“The Report of Findings and the Paradigm Shift”
Part 2 of 3
The Tools Needed & Why
If you don’t do a patient report of findings, please fly to New York and come to my office, so I can smack you in the back of your head. If that is too obnoxious, well…that’s my point. The single-most important thing you can do is educate your patients. If not, they will come until their pain is gone, at best, and then they will stop.
Look at your patient visit average (PVA.) Your PVA is determined by taking the total number of visits for the month or year and then dividing it by the total number of new treatment patients (exclude any patients that come for a second opinion.) The following graph will help you:
5-20 Failing Practice
The practice is on survival and almost always on "critical liefe support." There is no report of findings as the patients do not understand why they are under your care and will exit the practice much too soon.
20-30 Pain Practice
The patients are coming under the medical model, only if it hurts. There is still something wrong and they need to continue until their pain goes away. They will then stop without the underlying problems or the causes of their pain being corrected because the report of findings was absent or centered on their pain.
30-40 Corrective Care Practice
These patients understand that their pain is not the problem. They have been educated to the concept of corrective care. They understand that the doctor cannot correct the cause of the problem until their pain goes away because until the spasm let’s go, the structure can’t normalize. This is a practice that is close to stability.
40-50 Rehabilitative/Stabilization Practice
These patients fully understand the above concepts and also have been educated on the concept of wellness. Their pain issues have been resolved and they like being better, not just feeling better. The doctor has successfully communicated the concepts of corrective care and wellness care to the patients. This practice is stable.
50+ Wellness Practice
These patients are fully educated on the concepts of wellness and have accepted it into their lifestyles. This practice is stable and will grow effortlessly because the patients will now tell everyone that they have found an answer to their health issues.
As long as your PVA is 30 or above, you are out of survival mode (providing your business model is efficient and you are collecting your fees) and you get to determine what services to deliver to your patients. Some doctors practice a pain model, while others focus on corrective/rehabilitative care, and yet others strive towards a wellness model. With the exception of the pain model, it doesn’t matter what your focus is; that’s up to you. The reason the pain model doesn’t work is simple. The problem isn’t their pain. It’s the underlying instability and that is what you need to spend time with during the report of findings. The patient needs to understand that if the cause of the problem is corrected, then the pain will not only go away, it will stay away and their spine-shoulder-knee-etc… will not prematurely degenerate and they get to keep that body part.
If they terminate care when the pain goes away without stabilizing the underlying cause, then soon enough, the pain will return and the joint will degenerate. If the problem is their spine, then subluxation degeneration will progress and over time, their spine will start to decay, like a cavity in a tooth. The only problem is unlike a tooth that can be replaced, you only have 1 spinal bone and that can’t be replaced. If you do not care for it, it will cause your body to malfunction and eventually, cause more serious problems both structurally and systemically.
The purpose of this consulting session is not to teach you the language of the ROF or how to communicate with your patients, it’s to give you a concept and then the tools needed to convey that concept. The message should not be delivered initially by you. It should come from a third party that appears well-informed and will deliver it in a clear and powerful medium. You then give the patient a completed, customized written report of findings that is both explanatory in their problem and educational about your care. The next step is to show them their x-rays in explanation of how you arrived at your diagnosis and then conclude the report of findings with choices for the patient to make. The next few paragraphs will give you a sequence of events and what tools you need to deliver an effective report of findings.
The patient, upon their first visit, gets evaluated and has x-rays taken, if clinically indicated. Be aware of State Education Law. Most require visualization of the area you will be treating and have diagnosed, especially if the patient has been injured in an accident. If the patient has an incident under your care and you do not have x-rays, there is a good chance you will have a poor defense. At the end of the visit, you tell you patient that on their next visit, you will be reviewing their x-rays with them, after they watch a brief 9 minute video. The purpose of the video is to help them understand what you are going to show them on their x-rays. Ask them to bring with them, their spouse, significant other or friend, as you are going to explain a lot of things to them and it is better to have someone with them.
