In my last column (Oct. 21 issue), I talked about the importance of listening to patients' stories as a way to negotiate a shared reality and improve clinical outcomes.
Use Stories to Attract Ideal Patients
Too often, chiropractors use facts, figures, fear or force to persuade patients to change behavior or commit to a treatment plan. However, with the exception of seriously right-brained engineers or maybe accountants, most people are more likely to relate to stories than they are to respond to facts and statistics. Stories touch people at an emotional level. If you tell someone that 75 percent of your patients experience improved function after a couple of weeks of care, that's nice, but not memorable. A potential patient has no way to connect what "75 percent improved function" might mean to them or how "a couple of weeks of care" would translate to their situation. Therefore, they cannot arrive at the answer to their all-important question: What's in this for me?
On the other hand, let's say you meet a gentleman at a neighborhood party and it comes up that you are a chiropractor. He then mentions that he's having shoulder problems and discussing options with an orthopedic surgeon. When you respond with a story about a patient you treated (without using their name, of course) who had a similar condition, was able to avoid surgery, and is now playing racquetball twice a week, that's a story this man can relate to. Now your neighbor is thinking, "Oh, you mean surgery might not be the only answer?"
For stories to be meaningful and have a positive impact, they must be concrete, vivid and transport the listener from the stance of skeptic or critic to that of relating to the main character in the story. A good story (with enough detail to be memorable and with a slightly humorous twist when appropriate) helps the potential patient grasp the fact that they are not alone and that you have successfully managed a problem like the one they are experiencing. Now you have an opening for a deeper conversation and, most likely, an office visit from this new patient.
How to Tell an Effective, Powerful Story According to the authors of Influencer: The Power to Change Anything, a story must instill understanding, believing, and motivation in the listener. Let's look at these three elements more closely. Understanding: The story must be plausible and include a cause and effect. For example, a patient was in extreme pain from an injury, entered into and took chiropractic care seriously, it worked for her, and now she's running five miles a day. Believing: Obviously, for a story to have impact, it must be believable. For a story to be believable, the storyteller must have integrity and be trusted by the listener. Keep the stories you use with patients within the realm of reality and convey them with pride (but not arrogance) in the fact that you were a player - but not the star - of the story. Motivating: A good story has a positive ending and one that give the patient hope that they, too, can achieve a good outcome by taking action and making specific changes. They must also have the feeling that making the effort to change will be worth it to them in the end. A good story "punch line" might go something like this: You can take control of your health. It's not too late to get back to the activities and relationships you value. |
Engage the Patient
After you share a story, ask the listener what elements of it they relate to. How is the story similar to or different from what they are experiencing? Can they see themselves having a comparable positive outcome as the patient in the story? Encouraging patients to open up about what they hope to achieve by engaging in care will give you insight about how to best continue the conversation and work effectively with them toward achieving their health goals. (Refer to my Oct. 21 article for details on how to listen effectively to patients' stories.)
There are two caveats to keep in mind about using stories to convey the value of your services. First, don't make yourself the hero of the story. Instead, keep the focus on the patient the story is about and the benefits they derived from the care you provided. Second, when you are face to face with a patient or prospective patient (whether it's in a social setting or during an initial office visit), stay aware of how engaged the patient is in the story. If they begin to get that glazed-over look, then it's possible that you're using too much technical jargon or that the patient isn't relating to the story as much as you'd hoped they would. If you sense this happening, wrap up the story quickly and move on to asking open-ended questions to get the patient telling their own story.
Writing Case Studies for Storytelling
A well-written story is much more lively and meaningful than the generic "She's great, I recommend her to everyone" testimonial. Case study stories (not case studies in the clinical or research sense, but narratives about the process and outcome of an individual case intended for a lay audience) are effective because they give patients insight into your approach to treatment and instill confidence that you have the ability to deliver the goods. There is tremendous value in the true words of a satisfied, happy patient. That, coupled with details of what the process is like, puts potential new patients at ease before they ever walk into your office because they have an idea of what to expect.
The first step in collecting a series of case studies is to make a list of patients you believe would be good candidates to share their stories. These should be individuals whose experiences with you are recent and memorable, who had fairly dramatic results, and who are willing to take the time to help you with this project. Once you have your list of patients, contact them personally to see if they would be interested and willing to participate.
At this point, you have a couple of options. You can hire a professional writer to interview the patients (either by phone or in person) and write the stories. This is probably the most effective approach because a skilled interviewer can draw a patient out with the right questions. A less costly route is to use a "share your story" form whereby patients provide information that is then used to craft the case study (with either a professional writer, you, or a skilled staff member doing the writing). If you use the form method, here is a format to consider providing your patients:
- What is your age, occupation and general state of health?
- Do you typically gravitate toward traditional Western (allopathic) medicine, alternative/complementary medicine, or both?
- What was your health problem or challenge when you first came to our office?
