The transition is complete, all the papers have been signed and filed, and the senior doctor has departed. You are beginning to make some changes in the office to your liking when you begin to hear an occasional comment that alters your daily peace of mind:
"Why don't you just adjust me, I don't need to be examined."
"Why x-rays, the old doctor never took any and he treated the same area for 20 years."
Do those statements put an adrenaline rush through you? Are you already preparing responses to the above statements to prove what you are doing is right, regardless of what was or was not performed in the past? Dealing with comments like those above and many more can give you a barrel full of second thoughts about the practice you had just, two weeks ago, been in love with.
So now what? Do you begin to give the patient what they want or do you perform necessary tests to establish your position? Well, let's examine this from three sides: the senior doctor, patient, and you:
A. Senior Doctor -- The senior doctor has probably taken care of the average patient for approximately two to five years (some obviously longer). The doctor has gained a comfortable rapport with the patient. The doctor will go about his way adjusting everything into place (while a conversation about the kids is taking place) and depart with a friendly goodbye as he moves on to the next patient.
B. The patient -- They too are comfortable with the doctor and his routine to realign what they have jostled out of place.
C. The new doctor -- Your dedication is at an all-time high to bring healing to all spinal infirmities. You enter treatment room #1 and find yourself directly in the middle of a verbal tug-of-war.
Let's assume the following scenario is presently ensuing:
Patient: "I was coming off that last step and down I went.
Doctor: "Did you land flat on your back?
Patient: "No, I fell off to the side, kind of broke my fall with my ribs and buttock, but yea, I really clobbered the ground!
Doctor: "Is this similar to any discomfort you have experienced previously in the low back?
Patient: "Yea, yea, the same. I come in here and crack, the old Doc puts it back. Out I walk good as new.
Doctor: "Now when was the last time that took place?
Patient: "Oh let me see, oh, I remember about 10-12 years ago. That's right. I remember I was at a surprise 50th birthday party for me.
Doctor: "Considering the type of fall you incurred and the time from your last injury till now, I think it would be a good idea to take some x-rays of the low back.
Patient" "What?"
Sound familiar? There are several variations to this verbal dialogue between doctor and patient, but one fact remains the same. Doctor, you must suggest to the patient what you feel will aid you to reach a reasonable judgment to either treat him or refer him to someone else. Doctor, you cannot be the shadow of the former physician. Furthermore, patients are not expecting a mirror image, but someone who will continue to express the concern and care they had previously received.
One of the most important people in the doctor/patient relationship after the assumption of a practice is the CA. She will be going to bat for you on the phone and in person. She will be handling such comments as:
A. Is he or she good?
B. Does he adjust the same?
C. What if I don't like him?
Questions like those above and all the others that your CA will field are basically the same question. "Do you think I will be happy with the new doctor?"
First of all, the CA when properly advised can defuse any question the patient may have. If the patient senses through the CA's tone of voice and attitude that other patients are continuing to come to the office, then so will this patient. Here are a few answers your CA can employ:
A. "You know Mrs. ****, before Dr. **** retired he searched for a doctor like Dr. **** to treat his patients like he would.
B. "He's a very caring individual.
C. "You know, he adjusts me when I have a problem.
D. We've had several positive comments."
Remember, the patient may be speaking to a CA that they have never seen before. But regardless of even this type of situation, when handled properly the patient will see you for their return care.
The following is the result of a survey I performed with CAs (all new to the office they were now working in), who had assisted a doctor in assuming a practice:
A. Impressed with the new doctor's thoroughness.
B. Welcomed a change in decor, i.e., plants, curtains, moved furniture around, created more functional and comfortable areas in the office.
C. Were impressed with the new doctor's concern for them.
D. The patients stated that they still felt comfortable in the office even though Dr. **** had retired.
E. Most patients will come in.
Now, not every patient will be impressed with the new doctor and his thoroughness, concern or manners. This particular patient will only be happy if the retired doctor would be beamed aboard for their treatment. This type of patient will be encountered on a regular basis, therefore, it will totally depend as to whether you can defuse this situation or watch it explode as you respond to the patient's uneasiness and the patient responds to this new environment. From personal experience I would say only 50% of this group of patients will stay. From that group of 50%, about half will see you again in the future for chiropractic care.
If you are updating your filing system, it may be necessary for the patient to fill out a new folder. This has several positive factors.
- The patient's name may have changed.
- New address and phone number.
- New employment.
- Change of insurance company.
- Newly divorced.
- A new child since last visit.
Most of all, the new folder will allow you to take a moment with the preexisting patient and take down a new history. Many things change. We all know when a year has gone by from seeing a patient and they begin to relate five new injuries since their last visit, it makes us feel good that we asked the question, "Have you had problems or injuries since I saw you last year?"
Occasionally the CA may receive some resistance from the preexisting patient to fill out the new folder. From the patient's point of view, he considers his previous folder adequate and up-to-date and considers all these new questions irritating. The C.A. can handle this quite easily.
"Mrs. ****, the doctor is attempting to update every patient's file to assist our office in better serving you."
The patient may also question whether or not his previous file and x-rays are still in the office. This deeply concerns some patients as they consider this their "bonding" to the office which, assures them that they do belong. Here again, the CA can, with a few words of confidence, put the patient at ease.
It's important for the new doctor to be himself, yet not deviate to such a degree that may jeopardize his relationship with his patients by making them feel uncomfortable. If the new doctor overreacts to that patient's statements (as previously mentioned) a negative charge could occur in his attitude:
A. Self-pity -- "Oh why did I make this decision?" No one cares, especially the patients. They don't know the pressure of accepting this practice and making it work."
B. Resentment -- If the new doctor feels that a number of his patients continue to exalt the previous doctor, he may resent the patients and the time spent with them.
C. General dislike for surroundings -- If the patients are asking you questions about the previous doctor and they are objecting to x-rays, filling out new folder or insurance forms, you may begin to hate going to the office daily.
The following comments are suggestions to remedy the above negatives:
A. Commit yourself to building up the practice to a quality of care unlike that of your predecessor.
B. Be honestly sincere. Patients will perceive this and you won't have to sell them on it.
C. Work smarter, not harder.
What about the patient that will not allow you to feel comfortable around them or fail to communicate with you? Make it possible for them to seek care elsewhere. Don't try to go beyond yourself with these patients. They will never be happy. It's not worth your time and effort to let this patient rob you of concern you have for the rest of today's patients, who are satisfied with you and your method of treatment.