How to Avoid the Nightmare on CA Street

Within our careers are the multiple inspirational stories that we not only hear about but actually get to witness. Real miracles in actual progress. It makes getting out of bed easy in the morning. Other times? Maybe not so much!

There are the moments where getting back into bed and pulling the covers over your head cannot happen fast enough!

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Part of the problem is that most of the people who are walking through your clinic door, are subluxated. Especially the ones that are the newest to your office, or even more so, the ones that are new to chiropractic all together. They can walk in your door and be ready to pick a fight. On the edge of letting you have it if you so much as look their way!  Remember, being subluxated just doesn’t cause physical pain! It can cause moodiness, sensitivity…

“What kind of wool are you trying to pull over my eyes?” she exclaimed indignantly, putting her hands on her hips. Her head had dropped and she was looking at me out of the tops of her eyes. I didn’t have a clue what had caused this patient to be so angry.

“Last week you were charging me $32 an adjustment and this week you charged me $40 for an adjustment. Did you just decide you didn’t like me?”

Examining her account, my brain raced to find the explanation behind what was feeling like a personal attack. Why would she think I hate her? Do I hate her? I certainly wasn’t feeling great about the energy being thrown my way at that particular moment! There ended up being a perfectly reasonable explanation for the difference in charges and upon relaying the reasons, she turned on her heel and harrumphed her way out of the office.

I had won. Or had I? Could it have been avoided all together?

Many years earlier in my first year of being a CA, I had worked for a husband and wife team. The husband was the softie DC and his wife was the hard ass office manager.  There was an ongoing issue of missed appointments with a few different patients that there had been much discussion on how to handle. Finally after some time, a missed appointment charge was added to the fee codes. One particular couple was notorious for being either late or not showing up at all. This particular day, this couple showed up late AND had two missed appointment charges…….. Each. And they needed to be informed. Mrs. DC, thankfully took it upon herself to inform this couple that the missed appointment charges needed to be settled before they would be seen, and they would have to WAIT for their adjustment since they were late. Now while I agree that a missed appointment charge can be a useful tool, it is just that – a tool. Not a weapon. And a tool can be put down. This event became a catastrophic confrontation.  My eyes must have been the size of dinner plates by the time the yelling stopped. The only thing that saved those patients from walking out of that office was because of the love they felt for Dr. Softie. It was not a testimony for Mrs. DC’s “mild” personality. But it was a lesson for me in the art of how NOT to handle your patients. Or life in general really!

One of the best tools you can have in your office that will help you avoid unpleasant confrontations like the ones described above are the coveted office and financial procedures and policies. These are carefully crafted documents that let your patients know how to navigate their way through the office and their care. The office policies let your patients know what you expect from them and what they can expect from you, the DC. Office hours,- contact information for emergencies, procedure for signing in upon arrival,  importance of the expectation that they stick to the DC’s treatment plan and what will happen if they don’t,  and what their options are if they are not able to make an appointment can all be outlined here in the office policies. This is a fantastic space to highlight the missed appointment charge if your office implements them as well.

The financial policies can cover a list of all the potential charges that could possibly be encountered in a visit, as well as the types of visits that they may encounter over the duration of their care.  They should also list the fees for adults, seniors, students and children. If you have block payment options, this is a great space to lay out the details and savings of the financial plans as well as what happens if they choose to buy a plan, then back out of the plan. The consequences for this can vary from office to office, but what YOUR office does needs to be clearly laid out to avoid confusion or denial of knowledge.

These documents are best presented in the first and second visits. The temptation can be to let the patient read through these documents on their own, but it’s our suggestion that the CA reviews these policies with the patient where possible and then have the patient sign each point discussed to acknowledge the patient is aware of each of your policies.  Copies of each should be saved in the patients records as well as be given to the patient either by hand or digitally through email for ease of reference. Any changes in policies would require all patients to be updated by being presented with a new form for going over and signed as well and stored in their file for future reference. It can be onerous, but really well worth it for the peace of mind of CA and patient! And by extension the DC.

If the financial policy had been gone over with the first patient properly, in the above scenario, they would have understood and been non-confrontational upon realizing their charge had changed with the demise of their package payment plan.

In the second scenario, if the missed appointment charge had been announced office wide and discussed properly with each patient in an office policy document that had been signed off on, the charge would have been met with little or no resistance, and possibly even happily paid. Rather than the near fisticuffs it had almost come to.

The second thing that will keep you from the nightmare is just the awareness that the patient’s mood and perceived attack has very little if anything to do with you to begin with! Remember, these patients are subluxated and in need of an adjustment to reconnect them more fully with their Innate, which will in turn ground them and make them more at ease in the world and your office.  Sometimes, patients just need to vent.

Don’t let it become about you and just let them vent and get their gripe off their chest. If you do, your DC might possibly have an easier time clearing out the subluxation when they finally get back to be adjusted. That’s not to say you need to be a doormat, but the ability to breathe, and be socially and emotionally grounded and flexible with the mix of moods that walk through your door, and having your policies on hand for easy reference and referral, you can maintain your office flow of patients on and off the adjustment tables  as a maestro conducts their orchestra.

Guest written by Bobbi Wright

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