Category Archives for "Chiropractic Care"

Apr 23

Back in the Saddle Update from Dr. Rosen PLUS Should I talk about symptoms?

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies

Should we talk symptoms?

I often get asked this question by doctors who are considering coaching with me.

More often than not they sheepishly ask this question as CLEARLY they are not comfortable NOT talking symptoms but feel that if they are a true, “Vitalistic” or “Straight” or “Subluxation based” chiropractor they should not talk symptoms.

Or they are religious zealots telling me how it is not “Real chiropractic” if you talk about symptoms!

Regardless, if we sheepishly ask that question or act like a religious zealot and to cram it down peoples' throats, we are all “Buck-toothed, inbred chiropractors”. Whether we consider ourselves one of the above types of chiropractors,  a technique freak, or a philosophy freak, we all seem to think that everyone else either sees things the way we do or are TOTALLY wrong!

Here is my opinion when it comes to speaking with patients about their symptoms.

I guess I should start off by saying: for several years, I did talk about symptoms in relationship to the subluxation and nervous system. Then, for 3 years, I would not talk about symptoms. I told my patients “If you are here for any other reason than connecting with spirit at a higher level, you are in the wrong office!”

Here's another way to look at that: if you were rushing into the ER on the brink of death, how would you feel if the doctor started out by asking you “Would you like to connect with spirit at a higher level?” After thinking through that, I then started talking about symptoms with patients again. 

I had a really funny experience when I was speaking in New Zealand. The speaker right before me was the legend Reggie Gold. Reggie was going on about how we should NEVER talk with our patients about any of their symptoms. That is just not what we do!

I was there at one time in my practice. The idea makes perfect sense. “I would not talk with you about what drugs to take, how to cut your hair, do your nails, or tune your guitar. All I do is address subluxations and not your symptoms.” Great rap, makes sense from a very limited point of view and has some great indignant and righteous teeth to it!

I was sitting in the audience listening to (at that time) a living legend, I was dripping sweat. You see, I was just about to go on stage and do my hour lecture on just how to talk with your patients about their symptoms, how to connect their symptoms to the nervous system from a vitalistic perspective, and why it is so critical to know how to speak with our patients about their symptoms when my dear friend Angus Pyke elbowed me in the ribs and whispers in my ear, “Mate, I would hate to be you right now!”

I think the real question is not “Should we talk about symptoms?" It is, “How should we talk about symptoms?" How do we put symptoms in context from our world view and through the lens of vitalism?

I think it is very harmful for our profession to NOT to talk about symptoms and I believe the pendulum swing from never talking about symptoms to only talking about symptoms and relieving their symptoms with no context of the subluxation and vitalism is a huge mistake and very harmful.

Let me ask you this question: If your patient is getting healthier, does it make sense that- in time - they should feel better, too? Yes, I get it can feel worse before it feels better and I get retracing or reactivation. I am just asking us to get out of our dogma for just a moment and answer this question. In most cases, if someone is actually getting healthier shouldn’t they eventually feel better? I believe most of us would say yes.

The problem is that so many doctors that do talk symptoms use it as THE indicator of their patient’s health.

If you are feeling better, then you must be better. You must be healthy. Nothing could be further from the truth! Just ask uncle Joe: never sick a day in his life, goes to the doctor, does all the tests and exams, leaves with a clean bill of health and on the way home, dies of a heart attack.

Did the heart go from 100% healthy to dead in an hour? I don’t think so! People can go from feeling a lot of pain to little to no pain because of adrenalin or endorphins. Fall in love, go shopping and buy something, break up with your lover, these can all dramatically effect symptoms.

So using symptoms as THE indicator as to whether our patient is getting healthier or not is not a good idea.

But I believe it should be AN indicator. I want to have tons of reliable OBJECTIVE tests as well as a very detailed outcome assessment questionnaire that not only looks at how they may feel different over time but also how their quality of life is changing over time. But yes I also want to hear from them how they are feeling. I think it is a critical indicator that too many of us either will not talk about or if we do that is nearly all we talk about.

Along those lines one of my favorite lines relating to symptoms goes like this. Patient walks in and says, “My RD (real doctor) said nothing is wrong with me.” And I say, “So it is all in your head? I am so sorry that your doctor misinformed you like that. What they meant to say was I am sorry I am so arrogant as to believe that there is nothing wrong with you and everything is in your head. The truth is my limited tests do not show me where the real problem is. And since I cannot be wrong. It must be you!”

Thanks for getting this far, doc! I hope that this content was helpful and interesting to you. Shoot me a message and let's talk about it some more. I'm always happy to hear from another member of the profession who is ready to better connect with their community and grow their practice!

Dec 06

How to Deal with Patients Who Tell You They Don’t Have the Money BEFORE the ROF

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies , Communications

In the past week, I have had a similar conversation with 3 of my chiropractic coaching clients so I thought I would write about it.

