Why Your Consultation is More Important Than Your Report

During some recent speaking gigs, and frequently during my telephone consultations, I will casually tell chiropractors that their consultation is more important than their report of findings. I generally wait to see if I get any objections. I don’t. So either I’m onto something or my assertion is being dismissed as simply one more raving of a non-DC who doesn’t know what it’s like to actually practice chiropractic. It wouldn’t be the first time that such an accusation has been leveled.

No matter, I believe it anyway. Here’s why.

Before I explore the consultation, let’s consider the report, which in many practices, appears to be little more than a confirmation to the patient that they have a problem that a chiropractor is likely to address (the patient already assumed that). Or it’s a sales session to get the patient to do something beyond what the patient had in mind. Or both. Either way, if a patient hangs around long enough for your report, or even more significantly, returns on a separate visit to receive your report, they’re already sold. The relationship is yours to lose.

This escapes some chiropractors who are often clueless about what it takes to prompt a patient to call your office, show up and endure whatever procedure you and your team will administer before they get your therapeutic intervention. Most chiropractors seem oblivious to what a huge concession it is to come to your office in the first place. Not to mention what an imposition it is coming three times a week for whenever.

We’ve all heard the stories of the crusty old chiropractor who flips on the X-ray view box and says gruffly, “You’ve got a problem here, here and here and I can fix it, so let’s get started.” Switches off the view box, motions to the adjusting table and begins to do his magic. I’m not endorsing this style of practice, but there are many chiropractors who just don’t give a formal report of findings.

So let’s examine the rationale expressed by Dr. Larry Markson who has long suggested that the purpose of the report is to answer four questions that every patient has. You’ve undoubtedly heard them. “What’s wrong? Can chiropractic help? If so, how long will it take? And, how much will it cost?” This wisdom has served thousands of chiropractors for decades. Yet, I still stand behind my original assertion that the consultation is more important. Why?

This is where rapport is, or isn't, established.

Establishing rapport with a new patient is the first order of business. One of the most powerful ways to do this is to answer a common, unspoken question, “Why did you become a chiropractor?” If you have a story that includes becoming a chiropractic patient yourself, share it. Be courageous enough to admit any concerns, fears or unfounded beliefs about chiropractic that you may have had back then. Doing so will go a long way toward putting patients at ease, while addressing their hidden fears and concerns. Don’t have an inspiring story? Address their concerns more directly. “Many people have some wrong ideas about chiropractic. So, before we get started, I’d like to put some of them to rest.”

Begin the healing process.

Assuring the patient that their particular problem is within the scope of your practice, and moreover, helping patients with their problem is so common as to be almost routine, is significant. Give hope without guaranteeing a cure; express your confidence without making a promise. “We see this sort of thing all the time.” “Chiropractic has been shown to be very helpful in cases like yours.” “I think you’re an excellent candidate for chiropractic care.” “We’re optimistic that we can help you and you should be too.” “We’ve helped a lot of people with problems just like yours.” Hope is an essential part of the healing process and it’s something you can invoke even before a complete examination and report.

It's a flag-planting opportunity.

The consultation offers the opportunity to contrast their medical doctor experience with what they can expect in your practice. “I think it’s only fair that I explain a little about what I believe to be true, and the lens we’ll be looking through as we evaluate your current problem and offer some help and direction for your improvement.” This where you explain your philosophy and your focus on the nervous system. The point you’re trying to make is that chiropractic is different from medicine. Remember, patients want different. They’ve more than likely already encountered the limitations of medicine.

Patients determine how safe you are.

Patients size you up during the consultation. Are you approachable? Will my secrets be safe with you? Will you make fun of my lack of understanding? Will you manipulate me with guilt or shame? Are you authentic? Patients take your emotional “temperature” during the consultation and make a determination whether they like you, trust you, and will permit you to touch them—physically and emotionally. They evaluate hundreds of subtle clues that form the basis for the amount of influence you will be able to wield.

Patients decide if the myth is true or not.

Virtually every new patient has heard the myth that once you go to a chiropractor, you have to go for the rest of your life. Put patients at ease by explaining how this myth originated because of the distinction between sick care (short-term diet of pain relief) and life care (wellness and a health-optimization lifestyle choice). “How long you decide to benefit from chiropractic is always up to you.” It’s helpful if you’re congruent with this obvious statement of truth as well.

You get to demonstrate your profound listening.

While I’ve explored much of the chiropractor side of the equation, the consultation is a time when you want the patient to do most of the talking. By demonstrating your ability to really listen—repeating in your own words what you’re hearing and asking for clarification when patients use unusual or meaningful terms, you communicate respect and understanding.

Make the first, most lasting impression.

You’ve heard the old adage that you “only get one opportunity to make a good first impression.” And let’s not forget that any first impression is usually the longest lasting! This makes your paperwork, consultation and first visit procedures vitally important since it can permanently color a patient’s perception of you, your practice and chiropractic.

It may be time to reinvent your consultation, since it’s even more important than your report. What would you consultation look like, sound like and feel like if you were to create it from the ground up today?

(Originally posted May 14, 2009)