January 2005

When patients don't bring in their families

by Dr. Dennis Nikitow

In building a family practice you must know specific strategies to reposition the way people use chiropractic. If people think chiropractic is for back pain alone, it'll be virtually impossible for you to build a successful family practice.

If kids don't have symptoms of back or neck pain it's most unlikely parents will bring them in. However, what if your belief is a wellness philosophy, your practice strategy is to get patients to position you as part of their health care team to maintain the alignment of their entire family's spine, and they still don't bring their families in?

Don't give up. I've had people bring their families in months ‑‑ even years ‑‑ later. The Certainty strategies I employ work consistently to get 70% of people to sign their families up by the second visit. When they don't, it's usually due to the following:          

1. They're skeptical. Patients who are skeptical may have past references where they were mislead by another DC or heard stories from someone who heard it from someone else, etc. When patients are skeptical, they're not in disbelief but merely cautious. While you may be able to minimize skepticism and increase patient certainty, some patients will still be cautious. Don't try to convince a skeptical patient of your view or you'll push them away. Instead, embrace patients and gracefully educate them during every facet of care ‑‑ adjustments, room dialogue, orientation classes and re‑exam.

Reiterate subluxation philosophy, medical research to substantiate the philosophy, and show and talk about testimonials. Mention the importance of maintaining the spine to prevent problems and crisis. Talk about postural habits causing spinal misalignment. Have children's posters reminding patients that kids could be developing the parent's spinal problems.          

2. Patient assumes spouse isn't interested. I've heard my wife make decisions for me based on what she thought I wanted. The truth is, no one can make a choice for someone else. I teach my patients not to assume but to educate their spouses.

I give them brochures on philosophy and most important, the two types of chiropractors. This usually offers the possibility for the spouse to at least be aware of the differences in DCs. This way, if they had a previous bad experience they may still gain by thinking they just went to the wrong type of chiropractor.

Beyond this, I emphasize that I'll show before and after x‑rays, which really increases certainty. I'll never push the patient, but I will simply ask whether the spouse has changed his or her mind and keep the door open. Although sometimes the spouse will stop the children from coming in, I've found in most cases the patient will convince the spouse to at least let the kids get checked. This is more likely if the mother is the primary patient.

3. Scheduling problems. When there's a scheduling problem, be gently persistent. The biggest mistake is dropping the ball and allowing lag time to occur from when the family offer is given at the Report of Findings.

The solution is to make note that the patient is checking schedules and have the CAs mention it every visit and remind the patient of the time limit of two weeks to schedule the family for exams at no charge.    

4. Money problems. Sometimes people don't bring families because they future pace the cost without checking the various possibilities. This is why it's important to emphasize to patients in your Report of Findings guidelines that this is just for an exam and they don't have to treat.

However, assure them that if they do choose to treat, you have family plans that make it more affordable to do it as a family than individually and that you will always work with them if they're concerned to get care for their family.

The most important thing is to continue to live your purpose and mission. People will see the successes of others, understand the principals and learn to convey it. It will eventually rub off and sooner or later they will get their family in.

Make sure your office is conveying family chiropractic by having kids posters and pamphlets. Kids mean family. Remind the patients that their postural problems started in childhood and they can prevent their children from having the same problems if they begin spinal maintenance now.

(To learn about the Certainty System, Certainty Practice Products and Dr. Dennis Nikitow's upcoming seminar schedule, call 800‑544‑3884. Outside the U.S., 303‑721‑6202.)