May 2003

Answering patients' questions

by Dr. David Singer

One of the least talked about, yet most important aspects concerning managing patients, is how you answer their questions. When patients ask a question, they remember your answer far longer (and better) than if you said the same thing without them asking about it first.

Remember those lectures in school where the teacher lectured and you remembered about 10% of what was said? Yet, if you stayed awake long enough to ask a specific question, you probably remembered the answer to that question far longer than just hearing the answer in a lecture.

Two common questions asked by patients (followed by the best ways to answer them) are:

Question #1: "How long will it take?"

This is a trick question because quite often the patient actually means, "How long will it take for my pain to go away?"

Most chiropractors, when asked this question, hesitate and respond, "Well, it will only take a few weeks to get rid of your pain; however, if you want to get rid of the cause of the problem, that will take longer." Since most patients only remember the idea that it will take a few weeks to get rid of the pain, many often drop out of care before true correction has taken place.

A more effective answer would be: "There are two types of care, relief care and corrective care. Relief care takes less time, but the results are less permanent. Corrective care, on the other hand, is an extension of relief care, meaning that once your pain is gone, care is extended with the goal of getting rid of the cause of the problem. This type of care takes longer. I will be explaining to you the difference between relief and corrective care, and once you understand the difference between the two programs, you can pick for yourself the type of care that you want."

When patients ask questions, it's very important to make them feel they have control over the circumstances. Always give them the power to choose! By allowing them to have the freedom of choice, it takes the question off your shoulders and places it back on the shoulders of your patients.

"How long will it take?" It's up to you. You'll make your own decision." This type of response does not stick the doctor with an answer he or she will feel bound to comply with.

Another effective response to this question of how long it will take would be: "Only two doctors move the bones in the body -- dentists and chiropractors. For a dentist to move the bones in a person's mouth, (i.e., their teeth) it normally takes a minimum of three years. It also would require having them braced in the new position. In chiropractic, we try to change the structure of a person in a much shorter time without any braces.

"Initially, the first phase of care is an intensive program that extends over a period of several months. At the end of this intensive program, you would be re‑examined to determine the extent of correction. At the end of the first several months of care (two, three, four, depending on the doctor's decision), you will be informed as to the amount of correction that has taken place.

"Since the intensive phase takes place in the first several months, we expect to have the major changes take place in that time. However, a program of care, perhaps once a month or once every two months -- or once a week depending on how you respond -- might be recommended at that point, to allow us to bring your spine to a complete correction, and to bring your health to its fullest potential." (Note: It is not my intention to suggest the length of care you recommend for your patients, but simply to illustrate how you word your answers can affect the patients understanding.)

There can be a tendency on the part of all doctors to try to cut patients' questions short when they're not sure of their own answer. But remember, unless you completely satisfy patients regarding their concerns about their health care, in all probability they will disappear without you knowing what happened -- because you failed to completely answer their questions.

Question #2: "Why am I going to need such a long program of care when the pain only started recently?"

Most doctors fall into a trap with this question. They say something like: "The reason we're going to need to see you for so long is that the problem you have was the straw that broke the camel's back. Even though your symptoms appeared only recently, the cause of the problem has been there for a long time."

This answer, although accurate and true, may not completely create an understanding in the patient, due to the failure of the doctor to give a sufficient analogy or options.

A better answer might be: "The reason that we are recommending an extensive program of correction is because we feel that the ideal care, or the highest quality of care is one which has as its goal eliminating the cause of the problem. You certainly have options, and they are to receive either relief care only, or corrective care which will fully correct the problem.

"There are several stages or conditions your body goes through. They range from being totally well to having symptoms of illness or injury. The first stage is the loss of normal body function. The second stage is degeneration and tissue damage. The third stage is symptomatology. Relief care has as its target to get rid of the third stage, which is simply the symptoms.

"Corrective care has the goal of correcting the loss of function. It is similar to the oil light going on in your car. There are several ways to get rid of that red light that's blinking. One way would be to take a hammer and break the light so it no longer blinks. The other way would be to put oil in the car and correct the cause of the problem. Breaking the light is quicker and less expensive than adding oil.

"It would be the same thing with your body. If we were to just treat you until your symptoms went away, it would be analogous to allowing you to try to run your engine without any oil. You know as well as I do that this certainly would lead to future problems that could be extremely costly."

You want your patients to ask questions. Because when they do, this indicates they are thinking. How you answer those questions has a lot to do with how much that patient complies with your recommendations.

(Dr. David Singer is the CEO of David Singer Enterprises -- www.davidsingerenterprises.com -- a company offering an honest and ethical approach to building a practice through one‑on‑one consulting programs, products and practice expansion seminars. Dr. Singer teaches lectures on the natural solutions to health issues mentioned in this column, among others. For information on workshops and how you can present these programs to groups and organizations in your area, call Robert at 800/326‑1797. To receive "The Purpose Fax Newsletter," Dr. Singer's free fax info letter containing practice-building tips and health research, call 800/326‑1797, ext 227. Leave your name, address, phone number and fax number to receive a copy approximately every six weeks. You must have a dedicated fax line, as this fax newsletter is sent automatically via computer.)