Part of our responsibility as practitioners is to be able to communicate clearly with our patients.

Today’s digital world can be dangerous for personal health because there is so much misinformation everywhere.

As a result of this misinformation, many patients come to us with expectations for the treatment’s length and cost. We talk a lot about chiropractor communication strategies and how to utilize them so that patients truly “get” what we do and want what we offer.

Chiropractor Communication Program

But what happens when a new patient brings up money even before your consult or ROF?

My ROF process specifically addresses cost by building value, understanding the true motivators behind the visit, and helping my patients understand that I am NOT viably substituted with a bottle of Advil. If you can’t get to that part of the process, what do you do?

This can be a bit tricky. I have just seen so many chiropractors ruin their relationship with the patient by using statements like, “Listen you want to get better or you don’t.” or, “You can’t afford NOT to get this care!” My favorite very well may be “Okay, tell me what you want and we will do that”. From our perspective as the certified experts, NONE of these lead to long term relationships and NONE of them honor the patient and their health!

When the cost of chiropractic care comes up at the front desk or during a pre-consultation with your CA, I would recommend that you address it right off the bat during your consultation.

Build rapport by relieving concerns and addressing fears. This would sound like:

Mary I understand that finances are a concern for you, please tell me what’s up.

Listen to what they have to say, commiserate, and say something like this:

Can I make a suggestion?
Why don’t we do a detailed consultation and thorough examination so we know exactly what is going on with you.
In my report of findings, I will tell you EXACTLY what’s going on and if we can help.
Then, you and I will get very clear about the level of health that you want to obtain.
I will show you what it will take to get there.
At that point, we will get clear about what it would cost to get to that level of health.
If we agree, then we will work together to make sure that you can get the care you need and respect your budget.
How does that sound?

A Critical Moment in the Report of Findings

During the report of findings – right at the beginning – you are going to let them know that you understand the finances are a real concern and that you simply want to help them understand the truth about what’s going on as well as the consequences of the choices that they have. This gives you the time to help them “get” what you are trying to do for them. Once this clicks, you can show them what it would take to get to the level of health that they choose. By taking it in stages, you can always customize a plan that will fit their budget.

This allows you to go through your entire report of findings without them worrying about money or that you’re going to try to hold them captive to make them do some type of care that they don’t believe they can afford. You will be amazed at how many people will find the money to get the care that they truly need once you take them through the entire process. (There’s a lot of time dedicated to this pivotal point in our Optimal Health Communications Program.)

An Example of Implementing This Chiropractic Coaching Concept

I teach my chiropractor coaching clients to record their patient interactions whenever possible. In one such recording, the patient let the doctor know right at the beginning of the ROF that finances were a real concern. She was a single parent with three children and she just truly could not afford the care.

He started talking with her about how important the care is for her now as well as for her future self.

You could hear her getting more and more frustrated… almost to the point of crying.

They were going nowhere! What came next was something that we have all experienced. The patient became extremely aggravated at her situation (NOT the doctor, by the way). She said that there are people in the world who “have” and there are people who ” have not” and she is one of the latter. She would have to get another job to afford the care she needed, but that would only make matters worse.

I want you to recognize that the doctor had not yet started the report of findings.

He had not yet gone into any details about how much care she would need or how much it would cost.

So why did she become so upset?

In this situation, her fears and misconceptions are telling her what to expect to hear from the doctor sitting in front of her. She has convinced herself that there is no ACTUAL scenario where she can get healthy and stay healthy. When this happens, we MUST de-escalate the situation before we start any type of conversation.

How do you de-escalate a patient who isn’t ready to listen?

We de-escalate the situation with the L.A.A.S.R. framework: Listen, Acknowledge, Ask, Solution, Resolution. By first listening, we are able to do something truly amazing. (LISTEN)

“Mary, I know how frustrating this must be for you.
I know that you are in a lot of pain and I know you really do want to get better.
I know you’re single mother with three children who eat like horses and the thought of having to get another job to pay for the care that you need is simply overwhelming.  (ACKNOWLEDGE)
I’m so sorry you’re going through this; I need you to know that you are not the only one.
Can I make suggestion? (ASK)
Why don’t I just go over my findings with you and show you what it would take to get this problem taken care of.(SOLUTION)
If that ends up being more than you can afford right now, we can customize a care plan that will fit within your budget.
I promise you if the amount you can afford is not going to be valuable to you – if it simply going to be a waste of your money – I will let you know. (RESOLUTION)
Mary, how does that sound?”

As always, we will use the L.A.A.S.R. process. You’ll notice the first thing I did was L for listen. I then A- acknowledged or commiserated what she was going through. I then A- asked her a question to see if that would find a S- solution and then I just checked in to see if we R-resolved this problem.

