Monday, February 11th, 2008
Whether a person chooses to continue or discontinue chiropractic care depends upon how much the person values the care when compared with how much they feel it is costing them.
If the value appears greater than the cost the patient will continue care. If the cost appears to become more than the value they will discontinue treatment. The more we can increase the perceived value the less we need to worry about the cost!
VALUE INCREASERS:
1) Experiencing benefits from chiropractic care. Especially if those benefits are over and above the initial complaint or the benefits expected.
2) Increased education and understanding about chiropractic.
3) Third parties (family and friends) experiencing benefits: Another great reason to stimulate referrals quickly.
4) A “paradigm shift”: Changing people’s attitudes from “don’t fix it till it’s broke”, to one of maintenance, prevention and/or preferably wellness. That is “getting the BIG idea”!
COST INCREASERS:
1) Financial constraints: The amazing thing about this factor is that the more you can increase perceived value the less important this becomes. If you want it then you will find a way to pay. However cost is one of the main reasons people discontinue.
2) Time constraints: The old saying is that “time is money”. If it takes a person more than 20 minutes to drive to your practice; then they sit in your waiting room for 20 minutes; then it takes 15 minutes to get adjusted; then it takes 5 minutes to pay and reschedule – that’s 80 minutes out of their life. And then you tell them you want to see them 3 times a week? Big cost.
VALUE DECREASERS:
1) No or slow perceived response to treatment.
2) A reaction to an adjustment.
3) ‘Chiropractic consultants’: Rumor, opinion and hearsay can always affect the attitude of a new member of the chiropractic “family”.
4) Our attitude towards chiropractic: It ‘rubs off’ you know!
5) “The law of diminishing intent”: Ever made a new year’s resolution; then a few weeks later it just doesn’t seem that important any more? Day to day stresses and commitments and the distractions of “life” seem to get in the way. That is – the original commitment gradually becomes diluted to the point of becoming unimportant:
If we constantly feed, reinforce and nurture our goals and resolutions there is less chance of them fading and getting lost in this way. It is never safe to think that a patient has got “the big idea” now, and will hence have it forever – they need constant feeding, reinforcement and nurturing of their goals and resolutions.
TWO WAYS TO GET PEOPLE TO DO THINGS:
1) Control and manipulate: This is like trying to get a donkey to move by putting a carrot in front of its nose or hitting it from behind with a big stick. The problem with these techniques is that the reward or the punishments need to be continually increased to receive the same response over a long period of time.
In our health care setting this would take claiming bigger and bigger benefits to our patients as they feel better (the carrot), or convincing people that if they don’t continue to see us something terrible will happen to them (the stick). At some point in time the carrot and the stick will not be big enough!
2) Build relationships and teach by example: This is not about getting people to do what we want them to do: It is about showing people how they can get what they want – by following our example!
Click Here To Find Out More About Practice Management Coaching…
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Wednesday, October 17th, 2007
There is compelling scientific evidence that what people know about diet and how they eat are in many cases two different issues? I’m sure you have observed that this void between knowing and doing crosses over into all health behaviours?
1) The acute antalgic low back or torticollis crisis patient who promises you that they will keep seeing you forever for maintenance care if you can only help them get out of agony; who then discontinue somewhere between visit two and six because “they are fine now and will ring if they have any further problems”.
2) The reactivating patient that confesses that they were feeling great while they were doing the exercises that you taught them, but then they just forgot about them because they didn’t have any pain. And then they ask you “why does this problem keep coming back?”
3) The osteo-arthritic retiree that starts complaining of increased aching and stiffness, and when you ask them if they are still taking their Glucosamine, they respond “Oh I finished the bottle and thought I’d see how I’d go without them for a while”.
4) You meet an old regular practice member who discontinued 1-2 years ago, and when you ask them how they are going they give you the long list of ailments, diagnoses and prescriptions that they now take, and then pass comment “you know when I used to see you I didn’t have any of these problems”.
There’s a push in our profession right now to adapt us into risk-factor screening machines, who then pass appropriate educational brochures to those at risk, and warn them of the dangers of not changing their ways. Think about this: Most people who are overweight already know they are overweight; most people who are unfit already experience the effects of it; most people experiencing symptoms of Diabetes are aware of the symptoms… They don’t need you to identify the symptoms of their condition. They need help closing the void between their awareness and their behaviour!
If you want to be a wellness practitioner let me tell you a major paradigm shift you are going to have to make - It’s not about you, it’s about them. Wellness is a personal journey of lifestyle choices leading towards better life and health outcomes. You can’t make the decisions for them - if you try to then its not wellness - it’s medicine.
Here’s four questions that you must ask your practice members to make massive changes in your wellness relationship:
1) “What is your biggest health priority right now?” Their choice not yours.
2) “What are three things you think you could do to improve this area of your life?” Their choice, not yours. But this may be the point where they ask you for your educated opinion.
3) “What information do you think you need to help you make this change?” This is the point where they will most likely give you permission to feed them with resources.
4) “What would you like me to do to make sure you follow through on your plan?” This is where you help them to make some commitments, set some goals for them to achieve, define some measures for monitoring their progress, and set a time-line for review.
Click Here To See How Wellness Coaching Is Done…
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