QUESTION:  Are there strategies that can help in communications with new patients?

ANSWER:  Communications skills and the substance and integrity of your messages are key elements in your practice success.  Your serious consideration, planning and thought are needed to make sure that you utilize your communications skills as an effective part of the care and healing process.  There are some cases that are more difficult than others, and this segment is intended to help you better address those special situations.  Here is Part 5:

Not all patients will require or even be responsive to the same nature and/or volume of communications regarding the details of chiropractic science, practice and our unique approach to health and healing.  There are some patients that will inevitably be difficult, or even hostile, for a wide variety of reasons.  Communicating with those patients presents a special set of challenges that require advance consideration and preparation so that you will be best able to break through such resistance and provide the care that is needed; or, clarify your position as the doctor and the minimum expectations regarding patient compliance and in rare instances, ethically, legally and appropriately, decline the case.

Difficult patients fall into many categories.  Many new patients present themselves under pressure from friends or family, and they only come in initially because someone else insists that they do so.  In dealing with those situations, it is important to:

a.       Be aware of the possibility with every patient that there might be special circumstances surrounding their presenting in your clinic.  At the first sign of any unusual circumstances, take immediate steps to draw out the details of such situations by asking questions about what brings the patient in.  If they begin their response by talking about someone else wanting them to come in to see you, instead of talking about their specific health concerns, you will know that additional attention will need to be addressed to that case.

b.       Let the patient talk, and follow-up with such questions as the situation calls for, working to draw the discussion as quickly as possible towards  the details of their health situation.

c.       Emphasize to the patient how important their health is and that the steps taken by those who urged them to come in for care were actions made out of love and concern.

d.       Assure them that they did the right thing by coming in.

e.       Do not focus on the patient's fears or reluctance.  Focus on the patient's presenting problem and move the discussion as quickly as possible towards how chiropractic can help.

You will also frequently encounter patients who may be new to you, but are not new to chiropractic!  This means they may have developed expectations from what they have come to understand from the experience of others and/or what they have already experienced themselves.  They may have learned very little about chiropractic from their first doctor, for example, or, they may feel they have a full understanding of chiropractic.  They may never have learned what we call The Chiropractic Story!  What was their experience under previous care? They may have had an initially rapid response to pain relief from their first experience and need to learn about supportive and maintenance care in chiropractic.  How long ago was their initial care?  They may present to you with a very different clinical picture from their initial chiropractic encounter and need to understand why their needs and responses have changed.  Clarity and certainty over who you are as a chiropractor, and what you provide as chiropractic care in your own office, needs to be balanced with learning about and acknowledging what could be very important needs and expectations for that patient.  Addressing what someone is expecting from chiropractic care and expressing what you are providing through chiropractic care are important parts of your clinical communications, even with "experienced" patients. 

Sometimes patients' reluctance stems from financial concerns.  Many people have limited resources and tough decisions must be made on spending. Work with those patients in any ethical way to address their needs and concerns.  Let those patients know that it is ok to talk frankly with the doctor about those types of issues, and that your office has a system in place to explore payment options. 

There are some patients with physical disabilities and impairments that will require additional attention and concern.  Sometimes those patients bring additional practical as well as psychological concerns into the health care setting that require additional time, patience and consideration.  Blind patients, the hearing impaired and those with other perceptual problems fall into this category as well. Respecting their needs and special circumstances is very important, and you would likely know how to address those types of needs without much additional preparation.  Patients appreciate an office environment where their particular challenges are addressed and prepared for in a considerate and organized manner.  They can feel welcome and accommodated without feeling singled out. Those patients that do require additional advance consideration are those exceptional cases where mental or behavioral problems are present and situations involving substance abuse.  Here are some points to consider:

a.      You will need to assess the ability of some patients to comprehend any communication, and/or the level at which they may be able to comprehend what you are saying. 

b.      Do not hesitate to involve family members in the care and communications effort and to ask their help and advice, in advance if appropriate, and in the adjusting room too if this is what is indicated to support and assist you in providing the highest quality care to those special needs patients.

c.      Have an idea at what point a potential patient will not be accepted for behavioral or communications reasons.  Remember, taking on a patient that resists, does not want your care or is potentially disruptive to the practice brings ongoing difficulties that may eliminate any potential to help the patient with their health care needs.

d.      Your flexibility, patience, determination and integrity will allow you to provide the best care possible.  There are, however, some circumstances where even the most committed doctor of chiropractic will not be able to reach the occasional difficult patient.

Always remember that every patient is not only different, but unique, and each set of challenges you encounter and address in the course of your day in practice will open opportunities for patient education, chiropractic awareness, increased referrals, and long-term patient commitments.