July 2006

The Value‑driven practice -- Part 1 of 2

by Dr. Dennis Nikitow

Building a stable high retention practice requires a mix of different elements, but none more important than creating value. A value‑driven practice comes from communication and patient education strategies that impact patients to a higher level of understanding and commitment to put a chiropractor on their health care team.

Chiropractic Assistants (CAs) play an integral role in this process because of the contact they have with patients. Yet, many CAs are merely placed in an administrative role with only limited knowledge of how to impact patients and maximize their perceived value for chiropractic. They're well intentioned but not well informed on the dynamics of repositioning patients to a value‑ driven practice. The result is an administrative‑driven practice where patients make decisions based on administrative action like insurance reimbursement, rather than the essential need for chiropractic care for their family.

There are a number of ways your CAs can install value to impact patients.

1. Greeting/goodbye. Greeting and good‑byes should always be enthusiastic and heartfelt. Patients should feel you're genuinely happy to see them. Never say, "Hi, how are you?" This implies you want to know their symptoms, which will direct patients to a symptom‑based practice and away from wellness. Instead, say, "Hi, Mary, nice to see you". When patients are leaving, tell them they look better, the adjustment will help them, etc. If they mention how much the adjustment helped , acknowledge it with "Great! Tell someone else about chiropractic" or "Dr. James is great!" and "If you have any friends we can help, send them over."

2. The pre‑framing tour. When new patients comes in to the office, pre‑frame them on the educational materials you'll be giving them by saying, "We'll be giving you a series of brochures so you will be more educated on what we do. This will make you more comfortable." Then give them an office tour showing them the medical research posters and testimonials with before and after x‑rays on the walls. Say, "You're going to love the doctors here, they do great work! Look at these testimonials when you have a chance. With his unique technique, Dr. James is the only one in this area that gets these kinds of great results! This is medical research on different parts of the spine, showing that if your spine is out of alignment it could cause what you think is a medical problem, yet it's actually coming from your spine." This creates value from uniqueness and credibility and third party endorsement.

3. Confirmation call. Confirm all new patients or extended appointments like Report of Findings. "Hi, Mary, this is Cassie from Dr. James' office. I was calling to confirm your appointments on Monday at 3 o'clock. Since we run a tight schedule we'd like you to be here 10‑15 minutes before you designated time to fill out any form so we can start on time. If anything happens where you can't make it, please give us a courtesy call in ample time so we can fit someone else in your slot. These slots are limited and very valuable to us." This will give the impression of how much you value your service and appointments and set a future pace of value and decrease missed appointments later. Most people respect your values if they know what they are. In turn, their actions will be facilitated in the direction you want.

4. Pre‑Report of findings (ROF). When scheduling the ROF, tell patients the doctor will actually be showing them their x‑rays compared to normal x‑rays. Tell them, "If he accepts your case, he'll lay out a game plan to correct your spine and tell you how to maintain it." This implies a scarcity and raises the value for the opportunity to be accepted as a patient. Before the ROF, CAs will give patients the "two types of chiropractors" brochure, which explains the difference between chiropractic for symptom treatment vs. wellness. The CA should explain that you are the traditional wellness chiropractor using the most up‑to‑date techniques.

5. Reviewing payment plans. We show patients the average retail adjustment fee chiropractors charge around the country and then show ours at about 30% lower. Next, we tell them how most people do a multi‑visit pre‑pay plan, which saves them another 25‑30%. People follow the majority. Handle obstacles by explaining a principle or asking a question directly to them. Withdrawing has more benefit and value then trying to convince.

If patients want a second opinion, encourage it with certainty. Then give them specifics to compare and what to watch out for as a health consumer. Review the two types of chiropractors. Tell them to make sure the chiropractor has a plan and outcome goal, show them before and after x‑rays and testimonials of other patients to insure they get the results they want. Most importantly, there must be a maintenance plan for optimum wellness.

The CA must continually pump up the practice, uniqueness of techniques, the superior results, and personability of the doctor and staff, as well as any credible thing the doctor has accomplished and ‑‑ most importantly ‑‑ the satisfaction of other patients.

Next time, I'll continue to show you the secret of how CAs can add value during scheduling, new patients' problems, handling money, time problems and much more.

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