- How was this situation or condition impacting your life (work, home, relationships, ability to participate in activities, emotional state, etc.)?
- What were your expectations and prior beliefs about chiropractic when you first came to our office?
- What did you hope to achieve through chiropractic care?
- How did you or are you using the services of our office?
- What specific results or benefits have you achieved?
- How has your life changed as a result?
- What surprised you about chiropractic care?
- What would you tell someone else about considering care at our office?
The answers to this series of questions will help you craft a case study story using the following format. Keep your studies detailed, though brief (200-400 words) and be sure to use actual patient quotes in each section.
The patient's challenge: Give a brief description of the patient, the presenting problem, and how the problem was impacting the patient's life. For example: A 44-year-old woman was in an automobile accident and suffered from both neck and low back pain for more than two years. She tried acupuncture, massage therapy, and saw numerous medical doctors, all of whom recommended surgery. Secondary to her chronic pain, she felt isolated and depressed, and had gained a considerable amount of weight because she was unable to exercise. In addition, she used up all of her sick-leave time at her job and was beginning to suffer financially due to taking unpaid time off when pain impaired her ability to work.
The process: Describe the care plan and course of treatment. How often the patient was seen, for how long, what modalities were used, etc. Don't go overboard in this section, and avoid technical jargon. The reader will be more interested in knowing that you have an effective process to achieve good results than in the technical aspects of care or the philosophy underlying your process.
The progress: Describe how the patient progressed through the course of treatment. For a more realistic story, include minor setbacks or obstacles that the patient experienced (if there were any) and how you worked together to push through them.
The outcome: Discuss how the patient is doing today and the benefits she's experienced from having competed a comprehensive course of care. Be sure to include a raving positive quote from the patient, such as: "I never thought I'd be able to do my own gardening again; you should see the tomatoes I've grown this year!"
When your stories are complete, you're ready to put them to good use in some of the following ways:
- Tell the stories verbally when you meet potential new patients.
- Publish them in your e-newsletter.
- Post them on a special page (for example, "Our Patients Speak") on your Web site.
- Use the stories when you make public presentations.
- Print them in your marketing brochure.
- Format and frame them to hang in the reception area and in exam rooms.
- Write a more detailed story for publication with the original story as the centerpiece.
Your Story, Your Staff Members' Stories
Another way to use narrative to engage with patients is to tell your own story. Did you go into chiropractic after experiencing the benefits of care firsthand? Did you have a parent or sibling with debilitating pain who finally experienced relief and restored health through chiropractic care? Accounts like these - assuming you don't ramble on and on (remember, it's about connecting with the patient, not being in the spotlight) - are effective in helping patients gain an appreciation for the passion and commitment you have for your work.
Ditto for staff members who, ideally, have had positive firsthand experiences with chiropractic care and have their own stories to share. In addition to conveying to potential new patients that they found relief for their migraines or that they're now exercising regularly after years of being sedentary due to chronic back instability, staff should be trained to weave into their stories praise for your practice, not just chiropractic care in general.
Here are several sample phrases that staff could adapt and become comfortable using in conversations with patients: "You're at the right place for top-notch wellness care. Dr. Smith's patients love him and the results they get," "Dr. Gomez has special training and gets excellent results in treating cases like yours. We recently saw a young woman who..." or "The doctor is so caring and patient. You'll like her approach and her commitment to working with you on your goals."
Be sure staff members know how to tell stories that are short and effective before turning them loose with permission to use them, however. Have them practice their narratives, including references to your work, on one another and demonstrate their technique for you.
Benefits of Using Stories
The definition of story used by Richard Maxwell and Robert Dickman in The Elements of Persuasion is as follows: "A story is a fact, wrapped in an emotion that compels us to take an action that transforms our world." This may be the most significant benefit of using stories with patients - they compel or motivate an individual to take action. And what could be more transformational for a patient than feeling better physically and emotionally than they ever thought possible?
Another benefit of storytelling is that it helps patients appreciate the fact that they are not alone with their condition. Feeling unwell can be isolating. Patients with chronic pain or those who are limited in their activity may feel like they're the only ones ever to suffer. This attitude can cause them to slip into victim mode, which is not a state conducive to healing or behavior change. Well-crafted stories can help people feel hopeful and motivated to make the changes necessary to get better.
Storytelling is also an effective vehicle for improving ongoing communication with patients, a practice that can result in improved clinical outcomes. The better you relate with patients by listening to their stories and telling your own, the greater shared reality you create about what they wish to achieve. When both doctor and patient are clear on the desired goals or outcomes, the easier it becomes to work effectively and efficiently toward those goals.
The art of storytelling does not come naturally to everyone, and yet most anyone can learn the skill with a little practice. As you become more comfortable using stories and case studies to influence patients, you'll likely find that it feels good to remember and speak about the positive outcomes people have experienced while under your care. This will undoubtedly help you stay more fully engaged in your work and be continually reminded why you chose your profession.
Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.