May 2005

Permission‑based communication

by Dr. Gary Brodeur

21st‑century patient communication must actively involve patients in the decision‑making process throughout every aspect of care. Most of us have heard of 'scare care' and 'hard sell' tactics that some chiropractors are being taught. We need to also be aware of how wrong these approaches are and why we should stay as far away from them as possible.

In today's world, people want to be active participants in every part of their lives. In a wellness world, they don't need to be sold on care they already want. They just need to be shown how to participate. Selling to them and pushing them only pushes them away. Maybe 25 years ago we needed more aggressive communication strategies to get people to hear us. Now those strategies are repelling people. Is it more important to be feared or loved? The harder we push the more we look and sound like used car salespersons.

Remember the book "Tuesdays With Morrie"? We must take a lesson from that story and remember that love always wins. Ego and agenda need to be removed from our practice and our communication. With every patient encountered, we must, as Ernie Landie says, "hit the love button" prior to being present with that individual. It's a way to get centered, be present, and to innately connect with that person. As we grow our family practices and are telling our chiropractic truth while serving generations of families, these families will come in droves when we come from a place of love and service. Unfortunately, many chiropractors are too caught up in always having to be right. If being attached to some antiquated script is more important than actually connecting, teaching, and leading from your heart then time has passed you by.

We need to start asking ourselves some serious questions about what our chiropractic future is going to look like. So, "with your permission," I'm going to recommend that we make some very simple changes to our communication that will greatly enhance our patient experience, referrals, and retention.

What is permission‑based communication? In all of our patient communication from the consult and exams to the group reports, finances, and daily visits we must be using this type of communication. I've found that in using this strategy patients are put at ease, it makes for a much better relationship, and it's a lot less stressful and more in line with a vitalistic chiropractic approach. You'll discover that patients will embrace your message and actually be more compliant with your recommendations. It's more inviting and you're giving patients an active part in the communication and decision‑making process.

So, what am I recommending that we begin doing? When bonding with a new patient on the first visit, proceed as follows: "Mrs. Smith with your permission, I'd like to take a minute to tell you what we do here and how we go about it." ... "With your permission, Mrs. Smith, I will give you recommendations on how you can begin the healing process and if you choose to get your spine and nervous system as healthy as possible I'll be happy to teach what's involved." ... "Mrs. Smith, would you like me to give you recommendations on symptom relief only or would you like to know how to get your spine and nervous system as healthy as possible and keep it that way for the rest of your life?" ... "Great, Mrs. Smith, when you leave here today, my CA will give you some information about what I checked you for as well as an Active Life Plan explanation sheet. Please read the material before your next visit and if you choose to get your spine and nerve system as healthy as possible I will, with your permission, show you the most cost‑ effective way to go about doing that."

In other words, get patient permission every step of the way. Don't be pushy or use 'my way or the highway' approaches to care. Every person coming into your office wants care, every person needs care, and he or she just needs to know how to participate. Let's preach what we practice and tell the truth. All patients walking through our doors have had a different amounts of information about chiropractic, good and bad. Some people are ready for correction and a lifetime of wellness with their families while others are not. Love and serve them anyway and don't be attached to how they participate or pay for their care. If we scare them away or push them out the door, we'll never get a second chance to educate them about the value of a chiropractic and why it's necessary for a lifetime of wellness and quality living.

Go forth to serve with love, and further the ripple in your part of the world.

(Dr. Gary Brodeur, chair of the WCA Council on Family Practice, has a high‑volume, lifetime family wellness practice in Warwick, RI. He is a coach for The Family Practice. For questions or comments, he can be reached at drgary@bfchiro.com or 401‑463‑9520.)