June 2009

The patient's first visit

by Dr. Joseph Borio

The first step with new patients is education. I often describe it as taking a soft bat and driving the chiropractic message into the patient's brain, one (gentle) swing at a time.

It starts with the new patient phone call, when your staff asks whether the appointment is for the individual alone or the entire family.

Now, to some this seems silly because you and I know in 99 out of 100 calls, patients are making an appointment for themselves only, but this simple question is the beginning of the family practice. It opens minds, if just a little, that your office is different. It says you do things at a different level. And, it will begin to move some tumblers in people's minds regarding children and chiropractic care.

Next, your staff member asks some normal questions, including whether the new patient has internet access. Here you can really begin to shape impressions of you, chiropractic, and your office objective. Your website will feature pictures of you and your staff, an office tour, office directions, phone numbers, articles, and new patient forms that people can complete and print out before their first visit to save them time. Who doesn't like that?

When patients first arrive it's a special time, so everything should stop at the front desk for a moment while at least one staff member offers a handshake in greeting. Personally, I like to have two on my staff say hello and welcome people to the office. This says you care, welcome to our family, we're glad you're here, we were expecting you. It's meant to convey to patients a sense of belonging and is another step in the process of family wellness.

Patients are then asked to read over very carefully an important brochure on subluxation and indicate to you when they're finished because you'll be asking them some questions on what they read.

Then comes the office tour (another beating with the soft bat). You must display pictures of you adjusting children, and feature an office area that's welcome and inviting to children. Tell them this is where children wait to get adjusted, where the doctor works on families for wellness care.

As you bring patients into the examination room, ask them three questions about the brochure. Assist them a little if they need help, but most will know the answers to all three. You never want to embarrass patients so make this fun and comfortable.

The four-to-five minute pre-consultation is next, your opportunity explain to them the objective of your relationship. You describe why you do what you do, as well as add value to every procedure you're about to perform. This pre-frames the initial visit, bringing together all of the education and setting the agenda for the examination. It allows patients to hear you describe the subluxation with the use of a model showing them what they read about a few moments earlier.

Now it's history time (this is your time, not theirs, so be aware of the clock). Every question has a purpose and gives you another chance to educate and improve patient understanding of the chiropractic principle.

"Now, Mrs. Smith, as you now know, when the spine is shifted out of alignment, pressure is placed on the sensitive nerves that carry information to the organs and limbs. This pressure can lead to pain or symptoms. Where are you having problems today?"

Each question is asked in this manner until patients know that there's spinal damage that will need attention. Since every part of your examination has meaning, always explain what it is you're doing and indicate whether there's a normal finding or if you see something that has you concerned. Let them know this suggests spinal misalignment, and tell them where these nerves go and which organs are affected. If you're serious about what you see, they will be too. Remember, everything you do is important and has meaning so be sure to express this with everything you say.

When it comes to x-rays, whether you do them in your office or send patients out, it's vital to explain that you're looking to identify areas in the spine that are out of alignment and the organs or body systems being affected. Assure them you'll take great care of them and that on their next visit you'll explain what areas of the spine need attention.

Finally, patients need to have a zero balance at checkout, and the next visit needs to be confirmed.

Doing things differently may take some getting used to but, drop your fear of change at the door. It has no place with your purpose!

(Dr. Joe Borio is president of Chiropassion Consulting. For more information about the topics raised in this article and to learn about the company's services, call 866-441-7928, or e-mail drborio@cnymail.com. Visit the Chiropassion website at www.chiropassionconsulting.com.)