File: Marketing Binder > Patient Education
REPORT OF FINDINGS Sample Script
You should read through this script and then customize it so that it fits with your treatment procedures and what you want to tell the patient.
1. Review case history (symptoms), x-ray findings, and exam findings before entering report room. While reviewing records, think of patient as a loved one of yours (mother, father, brother, sister, wife, husband, or child). Enter room with case folder under your left arm. Establish eye contact, call the patient by name and say (while at the same time taking the patient's hand in a gentle but firm, two-handed handhold--not pumping shake), "Mrs. Smith (or Sally if first name rapport has already been established), I (or "we") am really glad we took those x-rays on you...short pause)".
2. If spouse is present, ask, "Are you Mr. Smith?" while shaking his hand with a standard, two-handed handshake. "I'm Dr. ___________, I'm glad that you are here. We have some things to show you." Then return eye contact to patient and continue.
3. Explain cause: Look back at the patient and say "I have good news..." We have found the cause of your condition and I feel that we can help you", (short pause),"You have a condition (short pause) that is progressing (if it is) (pause), "You have had some injuries that have knocked (hit table or strike your hands together firmly) some vertebra out of place in your spine, and it has pinched some nerves."
4. Demonstrate Disc: (Take disc demonstrator in your hand and explain) "There is a shock absorber pad between the vertebra called a disc, and when a vertebra gets knocked out of place it causes abnormal stress and its pressure on the disc (demonstrate with disc) and this causes the disc to narrow and undergo degeneration and at the same time it pinches the nerve even harder and it seriously destroys the nerve energy flow from the brain.
5. Good Findings: Present the good findings and what it means. Caution: DO NOT tell the exam findings in the order that you performed them. That would be with 2 good findings and 1 bad, one and 3 good, and 2 bad, etc. This will confuse that patient. Instead, skip all the bad findings and give good ones only. Include the fact that most of the vertebra are lined up correctly and most of the discs have no degeneration and most of the spine has no arthritis (if so). Keep this very simple - very brief. Do not use any technical terms.
6. Bad Findings: Tell bad tests, what it means and what will happen if it is not corrected. Tell about advancing complications in sequential order with worse last.
7. Show x-rays Show x-rays. Keep it simple. You can use a red pencil to circle problem areas.
8. Show Plastic Spine: Take the spine (from its hiding place) and say "This is a plastic spine, but it is a replica of a real spine." Show how the spine “misaligns” and pinches a nerve opening, then pinch the patient's finder, then spouse's finger (for sympathy and understanding). Then explain cord pressure and palpate patient's neck--then spouses neck. Recommend appointment for spouse if appropriate.
9. Chiropractic Philosophy Explanation: Step to the wall charts and explain the Philosophy of Chiropractic with a "touch and tell system" to get the message of Chiropractic through to the patient and spouse.
Stepping to the autonomic chart, having the patient stand to your left, explain that, "As you know, the brain is here in the skull (Place your left hand on her head and your right hand on the brain on the chart), and here at the base of the skull there is an opening about this size (move your left hand to the base of her skull, and with your right hand indicate the position of the Foramen Magnum on the chart, and its approximate size) where the spinal cord comes through and goes through the spine all the way down (run your left hand down the patient's back and your right hand down the spine on the chart). Then the nerves come from your spine and go to control and regulate all the functions of all your organs and glands (point with your left hand to the patient's organs and glands and with your right hand to the organs and glands on the chart). A pinch on a different nerve here at the spine would cause a disturbance in a different area of the body here (touch corresponding areas on the patient's spine). This is true not only of the organs and glands, but also the muscles and joints (as you say this, you point to the chiropractic spinal nerve chart).
“We have prepared a report for you that shows the vertebrae that are involved in your case and the areas of the body that they connect by the nerves. Our CA will show that to you later. The whole idea of chiropractic is to find vertebra that are misaligned and choking off the nerves and blocking that vital life energy flow, causing all sorts of health problems, and then to realign the vertebra, put them back into place and unpinch the nerves so that the vital life force energy can be restored and the communication between the brain and body can restore health and normal functions. Do you get the picture? Good."
10. Summary: Have the patient and spouse sit back down and summarize your findings. Restate the patient’s health problem, and say something like: “My real concern (pensive pause) is right here, in the area of L-5. If this problem is not resolved, it could get worse, causing severe pain, dysfunction, and may require surgery in the future.” Express hesitation to take the case if patient is not serious on self-care and follow-through.
“Have a seat here again. I want to have a little talk with you about our greatest hesitation in accepting your case. In studying your case, it is obvious to us that you have a progressive condition that has been advancing for some time, and at the rate it has been going we know it will continue to advance. Your condition will reoccur again and again, and become worse and worse. Without proper care, your condition would gradually advance beyond repair. In short, Mrs. Smith, your case is not a quick-cure case. We have had a lot of cases like yours and have had good results, and in my (our) opinion, we can help you--but only with your determination to follow through. I feel quite confident about your case, and will accept you as a patient, but only with the agreement that you will work with us, follow through and give us the time that it will take to get the job done. I would rather not have you as a patient in the first place than to have you not follow through and get results."
At this point, the patient will usually commit herself to follow through. "Good, I'm happy for you that we will be able to help you. You will live longer and be healthier because of chiropractic."
11. Program of Care: Once they agree, explain (and you can write this right on the x-rays with your red pencil) that it is going to take three things from them. It's going to take time, effort, and repetition. "Now, Mrs. Smith, before we go any further, I want to explain some points. It's going to take three things on your part for this to work.
First, it's going to take time. From what we have found, the condition you have took XX years to get to this state, and we cannot correct that in one or two visits, or even one or two months. We can relieve a lot of the symptoms, but as I explained, the symptom isn't the problem So it's going to take time. In your case, we will have the relief stage completed in 1-3 weeks. The strengthening phase will take about XX months and the corrective phase will take about 1-2 years. Are you with me so far?"
"The second thing is repetition. We cannot just snap the bones back into place. Each time you come in we will be working on specific vertebra to release the nerve energy. We will be seeing you 5 times per week for X weeks, etc., etc.
(You can use the braces analogy here)
"The next thing is effort. Once we get you out of the pain stage, it is going to take effort on your part to make it in here for the corrective phase. We will give you our best effort, but we need yours as well. I want you to know I've heard all the excuses on why patients can't keep their appointment - my goldfish died, my cat had the mumps, etc. - but I want you to take the effort to follow through with your program of care. If you follow through we will work with you in every possible way to support you. Are you still with me?"
Good.
The last thing is our health workshop. With your condition, there are things that you must know and learn to get well faster. We used to work hard to get patients well and then they would unknowingly and unintentionally undo what we were doing. We've developed this class to handle this and, especially with a case like yours, this is vital data. There is no charge for the class, but we feel so strongly about the class that there are no exceptions. Kathy will schedule you for the class."
Once the ROF is complete - and it should take no longer than 10 minutes, have a CA come in, without fail, and do the POST REPORT script (procedure for checking out patients after the R.O.F.) as written.
Petty, Michel & Associates ã 1999 ROF-sammple script.doc – Revised 8/30/00 3 of 3