August 10th, 2015
Question: When should you recommend the maximum care that a patient might need?
Question: When should you give a patient more care than they need?
I’m standing in line with my five children at a Disneyland attraction called Splash Mountain. After moving slowly forward for about 15 minutes, we get to a sign that reads, “The wait from this point is two hours.” I immediately begin to whine. “Two hours, we don’t want to wait two hours. Let’s come back later when it’s not so crowded.” My kids would have none of that, they wanted to wait, so wait we did. At almost exactly one hour from that sign, we arrived at the end of the line and began the ride. I was ecstatic! One hour; it only took us one hour, not two! You’d have thought that I won the lottery. Whether or not it was intentional, Disneyland had just demonstrated a powerful business concept. Under-promise and over-deliver. Instead of wondering why I was demented enough to wait in line for over an hour to ride a two minute attraction, I was excited that I ONLY had to wait an hour to ride.
When you say, “You’ll need to see me three times a week for a couple of weeks and then we’ll re-evaluate,” what you mean is that you’ll see the patient three times a week for two weeks and then cut them back to two times a week for a couple of weeks and then one time a week until they’re done. What the patient actually hears is, “I’ll have to see you three times a week for two weeks and then I’ll be done.” The first two weeks pass and you start talking about two times a week and the patient starts to look for the back door so they can get away from this crazy chiropractor who wants to keep them coming forever. Essentially, in an effort to try not to scare the patient away with excessive recommendations, you have scared the patient away.
Next time you could say, “You’ll need to see me three times a week for up to six weeks. Please understand that everyone responds differently to care, so I'll be re-evaluating you along the way and adjust your schedule accordingly.” That way when two weeks pass and you are ready to reduce them to twice a week, they are thrilled to find out that they are progressing nicely and ONLY need to see you twice a week. Metaphorically, you just reduced their wait time from two hours to one hour. This method has the additional advantage of easing the communication with the occasional patient who responds more slowly than you had anticipated.
Please note, I am not suggesting that you adjust a patient more than they need. That would be unethical and dishonest, so please don’t do that. I am simply suggesting that rather than recommend the barest minimum of treatment that the patient might need, you recommend that maximum. That way the worst that can happen is you meet their expectations and the best is that you exceed them.
By Robert Hart, Hart Consulting, www.hart-consulting.com