How many times have you walked into a treatment room only to get blindsided by an angry patient?  They could have been having a bad day for many reasons, but you’re in front of them now so they take it out on you.  There treatment isn’t right, their supplements aren’t right and their billing isn’t right. 

So how do you handle this?

It’s very easy to lash back and take the authority position and “put them in their place.”  But what good comes out of that for either side?  You lose a patient; they lose a doctor, so every one loses.

So how can you handle this situation without everybody losing?  I’ve learned some valuable techniques over the years that I want to share.  The first technique is to never take the anger force head on.  The second is to consider the source of the anger.  And the final technique is to look for common ground you both can agree on and to look at the rest of the problem from that common ground.

Never taking the force of the anger head on is derived from studying the martial arts.  There is never a need to take a full hit.  Side step that energy.  Change the subject to something less volatile.  Diffuse the confrontation with your tone and body posture.  Then move them into a discussion about something you can both agree on.

The second technique I use is to consider the source of the attack.  If this person is prone to this type of behavior, or has had several conflicts in all areas of their life, consider the source.  The other piece to consider is how deep your personal relationship is with that person in the first place.  If they are just an acquaintance then take that into consideration.  If they are a family member, that is a whole different story. 

Finally, always look for the common ground you both can stand on.  This always helps to diffuse the situation and allows both of you to begin to put the emotion aside to analyze and address the current problems, without ramping up the emotional scale.

So always stay on the patient’s side by finding common ground.  Always consider the source of the situation and never take the brunt of the anger head on and your practice and your life will continue to grow into what you dream of.

If someone was holding a loved one hostage and you had to get a millions dollars to get them out, would you try to get criminals to lower their price?  Of course not, you would do everything you could to come up with the money.

This highly emotional situation is a great example of receiving a benefit for a cost, no matter what that cost is.  They could have said ten million or even a hundred million and you wouldn’t have said anything about price, you would do whatever it took to get it.

In daily practice the same dynamic holds true just on a much smaller scale.  When you are talking to your patients about their problems, if you don’t get them to assess their problems on an emotional level, you will likely encounter price resistance.

In other words, if a patient brings up price as an objection, you haven’t done a good job of connecting their problems on an emotional level.  They don’t understand the real effects their problem is having on their life, family, finances, and social activities.  They are still emotionally detached and you need to make them aware of the real consequences if they don’t take the appropriate actions.

This might sound like manipulation to some, but your job as a healthcare provider is to give the whole story and then let them decide to follow through or not.  If you only tell them about the intellectual side of the problem and only look at their issues from a cortical level, they’ll usually take the band aid approach to relief care.

Once you paint the long-term picture of their health and the effects it has on their loved ones, the entire dynamic of the consultation can change.  Instinctually, we all want to do what is best for our family and friends and will go to great lengths to help them.  But your patients have to realize the best way to help them is to help them self first.

So the next time someone asks you about price step back and ask yourself how well you have addressed the emotional side of your patient’s complaint.  Price resistance is a natural default response for people who want to get to the root of their problem but really don’t know how.

Your job is to recognize this and help them get to the next level of health by providing the best healthy lifestyle care possible.  I know you can do that.

I go to a lot of seminars.  When I listen to countless miraculous stories and fabulous results I get really pumped up and can’t wait to get to the office on Monday.  On Sunday night, I’m telling my wife and kids about the new things I can do based on what I learned and I go to bed with great anticipation.

Then Monday morning hits and it usually takes three patients and one staff or office problem to curb my enthusiasm and drag me back into the “same old, same old” of practice.  About lunchtime I think to myself, “I sure would like to practice like that speaker does; their grass must be much greener than mine.”

We have all had this happen multiple times in our practice lifetime.  And we all realize the grass isn’t greener.  But it’s hard to change what’s already working without huge amounts of time, energy, money and momentum.  So don’t fall for the Hollywood glitzy “greatest practice ever” scheme, just start digging deeper into the issues and problems you have greatest success within your practice already.

