Chiropractic + Naturopathic Doctor

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Chiropractic Health Assistant Education


June 7, 2010
By Brandi MacDonald

Approximately once a week, I receive a phone call or email about
recalls.  I also am questioned on this when I speak at seminars.

Approximately once a week, I receive a phone call or email about recalls.  I also am questioned on this when I speak at seminars. Generally, the question is how to perform recalls better or more efficiently to keep patients on their treatment plans and/or from disappearing altogether. Most of us have thousands of inactive files in our practices – patients who have decided to quit care, or try something else. Therefore, recall systems are crucial and it is equally important that chiropractic health assistants (CHAs) understand and execute them well. But, prior to a patient actually leaving, internal systems must exist – between the DC and CHA, that is – that will reduce the need for recalls in the first place.

In order to understand recalls from a philosophical perspective, we first must start with the beginning in mind. Before a patient leaves our practice, we must look at why they started and what their expectations were. In most practices, a thorough initial visit has been done by the DC, a plan of action has been created based on this initial visit and then it has been presented to the patient. In some practices, this is done all together in the first visit, but in many practices, presenting the plan of action to the patient is a separate visit called the “results” or “report of findings” visit. How well patients understand their health needs and their treatment plans is directly correlated to how well they will follow through.

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The CHA also must understand the plan. If a patient is coming for pain relief from a certain condition, the treatment plan ends when the patient is feeling better – therefore, what is the CHA recalling? The patient is in charge of calling the clinic when they feel worse again. But, if a patient is entering into a neurological or functional correction plan of some kind, then the CHA’s function is to recall the patient to remind him/her of the agreed upon plan, as people’s lives do get in the way of chiropractic when they leave our offices.

THE PATIENT AND THE PLAN
Getting the patient to agree to the plan, during the results visit, is critical for the patient to understand their active role in the healing process. As well as agreement to the plan, acknowledgment of your office policies is important. For example: how much notice does your office need for changing appointments? Does the patient have to make up the appointment in a certain period of time?  What happens if they don’t? All of these questions can be covered both with written policies and verbal discussion with the patient.

This conversation is not a one-sided agreement. It is within this period of time, that any objections to following through with care can be discussed. Do they have a time, money or interest challenge that may impede their healing? Can you do anything about it? Time and money can often be negotiated, but interest is a deal breaker.  If a patient truly understands their health problem, and the plan to correct it, and still chooses not to, they would not be a candidate for recalling. If the team or CHA knows this from the second visit, their time and energy in recalls can be much more focused on patients who have made the decision to take action.

IMPLEMENTING A RECALL SYSTEM
A great recall system in your office is simple to implement and requires answering a few questions:

  1. What is the prior agreement with the patient regarding following through with a treatment plan? Does your CHA know it?
  2. Have you role-played your results visits with your team so that they can support your plans more effectively when recalling?
  3. Can your CHA be more involved in the results visits? For example, can they go over office policies, booking appointments, etc.? This way, when they are recalling patients, they have previously talked with the patient and are empowered to empower the patients to follow through.
  4. Do you have a system that tracks patients who said they would call for an appointment, or patients who have missed or cancelled appointments? Also, can you keep track of recalls: when the person is called and how often? This should exist so that any CHA can follow the system regardless of who is working.
  5. Do you have a script for recalls? If a patient is due in for one appointment that week, can your CHAs cover that effectively?  “Hi, Mrs. Jones. I see here by your file that you are due for your weekly checkup with Dr. Smith. We have appointments available this afternoon or tomorrow morning, which one would work for you?”
  6. Do you train staff on the underlying purpose of recalling patients?  Role-play, role-play, role-play your visits and the phone scripts, and train staff on the purpose of recalling patients. The purpose is caring. We care that patients get results with chiropractic, we care if something has happened to the patient, we care if there is something we can do to help them. That is the purpose of recalls. If the CHAs see no purpose behind recalls, they will feel like they are harassing the patients.

But, recalls are symptomatic entities in a practice. This means that they have to be dealt with in a timely manner, but are not the real issue. Patients who make prior agreement regarding their plans, and understand their health goals in relation to chiropractic, have a much higher probability of following through with care, thus decreasing the need for recalls. The big picture of following through is not only patient retention, but patient healing and satisfaction with chiropractic – and that is a good thing for everyone. •


Brandi MacDonald manages a multi-doctor, high-volume clinic in Edmonton. She is the owner of True Concepts, which consults with chiropractors all over North America regarding staffing. She also is an international speaker for chiropractic assistants. She can be  reached at info@brandimacdonald.com.


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