Dear Bill,

I think I’m talking too much during my report of findings. I find myself going 15-20 minutes, sometimes longer. I even notice about halfway through, patients are ‘checking out’ and disengaging. How do I shorten my reports, but deliver the relevant information?

Talking too much (beyond 10 - 12 minutes) is likely doing more for you than the patient. Which can make long reports rather self-indulgent—unless of course you need convincing that chiropractic can help the patient!

Needlessly long reports are often a sign of one or more of these issues:

• Lack of clarity about what your report needs to achieve
• Choosing to include superfluous detail and nuance
• An effort to “front load” your patient communications
• Selling your solution rather than reporting your findings
• Attempting to do too much on a single visit
• Assuming patients are as interested as you are

We’ve all heard stories of the crusty old chiropractor whose report consists of throwing up the patient’s X-rays, followed by a few ums, ah’s, and a mumbled, “Just as I thought,” and pointing while observing, “You have a problem here, here, and here. I can help you. Shall we get started?”

Elapsed time? 15-seconds.

I’m not recommending this approach. But I mention it as an example of what’s possible when you have high levels of certainty, complete confidence, and no need to convince or persuade.

Somewhere between 15-seconds and 20-minutes is a sweet spot that is both effective and fulfills your communication obligations. Let’s explore each of the issues above.

Lack of Clarity

Long reports are often a symptom of not having a clear central message or purpose for your report. This can produce a report that wanders, covering a multitude of points in an effort to “see what sticks.”

It may be helpful to return to the wisdom of Dr. Larry Markson, who observed decades ago that your report of findings should answer four questions:

1. What’s wrong?
2. Can chiropractic help?
3. How long will it take?
4. How much will it cost?

If pressed, virtually every chiropractor can answer these questions in a minute or less. And while I’m not advocating that level of brevity, it reinforces the idea that most reports lack discipline, focus, and can degenerate into irrelevant lectures.

Keep in mind why the patient is in front of you:

They have an ache or pain they hope you can relieve
Their brush with a medical solution has been found wanting
They think their symptom is the problem

Which means you’re not valid for suggesting lifetime wellness care, asking them to bring their spouse in for care, hinting that their children should be checked, or suggesting that they become a chiropractor. Save all that for subsequent visits when you have greater credibility.

Superfluous Detail

Long reports can be a symptom of offering too much information about spinal anatomy, neurology, physiology, the colorful history of chiropractic, or the philosophical underpinnings of the chiropractic paradigm.

By all means explain the supremacy of the nervous system. Introduce the concept of subluxation. Clarify the need for repeated visits to create spinal changes. But go too deep into the weeds and you’re simply testing a patient’s patience and capacity to look interested.

This requires tremendous self-discipline. Because patients aren’t there to judge the relevance of your report or take notes so they can debrief you afterwards on ways to improve it!

At the very least, make it a habit to record your reports. Use the voice memo app on your smartphone to capture what you’re saying while in your trance-like state. Then, listen back to what came out of your mouth. While it may be painful, it’s how you can improve your communications.

And if you’re really brave, have a chiropractor you trust take a listen and offer suggestions as well.

Front Loading

Long reports are often a symptom of data dumping on the first visit or two, interpreting the early, near perfect follow-through as a sign you’ve successfully communicated the chiropractic model of health and healing.

Unlikely.

Countless chiropractors have squandered the possibility of deep, influential relationships by falling prey to this unhelpful echo chamber.

Worse than imagining you’ve fulfilled your obligation to “educate” patients about chiropractic, is thinking your words have prompted patients to swear off their ingrained allopathic mindset in favor of your new (and as yet unproven), vitalistic, nerve-centric perspective.

More likely, they simply find your enthusiasm strangely hypnotic.

Your passion for their health creates an overlooked burden on the patient to match your commitment. Which may last during the early visits but fades as the relief they originally sought tempers their interest. And then a troubling problem emerges: “How do I extricate myself from this chiropractor who seems to care about my health more than I do?”

Much of this stems from the fact that few chiropractors have developed a patient education curriculum. This can often produce a haphazard series of declarations, assertions, and one-sided monologues.

Salesmanship

Long reports can be a sign that you’ve exchanged professional objectivity for an outcome that serves you—justified as being in the patient’s best interests.

When you are inclined to persuade or convince you’ve switched from reporting to selling.

I wonder how many chiropractors, after reporting their clinical findings offer a patient choices other than chiropractic care? As in patients could:

Wait for their issue to worsen further before doing anything
Seek a drug solution that often involves stronger and stronger doses
Consider the work “hardening” strategy offered by physical therapy
Rely on massage to reduce trigger points and muscle spasms

I’m sure there are others. By not sharing these or other possible recommendations, you may have a thumb on the scales, abrogating your professional objectivity and potentially revealing an unhealthy attachment to their choices.

By all means, let patients know they’re in the right place, that you’ve seen this sort of thing many times, and that you’re optimistic you can help them. But lose the Always-Be-Closing strategies, the “Yes-Yes” manipulation, and other sales techniques that may reveal a mistrust of patients.

Doing Too Much

By the time a patient makes it to your practice, often having exhausted medical solutions, they’re quite ready to follow your recommendations. They won’t tell you this, but it’s mostly yours to lose.

Your initial consultation (PreCare Interview) is far more important than your report. On that first visit they decide if they like you, trust you, and sense a sufficient level of hope to partner with you.

When your onboarding process is a one-visit affair, meaning your consultation, report, and first adjustment are all performed within minutes of having just met the patient, it can place an inordinate amount of pressure to explain everything should their first adjustment not produce enough relief to affirm their confidence in you.

Yikes!

This is just one of the reasons for having a two-visit onboarding process—even if the second visit is later the same day. It more easily permits you to make the distinction between their problem and your solution.

Which can mean trading the rare possibility of the patient not returning for their second visit, for less pressure to produce dramatic improvement with the first adjustment.

When you turn the one-visit onboarding experience into a two-visit procedure you can properly communicate the value of the adjustment, set appropriate expectations, reduce the amount of talking, spend less time, and see fewer patients return months later for just a “quick pop.”

Attention Span

Most patients have little experience with a formal chiropractic report of findings. The medical experience is different, relying heavily on the social authority afforded medical practitioners combined with the typical brevity of visits.

As a result, patients don’t know if your report will take a few minutes or require a bladder check and a packed lunch.

Let patients know how long your report is going to be.

“In the next 10- to 12-minutes I’m going to explain what we found, what it means, and offer an action plan to help you get the best results in the shortest amount of time.”

Say that and patients will be hanging on your every word.

By offering a time frame and the purpose (and benefits) of your report, patients can pace their attention span and more fully engage.

Spending more time by minting more words rarely produces better understanding or improved patient follow through. When everything is important—nothing is.

Admittedly, delivering a report that’s too long, taxing the patient’s attention span, is far better than the other common report shortcoming: neglecting to give a formal report at all. If you’d like some suggestions be sure to download your free copy of our thought-provoking eBook: Remarkable Reports.

Hope that helps. Thanks for the question.

Ask Bill your question.

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