Upon entering the office for visit #2, the staff or you escort the patient to the ROF area and they watch the 9 minute Back Talk System’s video. Before the appointed time, you complete the written report of findings to be prepared for the patient. Remember the 6 P’s: Proper Planning Prevents Piss Poor Performance.
NOTE: I have reviewed numerous report of finding DVD's, brochures and report of finding's booklets. There are many that are good and some have sections that are outstanding, however Back Talk Systems combines all of the essentials without "trashing" drugs or surgery and is visually excellent in delivering the message. I firmly believe that we do not have to degenerate another specialty in order to thrive and change the consciousness of a population.
All marketing tools are from Back Talk Systems (see below.) I have arranged a 1 time discount of 10% for you (mention the Academy of Chiropractic to receive the discount.) So read this entire consult and decide what tools you choose to purchase and get 10% off. At the end of the consult, is a sheet from Back Talk Systems with contact-purchase information.
As a note, only because I have been asked and offered, I never make a profit on any business partner that I recommend. I would rather pass the savings on to you.
1. Report of Findings DVD: An entertaining 9 minute video uses powerful visual metaphors for your patients to learn the full nature of their problem and be motivated to keep their appointments and refer others. Available on VHS or DVD.
2. Report of Findings: The most widely used Report of Findings tool in Chiropractic is in “magazette format” allows you to organize you report in a way that any patient can understand.
After the patient watches the DVD, you enter the room and review the ROF magazette with the patient. Make sure you fill out the nerve function chart and recommendations. In your explanation, key in on the structural deformities the x-rays demonstrate. It is here when you explain the phases of care with the patient: the initial intensive care, to deal with the pain, and then corrective care, to make the spinal structural changes. If your practice philosophy is wellness, then you can discuss that with the patient.
When you show the x-rays, you need to use the visual tools of nerve chart, subluxation degeneration chart and cause and effect chart, you laminated and mounted on the wall.
- Subluxation Degeneration Poster:Educate and motivate your patients with this poster available in 24 x 36 or 20 x 24, plain or laminated.
- Cause and Effect Poster:A larger and more detailed version of our nerve function handout, this poster explains how the nerves effect the organs and symptoms. Available in 24 x 36 or 20 x 24, plain or laminated.
- Nervous System Charts:I have three that may serve your needs in addition to the Cause and Effect poster. 1. Autonomic Nervous System 2. The Spinal Nerves 3. The Nervous System all from the Anatomical Chart Company. You can view them on our website.
- Nerve Function handouts: This handout graphically illustrates how the spine and nervous system relate to complete neurological, muscular-skeletal and visceral function.
This is then placed in the report of findings booklet and is critical for success.
- Stages of Lumbar Degeneration handouts: This handout graphically illustrates the stages of spinal neglect and how this is central to the care of your patients.
This is then placed in the report of findings booklet and is critical for success.
At the end of the ROF, which should take no more than 15 minutes of your time, you ask the patient if they would like only initial relief care, corrective care or wellness care. If they answer with relief care only, then you acknowledge that and say, "Remember, you will be back shortly after the end of the care, as the underlying cause of the problem hasn’t been corrected and the pain will return, usually worse because the supportive structures have weakened and the spine will have degenerated." If they choose corrective care, your answer is, "Great. However, remember your spinal supportive structure has been weakened and over time, the spine will prematurely degenerate, as I explained on the subluxation degeneration poster. Research has proven that I can’t reverse the degeneration, but I can slow or stop the forward progression of the degeneration." Explain that wellness care is once or twice a month. A third of your patients will choose relief care, a third will choose corrective care and a third will choose wellness care. That’s okay because over time you will build up a wellness base of patients that are cash-based and significantly increase your PVA.
At this point in time, you turn to the significant other, friend or spouse in the room and ask them if they would like to have their spine checked. They have sat through the same educational process as your patient and if done properly, my experience is that 1/3 will want to have their spine examined and most will start care if there is a problem that is clinically demonstrable.
