Back in the day, long before insurance carriers reimbursed for chiropractic care, patient education was the cornerstone of the busiest, most successful practices. Patient lectures, health tracts and other strategies were routinely part of providing effective orientation for new patients.
These and other patient education overtures seem to have fallen out of favor, especially as the distinction between medical treatment and chiropractic care has become blurred. The result? Many patients think chiropractors are merely spinal specialists, hamstrung by their inability to prescribe medications.
Granted, patients today don’t show up in your practice begging for an educational experience! And while this makes your patient education overtures more challenging, it means you need to be more creative if you want the benefit of educated patients.
Is Chiropractic Patient Education Sales?
Truth be told, few chiropractors want to educate patients. Instead, they desire the
effect or result of educated patients.
Take an inventory of the curriculum at virtually any chiropractic college, and you won’t find a single course devoted to teaching the basics of patient communication and methods of persuading patients to embrace the vitalistic principles on which chiropractic is based.
That’s too bad, because most chiropractors resort to modeling the strategies used by their neurology professor or radiographic interpretation instructor, and they imagine that their monologue at the X-ray viewbox constitutes a patient education experience.
Patients can easily feign interest, nodding their heads, but rarely does this performance create a new meaning for their symptoms, change their beliefs or cause them to modify their behaviors. Even chiropractors who have turned the reporting of their findings into a sales session find the effect of their so-called “patient education” limited.
That’s because what passes for patient education is actually patient teaching.
If You’re Talking, You’re Teaching--Not Educating
If you want the benefits of an educated patient base, acknowledge that you’re actually in the belief-changing business and meaning-making business. This rarely occurs within the limitations of traditional patient “education,” which is
- a series of claims, declarations or assertions;
- easily ignored or considered irrelevant by patients;
- rarely an explanation of how chiropractic differs from medicine;
- passive, one-sided and not interactive; and
- sometimes confrontational, making them wrong.
This approach has little hope of changing the patient’s worldview and allopathic orientation of the typical belief. That’s because this strategy relies almost entirely on the spoken word. In fact, it’s largely a form of self-expression for the chiropractor!
In the same way that you can’t heal someone else or lose weight for someone else, you can’t educate someone else. But you can provoke critical thinking and self-reflection. You can help patients become present to their beliefs. True education is an inside-out process.
The Nature of True Patient Education
Since the mid-1800s, when traditional schoolrooms adopted an industrial, assembly-line model of instruction, there have been few places to see true patient education in operation. So most chiropractors rely on the spoken word.
But if you’re talking, you’re teaching, and teaching falls on deaf ears. Whatever you say goes in one ear and out the other. Teaching has little hope of changing patients’ beliefs about their symptoms, their spine, their nervous system, their body or their health.
Instead, the key is to ask, not tell.
What’s your theory about what causes cancer?
Why would the vaccinated be afraid of the unvaccinated?
What is the purpose of a surgeon’s mask?
Why do you suppose they call it the germ theory?
How do you explain the fact that some people are allergic to pollen and others aren’t?
What is the biggest difference between medical treatment and chiropractic care?
How do you “catch” a cold?
Socratic questions like these (and others) help reveal areas where many patients have neglected to do even the most rudimentary critical thinking. Questions can engage patients and invite conversation—volleys that can help patients reach a new understanding. Questions, when asked respectfully and without an agenda, can lower their guard and reduce their resistance to a new perspective.
Patient Education Changes Everything
By engaging the superior portion of patients’ nervous system, you’re likely to have a different patient relationship than those who pigeonhole you into their allopathic, symptom-treating mentality. Here are some of the pleasant effects of educated patients:
1. They have greater respect for you. It all starts here. Due to the apparently repetitive nature of each visit, patients are tempted to minimize the difficulty or significance of what you’re doing. But effective patient education enhances your professional reputation. Patients will sense your profound respect for the body’s self-recuperative abilities.
2. They’re more likely to follow your directions. When patients have a greater appreciation for what you’re doing and why you’re doing it, they are more likely to come on board and support your recommendations. When patients understand that most of the healing occurs between visits, based on what they do to support their adjustments, they are more likely to make lifestyle changes that can enhance the healing process. Effective patient education reduces patient resistance and involves the patient as an active partner.