Without the L.A.A.S.R. framework, you are left with pretty terrible options:

•Roll over, agree with the patient, then just give them what they can afford right now and send them on their way

•Blast the patient with scare tactics and shame them into submission (I will NEVER agree with this option, by the way)

Neither one of those have any value for you OR your patient. Use L.A.A.S.R. and you will find you get much better results.

We go into great detail about the L.A.A.S.R. process as a key part of our Optimal Health Chiropractor Communications Program. Take a look – if this article has been helpful, it may be what YOU really need to move forward and help your patients “get” what you do.

Oct 27

Chiropractic Practice Building (good chat)

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies

One of my all time heroes, amazing communicators and Legends in our industry, Bill Esteb, and I had a very fun and interesting conversation that ended up being a really great blog. Do you ever have a really good chat with someone and think afterwards “Boy, I wish I had written that down!”? Well, I had that thought, but was fortunate that we DID write it all down!

We talked a lot about communication and just how important it really is in all aspects of practice building. In fact, it’s probably one of the most misunderstood and overlooked parts of a successful practice that few figure out on their own. I built The Optimal Health Chiropractic System with it as the “hub” of success, so that I could help docs nail their communication and grow their practices quickly and effectively.

Without further ado, I present my conversation with Bill Esteb as part of his “Chiropractic Practice Building” series. Take a look and let me know what you think!

Chiropractic Practice Building with Dr. Russ Rosen

Oct 17

Do you Struggle getting patients to your WORKSHOPS?

By Dr. Russ Rosen | Chiropractic Care , Communications

Has this ever happened to you?

At the start of the day, you have 10 people scheduled into your workshop. You’re pumped about the opportunity to share the chiropractic message and are looking forward to providing boat loads of value. But…as the day goes on you can hear your CA on the phone taking call after call as your patients continue to come up with excuses about why they can’t make it to your workshop tonight. By the time the workshop comes around your delivering your talk to 2 people….arghhhh!

If this sounds familiar then know that you’re not alone. This scenario plays out in this form or very similar ones in chiropractic offices around the globe!

So how do we get patients to our talks?

I have doctors and their entire teams tell me all the time that people just won’t come to talks in their area. And my response to them is this… nonsense! The truth is they just don’t know how to get people to their talks.

If this has happened to you enough then you’ve probably starting telling yourself that running workshops aren’t a good use of your time and you’re better off leaving the office early and spending some time with your family.

Well…the good news is, there is another way.

Don’t kid yourself though, if you really want your patients to GET IT…
• If you want them to see the value of a healthy functioning nervous system and reasonable lifestyle…
• If you want to be able to see a reasonable volume of patients and not have to spend tons of time with each patient every visit “educating” them…

Then you MUST do a killer series of talks!

If you want to get your patients to your talks you MUST have the right headspace as well as the right procedures to get them to your talks.

I’ve written an article that will show you EXACTLY how to get boat loads of your patients and their family and friends to your talks. (And if you have seen this article before I just added a new section of how to get your active patients to the talks, not just the new patients.)

Just click this link and it will take you right there. (Don’t worry, there’s no opt in and there isn’t even anything for sale, I just wanted to “hook” you up).

 

Love to hear your thoughts and comments.
Much love and aloha,

Russ and Angie

Oct 17

What to do when a patient says, “I can’t afford your care.”

By Dr. Russ Rosen | Chiropractic Care , Chiropractic issues

If you’ve been discovering how to run a profitable chiropractic business for more than 5 minutes, then a patient has told you that they need to stop or reduce care because they could no longer afford it!

This exact situation tends to impact us as chiropractors on so many levels. For many of us, it’s like an arrow to the heart and brings up all sorts of issues around value and self worth.

I want to share with you the two big mistakes chiropractors make when confronting this situation and share my top strategies for getting to the real reason your patient wants to stop care.

How You Respond Initially is Important

In my experience working with thousands of doctors around the globe, I have realized that most chiropractors respond to this statement in one of two (equally bad) ways.

Bad Response #1: The Confrontation

Classically “High Ds” or “Drivers” or “Assertives” respond by getting snippy or angry with their patients – trying to scare or manipulate them into care. By letting these troubled patients know about all of the terrible things that are going to happen to them without their care, “Assertives” tie up their frustration and anger in a beautiful pink ribbon labelled “in their patient’s best interests”.

At chiropractic seminars, they get to tell their friends about the time they really laid into their patients. They get to feel good knowing that they said what they wanted to say.

Bad Response #2: Rolling Over

Classically “Non-assertives” join what we call the “O.K corral” and just say, “okay”, letting the patient simply leave without a discussion. They feel very frustrated because they didn’t say what they really wanted to say and the relationship is essentially over.

