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1. 

   Chip Patterson
   Member

   I know there have been posts in the past for this topic, but I was just wondering if there were some good communication points for people when they are choosing non-compliance.

   I've had a couple of patients over the last few weeks who have come in, accepted my recommendations and then after a week or so, come in sporadically...maybe one or two times per week, vs. the 3 I've recommended.

   I let them know that they chose to come here because where they were going before, they were not getting the results they were looking for. They came to me and because of their exam and xray findings, I recommended an initial series of care at 3x's/week because that is what they need in order to begin making a change, etc.

   Now, they are not following my recommendations and I have used several of the suggestions before, "in my opinion if they do not follow the recommended schedule of care, they will not get the results they are looking for and therefore would be a waste of their time to continue.", etc...

   And so, these people still choose to come in to get adjusted once or twice a week, and seem to be ok that they are hurting still...I know, sounds crazy. So, my question is...if they are happy with the treatment and the results that they are getting, should I just say, ok...if you're cool with it, so am I...or should I let them know they should go somewhere else, discontinue until there schedule/finances/or whatever the excuse is is gone?

   Just thought I would throw this out there...thanks for the help

   Posted 2 years ago #
2. 

   DrPerron
   Member

   I would go somewhere in the middle. Telling them to go somewhere else is a bit extreme to me, telling them that it is "okay" is lying. So I would keep to your recommendations, especially if they are not complaining and wondering why they are not better and get to that update exam in another week or two. If they are patients that have been to other chiro's, which is what I interpreted, then they may have some habits to get over and their expectations may be low because of previous experience. I would keep to your original recommendation unless their needs change and that would be "see you on Wednesday" (if it were today, Monday) and at next visit "see you on Friday" so you keep telling them when you recommend they return and then they do what they do. When you get to the update exam, use that as your moment to revisit their goals and options based on THEIR goals. The whole "waste of time" is a bit dogmatic to me. Each case is different. Each patient brings different baggage that needs to be contended with once in a while and I am sensitive to that. I try to work with the patient, while never waivering on my recommendations. As long as they are not griping and if they do I remind them what I recommend versus what they have done. I think it is alot in the presentation (as with everything) where a pissing match never goes anywhere and benefits no one. Telling the patient what you think they need and working from that can be different. I also throw out the point that this is meant to be a short period of time upfront that gives the opportunity to get ahead of things instead of just keeping pace. I adjust it and it stays for two days and you come back in four, it spent two days in the right place and two in the wrong spot. Since the wrong position habits are strongest at the moment it is not realistic that this dynamic will get you ahead versus it staying for two days and then adjusting shortly after it shifts so it is spending the majortiy of time in the right place therefore giving your body the opportunity to get used to this new alignment and steadily forget about the old alignment. Remind them that you are going for resolution not just relief for them, if that is what they want. I tell patients that relief is easy, you can get a shot or pill for that but stability so that you have sustained relief takes more work but mostly on the front end.

   Hope that helps. I am interested in what others would do in similar circumstances.

   Posted 2 years ago #
3. 

   Ed
   Member

   Wow, never had that happen to me!!!! Not!! This situation always provides a certain amount of emotional turmoil for me! When I am thinking with my executive brain and depending on how far in to the series of care you are I would simply "AS IS" the situation - ask the patient what is really going on, was there anything in the report that they did not understand and then make sure you clarify exactly what their expectations from care was! And then if appropriate reiterate why it is important for them to attend 3 times per week! Again it all goes back to us caring more than they do - we often want to achieve alot more than they do! But big front door, big back door! Define not defend! Don't react defensively just respond in a very calm manner and then NEXT! From a statistical perspective only 30% of patients will follow our recommendations to the letter - so try not to get too hung up with the 70%!!!

   Posted 2 years ago #
4. 

   Chip Patterson
   Member

   Thanks for the info...like you said Ed, sometimes we just care more than they do. The patient's come for the right reasons...theirs. All we can do is communicate what we feel is the best for them, and then go with the flow. It is hard not to get frustrated, but such is life at times.

   Posted 2 years ago #
5. 

   DrPerron
   Member

   You all and your empathy! Pathetic! :) Sympathy good, empathy not as good.

   Posted 2 years ago #
6. 

   Chip Patterson
   Member

   I'm doing my best to toughen up Dr. Perron...

   Posted 2 years ago #
7. 

   DrPerron
   Member

   I am just giving you a hard time. If you have not figured it out yet Dr Paul that is one of the most common challenges. It is the same heart that brought us into this type of work that at times can get in the way. So not tough but objective. Fine line of difference.

   Posted 2 years ago #
8. 

   Anonymous
   Unregistered

   Interesting... I think a great comparison for this is with our relationship with our coaches. They give us their best recommendations and do we follow them? Have you followed 100% of the recommendations that they have given you? Maybe yes, but from the sound of most conversations I've had... more likely no. But our coaches have always come back to the same "best" recommendations. They could just as easily say "next" to those of us on the slow bus. But they still see a possibility there. And I think that is what we need to do with our patients. Yes, we always give the patient our best recommendation each and every time that they come in (it's even part of the day to day communication procedure that our coaches have wisely recommended), but ultimately our patient will do what they decide to do with that information. Just like the DC who has been instructed to change his or her office hours but has decided to keep things as is for now, or the DC who really should get his butt in gear with Seven Accounts (you know who you are :)). But our coaches keep showing up and giving us the same recommendations because they know that is what we need to hear.

