Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Prescription for Empowering Your Clients: Less Advice, More Coaching
As healthcare practitioners concerned about the well-being of our clients, we all face a risk of going overboard in telling people what they ought to do. Of course, some degree of advice giving is perfectly appropriate. A client asks about treatment options, and we tell them what we'd recommend. Or we see signs of a potentially serious medical problem, and we strongly suggest that the person goes to see a physician. But it's easy for that line to get blurry.
Suppose one of your clients is considering leaving their high-powered, stressful job, and wants your opinion on whether it's a good decision. You think it's obvious that they should quit. Do you tell them that directly?
Or perhaps a client mentions they've had trouble sleeping recently. You used to sleep poorly yourself, and have experienced great results from a natural remedy recommended by an herbalist you see. Do you recommend that this person try it out, or even give them a sample from your own supply?
Advising a client isn't as straightforward as advising a friend or other peer. Your role as practitioner automatically sets up a power differential (See "Power Differential," Massage Today, February 2004). You're in a position of greater power and authority, while the client is more vulnerable – emotionally, intellectually, and physically. As a result, clients may give a great deal of weight to your opinions, even when you have no expertise on the topic you're discussing. It's not uncommon for a client to believe that their massage therapist (or acupuncturist, or other complementary health practitioner) has deep insight into them and what they need. And even if the person disagrees with what you're saying, the power differential might make it difficult for them to tell you that.
In some situations, the only ethically responsible response is to refer the individual to another practitioner. For instance, if a client looks to you for advice around a serious psychological concern or relationship breakdown, the best advice you can give is to look into getting psychotherapy.
In other circumstances, though, you may have a very useful role to play in helping a client to solve their problem. In fact, for certain clients, this type of support may make an even greater impact than the hands-on work you do. I've had that experience quite a few times in my own practice; as rewarding as it is to relieve someone's immediate pain or discomfort, empowering them to make positive, long-term changes in their lifestyle or health-related habits feels like a greater service. The question is how to discuss these issues in a truly empowering way – helping clients to help themselves – while remaining within your scope of practice. You can do this most effectively when you keep the following in mind.
If the client hasn't asked you for help with an issue but you think it's important and relevant to your work with them, ask permission before initiating a discussion. For instance, with a client who complains of sleep problems, you might ask, "Is this something you're interested in thinking through with me to try to find a solution?" If they say no, let it go. If instead, the person asks you for directive advice ("Should I quit my job?"), essentially asking you to solve their problem for them, you might ask permission to redirect the discussion (e.g., "This is a big decision, and it's hard for me to know what's right for you. I'd be happy to talk the issue through with you to help you get clearer on what you really want. Would that be useful for you?").
Inquire More Than Advocate
The client possesses much more information than you do about the nature of their problem and the usefulness and feasibility of possible solutions. It's rarely helpful to lead with your own idea ("Why don't you try this herb?" or "You should talk to your doctor about having a sleep study") or to ask narrowly focused, yes/no questions ("Have you tried meditating before bed?"). Much more productive are questions that help the client tap into their own knowledge, experience, and creativity ("What would be the ideal conditions for you to get a decent amount of sleep?" "How much sleep do you need to feel really well-rested?" "What do you think needs to change for you to get that much sleep?"). Even if the client thinks up the same solution you would have proposed for them, having the idea come from them makes it much more likely that they'll feel a sense of accomplishment and ownership over the decision and actually follow through.
Reflect What You Hear
An important complement to inquiring is paraphrasing what you're hearing the client say – for example, "You're saying you get all revved up because your mind keeps racing." This gives them a chance to either agree, and possibly elaborate ("Yeah, as soon as I lie down, I start obsessing about all the work I need to do the next day"), or else provide a clarification ("Just the opposite – I think I start off being all revved up, because of all the caffeine I end up drinking, and then that's what gets my mind racing"). You may also want to empathize ("How frustrating!" "That sounds really challenging"); this, too, can help the client feel heard and understood.
If you come in thinking you already know the true cause of the client's problem, or what the best solution will be, you're unlikely to be able to inquire, listen, and reflect effectively. Even if you try to suppress your point of view, it will probably leak out in one way or another, leading the client to feel pushed or pressured. A mindset of curiosity leaves both of you open to consider more creative, unexpected solutions.
Focus on Solutions, Not Problems
Be wary of digging deeper into a client's problem. Probing into a client's psyche ("Are you a very anxious person?") or personal history ("Did you grow up in a family where people worried a lot?") not only risks taking you into the territory of psychotherapy; it also keeps the person's thinking focused on what's wrong rather than what they can do about it. In contrast, solution-focused questions ("What types of thoughts and feelings at bedtime would help prepare you for a restful night?" "What helps you to feel that way?"
"How might you bring some of that into your nighttime routine?") connect the person to their emotional and intellectual resources and problem-solving capabilities.
There is a whole (large, and rapidly expanding) field dedicated to this sort of communication: coaching. In my next few articles, I'll go into detail on how you can apply a coaching approach to specific challenging situations you might encounter with your clients. Stay tuned!