Regardless of where you land on the assertiveness scale, the end result is almost surely the same: you are frustrated and the patient fails to get the results they came in for. It’s an absolute lose-lose scenario.

Responding with the Patient’s Perspective in Mind

I want you to imagine your patient has mustered up enough courage to finally say to you that they feel that they need to stop care because they don’t have enough money. I want you to recognize the stress that they are most likely under by the time they finally say this to you.

This is a big deal.

Now I want you to imagine you say to them:

“Mary, if you stop care now you will never get the results that you’re looking for and you will have serious problems in the future.”

Although you may manipulate her into continuing care in the moment, the odds are she will very soon quit care for good and never return.

What we find rarely ever works is TELLING people what they “HAVE TO” do. Regardless if they are patients, spouses, children or bank tellers, telling people what they have to do rarely works!

Instead, we need to ask Socratic questions to help us clarify what the problem truly is so we can come up with a reasonable and logical solution.

LAASR Focused

In our L.A.A.S.R process (Listen, Acknowledge, Ask, Solution, Resolution) we always make sure that we actively listen to our patients. Then we must acknowledge them. In this case I might say,

“Mary I am so sorry you’re going to have to stop care. I absolutely love working with you and you’ve been gaining such ground and doing so great.”

Do you see how this de-escalates the situation? Remember: she is stressed about having to quit -or even disappoint you – and has possibly come in ready for a fight! By Acknowledging their concerns and the situation this way we can take the wind out of the sail and de-escalate the situation. Now we can begin to have a conversation. But I am NOT going to TELL her what she HAS TO DO!

Instead we want to ask appropriate questions. I.e. “Mary let me ask you a question, if finances were not an issue – and I know that they are – but if they really were not an issue would you want to continue care? Or are you just (feeling good/unhappy with care/feeling stuck in care etc.) And would rather not continue at this time?”

If Mary says that she would do anything to continue care but she simply cannot afford it. She just lost her job, her mother got sick, her dog got hit by a car and she was living out a country song then I personally would buy it. And I would try to figure a way for her to be able to get some of the care that she needs. The odds are some care will be better than no care. (Of course you have to do what you feel is clinically best for your patients.)

But it if she were to say, “Yes the truth of the matter is I am really feeling pretty good and I think I will just stop at this time” then you have clarified the real problem that you can now address.

My experience is, if you will really focus and clarify the problem the solution will become self-evident. Then if you will use the L.A.A.S.R. process you can help people find solutions and resolution versus pissing them off or joining the okay corral.

I’d love to know your thoughts and hear what’s worked for you.

Much love and aloha,
Russ

Oct 17

Feeling versus Function (Improving Chiropractor Communication)

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies

As a chiropractor, it’s sometimes challenging to get our patients to understand what we REALLY offer. If they did, they’d want it, every single time. My chiropractic coaching experience has given me some clarity on the matter that I’d like to share with you.

So where’s the disconnect?

One of the great challenges I find is that most chiropractors never find out what the patient actually wants before we tell them how much care they need. Chiropractor communication as a root cause leads to all sorts of problems with your practice.

You can picture it like a conveyor belt intended for mass production:

  • Patient comes in, seeking care
  • Staff greets them, checks them in, gets them ready for you
  • You say hello, explain what you do, and go right into “where we go from here”
  • The patient seems happy, thanks you for your help, and never comes back
  • New patient arrives, you shake off the last one as “a bad apple”, and the process repeats

That’s an awfully bleak way to look at things, so let’s try it a different way:

  • A patient comes in with a mildly sore neck
  • They have seen a chiropractor before and got “Cracked” once or twice. It felt better & “Fixed”
  • You do your consultation and examination, they come back for the report of findings and you tell them that they need “Lifetime care” or a “year of care” or whatever you tell them
  • When they’re not convinced, you either try to scare them into care (beware, the SILENT KILLER!) or roll over and “admit” that they’ll feel better after a few sessions, but more “wellness care” would really be nice

By the way: neither the boogeyman nor passivity creates a loyal, fanatical follower who will stay, pay, and refer.

What’s Missing?

One of the most important concepts we need our patients to understand is this concept of “Feeling VS. Function”. We must ask questions of our patients in order to understand their headspace.

In the ROF we walk our patients through a particular process where we help them understand that on this “Path to optimal health” chart, a negative ten (-10) means near death.

A zero (0) means you are feeling comfortable but you are not functioning at your optimum. We have not resolved the underlying problems and if we were to redo all of these objective tests they would still show that things were not working right.

A positive ten (+10) means that not only are you feeling great but your body is functioning at its optimum, we have resolved the underlying problem and of course if we were to redo these objective tests we would expect them to be cleared.

Now that they understand the difference between feeling and function, we can find out what is best for them at this time in their life.

