Have you ever felt a gnawing in the pit of your stomach – a vague frustration that the condition you've diagnosed is going to go untreated? If you practice in the real world, you know all too well that not many patients approach the front desk and announce, "Schedule me anytime you like.
Case acceptance begins before you even meet a patient. It begins with your state of mind. Poor case acceptance usually comes from perceived fear of rejection on the part of the doctor. If you're thinking about a person who rejected you in the past or are worried that the person in front of you is going to reject you in the future, you're living in the past or the future. A wise proverb instructs, "Don't bring your past into your present because you'll destroy your future."
Take the Case Acceptance Aptitude Test
Would you be a patient in your own practice? Would you pay the amount of money that you're asking your own patients to pay for your own services? The length of time that it takes you to respond is very telling. If you're hung up on the cost of your care, make a list of the reasons why you feel your care is not affordable. Then make a list of the reasons why you feel you care is valuable and don't stop until you have double the items on your first list. This exercise is valuable for you and for every member of your practice team. Make it the theme of your next team meeting.
Jack Canfield uses applied kinesiology (AK) muscle testing to choose the covers of his best-selling books. You can use AK to test your comfort level with the value of your case fee. Say out loud, "My case fee is $2,000." Now, have a colleague therapy localize a strong muscle and see if it remains strong or weakens. Repeat the process, lowering your case fee each time until the muscle remains strong. This is your "number" and you are stuck at it until you raise the value you perceive in the care you deliver.
Losing the fear of telling patients what they need, not what you think they can afford, requires practice, practice and more practice. Be certain in your scripts. Show concern without being alarming, and without diminishing the patient's condition and need for care. Be one-on-one with the person in front of you; be in that moment and make a connection. This is an essential component of case acceptance.
Focus on building rapport with your patients on each visit. When people are fearful, help them to feel safe and trusting. Use the neuro-linguistic programming (NLP) techniques of matching and mirroring to expedite the process. A Google search of these NLP terms will reveal many sources of guidance to assist you in the process.
Six Magic Words
Once you feel comfortable with the value of your services, you are ready to instill that value in the eyes of your patients. Always communicate these six words: "what's in it for the patient." Your patients care most about what's in it for them! Set specific goals, meaningful to the patient, for each phase of care. Relate treatment goals to activities of daily living, hobbies, work, family time and other activities that the patient holds in high value. This lets patients' know that you are listening to them and can relate to them and how their condition impacts their life.
Ask your patients, "What do you think would happen to your condition if you did nothing for it this year?" "What do you think would happen in five years?" Listen closely to their answers. Before a patient leaves your report of findings, ask, "Is there anything you feel is in the way of your starting care today?" This will help to uncover any objections the patient might raise before beginning care. It will also provide you with the opportunity to address them without being surprised later.
Remove Financial Barriers
Handling patient finances is one of those "problem" areas for many chiropractors. Money and related issues tend to be subjects that most people have some emotional feelings about. Everyone has a natural tendency to refuse spending money on anything they do not feel is worthwhile.
During a recession, dentists are quite often hit the hardest because most people don't consider dental care to be a necessity. They see it as more of a luxury. People look at chiropractic in a similar way – unless they are properly educated about the importance of chiropractic care. Your job is to help them see the value of receiving the care they need now, not at some undetermined date in the future.
The Most Powerful Secret of Case Acceptance
The most difficult way to manage patient finances is to ask patients to pay each time they come in. Every time a patient has to think about paying, they have an opportunity to reconsider the value of care. This is complicated by the fact that when a patient's pain goes away, the financial value seesaw is weighed against you and the patient is more likely to discontinue with your recommendations.
Create flexible payment options that give patients a variety of choices. (Always check your state and local regulations before implementing patient payment plans.) Emphasize the fact that you will work toward the goal of fitting the cost of care into the patient's monthly budget. Presenting payment plans gives patients the opportunity to choose from several financial options.
If given only one choice, the response can only be "yes" or "no" – and too often, it will be the latter. Allow the choice of a financial plan to be the "patient's idea." Ronald Reagan once said, "It's amazing what a man can accomplish when he doesn't care who gets the credit."
Write It Down
When most patients come to a chiropractor for the first time, they are typically in some degree of pain and uncertainty. Written communication reiterates your verbal communication and helps to ensure that everything was clearly communicated by you and understood by the patient. Prepare a written handout of your recommendations for care as well as the patient's financial plan. This provides an excellent tool if a patient must relay the events of their visit with a decision-making spouse or family member. You also can help prevent "buyer's remorse" after treatment and keep your patients thrilled by phoning to check in on them after their first visit.
It's a Team Sport
It takes more than the doctor doing a great exam and presenting a great report of findings and financial plan to achieve colossal case acceptance. Make every member of your practice team accountable for success. Empower your practice team to delight your patients!
Dealing with patient finances can frustrate even the most seasoned practitioner. Never take rejection from a patient personally. Remember that no doesn't mean no, it just means not now. As Abraham Lincoln said, "Always bear in mind that your own resolution to succeed is more important than any other."
Dr. Mark Sanna, a 1987 graduate of New York Chiropractic College, is a member of the ACA Governor's Advisory Board and a member of the President's Circle of NYCC and Parker College of Chiropractic. He is the president and CEO of Breakthrough Coaching (www.mybreakthrough.com).