We all know we can’t be all things to all people.  I don’t want to talk to patients about drugs or surgery.  I want to talk to them about staying healthy.  So the more systems you create that bring up these topics in conversation, the stronger your patient-doctor relationship becomes.

We all want referral based practices including grandpa, grandma and all the kids down to the newborns.  The best way to do this is to keep talking and listening to the real life problems and issues people have every day in their lives.

Problems with digestion, blood sugar, energy and weight loss can fill your day with conversation as you assess, diagnose and treat subluxations.  So don’t throw the baby out with the bath water, use your treatment time as a starting point to educate your patients to help them create a healthy lifestyle for life. 

We all have miracle cases in practice.  But 95% of our patients don’t fit into the “Hollywood” practice model.  When you come back from your next seminar think of one thing you can add to what’s working already and implement it.  This will create long-term relationships and a stable practice for years to come.

How often have you experienced a moment of silence in a conversation with a patient and you felt awkward? Most times this awkward feeling is felt by both people and the person who speaks next is at a disadvantage.

This is the biggest difference between recommending and selling. Your job as the doctor is to educate your patients on all aspects of your care. You need time to explain how your adjustments work and will benefit them in the long run. You need to tell them how using exercise, whole food nutrition, stress management and stretching will provide continued benefit and value to them. They need to hear why a long term relationship with your office is really in their best interest.

However, all of these communications cannot be done in one or two visits. Your job is to pick one and tell this side of the story on each visit. Even more important is to make your point and then shut up and listen to the response you get from your patient. If you have engaged them in the proper way, they will provide you with their point of view.

Some will agree, some will disagree and some will have further questions. Any of these three responses gives you the opportunity to strengthen your doctor-patient relationship. The last thing you want to do is to continue talking through the pause or further clarify a point you made without letting them talk. When you do this you are walking into the selling realm. You want to make your recommendations and then listen to their response.

Our goal as physicians is to make our patients accountable for their own healthcare decisions. They need to take a proactive role in staying healthy for a lifetime. Our job is to challenge them to do so. Your recommendations should be designed to lead them in that direction. They might not agree with you because they have no other frame of reference, but if you consistently tell them the same story and they hear similar stories from other sources, this leads to credibility and validation.

So make your point then listen. You don’t always have to be the one leading the conversation. Besides, everyone loves to make things their idea anyway. If you give them a story they can agree with, they will take the ball and run with it, and you have another patient for life.

Every patient encounter gives you an opportunity to add value and benefit to your patients life.  There are three easy ways to talk nutrition with patients to help seize that opportunity.  The first way is relate function to structure.  The second way is ask questions about specific areas you notice they have issues with.  And finally, seize every opportunity to talk nutrition using a vicarious experience.

Relating structure to function comes natural to chiropractors.  We have been taught to think this way.  The next step is to think and talk about nutritional support.  The classic example is adrenal fatigue and low back pain.  Any patient that can’t hold my adjustment I start asking them about fatigue and adrenal issues.

The second way to talk nutrition is use clinical observations to ask about their nutrition.  If someone is overweight, I’ll ask them about their blood sugar or toxicity issues.  If their tired all the time, I’ll discuss their adrenal gland.  If you notice they retain fluid, have a conversation about their liver.  Relate their signs to their nutritional deficiencies. 

The final way to talk nutrition is to use vicarious experiences.  I use vicarious experience conversations with patients who aren’t very open to anything else.  A vicarious experience is a story you tell about another patient who is just like them that you have helped with the problem they are currently experiencing.

The story usually goes like this.  You’re talking to a forty year old female and you tell her about another similar woman you’re working with that has the same or similar problems. Then you tell her about the nutritional support you used and the results which came from using that support.

I start the story in a matter of fact way so it doesn’t look as if I’m beating them up.  I might start by talking about another case totally different from theirs, and then bring up the similar case. 

By doing this, you make them think, “That’s what’s happening to me”.  Most of the time they’ll become engaged and ask you questions.  Then you can make your recommendations.

One of the great mysteries of running a successful practice is how to get your passion for helping people communicated effectively to your patients and your community.  There are three specific things that will help you tell your version of the chiropractic story effectively. 

