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Are You a D.C. or a D. S.?
Jul 18, 2007

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Whether you are a D.C. or a D.S. makes a big difference in your patient retention and patient referrals.

     Many years ago we were working with a doctor who, while he had a great practice, couldn’t manage it worth a damn.  Even so, because his patient retention and patient referrals were exceptional, he had a high volume practice.
     As we worked with him to improve and expand his business structure, his volume continued to increase. This was a while back; when note taking was very simple, but I think he got up to seeing around 500 visits a week, with peak weeks over 600. We helped with marketing and associate doctors, and he continued to grow. He had all kinds of marketing programs, plenty of associates, and made a great name for Chiropractic.  But at the heart of his growth was a special secret he often related.

     What was his secret?

     Well, one of them was the way he started each case.  On his initial consultation with each patient he would say:

     “Before I tell you what chiropractic does, let me tell you what it doesn’t do. As doctors of chiropractic, we do not prescribe drugs.  (Pause.) We also do not perform surgery. (Pause.) Lastly, we do not treat symptoms.” (Long pause.)

     He would let that sink in for a few moments. He would then briefly explain what chiropractors were really after.  Namely, subluxations. And while there may be other terms for this condition, from a marketing point of view, this has worked. It fixes in the mind of the patient that there is an underlying cause or a basic contributing factor that resulted in, or at least affected their current complaint(s).

     Over the years of consulting, we routinely see doctors “going shallow”, treating only the superficial symptoms that patients come in with. “Hey doc., I must got a crick in my back. Can you just give me a crack here (points) and fix it?”  Horror of horrors!

     It is easy to focus only on the symptoms.  First, it is the reason why the majority of your patients come to see you.  They have pain, stiffness, or discomfort and want it fixed.  Second, it is what your insurance company requires in your documentation.  Third, it is the path of least resistance. Give the patient some relief and then move on.  Fourth, chiropractic is usually SO effective with symptoms relatively quickly, that we often are just happy with that.

     I am certainly not advocating any particularly type of treatment guideline.  I am just pointing out that many successful chiropractors look for earlier traumas in their consultation and history and maybe spend just a bit more time on the general diagnostic process, if only a minute more.

     This is from a marketing point of view, not from a clinical perspective. In these times of higher deductables, you have to put the value into your service.  If a patient comes to you for a pain in the “keister”, and you only address that, not only is the patient being the doctor, but also you are relegated to “therapist.”

     Another doctor David and I worked with had a practice “melt down” one winter day. (By the way, we see these “melt-downs” every now and then! Too much insurance B.S., mid-life burnout, staff problems, etc. Please call us if you feel one coming on!)  He was mostly a “straight” doctor, but had purchased a very inexpensive, used EMS (muscle stim.) unit for patients.  One day, one of his patients came for his adjustment. He told the doctor that he didn’t want adjustments anymore, just wanted some of that electronic muscle stimulation.   Our doctor blew a fuse. “Fine”, he said. “Here, take the dang machine and go home. You can have it.” And he actually gave it to him.

     A bit extreme, but it was probably good to get it out of his system. The doctor was feeling that he had become only a band-aid therapist for his patients because of the therapy unit. It took a while, but we got him to see that it was not the patient’s fault. The patient simply did not understand the purpose of the doctor’s treatment program.

     D.C. could be called Doctor of “Chronicity.” I was reminded of this recently by one of our clients.  D.S. could be "Doctor of Symptoms."

We suggest the following:

1.    Be a D.C.   Doctors who emphasize the chronic nature of the patient’s symptoms seem to have busier practices.  We suggest that you should do both:  definitely help patients get what they want - pain relief.  But, as appropriate, work with them to get what they really need.

As a side note, some doctors can become so philosophical that they loose touch with the fact that “the Customer is King.” (In Japan, I have read they say that the “Customer is God.”) Philosophy, principles, and emphasizing the chronic nature, as indicated, is fine.  So is “Wellness.” Just remember that you have to also give the patients what they want and keep them happy.

2.    Integrity. Needless to say, in all things you have to call it like you see it and maintain your integrity. If there are no chronic conditions, then so be it. But at least, take the time to look.  Be curious, investigate, and don’t let the insurance company or the patient’s desire for fast results compromise your clinical integrity.
3.    Interest. Traumas may have occurred many years earlier, or accumulated over the years.  Be genuinely interested and focused on their case. Even intense about what you discover in their exam and x-ray and how you explain it. “Would you look at this, Mrs. Jones", pointing to a spot on the x-ray as if this was the first x-ray you had seen of this kind before. (And it is.)  This will increase the patient’s confidence in you and acceptance of your treatment plan.

4.    Time, Repetition, Effort. It may take time to correct the condition. It may take repetitive visits (like an orthodontist), and it will take effort on the patient’s part as well as yours.

Go over the factors of time, repetition, and effort with the patient. You can also ask the patient how long do they think it will take to correct the condition.   If you have educated them on the true nature of the condition, you might be surprised to hear that they often offer a longer period of time than you were ready to present to them in your treatment program. (A very successful doctor recently reminded me of this.)

5.    You Are, And Have Been, A Leader. And finally, don’t sell yourself short. As a chiropractor, you are an active member in a profession that, no doubt, has led the way in real health care over the last 100 years.  Certainly, it will continue to do so in the future, provided that you stick to your guns, while always adapting to the ever-changing market.

By looking for and working to correct the long term causes of spinal related symptoms, you will inspire trust and confidence in your patients as their doctor of chiropractic, coach, and friend. As such, your patients will be loyal and refer their friends because of your care. And, as such, you will be a D.C. 

 Ed Petty

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Petty, Michel & Associates
Practice Growth & Development Since 1988
Voice: (414) 332-4511 Fax: (414) 332-0909
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