through with Dr. __________ instructions. Are you adhering to the treatment plan and following through with your home care instructions? Second, if you have had your problem for a long period of time, it will take longer to relieve your symptoms. It is not unusual for some patients to take several weeks before they begin to feel relief. The important thing is to be patient and give Dr. __________ time to develop a program that your body will respond to and begin the healing process." "I was feeling fine yesterday, but today I am feeling much worse." "Having good days and bad days is not unusual at all. What often happens is you begin feeling hotter and you start to do things you haven't been able to do. Unfortunately, it was a little too soon to resume some of the more rigorous activities and you must resist the urge to overexert yourself." Almost always the patient will admit doing something they shouldn't have done. "It is not unusual to have good days and bad days during the healing process. In fact, you should expect them. One thing you will notice about setbacks is that they get shorter in duration. That's because your spine is in better condition than when you first began treatment. The correction is becoming more evident." "I am actually worse now than when I first came in." "At the beginning of the healing process, very often you actually get worse before the improvement begins. I like to make an analogy that when you are cleaning out a closet, it gets worse before it gets better. Let Dr. _______ know that you are feeling worse and let him explain exactly what is happening. Don't be uncomfortable discussing this with Dr. ________. It is very important that you let the doctor know exactly what you are experiencing. Don't get discouraged. It's part of the healing process! "I came in for low back pain and now I am having pain in my upper back." "It's important to remember that everything is connected. You are connected from your toes to the top of your head. When the doctor is working on one area of your spine, the rest of your spine is affected. Very often a correction to your low back will create a response in another area of your spine. It is perfectly normal. Be sure to let the doctor know what you are experiencing so he she can explain it to you. Your body can only feel one intense pain at a time. Lots of times when your symptoms are alleviated in one area, you will notice discomfort in another area. It was probably there all the time and your low back pain was just more intense." "Why do I have to come back so often? Can't I just come once a month?" "It's extremely important to follow through with the initial treatment plan. The first few visits are vital to the healing process. Each visit builds on the one before. It takes a series of visits for the doctor to see what type of treatment your body will respond to. As soon as you begin making progress, Dr. _________ will discuss the possibility of reducing the frequency of your adjustments. Please have a little patience, and whatever you do, follow through with the recommendations. The healing process will go much more quickly." Each patient must be encouraged to communicate with the doctor. Patients need to feel comfortable enough with the doctor to share their frustrations during the healing process. Let the patient know that your doctor will be glad they shared their feelings. Two-way communication is necessary to the healing process. If patients aren't completely honest they are actually compromising their chiropractic care. Often patients will misunderstand or misinterpret instructions. Instructions should be explained many times to make sure they understand the importance of their responsibility in the healing process. For the first twelve visits or so, it is the responsibility of the doctor and the staff to manage the patient's care. In order to see if you are keeping your patients beyond those first few visits, look back to the past few months. Check on those seen during the past few months and make sure they are still actively participating in their treatment plan. To figure your patient visit average (PVA) divide the number of new patients into the number of total patient visits for a specific period of time. This should give you an idea of how well you are encouraging and educating your patients. If your patients are not following through with their care, you need better communication procedures! Does every one on the staff know the patient's treatment plan? Do you communicate with your doctor when you get the feeling the patient is getting discouraged? Is every staff member actively involved with the patient's care? Every morning, look over your schedule with your staff. Identify the patients on your schedule who you feel are about to drop out of care. Make it the entire staffs' responsibility to encourage your patients. A wellness practice does not happen by accident. It takes Belief, Enthusiasm, Education, Focus, and a large amount of encouragement to make a wellness patient. Knowing what to say and how to say it is your most valuable tool in patient education. Don't ever underestimate the power of scripts. Remember, it's not what you say but what you believe about what you say, that gives what you say POWER! Presentation is everything. You may order our new TEAM TRAINING AND PRACTICE MANAGEMENT MANUAL package, from which this article is taken, by calling 800/937-3113 today.