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 #71 SCRIPTS (part 3) by Susan Hoy MUTUAL RESPECT IN THE OFFICE: I once had a front desk CA who was a single mom. She had two school aged children, and needed to generate an income to take care of them. I have great respect for anyone who manages a career and a family simultaneously. Before this CA came to work for us, the busiest time in our schedule was after 5:00, when our patients could come into the office after work. Several months afterward she started, however, I began noticing an interesting phenomenon. Our after five o'clock patients began dwindling. It didn't take a rocket scientist to see what was happening. This CA needed to get home to take care of her children. Either consciously or subconsciously she was limiting our schedule. I know this happens in many offices and I think it is grossly unfair to the chiropractor and other staff members who view their jobs as a career. No one should limit the patient schedule for any reason. If schedule limiting is happening in your office, take steps to solve the problem! In our particular case, the CA and I worked out a deal. She would go home at 5:00 and I would work the front desk until we closed. I think that children should be our first priority and I was willing to find a solution that would benefit all of us. I hear complaints from CA's that their chiropractors volunteer to treat patients long after normal office hours are over. Many new chiropractors view this as a practice growth maneuver. I personally don't agree with this idea. I think patients should conform to the set office schedule. If we don't respect our schedules, patients won't either! Nevertheless, this is the chiropractor's business. The dilemma that arises, however, is the insistence of the chiropractor that staff must stay until the day is finished. Certainly, emergencies arise and staff members should make allowances for these emergencies. However, they should not be expected to stay late on a continual basis. I often have to remind my chiropractor that the staff should not be expected to be as dedicated as the business owner. It is important for all of us to have mutual respect for each other's endeavors, both in business and our personal lives. In a practice where all staff members have respect for each other, there is a feeling of care and consideration that can be felt by the patients and will produce respect from them also. I can't think of a more desirable atmosphere than that of an office having mutual respect! INITIAL VISIT SCRIPTS (continued) In the exam room we like to keep pamphlets that address the many conditions that benefit from chiropractic care. Patients do not know the different conditions you treat, and can often identify conditions from which their friends and families suffer. They are encouraged by the doctor to share any questions they might have so assistance can be offered. Once the patient is finished with any treatment that might be given on his first appointment, he is directed hack to his changing room and given instruction to return to the front desk. He is not to be asked if he is feeling better! This gives the patient the idea that he is expected to feel better immediately. Instead, say something positive like, "Congratulations, you made it through the first visit. It's easy from here on!" Now your next task is to set up the next appointment and to collect his first visit fee. NEW PATIENT CHECKOUT: We always give our patient written instructions called the DO and DON'T sheet. We highlight the instructions that pertain to this particular patient. On the back of our DO and DON'T sheet is an article written by our doctor on the use of ice in treatment. We go over the instructions and we give the new patient a pamphlet on the "Subluxation Complex ". Additionally, if the patient had therapy on the first visit, we give him an informational pamphlet on that therapy. This helps the patient understand why the therapy is being used. The script is as follows: "Mr. Smith, here are your instructions that we ask you to follow until your next visit. They are highlighted in yellow, and should help you feel better if you follow them. Here is some literature for you to read about your particular problem. It will give you a better understanding of your condition." "Dr. ___________ has indicated that he would like to see you again tomorrow. Your visit will take approximately _______, because he will have a written an individualized report for you to read and will want to spend time with you to go over the results of your examination and your X- ray. He will let you know how he can help you at that time. Would you prefer 10:00 Or 2:00?" "OK, Mr. Smith, your appointment is at 10:00 tomorrow. Please be on time, since we have allotted extra time for the doctor to spend with you." "Here is an appointment card with our phone number on it, in case you need to contact us." "Now, let's total today's initial visit fees. Because your insurance doesn't cover chiropractic care, today's visit is 75. You also had full spine X- rays at 95, and you bought an ice pack for 7. The total today is 177, will you be paying with cash, check, or credit card?" If his insurance partially covers chiropractic care, explain how much he will pay out of pocket. When you finish the collection process, be very positive and caring with the patient. "Mr. Smith, we will see you tomorrow at 10:00. It was a pleasure to meet you and I sincerely hope that Dr. _________ will be able to help you. Make sure you follow our instructions and hopefully you will feel better soon." Remember, the first visit is for gathering information, your doctor doesn't even know if he can help Mr. Smith yet. Do not promise that he can be helped or indicate that there will he a treatment plan. Your doctor will do that on the next visit. Your only job on the first visit is to make your new patient feel comfortable in your office and to feel confident about the doctor. If your new patient had a positive experience in your office, you have done an outstanding job. This patient must leave your office, hoping that your doctor can help him. Being too eager to accept this patient into care will result in the patient feeling slightly overwhelmed and wondering if you have a problem getting patients! STAFF SCRIPTS FOR THE REPORT OF FINDINGS: When Mr. Smith keeps his appointment the next day, be expecting him. Do NOT ask him how he is feeling. This would indicate to him that you