Patient Education

The Art of Patient Motivation

Perry Nickelston, DC, FMS, SFMA

You spend countless hours in school learning the art of chiropractic. You take classes in technique, diagnosis, application and philosophy. Every aspect of chiropractic skill is taught so when you have a patient under your care, they have the greatest chance of getting well. But, what happens if you cannot motivate patients to keep coming back? How can you keep them excited to continue their care plan? How do you ensure they understand the value of chiropractic beyond pain relief?

Good questions; and here is the answer. You must master the art of building quality relationships. There is a skill to understanding human behavior, motivation, compliance and the emotional triggers for taking action. Forget trying to memorize scripts or following some cookie-cutter practice-management program. The secret lies in understanding the essential communication skills of building rapport with others. Rapport creates trust, allowing you to build a psychological bridge to someone. This bridge will be the reason your patients become loyal chiropractic advocates and raving fans.

Business Success Lesson 101: motivation is selling. You must sell someone on why they should do business with you. More importantly, you must also motivate them to continue doing business with you. Many doctors have an aversion to using the word selling. It sounds so negative, like a used car salesman. Sorry to burst your bubble, but everything in life is about selling. No purchase is ever made without some type of selling. Make no mistake about it; every time a patient comes in to see you they are making a purchasing decision. They are paying for services rendered. Never, ever forget that fact. You are just like any other business. If you do not value and appreciate your customer, they will take their business elsewhere. Fancy gimmicks and marketing tactics may bring people to your business initially, but the relationship you establish motivates them to stay.

People do business with people they like. When they like you, they trust you, and trust builds loyalty. The number one rule to get people to do what you want is to get them to like you. You can educate a patient 24/7 about the benefits of chiropractic, but if they do not like you, there is no chance of motivating them. You can spend all day trying to get someone to like you and think well of you, but it is how you make them feel when they are around you that makes all the difference. Remember, that someone likes you not on how they feel about you, but on how you make them feel about themselves. Read that again. It is a powerful and subtle difference.

The process of motivation starts from the very first interaction you have with a potential patient. What type of first experience are you giving the patient (customer)? There are key moments of patient interaction that will make or break your ability to motivate. Let's take a closer look at these moments and review strategies you can implement today to help improve your art.

First Visit

What does the patient see when they enter your office? Is it clean, up to date, uncluttered, warm and welcoming? Is your staff professional and courteous? Do they smile? A smile is the best way to make a favorable first impression. It accomplishes four powerful things: it conveys confidence, happiness, enthusiasm and most important, it shows acceptance. The first impression is so crucial because everything we see and hear afterwards gets filtered through our initial opinion. So if the first impression of you is favorable, people will have a kinder evaluation of you in future.

Your first meeting with someone is the best opportunity to establish rapport. This is where you must interact with people on an individual basis. You cannot follow a script here. Learn to recognize personality types and match communication style accordingly. For example, you cannot talk with a quiet, reserved, introverted person the same way you do an extroverted social butterfly. They respond differently to body posture, language, tone of voice, rate of speech and your level of energy during conversation.

Conversations are more likely to be positive and comfortable when two people are in sync with each other. Just as we tend to like someone who shares our interests, we are also subconsciously driven to like a person when they appear as we do. When someone makes gestures the way we do, or uses words or phrases as we do, we tend to find them more likeable. During conversation, make observations on body language and speech. Attempt to mimic a few gestures and see how people respond.

Report of Findings

Excitement and motivation for your entire care plan begins here. You must appeal to a person's emotions in your attempt to educate and motivate. No matter how rational and logical your recommendation, you will have great difficulty influencing others if you do not arouse emotions. People make purchasing decisions on an emotional level and then use logic to justify that decision. You need to translate the facts into emotion-based statements and give clear and specific benefits that appeal to a person's emotions.

When reviewing a potential patient's care plan, offer a specific game plan with a clear-cut course of action for proceeding. When people are passionately motivated to take action and continue moving forward, it is essential they understand the direction and the method for proceeding. Patients will feel comfortable and secure knowing that the path is clearly lit and laid out. When you want to motivate someone to listen to your advice, provide more than just the desired destination; also give them a detailed map for getting there. Break down your care plan visit by visit and give them a personalized copy with their name on it to take home.

