Five Chiropractic Patient Communication Hacks

Posted by Bill Esteb on Mar 18th 2020

patient brain illustration

Chiropractors committed to leading and influencing patients recognize the value of great communication. Most would acknowledge that excellent clinical skills, when backed up with effective patient communication, are an unbeatable combination.

The best chiropractic communicators rely on a handful of techniques and strategies to get their message across. We’ll call them “hacks.”

I’m not talking about a data breach but rather the meaning according to Webster’s, which defines a hack as “a clever tip or technique for doing or improving something” or “a creatively improvised solution.”

These five patient communications hacks can catapult your practice to the next level. But first…

Waiting for Your Cat to Bark?

Cats don’t bark. Dogs do.

Thinking you can use some type of communication tactic to turn a symptomatic relief patient into a wellness patient is about as ridiculous as expecting your cat to fetch a tennis ball or greet you at the door with a wagging tail.

That probably won’t stop you from trying, but this isn’t a communication issue. It’s about acknowledging a patient’s values.

Simply put, if, out of the 400 or more different human values (courage, frugality, preparedness, etc.) your next new patient has dozens of things they value more than their health, they won’t be available for anything but minimal amounts of relief care. And unless they particularly cherish it, most patients don’t know how they prioritize their health.

So don’t bother asking. They don’t know. And what most would tell you probably couldn’t be trusted anyway, especially if they’re symptomatic.

However, there are some fairly helpful proxies that may give you a clue. Ask them how often they floss their teeth. Regular flossers are likely candidates for wellness chiropractic care.

Ask patients what their gas gauge typically reads when they start to look for a gas station. Those who never let it drop below about half full are probably better candidates for wellness care than those who flirt with “E.”

The only tactic I know of to motivate non-flossers and those who frequently run out of gas is to creatively link chiropractic care with something they value. If it’s golf, sleeping through the night or keeping up with grandkids, that’s relatively easy. But if their passion is crafting with paper mâché or volunteering in second-grade classrooms, that might be more difficult.

Let’s imagine you have a patient who seems moderately interested in their health. Here are five communication techniques you might want to develop.

Hack #1 Set Appropriate Expectations

You need to install a chiropractic covenant. Because if you don’t, most patients are going to drag in their medical doctor covenant and project it onto you. Unhelpful. That’s like playing basketball to the rules of hockey. They both have goals and nets and timed periods, but that’s where the similarity ends.

What is the medical doctor covenant? It’s what patients come to expect from consulting someone of the medical persuasion—either personally or by consuming media. It consists of these and other beliefs:

1. I’m weak (victim)—you’re strong (smart)
2. You’ll make my problem your problem
3. You’ll be doing most of the work
4. You control the speed of my recovery
5. You’ll be treating my pain or symptom
6. I’m buying time with you
7. It will be a short-term relationship
8. I’ll be permanently fixed

This is more or less the baggage your next new patient will bring with them as they sit in front of you at your consultation. If you don’t have any conflict with these assumptions about you and what you’re going to do, let the medical covenant stand. But if you recognize the difference between medicine and chiropractic, you should attempt to install a chiropractic covenant. Perhaps these 12 points taken from our How Our Practice Works poster and patient flyer will give you a head start:

1. Chiropractic is different from medicine.
2. Health, ease and well being are normal.
3. Your nervous system controls everything.
4. Stress can overload your nervous system.
5. This can produce vertebral subluxation.
6. We will conduct a thorough examination.
7. We’ll explain our findings in plain language.
8. A series of adjustments will be necessary.
9. Adjustments do not treat your symptoms.
10. Consistent visits help retrain your spine.
11. You control the speed of your recovery.
12. Choose wellness care to avoid a relapse.

Explain these distinctions at your consultation, and you can avoid a variety of misunderstandings and communication challenges later.

Hack #2 Preframe Goodbye

You’d want to talk about how a patient can disengage from the practice when they’ve had enough care. Why? Because the myth still abounds that once you go to a chiropractor, you have to go for the rest of your life.

And while you and I might think it best for everyone to avail themselves of some type of ongoing supportive care, many new patients are wary. They’re afraid that by consulting you, they may be getting into something from which they won’t be able to extricate themselves.

That’s a problem.

The key is to talk about the dismissal process at the beginning—even if the patient doesn’t mention it. Rest assured that if they lack the courage to raise the issue, they’re probably thinking about it. Be proactive.

“Hey, have you ever heard that once you go to a chiropractor, you have to go for the rest of your life? Yes? Well, I just want you to know that it’s not true. How long you decide to benefit from chiropractic care is always up to you. All I ask is that you let me know on your last visit so we can celebrate and close your case file properly. Because my job is to provide you the best chiropractic care possible. And your job is to decide how much of it you want. Fair?”

I’m guessing you don’t regularly get patients announcing their last visit. Make no mistake. They know it’s going to be their last visit—even if they march out to the front desk to dutifully make future appointments they have no intention of keeping.

Hack #3 Use Metaphors

Since the beginning of time, the best communicators have used parables, allegories, stories, metaphors and other literary devices. Metaphors are communication tools that suggest this “new thing” is like this other thing you already understand.

If you want to amp up your ability to communicate with patients, you’ll want to become a master at some of the more effective metaphors. There are probably some you already use—even if you don’t recognize them as metaphors.

Use metaphors regularly, and you’ll likely see a light bulb brighten above a patient’s head. Which, as you may have noticed, is a metaphor!

