The essence of human interaction is communication. Communication is comprised of many elements, verbal, non-verbal (physical), and environmental. Each of these elements contributes to the overall success or failure of doctor-patient communication. This article will deal specifically with the first impression created by a chiropractic office, from the first telephone call, to the doctor meeting the new patient.
In order for doctors to fully engage in dialogue with patients, they must be rooted in chiropractic philosophy and in a sound technical and clinical approach to patient care. This foundation or platform provides the basis for confidence and technical, as well as clinical, certainty. If a doctor attempts to enter into practice or is in practice with uncertainty regarding technique, treatment model, or goals for care, the doctor will fail to sincerely connect and communicate with patients. The uncertain doctor presents a muddled and or confused message to patients. In many existing practices, doctors have found themselves selling care because they are not firmly rooted in their own clinical and philosophical platform.
Doctors must know their “weight.” In other words, doctors must understand their confidence level, physical presence, and willingness to engage. In this way doctors can approach patients in a sincere, comforting, focused, yet direct way. The effective doctor will allay patient apprehension, and directly address patient concerns. The most effective doctor will exude confidence, and be at ease. This will translate subtly, but directly, to the patient as positive non-verbal communication.
By touching the area of a patient’s pain, doctors connect in a very intimate, physical way. Therefore, always be sure to touch patients appropriately. Attempt to convey your concern with your touch. Most experienced chiropractors do this naturally. For doctors just starting to work with patients, effective communication with touch is a critical part of communication.
Much has been said and written about dress and personal image. There are two primary schools of thought on this matter. The “Dress for Success” philosophy, and what I like to call the “Anything but a Tie” approach. Either can work; however, the “Dress for Success” approach is reliably replicable. In instances where the doctor is young, (35 or under...) or appears young, regardless of age, the doctor will often be considered more credible if he or she appears more “establishment” or professional. This effect will be more significant regionally. For example, in business districts in the Midwest or Northeast, more conservative dress is often more effective in creating a positive first impression. However, in Newport Beach or Santa Cruz, CA, this attire may seem out of place. Ultimately, each doctor must become “comfortable in his or her own skin.” Doctors must develop their own individual style, their own comfort zone. I have personally seen this range from shorts, sneakers and a polo shirt to a suit-vest and trousers with shirt and tie. The context of the doctor in his or her space is the critical element determining success. There is no hard and fast rule regarding dress. However, one thing is absolute; the doctor and staff must be well groomed, healthy, clean (even mildly fragrant...) and comfortable. This comfort will help to bolster the doctor’s confidence and make the new patient more comfortable and receptive as well.
The Office Staff
The staff in a chiropractic office must be an extension of the doctor in all areas of the practice. Though the staff supporting the doctor need not possess the same level of technical expertise as the doctor, they must be fully inculcated with the doctor’s platform. The staff must understand why the office exists, what the goal of their (team) effort is, and ultimately what the combined efforts of the entire office produce. A staff member must be taught by the doctor to fully understand chiropractic from the doctor’s perspective. The staff must also fully understand the technical elements of chiropractic at least as well as the best-informed patient in the practice.
The New Patient
Consider your own experience in reaching out to a new physician or dentist. There is a bit of apprehension, even angst associated with this task. Perhaps you were in pain when you began your search for help. What is the mind-set of a patient in need of help?
Patients in pain are akin to a sponge, absorbing everything in their immediate area; or they are internally focused and perhaps a bit withdrawn. (Usually these individuals will have a support person with them to assist.)
The “sponge like” patient is in a heightened observational state. Sensory clues will create a significant impression with this type of patient. In many instances, a person involved in a crisis or emergency situation, either as a witness or a participant, can reiterate each minute detail of the event. Though this type of observation has been shown to be personal and often different between individuals witnessing or experiencing the same circumstance, the descriptions are often excruciating in detail. The patient presenting in pain, whether acute or chronic, is an individual in crisis, therefore, an extremely observant individual with a significant personal bias.
The patient who is withdrawn or more internally focused (often the person in chronic debilitating pain) must be approached differently. This person is often oblivious to most everything outside of their immediate focus and area. This condition is, however, usually temporary; for as soon as this patient obtains relief of their pain, they begin to “come out of their shell” and begin to observe with great interest just as the hyper-observant, “sponge-like” individual.
