Chiropractic + Naturopathic Doctor

Communicate and appreciate: Accessible business communication systems

By Dr. Emily Roback, DC   


Accessibility is not my passion, but rather a necessity of life

Here are some helpful signs for practitioners and patients alike. For more resources, visit

 Born with a severe-profound sensorineural hearing loss, I found myself in an endless struggle to fit into a hearing culture. Looking back, I remember one classmate in elementary school who said I must have been an alien from another planet. I have to admit it was not always easy carrying the label “hearing-impaired” or “profoundly deaf” or referred to as “that little girl with the hearing aid stuff” while attending mainstream education. Although wearing a box on my chest with cords running up to my ears did give me the privilege of hearing educators with less effort, it did not exactly score brownie points with classmates.  To them, I looked and acted different, and that was that. However, if I did indeed come from another planet, then I ended up coming with a mission — to make a difference in the chiropractic profession. 

If you wish to operate a truly accessible and growth-type practice, a good place to start would be to encourage your business administrative team to become more curious. There is an endless suite of tools that can be instigated — both formal and informal — to bring curiosity into the fold of your office management team’s daily routine. 

Accessible business communication systems
The workplace environment is a perfect, low-stakes setting to develop basic accessibility skills with your staff. Here are several entertaining and easy mechanisms to look for in an accessible business communication system. Everyone, from management, to staff, to patients, can benefit both intrinsically and financially.


1. A cloud-based communication and collaboration business solution for businesses.
Find an APP for Desktop with a comprehensive communications solution featuring voice, fax, text, conferencing and web-meetings. The APP must be available to download onto mobile devices like tablets and cell phones.

2. A leading software vendor in the health industry who develops, provides, and supports clinic-based applications for healthcare professionals.
Ensure your software company choice offers training via documentation, videos-on-demand (closed captioning), live online and in-person sessions. A software program should also provide appointment management, billing & invoicing, claims management, EHR certified, outcome assessments, patient account management, patient records (written and video), and SOAP notes.

3. Contact information for disability-related help.
Contact your provincial or territorial government to find out which programs are available to help individuals thrive in the workplace. Supports may include the following: 1) Assistive devices, equipment and technology; 2) Ergonomic supports (ie ergonomic furniture, lighting systems); 3) Attendant services related to work (ie assistance with mobility and sensory); 4) American Sign Language (ASL) interpreting and captioning services; 5) Communication and hearing devices related to work; and 6) vehicle modifications. The services should be available to individuals who have a work-related barrier due to a disability or functional limitation.

4. Website Accessibility.
Website accessibility refers to the tools and technologies designed and developed so those with disabilities can use them. A website is designed fundamentally, to work for all people, whatever their hardware, software, language, location, or ability may be. When the website meets this goal, it is accessible to people with diverse ranges of hearing, movement, sight, and cognitive abilities.  Additionally, those without disabilities also benefit, for example: 1) People using smart watches, mobile phones, smart TVs, and other devices with small screens, different input modes; 2) Older people with changing abilities due to aging; 3) People with “temporary disabilities” such as a broken arm or lost glasses; 4) People with “situational limitations” such as bright sunlight or in an environment where they cannot listen to audio and 5) People with slow internet connection, or who have limited or expensive bandwidth.

5. Ongoing training of all staff and members to provide appropriate responses to requests for communication supports and accessible document formats.
Example: Clinic owners and administrators must review their safety plans to ensure that it reflects the requirements of the provincial health officer order around the use of masks by administrative and health care team. There are exemptions for: 1) People with health conditions or with physical, cognitive or mental impairments who cannot wear one; 2) People who cannot remove a mask on their own; 3) Children under the age of 12; 4) People who need to remove their masks to communicate due to hearing impairment. Not following the order can result in a lawsuit.

As a practitioner with hearing loss, I wear a clear mask for patients. When I need the patient to speak, I step six feet away and ask them to pull down their mask to express their concerns. At the same time, I believe I am one of the few chiropractors whose patients get to see a smile behind the mask during a pandemic. Great therapy!

