Listen To Your Patients With Both Ears
by Phil Mancuso, DC
The realities of the current climate of health care have settled in:
fewer new patients, balky insurance companies, managed care, HMO's PPO's!
It can leave you feeling that you need to do something before your practice
winds up on the critical list! In the crush to get new patients, a lot of
time, money and energy is being spent on advertising, free dinners, trips
to Hawaii, mall screenings, you name it! While all this stuff can be helpful,
what I have found over the years is that the number of 'quality' new patients
we get is directly proportional to the quality of our internal marketing.
Internal Marketing -The Best Approach!
Most of us know how to listen to our patients. We know how to recognize
when they are telling us how they really feel or when they don't feel well.
But there is another level of listening which I call listening with two
ears. By listening with one ear we can hear all the nuances of the patient's
complaint, and everything required to manage his/her case from a chiropractic
standpoint. On the other hand, if we want to maintain and grow a practice,
we need to listen with the other ear, too.
What The Patient Says vs. What The Patient Means
Being a good listener is a benefit to any health practitioner. By listening
with two ears, I refer to the ability to pay attention to what you need
to know to properly manage the patient's case, while listening for signs
of discontent, signs that the patient may be ready to discontinue care prematurely,
or, simply for an appropriate time to start a referral dialog. This requires
that you give each patient 110% of your concentration. The ability to sort
out the real message from all the background noise can mean the difference
between success and failure in case management as well as practice growth
Dr. Dan Goleman's book, Emotional Intelligence, states that it takes
more than academic intelligence to be a success. This best selling book
stresses the importance of good interpersonal skills as a predictor of a
healthy and successful life. While psychologists predict that a high IQ
contributes to about a 20% chance of success, the other 80% comes from many
other factors not the least of which is people skills. This is the ability
to know how the other person feels. "We transmit and catch moods and
feelings from each other on a subtle, almost imperceptible level."
writes Dr. Goleman. "The way someone says thank you, for instance,
can leave us feeling dismissed, patronized or genuinely appreciated, "
he continues. "The more adroit we are at discerning the feelings behind
other people's signals, the better we control the signals we send."
The ability to read other people and situations can mean the difference
between practice success and mediocrity.
Let's take a typical patient dialog: "Doc, I've changed insurance
plans and you're not in my network." is a pretty direct statement which
doesn't need much interpretation. On the other hand, "Gee, Doc, I really
can't believe how good I feel. Thanks for the help." may seem like
an innocuous statement. It may, however indicate a good time for you to
approach the patient for a referral, or the -patient may be feeling good
enough and be ready to discontinue care before his correction has been made.
Look To Your Treatment Records
Besides using your treatment card or file to write progress notes, check
it each visit to see if there are any other patient needs to be attended
to. The obvious would be to pay attention to the patient's birthday. You
may be the first person that day to wish them 'Happy Birthday.' It may seem
insignificant to you,. but it will let the patient know you think they are
really special. After all don't we all want to think we're special?
We keep information about the patient on a travel treatment card I devised.
It contains all the necessary information for patient care plus information
about family, job, number of kids, hobbies and special interests the patient
may have. I don' t know about you, but I've got a mind like a sieve- If
I meet a patient in the local supermarket, I may have a hard time remembering
their name. But, in my office, armed with my travel card, I am a virtual
font of knowledge about (sometimes) the most intimate details of a person's
life. "Mary, I see your husband is a truck driver, is that right? well
do you know that most people who drive trucks wind up with bad backs? How's
he doing?" Or try this: "Mary, Nancy tells me your 13 year old
is playing football. Do you know that contact sports can cause spinal and
structural damage that can last a lifetime if not corrected early? Why don't
you bring him in for a courtesy screening to make sure he's not developing
If the travel card has a notation that a family member is into weight
training, you may say, "Mary I see that your husband is into weight
training. It's great that he obviously cares a great deal about his health.
Do you know that he may be doing damage by putting muscle mass onto a bent
or crooked frame? Why not have him come in for a check-up to make sure he's
doing the right workout for his body?"
The Team Concept Of Referrals: The Ultimate
Adequate in-house referrals are the cornerstone of any successful practice.
While it takes very little time and effort to implement the above plan,
imagine how much more effective it can be if the entire office staff is
trained to keep both ears open! This team concept approach to listening
with two ears can be one of the most effectual methods of practice building,
yet is seldom included in staff training
Training for the front desk staff, in conjunction with the doctor or
doctors in the clinic, and any other support staff, can have many positive
benefits. Your staff needs to recognize advantageous occasions for referrals
to help staff members work as a 'referral team.'
Here's how it works: Let's say a new patient comes in for an exam. The
front desk C.A. hands the patient an introductory form to fill out and notices
that the patient's spouse is with him. The spouse in this case was a previous
patient with a history of severe recurrence of a chronic problem. After
executing the proper new patient procedure, the front desk C.A. talks to
the spouse. In casual inquiry she asks about the spouse's health and previous
condition. Then discuss the frequency and severity of the person's episodes
of pain, or have CA discuss the benefits of regular chiropractic care. (If
you don't have a history of previous painful episodes, this is the time
for the discussion of the family care concept of chiropractic.)
The C.A. then lets the doctor know about the spouse's situation, so that
the doctor can begin dialog with the patient at the appropriate time. It
is highly effective for the doctor to quickly review the spouse's record
and go out to the reception room and greet this former patient. Armed with
the necessary information about this patient's history, it is always proper
for the doctor to suggest an exam update on this person to evaluate their
current status. If you're really concerned for the person's health and well-being,
you can offer your exam as a courtesy service. "Mary, we really need
to update your case to make sure there are no recurrences." etc.
Anyone who chauffeurs a patient to my office gets very special treatment.
The front desk CA lets me know there's a 'visitor' in the office. I always
introduce myself and usually sit down next to them in the reception room,
if time allows, and say, "So who's your chiropractor?" "Oh,
you don't have a chiropractor, why not? These are great conversation starters
in your office and at parties!
Know When And How To Ask For The Referral
In the course of every encounter with any patient, you will be handed
many opportunities to directly ask for a referral. The key is to know when
to ask and when to keep your mouth shut. Once you've decided that the time
is right, for example after the patient gets done telling you, "...how
great I feel and I can't thank you enough, after I've been to so many other
doctors, why didn't they tell me about chiropractic..." your second
ear is telling you the time is right! The best way to ask for a referral
is, well...just ask! Directly! Don't beat around the bush! "Mary, I'm
really glad you're feeling better. You know, my practice grows by the enthusiastic
referrals of people just like you. Here are some of my cards; I want you
to hand them out to people who need my help, will you do that for me?"
Teach each member of your staff to listen with both ears and watch your
direct referrals soar!