are expecting him to be feeling better. In fact, it is best not to ask your patients how they are doing at all, especially when they are relatively new. How many times have we heard, "If I were feeling good, I wouldn't be here". Instead of ASKING the patient how he is doing, TELL him how he's doing' "Hi, Mr. Smith, you're looking much better today and you look like you are in less pain." Or, if Mr. Smith is obviously still in a great deal of pain, greet him in a positive, caring manner and move on. "Hi Mr. Smith, welcome back to our office. Dr. __________ will be with you in just a few minutes. In the meantime, please sign in and be seated for just a moment. We will be right with you." Do not be surprised that he is still in pain. He must be aware that this is not an overnight cure. Any indication from us that we are surprised that he is still in pain would be disappointing to him. If you show a Report of Findings video, it must be presented properly or the patient will not want to view it. "Mr. Smith, Dr. _________ has requested that you watch one more video. This video will explain some of the things Dr. ___________ will be going over with you today. Pay close attention to the explanation of X-rays. That will help you with chiropractic terminology, etc. If he refuses to watch the video, simply say, "No problem, I'll just let Dr. _________ know that you don't care to see the video and that you'll be ready sooner." This comment makes him a little uneasy that he is not following the doctor's request. Never get into a conflict with the patient. Tell your doctor and he or she will handle it. When the video is completed, we give the patient his individualized report folder with the following script. "Mr. Smith, here is the written report that Dr.___________ has prepared for you. Please take a few minutes to read through it and Dr.__________ will be with you directly to answer your questions." Once the doctor has completed his ROF consultation, and gets a commitment from the patient, a staff member should follow through with some final instructions and get a financial commitment from the patient. This staff member should be equipped to answer the patient's questions about insurance and should know what his treatment plan allows. Since some patients have difficulty understanding their condition and are too embarrassed to tell the doctor, ask him: "Mr. Smith, did Dr. ________ answer your questions to your satisfaction? I know that Dr. _________ has given you a lot of information." At this point, the patient will indicate his understanding or confusion. "I want you to know that even though we back his findings up with a written report, Dr. __________ will be happy to answer any additional questions you might have. He will contact you at the end of the day and give you as much time as you need." It is very comforting for the patient, when the doctor calls him after the first adjustment. "We think it is important for you to understand three things, what your problem is, what the doctor is going to do to help correct it, and what your responsibility is in the process. If you have questions about anything, please let us know. We are here to help you in any way!" MULTIPLE APPOINTMENT SCRIPT: "Mr. Smith, Dr. ___________ has indicated that you will be receiving adjustments twice a week. I always recommend that you make your appointments in advance so that you can get the times that are convenient for you." Dr. __________ is very busy. That's because he's the best! May I suggest that you choose two days and times that are the best for you. I will have Robbi, our front desk manager, schedule your appointments in advance for the next ____________. That way, if you schedule at the same time, you appointments will be easy to remember." "These visits are not cast in stone! If you need to reschedule (do not say cancel) an appointment, Robbi will be happy to work with you. Please let her know as soon as possible so she can schedule a makeup appointment. Please follow through with these appointments, as it takes several visits for the doctor to see what techniques will work best for you. Each visit builds upon the next, so don't get discouraged." "Some of our patients start to improve immediately, others take longer to get results. If your problem is chronic, the response will take longer." "If for some reason you choose not to follow through with your recommended treatment plan, please contact us. You have chosen a doctor who worries about his patients. Please contact us and advise us of your decision. Otherwise, Dr. _________ will be concerned and either call you directly or ask me to contact you." "It is our goal to educate you on the benefits of chiropractic care. Those benefits involve diet, nutrition, exercise instruction along with spinal manipulation. Our office will never pressure you into care you do not want. We want to educate you so that you can make an informed decision as to the level of care you desire from us." "Most of our patients choose to maintain their spines by Having an adjustment once a month or so. Still others will disappear when the pain goes away, and then come back when they have another episode or crisis. We will be happy to treat you, whatever treatment plan you choose. We believe that maintenance care is less expensive and less traumatic for you. However, you will always be welcome back to our office at any time!" COLLECTION SCRIPT: Be sure to tell your new patients what is expected of them. Let them know you will be expecting them to pay for every visit or pay in advance. Also, let them know what charges may be involved in addition to their insurance coverage, such as chiropractic supplies or nutritional supplements. An informed patient is a better patient! "Mr. Smith, your insurance coverage requires you to pay a $10 co- pay. This co-pay will be required on every visit. However, many of our patients like to pay their co-pay in advance. That way, because you have scheduled in advance, you can just leave after your treatment and not stop at the front desk, and you won't have to write frequent checks or charge your credit card." As I have indicated, every member of the staff must know what to say and how to say it! Everything is in the presentation. It is for that reason that scripts are important and should be practiced at every staff meeting. You may order our new TEAM TRAINING AND PRACTICE MANAGEMENT MANUAL package, from which this article is taken, by calling 800/937-3113 today.