Most importantly, follow the plan. Keep your word to avoid breaking the established trust factor. Follow your road map of care to perfection. If you tell a patient they will get a re-evaluation on visit four, then you had better make sure you do that on visit four. If you promise to call them, do so. If they lose trust in you, they lose motivation. People don't care how much you know, until they know how much you care. Honoring your word shows them you care.

[pb]Evaluations

Every visit is an evaluation. It's a two-way street on evaluations. You will be evaluating the patient for change in condition and progress according to the original care plan. Meanwhile, the patient will be evaluating their decision to continue care. Patients will determine this in two ways. First, are they getting better? Second, do they feel valued and appreciated as a customer and a human being? Many businesses get so caught up in trying to attract new customers, they forget to value and respect the ones they currently have who already believe in their services. This is a big mistake. So, let's take a deeper look into the two ways patients evaluate you and offer some suggestions to improve these interactions.

Are they getting better? Patients have a preconceived notion of a timeline that is acceptable for them to get well, regardless of how long they have been suffering. You must constantly re-enforce to them the steps necessary for the healing process. Reassure them at every visit they are getting closer to their goal. If they are not getting better, then you must assess their condition and the course of action taken. Change what you are doing: add therapies, change the order of therapies, visit frequency, etc. Show respect and validation for their feedback. Accept the fact that you might have to refer them to another health care provider. Don't worry about losing them as a patient if you refer them out. They will respect your honesty and refer many others to you for the character and integrity you demonstrate.

Value and Appreciation

Am I valued and appreciated? This is where the little things are big things. There are many simple gestures that will make all the difference in how someone feels. These gestures may not seem like much, but they are very powerful. Here are four effective ways of showing value and appreciation:

Say thank you. Thank them for choosing you as their doctor. Remember, they could have walked into any chiropractor for help, yet they chose you. If you think they base that decision on what insurance you take, you would be wrong. Sure, that might be the initial reason some call you, but it will have nothing to do with their motivation to continue seeing you. Thank them for any referrals. Make sure they know that referring friends and loved ones is the highest compliment that you could get as a doctor. Send them a hand-written thank you note as follow up gesture.

Compliment them. Everyone loves a compliment. Let me clarify that; everyone loves a genuine compliment. Tell them you are proud of them for staying dedicated to their care plan and working towards becoming a healthier person. Congratulate them on the effort, commitment, time and sacrifice they have given to investing in themselves. Literally place your hand on their shoulder and say, "I am proud of you for doing such a great job in staying dedicated to your goal of getting healthy."

Value their time. Show respect by valuing their time. Do not keep them waiting. Learn to control your schedule book with cluster visits, without sacrificing service. Overbooking will become a problem if patients feel their time is not respected. Remember, two to three visits per week out of their lives to see you for care, is a big commitment. They have responsibilities and obligations outside of your office and that must be respected. Make your office a well-oiled machine where the system is never bogged down.

Show genuine interest. Are they more to you than a patient? Express interest in their life. Ask about hobbies, families, lifestyles and talk about other things besides their condition. Turns out, all of these factors are critical to understanding their mindset and what outside forces may be positively or negatively affecting their health.

For example, knowing that patient XYZ loves to run and work out is important to understanding their motivation toward getting well. Appeal to their emotional triggers and desires for getting well by linking chiropractic care to running. Tell XYZ they will get back to running without pain, but also run better and faster since they are correcting underlying problems that negatively affect performance.

The most important thing to remember is that we really can't motivate others. Real motivation comes from within. People motivate themselves. You must set the stage to help this self-motivation process by creating the right environment and conditions for it to blossom. Ultimately, your practice environment is determined by you.

However, your staff is always on the frontlines interacting with every client. So be sure to honor, respect, and motivate your staff. Devote whatever resources you need to keep them well-trained, friendly, and enthusiastic. Why? Patients form an opinion of you based on how they are treated by your staff. Bad experiences with an unmotivated staff will foster negative patient compliance. This is what I like to call an a-ha moment, where you realize just how important relationships are to success. So how can you motivate your staff? Apply all the principles you learned above. Your staff craves the same magical connections as your patients.

Rule number one: You are in the people business. You just happen to also be a doctor. Always remember this rule and you will be ahead of the majority. Get back to the fundamentals of building and establishing quality relationships. If you are currently having a problem keeping patients motivated, stop searching for outside fixes and take a deep look inside yourself for answers. Change who you are so you can get better results. You just might be surprised at what you discover.

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