   I'm listening to the E-myth Revisited right now and what I heard today made me actually pull my car over and rewind it so I could hear it again. I think it is totally applicable here. I took the liberty to change the word customer to patient. It reads..."To the technician the patient is always the problem because the patient never seems to want what the technician has to offer at the price at which he offers it. To the entrepreneur; however, the patient is ALWAYS an opportunity because the entrepreneur knows that within the patient is a continuing parade of changing wants begging to be satisfied. All the entrepreneur has to do is to find out what those wants are and what they will be in the future." I think that one statement was worth the price of admission and totally sums up what we need to do every day in the office...

   Posted 2 years ago #
9. 

   Ed
   Member

   Certainly writing this stuff is a lot easier than actually doing it but another point worthy of repeat is that the patient in your office actually wants to be there and despite our feelings to the contrary they certainly did not set out that day solely with the intent of pissing us off!!! And as Danella just said if you have to give the same recommendations and repeat something every single time, then so be it but keep it light hearted, non judgemental and non accusatory! But remember that we all learn differently and sometimes simply repeating ourselves is just not enough, occasionally we need to totally change our approach whether it is to make it more visual, more auditory or more kinaesthetic! But overall we need to think of it as a game, this is meant to be fun! As I mentioned in a previous posting Dr Sea told me that when a patient is objecting or complaining envisage the words “teach me” emblazoned across their forehead!

   Posted 2 years ago #
10. 

    Chip Patterson
    Member

    One big take away from this posting is, the day to day communication...by simply making the recommendation each time they come, see you wed, thur, next week, month, etc. This keeps us (me) in line with what I have recommended and focused.

    Also, like Ed said...they want to be there or they wouldn't be there, I have to keep remind myself of this at times...the whole change your thoughts and change your practice/life concept at work here.

    Posted 2 years ago #
11. 

    DrPerron
    Member

    Touche! Dr. D :) I am just providing a growth opportunity for you, and the coaches. If I did everything right where would your needs be met? :) I'm a giver.

    I love the E-Myth quote. It is uncanny how the technician, manager and entrepreneur get so tangled. It is a multiple personality disorder, that we are trying to bring into order. Kind of like in the movie 'Beautiful Mind'. The better we get at recognizing which mode we are jumping into, the better we can get at controlling the response. All the roles necessary, but it is when and how they are applied. I am weak on the manager role. The other two are naturally more fun for me but tough @#$%. If I want to do big things I need to take care of all three just like anyone else. I am aware of that and I have made strides to force myself to do things and focus on things I would have ignored or avoided. I still have more organizing to do (ie. 7 Accounts) but I accept full responsibility for my results based on what I am and am not doing. Funny being a Core C with the biggest hang up being organization.

    So as Ed said, easier said than done but we really don't have any valid excuses since the answers are handed to us. So I have stopped using that as an excuse and I would recommend the same for anyone else. "As you believe, you will be." So everytime that thought gets rotated through the brain it gives an excuse. Versus the outlook of I am where I am because of what I have done so far and I know I can be/have more if I... we all have a list. Total accountability. For me it all starts there. That is the good control. The power is within us to do what we want and achieve what we want. Be honest with yourselves, it is freeing. Then you can get to work, if you want. ;)

    Posted 2 years ago #
12. 

    DrPerron
    Member

    Did not want to start a whole new topic for this, so I searched for a "vintage" title that worked reasonably well. This is a humerous list that has circulated in Virginia recently. I was just glad to see that there were some chiros with a sense of humor. So I thought I would pass it along for your amusement as well.

    8 Reasons NOT to Visit a Chiropractor

    If you’re looking for reasons not to visit a chiropractor, here are eight of them!

    1.) You don’t have a spine. If you’re born sans spine, there’s really no need to worry about spinal degeneration, is there?
    2.) If you can’t see it, it must be fine. Skin, eyes, hair, teeth… These front-facing body parts are important because other people can see them. If a healthy spine was really that important, it wouldn’t be in the back.
    3.) You love taking medication. Taking risks makes life more enjoyable! Dizziness, headaches, dry mouth, constipation, seizures, cancer, death… What’s not to like about side effects?
    4.) Your insurance doesn’t pay for it. Money is for important stuff like Netflix, cigarettes, and gambling. If your insurance plan doesn’t cover it, maybe chiropractic care just isn’t necessary?
    5.) They don’t prescribe drugs. Why would you want to go to a doctor who doesn’t think you need another prescription? (See #3.)
    6.) They think lifestyle “stress” can make you sick. Apparently they’re not aware of bad genes. Everybody knows you only get sick because certain diseases just run in the family.
    7.) They expect you to do stuff at home. They want you to make time for rest, exercise, and stretching. On top of that, they think you should change your diet. Evidently they don’t understand how busy you are…
    8.) Besides, you’re impervious to mistakes. You eat just fine, and there’s nothing wrong with the way you’re living. Even if your “habits” are making you gain weight and age prematurely, that’s none of the doctor’s business! Their job is to get you out of pain so you can get back to doing the things that brought you there in the first place.

    Posted 2 years ago #
13. 

    Anonymous
    Unregistered

    Would it be in bad taste to print that large and hang it on the reception room bulletin board?

    Posted 2 years ago #
14. 

    DrPerron
    Member

    You are in Philly! Isn't a large order of sarcasm the perfect side item to a cheesesteak?

    Posted 2 years ago #
15. 

    Anonymous
    Unregistered

    Yo! youse talkin about Philly? I'll tell youse what to put on that cheesesteak and what to eat it wit and what part of your body to eat it wit too.

    Posted 2 years ago #

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