How to Transition More Patients to Care Plans

This seemingly simple exercise is the key to unlocking your chiropractic patient’s understanding of how your care really works. We have to first meet them where they are, explain how you will resolve their immediate issues, and then inspire them to commit to wellness.

  • Someone who rates themselves as a negative five (-5) has to know that they’ll be out of pain before they can begin to listen to the idea of wellness care.
  • Someone who comes in at a zero (0) isn’t experiencing the crippling emotional and phsyical punishment of constant pain, but they’re not in top condition, either. They’re going to be more open to the idea of wellness care but still need to express a desire to move closer to positive ten (+10).
  • Someone who rates themselves as a positive five (+5) isn’t looking to remove pain because they don’t really have it. They’re ready to see the vision of wellness care.

Once you clarify what THEY truly want in relation to what you can truly do for them, you can then simply show them how to have it.

Oct 17

Staff Suggestions for Improving PVA and More

By Dr. Russ Rosen | Chiropractic Care , Communications

Dr. Jake Smith in Spain asked his team to come up with ideas to help improve the retention or PVA. In essence how do we get patients to stick around longer so they can get amazing results?

This was their response in black and in red are the comments I made.

Do you or your team have anything you would like to add to this?

If so please put them in the comments section.

Tasks to improve PVA and overall numbers (1-27 my C.A.’s ideas/ 27- 38 are my ideas)

  1. If one of our patients has a business, try and use their services or purchase items from their businesses.
  2. Believe in what we do and never give up on our patients.  Never stop encouraging them to continue with care.
  3. Develop our Facebook page more
  4. If possible, reduce the frequency of care so that the patient does not “throw in the towel” due to economic problems.  (i.e.  I understand that you cannot come in 3 times a week, but due to your speedy recovery I believe we can go down to once a week and achieve your health related goals.)
  5. Do not classify new patients as “new patients” if we know that they will only be here for a few weeks or if they are already under maintenance care with another chiropractor and want to switch to us (this happens often as I used to work for another chiropractor in town six years ago.  Some people are just finding out that I am still here, and others are unhappy with his new associate so they seek me out.)  The intention is to have a more realistic appraisal of our PVA.
  6. Revamp our phone calls.  Our current system is that we call the patient 3 times.  If we do not get a response we stop calling.  If they are in the first phase of care we send them a letter within one month.  If they are beyond the first phase of care we send a letter within 3 months. Any ideas??? You can check out my system 4, module 1 REACTIVATIONS section. But for sure Listen to System 2 module 2 dive deep “Missed Appointments”
  7. Inform our clients about our facebook page and tell them they can receive important info about their health if they “like” us.  Maybe there is a way we can request they “like” us, via FB after we inform them??? Create a tribe (Listen to Tribes,system 4 dive deep section) and community! Regular internal series of talks goes a long way
  8. When I am the “runner” work harder to talk to the patient to figure out what their habits are, and how they could be affecting their progress.  (We could also find out positives as well.)
  9. Remember to ask patients for recommendations when they tell me how happy they are with chiropractic and their results.
  10. Insist more that patients schedule their appointments in blocks of 10-12.  Pre-paid plans should help with this (her words.) In Doc Handoff to CA use that scripting and form. Let them know up front that we will support them every step of the way but they need to do their part
  11. When a patient calls to tell us that they are quitting care, insist more that they do not quit careUse LAASR system 3 module 11. Find out why? See if there is anything we can do to fix or help? Get the doc to call and check in as he will be concerned.
  12. Develop blog and social networks more. Write articles in first person. This will bond them to us more and condition them to ask questions. Post more photos of seminars that I attend, the Barcelona College of Chiropractic (I sit on the board) meetings, events etc.  Posts outside of chiropractic such as nutrition and exercise to get more hits on Google.
  13. Post Big Idea video on website
  14. Post other video (don’t know name but I have it) shows split screen of same older man.  One is sick the other healthy.  Emphasizes quality of life.
  15. Once a year, hold a seminar for our patients (Saturday morning)  basically an advanced talk.  Also let patients share their experiences with others. Have the event catered. I did a few advanced talks a year. Biggest had 175 people. We can talk these down
  16. Create more handouts on how to improve habits.  We have on sleep.  We should make one about diet, exercise, mental health. See the ones I have system 3, module right after overview
  17. Encourage parents to bring their children.  Create a “Path to optimal health” for kids.  Make a game out of it.  Give them prizes along the way (we do a bit of this now)  Give them a medal when they reach maintenance care/optimal health. Go through system 4, module 4 no stress secrets to easy and instant referrals. And module 1, marketing, internal, family referral program. Brock did this and killed it
  18. Order gowns for kids
  19. Keep our patients engaged all year with nice touches and details such as:  Have a hot chocolate machine during Christmas, eggs for kids at Easter, Give out pens, t-shirts etc. with our name and logo to celebrate our anniversary. make it a fun place to come!
  20. Nice gift when patients reach 5 years 10 years etc. under care
  21. Give stretching exercises to everyone in first re-exam
  22. In second re-exam re-visit their worst habit and see if they have improved it tons we can do on this…
  23. Show them where they are on the path to optimal health keep talking about where they are, where they want to be and what they need to do to get there… and of course WHY they want to be there. Make sure we do meaningful re exams and re reports. Make sure the entire team utilizes the whole story brochure!
  24. Third re-exam.  If they have improved a bad habit, praise them. If not inspire them to do so.
  25. When patient achieves maintenance care (once a month) the whole team congratulates them and encourages them to continue care.
  26. After one year of maintenance care give them a bottle of nice olive oil (it is common to give bottles of wine but many people do not drink so we found oil is better and is more in congruence with health) to show them we still care and are here for them on their path to health.
  27. Force myself to ask everyone that accompanies a new patient to start care.  Sometimes I don’t do it because I think they can’t afford it or I feel like I failed to make a connection with them and they will say no. review no stress secrets to easy and instant referrals and learn HOW to ask for referrals
  28. Network more.  Take advantage of opportunities to meet new people.
  29. Improve Daily Interactions / Incorporate Path to Optimal Health.  Where do you think you are now? When patient wants to reduce care. And who do you know? And nail the TTAT Whole story brochure
  30. Keep refining first visit.  Get it locked in. and keep reviewing it forever!
  31. Schedule new patients better (i.e. so I am not rushed)if we are rushed or run behind people will put up with it until they are out of pain, but not after that
  32. Improve re-exams and health talk
  33. All of us need to watch Big Idea video and my health talk then critique them to make sure they are congruent and useful.
  34. Help patients more with their habits. Publish info in FB
  35. Start emailing patients once a month with useful info.  Encourage patients to “like” FB page.  This keeps us on their radar.
  36. Be more consistent with making calls to patient after first visit to see how it went. 100% of the time, First impressions!
  37. Be more consistent with keeping up with patients who dropped out of care for medical reasons (car accident, broken bones, in the hospital, surgery, heart attack etc.)
  38. Have an annual event that coincides with bank holidays something like a 4th of July BBQ.
  39. Testimonial week! System 4, module 1, internal, testimonials
  40. In essence,
    1. if we all do our job, if we do a great job, if we continue to improve people will stay, pay and refer!
    2. Get our patients to REALLY see the value of long term chiropractic care.
    3. Make sure everyone on the team understands how to use the TTAT brochure and discuss the whole story and make it personal with each patient.
    4. Make it about THEM vs. making about YOU or your “Numbers”.
    5. Love these people, give them a Red Carpet Experience, (see Red Carpet article in system 3, first contact process, CA Communications)
    6. Take the team through “Get the team to grow the practice” System 2 module 1. Get them philosophically on board and make sure they have regular quarterly objectives that you review in the brag session in your weekly meetings.
    7. Make sure your team has been to your talks and REALLY get the value of long term care.