First is your personal connection with chiropractic.  People want to know how you became involved, what has it done for you and why you feel so passionate about your brand of chiropractic.  People really love to hear about other people’s trials and tribulation.  They want to know that you have walked in their shoes and have come out smiling on the other side.

Second is to make sure all of your internal marketing is in alignment with your chiropractic brand.  If you promote nutrition and a healthy lifestyle, you better not have processed foods and candy bars lying around the office.  Your staff has to walk the walk the walk and talk the talk also.  But it is your job to educate your staff to the point they want to follow your lead because it’s in their best interest.

Finally, does all of your external marketing and promotional material match what you are doing internally?  If you are getting people’s attention by talking about weight loss or fatigue and they walk into your office and that message is not being demonstrated inside the clinic, they will become very suspicious.  Your story of chiropractic should be woven throughout all of your policies, procedures and communications with your patients and your community.

Everybody loves to hear a good story.  It starts with an interesting idea to capture their attention.  Then you explain the trials and tribulation and solutions which have worked for you.  Finally, you provide proof other than yourself that your solutions have worked for other people. 

This formula is simple, but it allows you to tell your story consistently and easily and also allows others to repeat your story to your friends and family to create referrals.  

One of the most important parts of every day practice is your ability to make recommendations that can be carried out by your patients.  If you are able to communicate effectively with your patients, they follow through, get better, tell their friends how great you are, and your practice continues to grow.

In his book, How We Decide by Jonah Lehrer, he explains how we all go through different filters to make decisions.  If we are guided by his blueprint to make our recommendations to our patients, it doesn’t go against the grain and makes sense to your patients.  This makes it easier for them to follow through effectively. 

Mr. Lehrer describes three different filters we all go through when making a decision.  The first filter is the emotional filter, the second is the rational filter, and the last filter is the moral filter.  Depending on the size of the decision, you might use one, two or all three filters.  The emotional filter is used to make smaller decisions.  Daily tasks, grocery decisions, what day to make your patients next appointment are examples of simple emotional filter decisions.

The rational filter is used for larger more complicated decisions.  Deciding about a care plan or a supplement protocol are examples of rational decisions your patients make in your office. 

The moral filter is sprinkled throughout all the decisions.  Does your office feel right?  Do you have your patients best interests at heart all of the time, even if it means you refer them for outside services or not selling them something they don’t need.  Does your practice fit their internal moral code of conduct? 

I’ve created a flow chart to make sure my practice uses these guidelines for my recommendations.  First, I make sure my patient communications are such I get them emotionally involved in their care.  I make sure they feel what is happening and what could happen if they do nothing about their situation.

Then I make my recommendations based on their emotional response.  I follow up by giving articles, books, testimonials or other information that assures them rationally they have made the right decisions.  Because you always start with the emotional side of the decision and then justify it with the rational side.

Then I continually make sure my policies, systems, procedures and attitude in the office fit my personal moral code of conduct so everything feels right and they know we are always on their side.

I’ve recently read a Seth Godin book on marketing called All Marketers Tell Stories, The Underground Classic That Explains How Marketing Really Works and Why Authenticity Is the Best Marketing of All.  Like it or not, we’re all in the marketing business.  We need to understand how to get our story out to help all the people who need our help.

This book goes through five steps to getting your story told.  As you create your practice story, think about these five steps so your patients and community can understand and listen to your story then benefit from your products and services. 

Step 1:  Tell your story with their worldview and frame of reference in mind.  This means every person already has an opinion about your practice.  Your job to begin telling your story with what they think they already know.  Most people’s world view of chiropractic is back pain treatment.  So start with this world view as a frame of reference. 

Step 2:  Make your story sound like something new, then people will take it from there.  Your story must be different enough to get noticed.  What’s different about your back pain relief story?  What do you do better and faster than the guy down the street?  Once you get their attention, they will take the ball and run with it themselves. 

Step 3:  Their first impression of your practice starts the story for them.  From the time they read your story, go to the internet for more information, then finally decide to make the first phone call, they have already created a very quick and permanent first impression of your practice.  Make sure every part of this process tells the same story and is authentic and truthful.

