Monday, April 18, 2016

Patient Communication is a Key to the Kingdom of Practice Success


A few weeks ago I was on the phone with my friend Marilyn Allen (whom many of you know, I am sure!), discussing ways that business education and levels of success could be improved for acupuncture students and practitioners in the US and how we could continue to participate in that effort. We agreed that, while anyone can learn what needs to be learned with respect to budgets and bookkeeping, taxes, insurance forms, and charting, the difficult and more important part of practice success had to do with patient communication and management.

Why? You can (and as a new practitioner you probably will) spend lots of time out in your community building a clientele through volunteering, giving talks, joining networking groups, writing blogs, and working on your website. But once someone decides to book an appointment or come to a free consultation, how do you WOW them enough to keep them coming back for life and believing in our medicine, and more importantly, in you? We need new bookings every week as a new practitioner, but we need steady, long-term patients for success over the long life of a successful practice.

So what are my five keys to making a life-long patient?

  1. The greased-bannister effect
You want a prospective patient to find there way onto your treatment table as easily as if they were sliding down a greased banister…in other words, effortless and natural. A prospective patient’s experience should be such that they think “why would I go anywhere else” or “how could I not choose this person to be on my healthcare team.
To get that response, you have to think about every experience a person coming in for the first time or two will have: phone service, ease of finding you, parking or public transport, paperwork, educational materials, smells, sights, sounds, lighting, retail displays, office accoutrements, your library, your bedside manner, the way you touch them and work with them in that first session, and the ease of the check out process. To get a more objective assessment of how well you are doing in all of these areas. Consider creating a check list of these things and having a good friend (one who is willing to be unflinchingly honest) walk through this experience and give you feedback. Then decide what you are able to improve or change to make a new patient’s experience “wow” them.
  1. Generate trust and relaxation
My suggestions in this area might begin before they ever arrive at your door. Trust could begin when they meet you at a lecture, a volunteer event in the community, or because of something they read on your website. If you send out a “Welcome Packet” it can include a number of simple educational items to help a patient understand that you are a professional and you are going to take good care of them. If there is more than one room, show a new patient around your clinic so they know there’s nothing “weird behind door number three.” Introduce them to anyone else who works at the clinic (or train for front desk person to do that). Offer water or tea. Then, the room or area where you take histories and do initial consults should:
    1. include a library, which could be an impressive sight for a new patient, and have a significant placebo effect
    2. be clean, comfortable, and nicely appointed so that it looks professional
    3. include educational signage as well as or instead of just artwork.
  1. Make a real connection 
    1. Whenever you are with a patient, you must control the time but allow them to ask questions to the extent that you can and stay within your time frame.
    2. Always educate them about their own body or their health condition…a little at a time. Your knowledge also has a placebo effect.
    3. Touch and treat with confidence. Even if you are shaking in your boots, your body language must remain confident, calm, and assuring. Even if you can only be certain of one or two things in your treatment for that day, those things should be done with the grace of a master.
    4. Make eye contact. Nod your head. Let them know you hear them, you are listening to them, and you understand them. There is more power in that, perhaps, than anything else you do with a patient.
  2. Educate for the long term
Make the assumption that this person will be using Chinese medicine for their health care for the long haul. In order for that to happen, you must slowly and continuously share with them more and more about Chinese medicine and acupuncture. For the first three-four-five visits, your patients should go home with some information about the medicine, a brochure, an article, a piece of research, an assignment such as a food diary on a form that you create, a recipe, an exercise or self-massage regimen (on paper with illustrations), a book to read, a liniment or plaster or poultice to use (with instructions). These things both keep you in your patient’s mind when they are not with you and they increase understanding and enthusiasm. Both of these are requirements for keep patients for the long haul.
One word of caution about education: be careful of Chinese medical jargon. Try to speak in terms that most people can understand. Talk about immune modulation, increased blood flow, energetic balance, reducing energetic stagnation, increased endorphins and brain neurotransmitters, etc. rather than “qi” and other Chinese technical terms. This helps patients share their experience of your care with others more easily.
  1. Make as many decisions as you can for the patient
A person coming for treatment is often worried or even frightened about their condition (will it go away, will it get worse, will I have this for life?). One of the mistakes I used to make as a newbee was to say something like “do you want to come in again next week?” to my patients. This was a really uninformed and poor choice of words. I should have been saying “I’d like to see you again this week if possible and again next week at least once as well.” But you can learn from my ignorance!
      You should be the one to decide what the treatment plan should be and tell the patient what your findings are. This is what most patients want. It gives them confidence that you know what you are doing, what the treatment should look like in their case, and how long it should take. You can suggest a course of so-many-acupuncture treatments over a specific period of time, and/or how long they will need to take Chinese herbal medicine. Write it down on a form with your clinic contact information and go over it with the patient. Ask them if they have questions about the protocol and perhaps offer them payment options to save money. Send a copy of this form this home with them.

That’s my top five patient communication suggestions for maintenance of a successful long-term relationship with a patient who will come back again and again for life. Of course, this list could have had ten points instead of five, but these are the ones that I believe are not optional for your prosperity.

Thanks for reading. Best wishes for success. Send me your ideas for a happy and successful practice any time.

Honora Wolfe is the author of Points for Profit: The Essential Guide to Practice Success for Acupuncturists. She paints watercolors, practices Buddhist meditation, cooks gourmet meals, and  tries to make at least a little bit of trouble from her home in Lafayette, CO.


Monday, April 11, 2016

Green Willow Liniment vs. Dragon's Blood LIniment

In January of 2015 Bob and I were lucky to be invited to Sikkim as companions of one of our Buddhist teachers. It was a really interesting journey and Sikkim is a beautiful, steep, Himalayan landscape with wonderful scenery and a pretty comfortable climate, even in January. Still, travel there is slow and arduous. What looks like it's "right across the valley" can take an entire day of switchbacks down one and up another mountain to get to!

The most difficult challenge for me, however, was that two days into the trip I fell and badly sprained my ankle. Though Bob treated me almost every day for the remainder of the trip, it was at least a minor irritation with all the hiking through relatively mountainous terrain.

Months of treating it with moxa and Green Willow liniment provided very slow improvement; baking it in the sun during the summer helped a little bit more. Still, a year later it was not really healed and I felt very discouraged.

Recently the famous statement from the Nei Jing occurred to me that "new injuries are in the channels and old injuries are in the network vessels." Thus, I decided to switch from using Green Willow, which is for traumatic injuries, including old ones, causing pain due to cold, damp, and blood stasis and to try Dragon's Blood instead. I have usually used this liniment for new injuries with bruising and frank, immediate, visible signs of blood stasis. I had never really used it for OLD blood stasis that will not resolve and, frankly, often shied away from this liniment due to the skin-staining nature of its main ingredients. But no more!

Lo and behold, the ankle has started to improve again and is getting stronger. While it is clear that injuries in an older human being don't heal quickly, I have developed a new respect for this liniment and I'm glad to have discovered another use for it with my patients as well as for myself. Just thought I should share this with any of you who use liniments in your practice. While I expect I'll always love Green Willow, Dragon's Blood is my new fave.

Good luck and best wishes!