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Consultation, Examination and R.O.F.

The importance of the consultation/examination and the R.O.F.

Too many doctors do both of these events in the same visit, or they report too much of their findings during the first visit. The following is an examination of the difference between the two and the importance of doing them separately.

Visit 1- The point of this visit is to stimulate the patient's interest.

My visual is that the patients have a door that is closed when they come to see you.

They have preconceived ideas of health and healing, chiropractic and chiropractors, and what they want to experience during your interaction.

In visit 1 our job is made easier by using LAASR. We first must hear what they have to say and make sure that they feel heard. We can then acknowledge their concerns so they can hear what we have to say. Only then should we begin to ask appropriate questions. The questions allow them to begin to explore their belief systems. It allows us to begin to enlarge their point of view, to help them begin to see a bigger picture.

Notice how many times I wrote "begin." Just because we tell them something does not mean that they've "got it" and are for ever changed. It means they are beginning to see or beginning to change.

The goal in this first visit is to open the door to a new room in their heart, mind and soul. Once the door is open we can begin to fill the room with what we want them to know about; or our point of view. We can begin to educate them. But, if we do not use LAASR, we immediately jump to the solution and try to educate them. The problem is the door is still shut! So we deliver all of this information to them, but none of it gets into the room. Oh yes they nod their heads up and down in agreement, but they do not "get" the information. All of the information falls down in front of the door into what I call the wastelands.

Later, when our patient leaves as soon as their pain goes away, we ask ourselves, "How could that happen, what about all of the education I did with them?" Of course we then just chalk it up to them just being stupid.

The fact of the matter is because we tried to dump our dogma on them without opening the door to communication first, none of that information really got into the appropriate room of the brain.

So, visit 1 is all about connecting, building bonds and opening the doors to communication. It is about stimulating their interest so they are ready to hear what we have to say. It is about asking appropriate questions and planting seeds to possible solutions. We accomplish this by using L.A.A.S.R. and Touch, Tell, Ask and Teach. After our "few minute history", we give them a 60 second education/foundation about chiropractic. We then have the opportunity to finally have them really hear what we have to say about chiropractic. We do this during the examination. From my perspective, most all of our teaching needs to happen when our hands are on our patients spines. This is where T.T.A.T. is invaluable.

From my perspective, my goal is to have the patient leave after their first visit and have them absolutely know that you are the right doctor for them. In the L.A.A.S.R. course we study how to "cause" this to happen.

Visit 2 is where we get to tell them what we have to say. We report to them our findings or we relate our findings with them."

Again, if we do not separate the two events, our patients do not have time to process the information and come up with why this is important to them. They do not have time to formulate the appropriate questions. Remember, until the student has asked the question, they cannot hear the answer. Help your new patients ask the appropriate questions. Help them better define the problem and the solution will become self evident.

The other obvious reasons for doing the ROF on separate visits is we need time to evaluate all of the tests and exams, and the patients need to "value" the tests and exams. If they see you hold their x-ray up to the light for 15 seconds and then tell them what they need, they may not feel so good about the price they paid for the films. Last but not least, it is simply too much information for the patients to absorb all at once. Remember, patients come into your office in pain, in overwhelm, dazed and confused. They need time to absorb what you have just told them. They need time to go home and digest all of the information, they need time to realize that they most likely will need and want to get to the underlying problem vs. just masking the symptoms.

Consider taking the L.A.A.S.R. Your Communications and be Brilliant at the Basics Course and master your consultation/examination, R.O.F. and much, much more.

Russ Rosen, D.C. - Mar 19, 2003