Build Your Practice With Internal Marketing

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 potential.

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 problems?"

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 Approach

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!

There are other materials like this at our Chiropractic Assistant (CA) Page

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