May 2005

The new patient attracting image

Part Six: Consultation procedures -- The good and the bad

by Dr. Peter Fernandez

Almost all new patients who come through your door have left a multi‑million dollar medical facility with multi‑million dollar equipment because they didn't get answers to their health problems. Now, they've come to you and you must establish yourself as more credible than the multi‑million dollar facility was. How do you do this? By conducting a "credibility" consultation.

The "credibility" consultation must clearly confirm to patients, the chronicity of their health problem, whether they're suffering from a syndrome and at what stage, and your total understanding of their health problem. Failure to satisfy these points during the consultation, leaves patients unsettled and unsure of your ability or desire to help them, effectively creating a barrier that makes it very difficult, if not impossible, for you to get them to follow your recommended care ‑‑ a serious blow to your new patient attracting image. And, of course, patients who don't follow recommended care, also don't refer!

Determining chronicity

Patients who believe their health problems are acute, will only stay under care until they're relieved of their symptoms. Then, who gets blamed when the symptoms return? You do, which is a killing blow to your new patient attracting image. However, a patient who understands that her or his health problem is chronic (if true) will stay under care until she or he reaches maximum wellness. And who do patients credit for their recovery? You ... and this is a tremendous boost to your new patient attracting image.

When determining chronicity, ask the patient "When is the last time you had a back (neck, shoulder, etc.) attack?" Then ask, "When did you have a back attack before that?" and, "When was the first time you had a back attack?" By questioning a patient in this manner, you are revealing a picture of chronicity that the patient can easily relate to before you explain what it means.

Health problem progression

When patients first come to you, their mental concept of their health problem is typically a "just happened," "acute only," "'tain't nothing" sort of thing. It's human nature that no one wants to tell a doctor "I've had it for years" or, wants a doctor to find something seriously wrong. People want to believe their health problem is really nothing, so they keep it as small as they can in their minds. Think about it. Have you ever gone to a doctor for a physical examination hoping he or she finds something seriously wrong with you? Of course not! And your patients are the same as you. They're hoping and believing that you will only find a very minor problem that requires little or no care.

In order to counter a patient's "just happened," "'tain't nothing" concept, the doctor must determine whether the patient has presented herself or himself with a syndrome, and how far it's progressed. The doctor does this by asking "yet" questions: "Has the pain spread to your buttocks yet?" "Has it progressed down to your knee yet?" "Does the pain go down to your foot yet?"

"Have you noticed any numbness or tingling of your leg yet?"

It's the doctor's responsibility to make sure patients understand their health problems, what they need to do to get well, and what their doctor needs to do to heal them. This process begins in the patient's initial consultation.

Listen intently

During the consultation, it's extremely important for the doctor to make a genuine and assertive effort to listen to the patient. The doctor must impress the patient with his or her undivided attention and obvious desire to want to completely understand the patient's problem. This is a major step towards getting a patient to want to follow your recommended care. IMPORTANT NOTE: Patients don't want to hear a "sales pitch" for something that's good for them from someone who hasn't taken the time or interest to clearly understand what their chief complaint is.

"I Understand" procedure

This is a simple procedure that quickly communicates the doctor's sincere and total interest in the patient, and assures that she or he gets an accurate understanding of the patient's symptoms. At the end of the consultation, the doctor uses the following "I understand" script:

DR: "Let me see if I understand your problem like you understand it."

The doctor parrots the symptoms back to the patient.

DR: "Did I get it right? What did I miss?"

The doctor repeats the problem to the patient until he or she gets it right.

Explaining clinic procedure

It's also important for the doctor to explain clinic procedures to new patients. The courtesy of telling patients what to expect during their office visit and why, is the foundation for creating "healing partnerships" between doctor and patients. These partnerships motivate patients to accept and fulfill their responsibilities in the doctor's prescribed plan of care, i.e. keeping scheduled appointments, following the doctor's recommended "at home" care or exercises, losing weight, etc..

The following is a sample script that the doctor would use at the conclusion of the initial consultation:

DR: "Mrs. Jones, at this time I would like to explain our clinic procedure to you. The first thing I must do is perform an examination to find the underlying cause of your problem, and the amount of secondary tissue damage that may have occurred. Then, I will determine what can or cannot be done to help you. Once that occurs, I will explain my findings and make whatever recommendations I feel necessary in your case. Then, you can decide what you would like to do about it. Fair enough?"

CLOSE

DR: "Mrs. Jones, Mary (the CA) will take you to an examination room and I will be

with you shortly."

Doctors, if you don't conduct "credibility" consultations, you will have to spend more time and effort to "sell" patients on your recommended care, and none of us chose this profession because we wanted to be great salespeople. Conduct "credibility" consultations. Your new patient attracting image depends on it.

(Dr. Peter G. Fernandez, is a 1961 Logan graduate. His practice with five staff chiropractors and 12 satellite offices, was one of the country's largest all‑referral, high income chiropractic clinics. As a practice consultant for the past 24 years, Dr. Fernandez has taught practice building techniques to nearly 15,000 DCs, and consulted in the opening of approximately 3,000 practices. He can be reached at Fernandez Consulting, 10733 57th Avenue North, Seminole, FL, 33772, by calling 800‑882‑4476, or via e‑mail: DrPete@DrFernandez.com. Visit on the web at www.DrFernandez.com.)