3. They ask fewer inappropriate questions. “Will you prescribe medication for my pain?” “Can I get muscle relaxers as part of my treatment?” “Do you have to crack my neck?” And you’ve probably heard worse. These questions are signs of passive aggression, or more likely, of ignorance. They result from assuming chiropractic is a subset of medicine and that your adjustments are treating their symptoms. Effective patient education reduces wrongheaded questions by reframing the chiropractic experience.
4. They get better results and greater satisfaction. One of the often-overlooked effects of patient education is the management of patient expectations. Make sure patients don’t see your three-times-a-week recommendations as “dosages,” like a prescription. Help patients understand that your adjustments aren’t treating their pain. Make sure they accept the fact that the speed of their recovery reveals more about them than about you. In short, effective patient education improves patient satisfaction by setting appropriate expectations.
5. They remain under care longer. Educated patients have a greater understanding of the relationship between physical, chemical and emotional stress, and their spine and nervous system. Thus, if health, hygiene and prevention are among their higher values, they are more likely to adopt some type of ongoing supportive care beyond the relief of their symptoms. Simply put, effective patient education can increase the likelihood of enjoying the predictable and stabilizing effect of a practice filled with asymptomatic once-a-monthers.
6. They’re more likely to pay cash. If patients don’t understand the whole-body effects of an optimally functioning nervous system, they won’t value the significance of regular chiropractic care. If patients place a value on good health and they “get” the influence of the nervous system, they are more likely to value chiropractic care and reach into their pocket or purse to pay for it. Effective patient education helps link chiropractic to something they value, increasing the likelihood of patients paying for the care insurance companies won’t.
7. They become better referral ambassadors. Patients who understand chiropractic are more likely to notice opportunities in which it could benefit others. Moreover, educated patients are better able to make a compelling case for chiropractic care beyond saying “It worked for me” or “She helped me with my headaches.” In other words, educated patients are not only healthier and happier; they have the experience, language, passion and motivation to persuade others to try chiropractic care.
I’m sure there are other benefits, such as requiring less face time and reducing your reliance on new patients, but these are the most obvious. They make a strong case for investing in effective patient education.
Delivering Effective Patient Education
If your patient education overtures have been limited to an overly detailed report of findings or to force-feeding your topic du jour while a patient is face down on your adjusting table, you can do better. Here are three simple action steps you can take immediately:
Create a Syllabus. It’s breathtaking how few chiropractors have taken the time to list the things that every new patient should know. Create your own list and review it with patients during the pre-care interview. If I were in practice, there are a dozen things I’d want every patient to know:
- Chiropractic is different from medicine.
- Health and well-being are normal.
- Your nervous system controls everything.
- Stress can overload your nervous system.
- This can produce vertebral subluxation.
- A thorough examination will be conducted.
- We will fully explain what we find.
- A series of adjustments will be needed.
- Adjustments do not treat your symptoms.
- Consistent visits create momentum for healing.
- You control the speed of your recovery.
- How long you decide to benefit is always up to you.
Show Up Curious. Develop your sense of curiosity by uncovering what patients believe about their body, their spine and their health. Ask questions to provoke critical thinking—not to manipulate patients, not to dump your beliefs onto them, and not to force them to accept your beliefs. Ask questions to understand (to stand under) and support patients as they abandon old, unhelpful beliefs in favor of the principles on which chiropractic is based. Here are a few questions to get you started:
Why do you think chiropractic could help you?
How would you define the word “health”?
What is the purpose of pain?
What’s the difference between a good drug and a bad drug?
What controls every cell, tissue and organ of your body?
If you have a fever or find yourself vomiting, are you sick or well?
What is the greatest stress on your body?
The Most Significant Adjustment of All
My commitment to understanding effective patient education started back in 1981, when I was asked to help create the profession’s first video-based patient education. Since then, I have searched high and low for the best technology, the most effective brochures, the highest-impact metaphors and the best way to move people to embrace the principles of vitalism. As helpful as those tools can be, true patient education begins with you and your purpose for practicing chiropractic.
My guess is that you didn’t become a chiropractor so you could be a spine mechanic, but rather so you could make a difference and profoundly change lives. This requires attending to the superior part of the nervous system, the cerebral cortex of each patient—and regularly adjusting them above the Atlas.