Now obviously a lot of this feedback I gave Dr. Smith was referencing our 3 Pillars and 5 Systems content. If you don’t know what that is, take a look at this video introduction and start to learn about the program we have – it’s thorough, it’s constantly evolving, and it works.

Oct 17

Capitalizing on the Limited Scope of Other Chiropractors Near You

By Dr. Russ Rosen | Chiropractic Care , Chiropractic issues

I just had one of my coaching clients send me this email today.

“I had a new pt today from my talk. He’s a big guy, poor lifestyle in his early 30s. He told me he is afraid (brought to tears) he is not going to be around for his 9 week old son, in fact he wakes up everyday scared. He was there because of what I said at the talk at his office and he was crying out for help. It brought tears to me also. This guy gets the whole story and big picture and seems very motivated!

My dilemma is that he has been under chiro care for neck and back type symptoms which have cleared up, but his chiropractor never talked about the importance of clearing up the nerve interference and subluxations and made no mention of how important it is for this guy to live a reasonable lifestyle.  Again he was at the talk I gave the other day and of course I talked about how important the nervous system is and living a reasonable lifestyle and that’s why he came to see me. So his neck and back are feeling better however I tried to hint that his function will take longer. I would recommend more care not less, haven’t seen x-rays yet but scans especially HRV is not good. 

I suppose what I want to ask you, in a long winded way, is, is there anything different you would say or do, or really highlight? He told me he can be impatient and if things don’t happen quickly he moves on. This is a long term project in my view, I’m scared of what will happen to him if he doesn’t commit. He needs to understand the changes he wants to notice are ones that will probably take some time and a bit of patience will be needed.”

Have you ever run into this?

If you are out doing talks and really delivering the goods you will have a lot of people who GET IT and want what you have to offer. Many of them will have seen “limited scope” chiropractors who limit their scope of practice to neck and back pain. And these people will WANT more, they will want what you have to offer!