Paperless vs paper systems
We live and work in a digital world and every clinic owner is inundated with finding another solution to streamline work and take things “to the cloud.” Going paperless has its advantages, but there are still risks as to what to keep in digital space and what to relegate to hard copies. After working in ten different types of clinics in three provinces and one territory since 2007, I have observed not one clinic has fully, and whole-heartedly converted to a paperless system.  We still need some access to paper ‘just in case’. 

Keeping everything stored digitally is cheaper than printing and subsequent storage. Paperless systems eliminate cost and time for shredding services.  When storing information digitally, accessibility becomes quick and easy. Clinic owners, practitioners, and patients can have access to all data, contracts, and patient files onsite and remotely with a few mouse clicks. This eliminates having to locate a paper file or form, which saves everyone time. Further, there is greater flexibility in meeting with patients in the office or through tele/virtual health. 

On the downside, clinic owners often get too busy to update software and virus protections, making it easier for hackers to install spyware, steal information or hijack clinical data.  When digitally stored, a system could crash, and all information may become lost. A contingency plan, in the event of a failure in digital information accessibility, is called for. 

Unfortunately, we live and work in a world where some patients like to have a copy of their receipt and do not want to print out their transactions later. I am one of them. As a consumer, health receipts for my own personal records are important, often for tax purposes. Plus, some practitioners like to write their interview and assessment notes before converting into digital copy. Again, I am one of those as well.  Laminating most common used forms and using a non-permanent black pen to write notes, collect signatures, and scan the forms into the computer saves paper and helps practitioners, like myself, improve penmanship skills.  

Despite all modern technology, there are still clinics using traditional-based filing systems, which require considerable space, equipment, and maintenance. When initially employed as an associate at Cowichan Chiropractic in January 2019, I was re-introduced to a paper system. A year later, the clinic converted to a paperless system with options to print receipts for patients and laminate clinical forms for practitioners. Going paperless helped our chiropractic office save space and money, boost productivity and kept information more secure while also making it easier to share.

Basic ASL for the healthcare and/or business professional
Patient care suffers when patients and health business professionals have poor communication. If language barriers between doctors, business administration, and adult patients are not conquered, misdiagnoses and inappropriate treatment are more likely to occur. 

While learning some basic ASL does not qualify anyone to be an interpreter, it does allow one to engage in conversation with a patient and establish a personal connection. ABCs can be used for fingerspelling names, words, and phrases. Numbers can be used for counting and assessing the pain scale. The ten most common signs used in the clinic are: where, pain, appointment, back, doctor, hello, goodbye, thank you, help, and write. These words can be used together to create phrases and used to communicate some simple information to deaf and hard-of-hearing patients and family members. 

My definition of accessibility requires continuous effort and results in removing physical and sensory barriers. There is no magical, quick solution to create a sensory-friendly office, or to make everyone understand the importance of being curious and open in adapting to new systems, technology, and attitudes. Moreover, there is no “right” way to introduce accessibility to our profession.

Try out different tools to see how they improve both business communications and the conversations that you have with patients. You may be surprised at the enrichment made to your financial bottom-line. The cost of moving the business phone number to a cloud-based communication system allowed our office to run more efficiently, effectively, and save money. Our text messaging service allows patients to contact the clinic directly without getting a busy phone signal. An extra $200-$300 per week in patient revenue without any extra marketing is hard evidence that demonstrates our clinic is doing something right. 

So, what planet did you say you were from?

Dr. Emily Roback is a North Cowichan chiropractor with 10+ years of clinical experience. She works as an associate at Cowichan Chiropractic and producer at Dr. Emily TV. She has grown her accessible practice from zero to almost 6-figures revenue in twelve months of operation using a combination of proven structures, systems and strategies that she now shares with healthcare business owners across North America who are looking to build an accessible and growth-like business. Visit: or email 

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