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Category Archives for "Communications"

Engaging Patient Communication

By Dr. Russ Rosen | Communications

I was speaking with Dr. James Stubbs: one of our great “thinkers”.

He uses a whiteboard to puts up ideas to talk with patients about.

We were discussing the concept of framing things from a “Vitalistic” versus mechanistic perspective.

We were talking about putting up questions like, “Fever: good or bad?” (If you would like a great discussion on Vitalism vs. Mechanism just click here)

That would lead to discussions like:

If you were camping and knew that the stream water was bad and full of bacteria, what would you do before you drank it?

Of course, you would boil it.

Why?

You would boil it to kill off the bacteria and bad things in the water.

Did you know that bacteria can only live to a certain temperature and that is why innate wisdom or innate intelligence (not innate stupidity) causes a fever?

James and I were talking about putting up a poster with these three basic tenets (which are from the Five Branches of Philosophy that we learn from Pat Gentempo)

  1. What do you believe to be true?
  2. How do you know it is true?
  3. How do you act or behave because of what you know to be true?

Then we could have discussions such as: “Do you believe that fevers are good or bad?” Odds are they will say “bad”. That would be their basic premise or belief, (what you believe to be true?).

We could then have a discussion like this story above which would “poke a hole” in their belief system or “B.S.” causing them to reevaluate what they believe to be true. Realize if you argue with step three, or how they behave (I take aspirin to reduce the fever) because of what they believe to be true (their B.S.)  you will only find resistance!

But if you poke a hole in their belief system first they will realize that if their belief system (B.S.) is not true. Then we can install a new belief system which of course would lead to new behaviors.

Obviously if they now realize that innate intelligence (not innate stupidity) causes a fever to get rid of the bad stuff so we can heal, then what they choose to do when they get a fever would be different than if they believe that the fever was bad.

We were looking at other concepts we could bring up like this. Such as, “Swelling: good or bad?”

The downside to swelling is it hurts, it limits our range of motion, and it may take longer before we can go do the thing we want to do, like play basketball.

The upside, again from a “Vitalistic” perspective, would be to ask the question, “Why would innate intelligence do such a thing?” The swelling does several different good things.

  • First it is a natural brace and keeps us from moving the injured area.
  • Second it brings white blood cells to the area to initiate healing.
  • Third it brings blood and nourishment to the area so it can heal.

I think these are great conversations to have with our patients that could really shift their paradigm and consciousness leading to long lasting change.

Here is another good example: Why do we see lipping and spurring on X-rays and are they good or bad?

You would discuss the downsides to lipping and spurring AND from a VITALISTIC perspective why would innate intelligence (NOT innate stupidity) start to lay down calcium and eventually bridge the areas? Clearly to brace the area and stabilize the area. Mom nature is ALWAYS choosing the lesser of two evils. “Hmmm, I could just let this area continue to degenerate eventually severing my spinal cord, not a good thing! Or I could lay down calcium and brace the area. Yes I will have limited range of motion and pain but at least I won’t be paralyzed or die!” Do you start to get the idea?


I sent out an email and posted this on FB and got some really great other metaphors and stories.  I’ll be sharing them over the next few weeks, to spur along the conversation. if you have any you would like to add would you please add them in the “Comment” section of this blog? 

Here’s the first one:

From Dr. Lance Cotteril

Vomit, cough, sneeze, diarrhea…

Hi Russ. Back at school we used the examples of sneezing and vomiting as the base for the question of expressing health or expressing sickness.

We had great debates in philosophy class on this.

The question can be asked that when the body sneezes: “Is it expressing health or illness?”

Our initial answers were that sneezing was a symptom of disease. However if the body was working well and in a healthy state and detected that there was something present in the body that would stop the body from expressing full health, then it would be in the body’s best interest to remove it.

If there is a particle or irritant in the nose or throat then the body’s response is to expel it by sneezing. The exact same is true when thinking about vomiting, diarrhea and coughing; although it would be different toxins and irritants that the body is trying to expel.

The more pertinent question can then be asked would it be more concerning if the body wasn’t sneezing, coughing or vomiting when there are toxins and/or irritants present in the body?

(Dr. Cotteril, I agree 100%! Remember it is innate INTELLIGENCE not innate STUPIDITY!

Innate wisdom is ALWAYS making choices that will lead to survival even if it does not look that way. It is ALWAYS choosing the lesser of two evils… until it cannot… – Russ)

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.

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.

 

Survey: are your patients referring?

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

We all want patients who happily stay, pay, and refer. When new patients come to us, we want to make sure that they have a great experience so that they “get” what we do. We then move to ensure that they stay because we can’t restore them to optimal health if they don’t show up.

So when does that third part come into play? When do we figure out the right time to focus on “refer”?

This is a subject that is certainly up for debate. Head to a convention or a conference and bring it up during happy hour – you’ll hear lots of opinions and ideas. Which ones are right? Which ones are realistic? Most importantly: which ones actually work?


CLICK TO TAKE THE ONE QUESTION SURVEY

Sometimes, we need to step back and take a look at something that we so often forget to factor into the equation; the fact that YOUR practice is just that: YOURS.

So we’ll open this one up to the comments. When do you start asking your patients for referrals? How often do you do it? How well does that work? Leave us a note and we’ll publish the findings next week on our Facebook page.

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