So how do we deal with a patient like this?

In our communications program we teach our doctors to find out what the patient REALLY wants in relationship to what we can REALLY do for them and then simply show them how to have it.

Let’s break that down a bit.

We must find out what our patients really want from us in relationship to what we can really do for them. The odds are we can do much more for these people by clearing up their nervous system and showing them a reasonable lifestyle than what they thought when they first came in to see us.

Most people come in thinking that we can only help them with their neck or back pain. But the truth of the matter is by correcting their nerve interference and helping them live a reasonable lifestyle they can most likely not only feel better and prevent problems in the future, but they can literally reverse the effects of the aging process and have a better life!

So in our consultation, examination and report of findings we have to help them realize the value of a healthy functioning nervous system and reasonable lifestyle and the present and future benefits to them. Again odds are this will be a much bigger picture than what they thought when they came in.

Therefore once we know what they really want in relationship to what we can really do for them we simply need to show them how to get it.

In this person’s case in our consultation we would help him get extremely clear about the “why” behind the “how”. In his case the “why” is because he wants to be around to see his child grow up. In essence he wants to live and he wants to be healthier.

Once we help pull this person out of the river in Egypt called “denial” then we have to be extremely clear and honest with him about what it will take to get the results that he wants. We must address the fact that he can be impatient and the reality is this will not serve him if he really wants to be here for his child.

In our offices, we look at a scale of -10 to 0 and zero to positive 10 where -10 is near death, 0 would be feeling good but not functioning at our optimum and 10 would be not just feeling great but truly functioning at our optimum.

Once you help this person recognize that they not only want to feel good but they want to actually be healthy, they want their nervous system functioning at its optimum and they realize that to do so not only will they need to be adjusted for a significant period of time to correct the present damage but they will also need to live a reasonable lifestyle so they are not re-creating the same types of health problems over and over again.

So you can see that regardless of the person who walks into your office we always do the same thing. We find out what they really want in relationship to what we can really do for them and then we simply show them how to have it.

As always, we are very interested in questions and comments.

Much love and aloha.

Oct 17

Do you ever have a difficult time telling your patients the truth?

By Dr. Russ Rosen | Chiropractic Care , Chiropractic issues , Chiropractic Strategies

I was having a conversation with a doctor the other day who was having a challenge just telling the patients her truth.

She said that when it came to things like telling the patient how much care she thinks they really need or asking for referrals or a whole host of other things, she was really having a tough time.

The last thing she wanted her patients to think is that she is in it for the money.

Now the truth of the matter is this: I have had this same conversation with many doctors over the years. It may be about telling the patient what they need to get to a certain level of health, or asking for referrals. It may be telling the patient that if they really want this to resolve they will need to eat better, or deal with stress or get some exercise. It could be telling patients that if they don’t make certain changes like their frequency of care they really are not going to get the results that they want etc.

Now when it comes to different types of doctors it usually comes down to being more “Assertive” or “Non-Assertive”

In general, the “Assertives” may err on the side of overstating the seriousness of the patient’s problem, they may be prone to using “patient scare” tactics as they are “truly in the patient’s best interests.” They will often times use persuasion and high pressure sales techniques to get the patient to do what they want them to do, as they love the conquest.

The “Non-Assertives” may be seen as easy going, peaceful, unassuming, humble and even meek. Above all else these people want to be liked by other people and they want to be seen as a good, honest and truthful person. They are sensitive to rejection and combined with the desire to be liked; these people usually downplay the seriousness of their patient’s condition. They error on the side of telling the patient not to worry, that things are going to be ok. The doctor most often does not tell the patient the truth about how much care they need and how much it is going to cost. They are evasive and even cheery during the examination and R.O.F., the last thing they want is to use any of those “patient scare” tactics that many of the other doctors use.

If you are interested in a very detailed article on this subject, you can download it here. 

Regardless of which type of behavioral style you are the thing I have found works is to remember this single concept. Regardless of your behavioral style it is about THEM it is not about YOU!

We need to get out of our own way and just tell the truth and consequences of their choices. Patients are here because they want help. We owe it to them to them the Truth, the Whole Truth and Nothing But the Truth WITH ABSOLUTELY NO CHARGE!

As long as you remember that simple concept, and keep your patients best interests at heart you will be amazed at how much easier it is to tell them the truth in a way they can hear it.

As always hope that helps. Love to hear your thoughts.

Oct 17

I want you to go home and sleep on it.

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies , Communications

When coaching doctors through the report of findings process, we hear them say thing like

“I try to show them the care plan I would recommend and then tell them that I don’t want them to make a decision today. The last thing we want to do is pressure them to do anything. So we want you to go home and sleep on it and come back next time and let me know if you would like to do a program of care or just pay per visit for now.”