Often the new patient reaching out for help contacts the office by telephone. In order for this initial interaction to be productive, the individual answering the telephone must be well trained, and positive. They must also be sincere and comfortable. If the doctor has trained the staff well, and they, in turn, understand their purpose and duties as part of the office team, this initial interaction can be reassuring and comforting to the suffering patient. If a tentative patient is warmly received, handled efficiently, and professionally, yet still personally, their first impression will be a positive one.
A clean, organized, and well-appointed office is critical to creating a positive first impression. The office, by extension, should inform the patient about the doctor prior to the first doctor patient contact. The appearance of the modern chiropractic practice offering structural rehabilitation is fraught with challenge from an aesthetic perspective. The equipment can be imposing, even scary to many patients unfamiliar with most of what constitutes chiropractic practice. Plants, attractive furniture, an antique or two, and paint colors in soft tones will create warmth and soften the impact of the more harsh appearance of the chiropractic equipment in the office. Art (specifically non-chiropractic), indicative of the doctor’s personality and style, can help define the doctor for the patient. Patients want to know their doctor. Photos, articles, or mementos are also appropriate. However, these items should never cause a bottleneck in office flow when patients view them. If you are not well versed in decorating, consider meeting with a decorator who fits your style; or if your budget does not allow this, simply observe what you like and how you feel in the space, and try to emulate that in your own office space. Spending time in well-designed space with a note pad to document your observations can be helpful in this process.
The First Impression
The new patient telephones the office, is greeted warmly, scheduled appropriately, and the conversation ends with simple instructions and a sincere farewell in anticipation of the patient arriving at the time reserved for them. The well-trained staff person will note the way the patient interacted with them, and make specific notes about the conversation in preparation for and anticipation of the patient’s arrival.
The staff-person greeting the new patient upon their arrival at the office must do so with sincerity. A good approach is, “Hello, you must be Mr. Smith. I am Bob, Dr. Jones’s assistant. Welcome to Jones Chiropractic” or something similar. Patients should be escorted to a well-lit, comfortable room with minimal distractions. The patients should then be advised as to what will occur during the visit. The new patient paperwork should be explained and any questions efficiently answered. Patients should then be left to complete the new patient paperwork alone, with the reassurance that the assistant will check back with them in a few minutes.
Upon completion of the new patient paperwork, the doctor will review the information on the forms and prepare to enter the room to meet the patient formally for the first time. The doctor should know the pertinent details about each person, and be especially aware of patient’s size, demeanor, and how they communicate. At this point, it must be determined if the patients are more of “sponge-like” or more withdrawn? Are they more or less expressive? Are they detail oriented? By preparing in this fashion, the doctor will be well equipped to meet new patients in a comfortable, neutral way. The patients will more quickly connect with the doctor, and it is likely a positive first impression will have been made. Doctors must never underestimate the impact their first impression has on patients. This initial impression is often what sets the stage for future doctor patient interaction. Success in doctor patient communication is one of the critical skills that define the most effective doctors. Failure in communication is nearly always contributory to doctors constantly struggling in practice.
Action Steps to Assess and Improve Your First Impression
1. Become a “new patient” in your office. Call, schedule, and go through each phase of entering your office just as a new patient would. Fill out all the paperwork. Take notes on how you feel in the process. Assess and modify as required.
2. Videotape your office. Watch your videotape; look at the tape critically. Have your wife, husband, or other objective individuals watch the tape, get their feedback as objective observers. Note challenges and modify as required.
Alternatively, you could have your “objective panel” visit your office in person to evaluate the space.
3. Assess your personal image, look, and confidence. Are you pleased with your appearance? Are you fit? Healthy? What image or first impression do you make on people?
4. Consider videotaping yourself and critiquing your presentation. It never works to script, however, it does pay to study your actions on tape and make improvements as required. The finest speech coaches use this technique to refine and naturalize the presenter’s image and skills.
You only get one chance to make a first impression. What a shame it is when patients so in need of chiropractic care are negatively influenced in their decisions to take up care because of a poor first impression. Assess your office, your staff, and yourself today to insure you are providing a positive first impression to all those with whom you come in contact. Provide the public we serve with every possible opportunity to choose care with you for their health’s sake by always striving to create a positive first impression.
Creating A Great First Impression
©2005-2006 Dr. Scott J. Heun
All Rights Reserved
Previously Publishes in and with permission of The American Journal of Clinical Chiropractic