30 Improve Outcomes and Patient Loyalty with Coaching Conversations
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Dynamic Chiropractic

Improve Outcomes and Patient Loyalty with Coaching Conversations

By Shelley Simon, RN, DC, MPH, EdD

There is a saying in the coaching field that "if you're working harder than the client, something is wrong." This axiom can easily translate to the profession of chiropractic. You've no doubt worked with patients in situations in which you felt like you were more interested in improving their health, function, and well-being than they were.

I detect a deep level of frustration from clients when they recognize that their practice success depends, in part, on good clinical outcomes, but have too many patients who don't hold up their end of the bargain to achieve better health.

Is it possible for be more effective in motivating patients to stick with care plans, to follow through, and to take more active roles in improving their own health? Yes, it is.

Advising vs. Coaching

If you want to become more effective in motivating patients, it's important to understand how advising differs from coaching. Chiropractors can and should give advice. That's a big part of why patients come to see you - because you have knowledge that they don't have. But offering even your best advice only goes so far, as you've surely discovered in daily practice.

Let's say you're treating a patient in her mid-50s with chronic low back pain, who is also overweight, sedentary, and taking cholesterol lowering medication. Wearing your advising hat, you might explain why the patient should do back-strengthening exercises at home in addition to receiving regular chiropractic treatments.

Broaching the subject of weight reduction and physical activity, however, is delicate and potentially risky, but necessary if you are committed to helping the patient not only have a stronger back, but also enjoy optimal health. This is where coaching comes in, and this level of conversation is all about empowering the patient to take action based on their own motivation, not what you want them to be motivated to do.

Your Unique Role

Today's patients, and in particular baby boomers, have come to believe that if they take good enough care of themselves, they should be able to circumvent many of the aches and pains associated with aging. These patients are often eager to be active participants in wellness activities and appreciate a doctor who is willing to spend time coaching them.

Coaching in the situation described above, with a baby boomer who wants to stave off "seniorhood," might involve inquiries like these:

  • You've had back pain for over a year. What's making you feel more inclined to get to the bottom of it now?
  • How is being in pain impacting your vitality or making you feel older?
  • If we could work together to reduce or eliminate your back pain, what would you be doing a few months from now that you are currently unable to do?
  • What steps could you take that might help you feel better in general?
  • How motivated are you feeling right now?

So, are you thinking, "Who has that kind of time to spend with patients?" Ask yourself how much time you spend trying to attract new patients because you are not as successful as you'd like to be in retaining the ones you already have. I'd argue that chiropractors can't afford not to spend adequate time with each patient to more fully understand where the person has been, where they are and where they want to be with their health.

The Benefits

For the practitioner, one of the most important benefits of taking the time to engage in coaching conversations is that you gain insight into how ready a patient is to make lifestyle changes. Until a patient is emotionally ready to change, all of the coaching in the world won't matter. But when you determine through a coaching conversation that a patient is indeed ready, you can make a real difference.

A secondary (but also important) benefit to you is that when patients appreciate that you genuinely care about their well-being and they begin to have positive health outcomes, they become extraordinarily loyal. These kinds of raving fans cannot be valued too highly.

The benefit to patients derived from engaging in coaching conversations is that it helps them get clear on what's important to them and what they are willing to do to feel better.


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