That all makes sense, doesn’t it? When I hear this kind of statement, I find that the doctor is in one of two categories: they are non-assertive and “roll over” when a patient pushes back (sometimes referred to as the O.K. Corral) or they’re tired of the high-pressure sales tactics that they’ve been told they HAVE to use. (By the way – the second category almost ALWAYS says that the high-pressure stuff has ruined their reputation and cut down on their referrals.)

Here is the problem with using the quote above: it is BS!

It is YOUR BS (or Belief System) causing you to do this. You have to ask yourself if it is really what is best for your patient and for you. I am going to suggest the answer is “no”. This mentality is in neither your patient’s best interests nor those of yourself and your practice.

From a behavioral psychology and communications perspective, there is a window of opportunity when people want to purchase what you have to offer. When you miss that window, you literally CAUSE them NOT to get the care that they need. (Ouch that hurts!)

Should every patient make their decision in the heat of the moment?

Of course not. There certainly is a time and a place, though. We teach doctors exactly when and how to do that. However, you can actually cause people NOT to get the care that they need and want by telling them to go home and think about it instead of giving them an opportunity to get the program they want when they want it or when that window is open!

The first thing we need to examine is why do doctors do this?

If you have been burned by doing some of those high-pressure scare care techniques then your first reaction will be to avoid them at all costs. If you are the non-assertive type of doctor, then this feels really good and very genuine.

In fact, these types of doctors reason that asking for a commitment to care during the report of findings will GUARANTEE that the potential patient thinks:

  1. I am trying to scam them.
  2. I am trying to pressure them.
  3. I am a salesman/woman trying to SELL them.
  4. I am a charlatan or huckster.
  5. I am just in it for the money.
  6. Blah, blah and yes… blah!!

Separate from the patient’s potential thoughts, most doctors just hate being rejected!

The S Word

Now I did specifically say “If I try to SELL them up front.”

I used the S word (sell) for a reason.

That is what these doctors tell themselves.

This is their BS or belief systems that keeps them from just giving those patients what they want and deserve.

No you are not trying to SELL them anything.

Is this a business? YES!

Business comes down to one thing. You have a problem, I have a solution. If my solution fixes your problem then we MAY be in business.

Are you providing a solution that they want to purchase? YES!

You cannot be successful in practice if you look at your services as things to sell to people that visit your office. You will fail.

The Key Difference

The way we teach doctors to do visit one and two is very simple. We want you to find out what your patients want in relationship to what you can REALLY do for them. After that, simply show them how to have it.

When someone comes to your office with a stiff neck, they may say that they want to get their neck “cracked” so that they feel better. By the way, many management companies (even the really expensive ones) will tell you to seize onto the “crack addicts” that come in because you can do something that they are asking for and you can do it over and over again to make a lot of money.

Instead of surrounding yourself with “crack addicts”, you should help clarify your patient’s real wants. In most cases, they REALLY want to get healthy, stay healthy and have the best life possible for a lifetime, but probably don’t understand that you can help them do that (yet).

When people truly understand the value of a healthy functioning nervous system and reasonable lifestyle, they are better equipped to voice their real wants. Once you have done that for them you then find out what they really want: do they want to just feel better knowing that they have not resolved the underlying subluxation and health issues, or do they want to feel better and resolve their underlying subluxations and health problems?

Our experience in hundreds of offices tells us that most people don’t just want to feel better, they want to resolve the underlying subluxations and address their health problems.

Once we help people clarify that they want to get healthy and stay healthy for a lifetime, then all we have to do is show them how they can have it with a real care plan.

A Real Care Plan

Once people understand this, they recognize that it is not going to be a quick fix. It will take more than a couple of quick cracks to resolve these underlying problems.

Imagine that you have taken a patient through this entire process and they really realize that they want to get healthy and stay healthy. You show them what they would need to do to get there. That patient says to you, “I am sick and tired of being sick and tired, I want to get healthy and stay healthy and I will do whatever it takes to get there.”

If you respond with “Great! I want you to go home and sleep on this. It’s a big decision.” Then you have most likely undermined your efforts and effectively pushed the patient out the door. All of your efforts to educate your patient goes away when they leave and go back into the rhythm of their daily life. If you aren’t comfortable asking for a commitment once your patient shows that they really get what you do, then you most likely have some headspace issues to resolve.

  • You need to learn how to get people to truly value their health and value your care.
  • You need them to understand the difference between what most other chiropractors, practitioners and medical doctors are offering them.
  • You need to be able to separate what you are offering from the other options they have.

If you need a hand with this, I encourage you to use the link below to learn about our unique program, called Headspace and Personal Growth, that has helped hundreds of chiropractors across the world to feel certain, better understand themselves, and approach their practice with the right mindset, mentality, and methodology. It can change your life.

 

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