Step 4:  Your practice story has to match the world view that patient has just grabbed their attention.  In other words, if they were drawn to your story because they have chronic low back pains then you tell them a story about headaches, you lost them.  If the story is consistent, the patient will tell themselves an internal story and predict what will happen to them when they come to see you.  Then they will rationalize anything that doesn’t fit that story to give you the benefit of the doubt.

Step 5:  Once this new patient has experienced your story for themselves, does it hold up to their scrutiny long enough for them to tell other people about your story?  Is you story living up to their expectations?  Can they tell others about your story quickly and easily to help you build your business? 

Look at your practice through these five steps.  Once you master these basic principles you are taking your practice from a self-employed job to a full grown business. 

A business mentor and friend of mine introduced me to the idea of the star of business.  This icon, used correctly can take any viable business model and make it shine all the way to the bank. 

The five points of the star include: clarity, focus, strategy, leverage and momentum.  Then in the heart of the star is cash flow.  Every Chiropractic practice must study and consider all six parts to keep its doors open long-term.  You can limp along if you ignore one or two points, but you will never get where you want to go.

Clarity refers to your deep down passion.  What is the driving force that gets you out of bed in the morning?  Can you state your purpose practice in one sentence?  Do you have a clear picture in your mind’s eye of why you do what you do on a daily basis?  That is clarity. 

Focus refers to your ability to stay the course.  Do you ever stray away from core chiropractic principles?  Do you become jazzed by the latest seminar you went to and quit doing what has built your practice in the first place?  Center yourself everyday before you begin treating patients, it really helps.

Strategy refers to an overall plan that has been developed for your practice.  My strategy is to use chiropractic whole food nutrition, massage therapy and low tech rehab to move people towards a health lifestyle and away from drugs and surgery.  What’s your strategy?

Leverage refers to your ability to multiply your efforts using technology, staff and systems.  I have trained my staff to do the vast majority of the procedures in my office so I can focus my unique talents and abilities, adjusting and talking about whole food nutrition with my patients. 

And the final point of the star is momentum.  This refers to your ability to keep patients happy by providing more than they expected so they refer their friends and family.  Momentum builds with continued communication, promotion, and innovation.

No star of business is complete without its heart and that’s cash flow.  We all know if you don’t’ have enough cash flow you can’t do what you want to do in practice.  So make sure you have different events, promotions and activities going on throughout the year to minimize ups and downs in your cash flow to keep things humming along.

So spend some time thinking about your business and how you can improve it.  You’ll be glad you did.

How many times a day do you talk about the weather or a sporting event with your patients during your treatment time?  I understand this helps to build rapport between you and your patients, but you’re missing a golden opportunity to add value and benefit to your patient/doctor relationship every time you fall back into this normal default sort of conversation.

Your patients have come to you for your wisdom and guidance.  They have already shown a great deal of trust in you by receiving your care.  What other products or services would give them further benefit?  What is going to make their visit to your office go from just another doctor visit, to “man, you got to go see this guy”?

I have found it’s all based on the conversations you have and the material and knowledge you provide to your patients during and after your treatment conversations. 

It all starts with asking specific probing wellness related questions during your treatment.  I’m not talking about their dog or grandkids; I’m talking about digging deeper into the deeper health concerns.  When somebody comes into my office with a mid back problem, I’m going to start asking them questions about digestion.  When somebody comes in who has weight issues, I’m going to bring it up.  When somebody falls asleep during there therapy session, I’m going to ask them about their energy. 

The real key to starting up these kinds of conversations is how you ask the questions in the first place.  Never ask questions in a way that could put either of the two people involved in the conversation on the defensive.  Don’t ask, “How much weight have you gained over the last year?”  Instead ask, “Has your weight fluctuated much over the last year?”

Always allow the patient to answer your questions with a positive or negative answer without putting them on the defensive.  If they are ready to talk about you helping them, you move forward with the conversation and lead your patient down the path to that WOW experience you really want them to have in your office.