A great tool for helping the patients understand subluxation degeneration is anatomical models. This fits in with stimulating as many senses as possible during your presentation.
- Magnetized Anatomical Model: Phase-place for subluxation degeneration your patients while turning your X-rays into 3-D. This is part of creating the multi-media experience for your patients. $179.95
An additional tool for helping your patients understand chiropractic is a reception room DVD. (It is not a waiting room, as patients shouldn’t wait, they should be received.) This DVD is a continuous playing, silent program that is not intrusive, yet powerful in planting the referral concepts for your patients.
- Waiting Room DVD: This 65 minute silent program is a great educational and referral tool this is prompted to replay continuously during the day. Available on VHS or DVD but only auto loops on DVD. This covers nerves affected, spinal segments involved, subluxation degeneration and treatment plan recommendations.
It is also important for patients to be able to take information home with them on a variety of symptom-related topics to share with friends. Patients will take symptom-related material because they know other people with symptoms and want to help.
- This is the most important practice building tool as your patients both take this home and show their family members and friends.
- Lifestyle brochure series consists of 29 titles (some of which are not symptoms or conditions)
The next consultation will be on how to create a multimedia environment for your patients for the ROF to stimulate as many senses as possible to help them understand and be motivated to comply with all of your recommendations.
Patient Information Success SystemReport of Findings
- To Order: Call Back Talk Systems at 1-800-937-3113
- Any Item can be reviewed on Back Talk System's Web site:
- To order the entire program, ask for the CMCS kit.
- If you want to order individual items, that is OK as well.
- You will receive a 10% discount off by using the name CMCS or the Academy of Chiropractic
The numbered items are not optional for the basics of success in a report of findings. The other items will increase your practice in a very powerful way. I have used them for many years.
- Report of Findings DVD: An entertaining 9 minute video uses powerful visual metaphors for your patients to learn the full nature of their problem and be motivated to keep their appointments and refer others. Available on VHS or DVD.
- Report of Findings:The most widely used Report of Findings tool in Chiropractic is in “magazette format” which allows you to organize you report in a way that any patient can understand.
- Subluxation Degeneration Poster:Educate and motivate your patients with this poster. Available in 24 x 36 or 20 x 24, plain or laminated. 24 x 36 laminated chart.
- Cause and Effect Poster:A larger and more detailed version of our nerve function handout, this poster explains how the nerves effect the organs and symptoms. Available in 24 x 36 or 20 x 24, plain or laminated. 24 x 36 laminated chart.
- Nervous System Charts:I have three that may serve your needs in addition to the Cause and Effect poster. 1. Autonomic Nervous System 2. The Spinal Nerves 3. The Nervous System All from the Anatomical Chart Company. each laminated
Although the following items are optional, they will generate
new patients for your office…
- Waiting Room DVD: This 65 minute silent program is a great educational and referral tool. This is prompted to replay continuously during the day. Available on VHS or DVD, but only auto loops on DVD.
This covers nerves affected, spinal segments involved, subluxation degeneration and treatment plan recommendations.
- Magnetized Anatomical Model: Phase-place for subluxation degeneration your patients while turning your X-rays into 3-D. This is part of creating the multi-media experience for your patients.
- Lifestyle brochure series consists of 29 titles (some of which are not symptoms or conditions) including:
1) Adjustments 2) Carpal Tunnel 3) Children 4) Chiropractic 5) Degeneration 6) Disc Problems 7) Extremeties 8) Fibromyalgia 9) Headaches 10) Lower Back 11) Mid Back Pain 12) Myths 13) Neck Pain 14) Pregnancy 15) Referrals 16) Rehab 17) Results 18) Sciatica 19) Scoliosis 20) Shoulder Pain 21) Sleep 22) Sports 23) Stress 24) Subluxation 25) Symptoms 26) Types of Care 27) Welcome 28) Wellness 29) Whiplash