“The Report of Findings and the Paradigm Shift”
Part 1 of 3
The report of findings (ROF) is a very powerful tool in educating your patients as to what is wrong with them and to explain their treatment plan. That is the primary reason for an ROF and the more effective you are at a ROF, the more compliant a patient you will have because they now understand. As a marketing tool, I have always used the ROF to be able to help more people through teaching chiropractic and using every communication modality available. The goal is to stimulate as many senses as possible during the ROF so that the patient gets the message.
Research has clearly demonstrated, primarily in the field of education, that some people are auditory learners, others are visual, while yet others are tactile learners. That is why in the school systems, educators now incorporate a vast variety of learning tools stimulating a variety of senses in the classroom environment. We need to do the same in the ROF. Your patients are in school again, the school of their health and they must understand.
The other component is to be learned from the film industry. Theatres are now in surround sound with stadium seating. There are IMAX theatres where the seats actually vibrate, move, tilt and some even squirt water at you in a wet scene to give you the full experience. These techniques not only make it enjoyable, but allow you to participate at a higher level in the theatre experience.
If you look carefully, the film industry has incorporated what the educational field has discovered as well. Stimulate as many senses as possible to help all types of learners understand the subject matter at a higher level. We as doctors need to help our patients understand at a higher level as well, to understand their problem in the ROF. You don’t need a movie studio behind you, there is already enough in the field for you to use and if positioned properly, you can create this type of experience for your patients.
Before we get into creating the environment for the ROF which is in the next consultation, we must understand how practices historically acquire different types of patients, how they use those patients to get internal referrals and how to use the ROF as a marketing tool. It has been the practice of most doctors through the decades to acquire personal injury patients from their general population of patients. A certain percentage of your current or former patients get into accidents and come back to you, as you have gained their confidence as a doctor and have helped them in the past. That is the norm. In a few practices, you have lawyers referring to you on a regular basis. Both scenarios are good ways to get new patients.
There are as many philosophies of practice as there are practitioners. Some care for families, some only pain and yet others only want sports injuries. The one thing everyone reading this has in common, is that you all want more personal injury patients.
25 years ago, when I started practice, my mentor taught me the power of the health care talk and the ROF, and how to use it as a tool to educate the patients as to what is wrong with them, why they need to come for care regularly and to tell them I could help their family members as well. I educated them. Over time, I wanted to treat more personal injury patients because I liked treating the injured. It was more challenging. I then started using the ROF as a tool to get my message out. I would have the patient watch a video explaining generically what I was looking for and then I showed them their x-rays giving proof to their injury.
My report of findings to the non-trauma patient centered on the cause of their pain and/or problems. I would explain that if they were ever in an accident, they must get to my office within 24 hours, even if it was a weekend and gave them my cell phone number. The reason, if they were injured in any way, then the tissue repair process begins immediately and I didn't want internal scar tissue (adhesions) to develop, making the correction more difficult. I made sure they kept my card in their wallet as I watched them place it there. I actually told them I wanted them to do it in front of me, so they had me as their emergency number. I would receive numerous calls with new accident cases and surprisingly enough, it was usually on the weekends.
The other step I took during the ROF was to make sure that the patient brought a significant other, friend or family member with them. I would have them attend, with the patient’s permission, the ROF. After the video, the x-rays and the explanation, the other person knew as much about my care as the patient, and I would turn to the other person and say, "Would you like to have your spine checked as well?" I started 50% on the spot, as an average, because they were educated and motivated.
The other scenario is for the personal injury patient that came in for care. I would also have them bring someone else with them to the ROF (that is a hard rule). At the end of the ROF, I would again offer to check the spine of the other person, and I would say to the person in the accident, “You need to have you family’s spines checked as well.” Again, 50% of the time, they did. I also asked if there was any other person in the car with them and then called that person, as a courtesy to my patient, to have their spine checked. Most people would come in for a check-up and then start care if problems were discovered.
This is a perfect example of creating a paradigm shift from disease care to wellness care and how to use both the non-trauma patient to build a personal injury practice. Conversely, it is an example of how to use a trauma case to build a non-trauma practice. The reality is, you need to have both types of patients in your care. Remember, the more non-trauma patients you have under care, the more personal injury cases you will get, because a percentage of these cases will get into an accident and will use you as well.
Part 2 of this series will discuss tools needed and how to create the environment.