Rhino University EP3: Rhino R.O.F.
Dr. FJ Schofield Here.
A really, really important part of practice is the Report of Findings.
It’s huge! 1st and 2nd visit are obviously a big deal, and once you get those new patients in the door you have to then communicate effectively so they understand what is going on and so that they actually commit to care.
Most complaints that we hear from other patients that have gone to other chiropractors is that he or she didn’t explain anything.
“I would just come in, they’d adjust me and they’d say come back and I just had no idea about what was going on”
People want a plan, they want progression, and they want an explanation. Help them understand what’s going on in your mind. They want to know and it’s your responsibility to take them through the process. Start with this blue print
The biggest mistake that’s typically made is that people talk the entire time, not asking the patient question and going for way too long. If you don’t have a structured plan, you’re going to get wordy, talk too much and water down your message and impact. You end up not getting the people that you can help, but if you communicate the right way you’ll connect with the center bell curve of patients that will commit, that will follow through and that will get better. If you don’t communicate effectively to them then after 2 or 3 adjustments they’re going to give up, especially slow healers.
You don’t have to be super fear based or manipulative. You can have fun and be principled with your patients. Most people don’t master the fundamentals, they just want the shortcut. When you “sell” them on care using fear, those patients end up getting buyers remorse.
Recently I’ve noticed that a lot of the docs in the industry that are using fear with their patients have taken down their google page because their reviews are terrible. These docs have a lot of problems with the board and getting audits and when it comes down to it, they’re just not treating people the right way. It’s about Helping that person - THAT’S the reason we’re doing this.
We need to maximize the impact of helping as many people as we can, but you have to understand how to communicate and, the psychology and persuasion of influence to really maximize the impact on the patient.
1. STATE THE PURPOSE
Just like the first visit. Let them know what’s going to happen. Let them know it’s okay to say no
Communicating clearly - QUALITY service Review chief complaints and quality of life limitation Whatever the pain, it’s affecting in their life and something they care about. That’s why they’re coming in. Chiropractic is not considered standard care (YET), patients are coming to you when they’re in chronic pain. This is Relationship based selling/marketing. Figure out what’s important to your patients. We’re not transaction based - that’s where you say anything to make a dollar. We’re not into that. We want to help the Chiropractors that actually want to help their patients and you need to learn the fundamentals to it.
Maybe it’s playing with their grandkids, golfing again, working with wood – whatever IT IS, that is how you’re going to motivate your patient. If they know their WHY, they can endure any HOW. That’s how you’re going to keep them focused back on what’s important to them.
Recency biased always makes you think things are expensive – but back surgery and rehab are much more expensive. Your patients need to look out 1 year, 3 years, 4 years. “If we can make THAT a reality, can you commit to 2-3 per week for 90 days?” Almost everyone will say YES to that.
2. Review a Healthy Spine
Patients have no idea what a good spine looks like. Like my mechanic - He pulls out my break and a good break and shows me, this is what it should look like and this is what it does look like. “Okay, I get it, yes I definitely need a new break.”
Make them understand, give them what that contrast looks like. They need to see what it looks like, and ask questions! Most questions should be yes or no, some can be open ended. “Can you see see this, can you see that?” “Yes, Yes.” “Okay what does this look like to you?” You want them to respond and engage.
3. Review their spine
Now that they know what a good spine looks like, let them see theirs. It’s so important to go through that. Lateral Cervical is where most people would start and that’s great to show degeneration but then also do an APOM or Nasium too - show people something different. Most Chiros aren’t doing that, so this makes you different, this makes you unique.
Most aren’t doing an xray analysis either, it’s a business tool but you need to make it a clinical tool in your office, where you really analyze the xrays. Patients aren’t typically adjusted the first visit, not because the doc needs to analyze the xrays but because that’s what someone once told them, and it builds up some value and adds some urgency and it’s a whole smoking mirror.
I’m encouraging you to actually be a great chiropractor, to be clinically very, very good and analyze the xrays because, 1) it’s legit and 2) you’re going to get much better results, much better adjustments, you’ll get more people well and you’ll have more fun, more referrals, more money and people will stay with you long term. Most people are thinking short term. Think LONG term.
Draw a lot of lines
4. Review the phase of degeneration
Get a poster of disc, disease, decay and show them. Most people think “my back hurts, but I can wait 5 years and it’ll be the same” It’s not going to be the same. Your back hurts because tissue is being damaged, muscles will heal but those joints won’t. When you’re getting into phase 3 and 4 degeneration, they will never be straight again – Patients will improve a little but there’s just too much tissue damage. It’s amazing when you get kids and after a few adjustments, boom, they’re straight, but their tissue is so much more resilient.
Explaining their degeneration creates urgency and scarcity: “listen, can you wait 3 or 4 months, sure. Don’t have the time and money? Sure. But wait 10 years? It’s not going to be the same, there’s going to be more degeneration, more time, more effort and more money to heal”
If I need to fix my roof, in 10 years it’s way worse and it’s going to cost more money. Showing where they’re at and the progression of how it can get worse, it’s important to show them. Then most people are like “gahh, I better do it now”
5. Tissue healing time
Why 90 days? Because it takes muscles about 12-16 weeks to heal so that’s why I focus on 90 days. “Once they heal you’re more stable, you don’t have to come in as much, and your body will hold an adjustment. It takes nerves and soft tissue sometimes a year or even longer to heal. Sometimes it’s irreparable, there’ just too much damage, but we’ll do the best we can to improve your alignment and get you some relief.” Explain that, show them the reason.
Some docs do 12 weeks just because, not understanding that healing time is WHY we do 12 weeks. Focus on the first 90 days.
I go through ALL of those main points. I’ve explained, I’ve gotten some engagement, “what do you think will happen if we don’t do anything” “it’s going to get worse” “exactly”
6. The Plan and Agreement
Analogies are really nice to make something unfamiliar, familiar. It’s like braces for the spine – people understand that.
“Just like the wires are helping to move your teeth, we use our hands and xrays to help move bones into alignment to make sure we get it fixed.”
“It’s like a broken bone. Your bone isn’t fixed the moment it’s in alignment again. It has to set, it has to heal, it has to stay in a cast to keep the alignment for 6-12 weeks. Just like your first adjustment, you’re in better alignment, but we can’t cast your spine. So you have to come in here so we can better monitor it and make sure your alignment continues to improve. Just like with a broken bone, if it comes out of alignment, it’ll never heal.”
“If the frame of car is misaligned then your tires are not aligned and then some of your tires start wearing out. This disc and this disc are right next to each other but why is this one wearing out and this one not? Because of your misalignment, there’s less pressure on this disc and more pressure on this one”
“Can you get here twice a week for 8 weeks?” Get agreement on their care plan. THEN move to your finances. Which you or your CA/office manager can do.
Practice this a lot!
We need to give lot more details than just, “how long and how much” so explain why they’re at where they’re at and the importance of getting them pain free and working on their quality of life. These are their WANTS. Needs and Wants - You’ve maximized the impact.
If you’re getting 20 NP a week, you can’t do a 20 or 30 min ROF. You’ll be at the office all day long. Once you’ve nailed this, it takes 5-7 minutes to get through it all. With the adjustment, you shouldn’t need more than 15 min to go over everything and do it all.
Check this out, master it and do it.
We need MORE successful Chiropractors.
Do this so you can help people in your community and DO IT THE RIGHT WAY.