I’ve been somewhat of a collector of metaphors over the years, publishing 50 of them in an eBook you can download for free. You’re probably familiar with many of them. Some might be new. Enjoy!

Hack #4 Ask Rather Than Tell

When it comes to chiropractic patient education, most of the modeling you’ve received is from a professor at the front of the room, yakking.

Yakking isn’t education. It’s called education, but it’s actually teaching. If you’re talking, you’re probably teaching. The distinction is important.

Teaching mostly benefits the teacher who must generate and deliver the information. Teaching concerns itself with presenting data and testing short-term memorization. It’s characterized by students who, if given the chance, would rather not participate.

Education is a partnership in which the student is actively seeking information and new perspectives. The student is curious, and finds the information relevant and meaningful. Education is highly interactive and often directed by the student. It is the precursor to learning.

As a chiropractor, you’ll probably want to be mindful of two additional distinctions. The first is exploring the beliefs the patient has about their body, physiology and nervous system. The other is having clarity about what it is you’d want every patient to know about chiropractic.

It’s interesting that chiropractors who recognize the value of patient education are often unable to produce a syllabus or even a rudimentary curriculum. Here’s my stab at it. It’s not that extensive, and much of it was introduced on the first visit when you installed your chiropractic covenant:

1. Chiropractic care is different from medicine
2. Chiropractic care doesn’t treat anything
3. The nervous system is the master system
4. Vertebral subluxation is the result of stress
5. A series of consistent visits will be needed
6. Patients control the speed of their recovery
7. How long a patient benefits is up to them

How many of your patients know and understand these principles? Would a visitor to your practice encounter something similar on a practice tour?

Rather than minting words or yakking at the patient, ask questions. If you’re going to employ the Socratic method, you’ll want to ask patients questions that introduce these topics. Granted, there are patients who won’t want to play, but asking rhetorical questions to provoke a conversation would be far more effective than ear-raping the patient while they’re lying face down with their head wedged in some headrest paper.

In fact, you might want to foreshadow the question you’re going to ask each week in the reception room, so patients can organize their answers to questions such as:

What is the purpose of pain?
What is the biggest difference between medical treatment and chiropractic care?
How does the medication find the headache?
What controls every cell, tissue, organ and system of your body?
What do you have to do to “catch” a cold?
If you have a fever or find yourself vomiting, are you sick or are you well?
What are the three causes of subluxations?
When do most people get their first vertebral subluxation?
What are the two things that most drugs do to your body?
What does a chiropractic adjustment do?
Why are some people allergic to pollen and others aren’t?
Why does chiropractic work? And what does “work” mean?

Remember, you’re interested in their answers, not in using these questions as a set up to fill the air with your point of view. Only share your perspective if you’re asked. You may be severely disappointed by how few ask, especially if your practice is largely centered on pain relief rather than attaining natural health.

Hack #5 Use Pattern Interruptions

Our reticular activating system is responsible for many cognitive functions related to the awareness of our surroundings. Virtually every piece of sensory information is first evaluated by this system to determine its importance. Based on a typical patient’s experience in a chiropractic practice, wall graphics are only used on the first and second visit—and many times, not even then.

Within a handful of visits, the messages on your walls, both implicit and explicit, are ignored. They become invisible. Simply having them within a patient’s sightline is not enough.

Don’t believe me? Take down that poster in the reception room you mounted there seven years ago and replace it with something else. Then, count how many patients enter your practice and, with a start, ask, “Did you guys get new carpet?”

Rotating your poster and charts each month means patients (and you) are more likely to see them. It’s a simple use of a pattern interruption. Turns out we humans are wired for noticing patterns. What’s different? Which one isn’t like the others? What’s changed? Is it a threat? Am I safe?

Use pattern interruptions in your practice to provoke conversations with patients. Here are a few ideas to get you started:

Worn tire – Visit a tire store and pick up a tire from that’s seriously worn from poor front-end alignment. Clean it up if necessary and lean it against a wall in your practice. “What’s the tire for?” some will ask, inviting you to share your observations about the importance of spinal alignment.

Pile of sugar – Measure out 39 grams of sugar onto a pile at your front desk. “What’s that?” asks a patient. “It’s what comes in one of these,” your front desk team member smiles, reaching below the counter and producing a 12-ounce can of Coke.

Annotate your posters – If you value the wall graphics and chiropractic art on your practice walls, you’ve had them professionally framed behind glass. That creates a surface on which to use dry erasable marketing pens to circle key points, make annotations and generally draw attention to your wall charts.

White board – Some practices take this even further, mounting a dry erasable board somewhere prominent in the practice and inscribing ambiguous statements on it. The key is to be ambiguous to tap the curiosity of interested patients who want to know the significance of the statement. (Here’s a list of over 100 such statements and what you might want to discuss should patients ask.)

The idea is to break the pattern and interrupt the routine. During that brief gap, you have an opportunity to connect.

A Hack Isn’t a Short Cut

When it comes to patient communication, there aren’t any shortcuts. These simple hacks are a distillation of strategies used by the busiest chiropractors to lead and inspire patients who are interested in better health. If you limit your practice to the low-tech resolution of spinal pain syndromes, your patient education obligations are rather modest.

Today, in the era of coronavirus, offering health care rather than mere pain relief is probably a wise choice. Seems those chiropractors who do are busier than ever. Coincidence?