If you find that your patients are dropping out of care, telling you they "can't afford it," not referring their family or friends often enough, your report of findings (ROF) may be the culprit.
Here are five tips you can use to make your ROF more effective:
First, shorten your ROF. If it is more than 10 minutes long, chances are you're giving too much information. Contrary to what most people think, too much information can work against you. Many doctors overload the patient with information, and the net effect is that the patient retains almost nothing. It is impossible to give a chiropractic lay lecture during your ROF; it should be short and to the point, answering the questions, "What's causing my problem," and "How do I fix it?"
Next, stop using "big words." Many doctors don't realize that the words they use to describe the vertebral subluxation complex have no meaning to the average person. A good rule to follow is that your language should evoke a mental picture for your patient in order to be effective. What mental picture do you think is evoked by the term spinous process? What about foramen? Kemp's test? The fact is, when the average person hears a term they don't understand, they stop listening. Assume your patient has no knowledge of anatomy, and keep your language simple. This increases the chances of your patients understanding and remembering what you said ten fold.
Another way to increase the effectiveness of your ROF is to ask questions. Remember, communication is not a one-way process. Many doctors find that they do all the talking and at the end they're not sure whether the patient really understood or agreed with what was recommended. This is a common problem. The doctor talks and talks, and even though the patient nods once in a while, the doctor doesn't really know what the patient is thinking. The only way to know if your patient understands is by asking questions.
If you ask your patient to answer questions at various points, and then acknowledge the patient for a correct answer, you will improve your ROF tremendously. At the end, try asking your patient what a subluxation is, or "What's causing your problem?" You may be surprised by the answers.
Next, don't "minimize" the patient's problem. Many doctors use language which weakens the message of the ROF and causes the patient to feel that treatment of the subluxation is not important. If you use terms like, "minor misalignment," "some," "could," "a little," "maybe," "possible," when communicating your ROF to your patients, you are giving them a message: It's not important for you to receive care. Tape record your ROF and listen for these words. If you find them being used, change your language. You need to become convinced yourself of the importance of chiropractic care before you can express it to your patients.
Finally, remember the purpose of your ROF -- to tell the truth. It is not to "convince" the patients that they need care. They know they need care or they wouldn't be in your office. Your purpose is to tell the truth. You need to explain the cause of the problem and the options available to correct it. Whether the patients decide to opt for relief care, corrective care, or no care at all, that's up to them. Your job, as the doctor, is to tell them what the best course of treatment would be. After all, the ball is in their court.
Incorporate these changes into your ROF and you'll find that suddenly your patients can afford corrective care, and that they refer much more often.
Andrew Orlander, DC
Tarrytown, New York