Find out how life coaching can help you succeed in practice
How can words work wonders when it’s a chiropractor’s hands that make an adjustment?
The power of your words can make a huge difference to your patients, and do more than help them feel more relaxed and confident in your efficacy. As a doctor of chiropractic, you can use a coaching approach to communicate with, educate, and motivate your patients.
Coaching is a way to help people make changes in their life that is more empowering than simply telling them what to do. If you practice like most doctors, you’re probably acting like a consultant, where you tell your patients what they need to do before they ask, or the patient asks you a question, and you give them an answer. Often, patients will nod and seem to swallow the information you give them, but you don’t know whether they’ll act on it.
The medical model has advocated the doctor as being the knowledgeable person in patient-doctor interactions, and this has led to doctors giving orders and not engaging patients in the decision-making process. Patients are left feeling disempowered and unmotivated, which results in them not taking responsibility for their health, not being proactive, and doing the bare minimum, which is often just taking a pill once or twice a day.
But here’s the crunch; people come to you for help. You’ve got some awesome information and practical tips, yet most patients don’t perform the self-care activities you ask them to do.
Have you ever wondered why that happens, and more importantly, what you can do about it? If you’d like to learn how to increase the success rate of patient compliance then read on, because using the coaching approach, you’ll discover how you can help your patients take better care of themselves between visits.
But hold on, why should you use a coaching approach ?
- Clients stay pain free for longer;
- They’re happier;
- They see the value of your work;
- They refer you to others;
- You help more people;
- The referrals keep coming in;
- You make more money.
Before you start asking your patients to engage in between-visit activities, you have to know how ready they are to change. If you don’t, your message won’t resonate with the patient, and they won’t act on it.
Knowing which stage of change your patients are in for the activity you want them to do is important. It will help you pitch your message in such a way that you’ll plant a seed of change in your patient’s mind. That seed will grow at some future, unknown time; initially it needs the patient’s mind to nourish it by ruminating on the topic.
The rumination leads to the patient becoming more aware of the importance of having a healthy spine. Education helps, but ramming information down their throat when they’re not ready to hear it will bring up feelings of resistance to your message, which is generally counterproductive. Engaging in self-care and regular office visits will become a priority for your patients when they’re ready to commit to making change. But before they can commit, they need to contemplate why they should change, and mentally and emotionally know that the pros of the activity you want them to do outweighs the cons.
Even though you don’t know when the seed of change will sprout, sadly for some people, this might involve them feeling more pain. When they’ve experienced enough emotional discomfort they’ll move a stage closer to committing to act, and then to acting. You need to trust their seed will sprout, and they’ll do what they need to do when they are ready, not when you, the doctor, want them to. All it takes is for you to trust it will happen, and be there to support them. Stop trying to change your patients – help them change themselves and watch miracles happen.
Below is a brief description of each of the six stages of change. Reading the book, Changing For Good by James Prochaska, John Norcross and Carlos DiClemente is highly recommended if you want to understand your patients, how to pitch self-care and even sales messages to them.
Precontemplation: patients are not thinking about making changes and may be actively resisting the need to make them.
Contemplation: The decision to change has not been made, however the patient is considering the pros and cons before committing.
Planning: The pros outweigh the cons, and the patient has committed to change. They’re looking around for information to guide them on what changes to make.
Action: Here the patient is taking steps to change their life. People in this stage represent less than 20% of the population according to research by Prochaska, Norcross and DiClemente.
Maintenance: After starting to take action, the patient is continuing to change for an extended period of time.
Termination: a change in values has helped the new behavior become part of the person’s way of living.
As you read this, maybe you realize you are in fact powerless to force your patients to change, no matter how many times you ask or tell them to engage in a self-care activity. You change no one; your patients change themselves. The patient must be aware of the need and benefits of changing. They must buy into change with their heart as well as their mind.
This is where coaching comes in. By building rapport and an ongoing relationship with patients, you connect with them deeply and open the door for them to change. Connecting with them deeply allows them to relax around you, trust you, and feel accepted for who they are – bulging discs and all. When people develop this kind of relationship with you through coaching, the way you talk with them will plant seeds of change that will sprout between office visits or over the course of several visits.
We’re not using coaching to manipulate. Instead, we’re joining with the patient to create a powerful relationship allowing them to safely explore the possibilities for change, and which gently allows them to convince themselves they can make it happen. Your patients will pick-up on your belief in them, and once they can believe they can change, it’s time to start planning and have them tell you how they can easily incorporate self-care activities into their life.
Let’s see some of these coaching principles in action. Below is an example of a discussion you could have with a patient to increase their self-care.
Scenario #1: John, a patient comes in with lower back and leg pain. He is in precontemplation with regard to doing anything between visits to prevent another subluxation.
Some of the conversational tools that can be used when a patient is in precontemplation include increasing their awareness of the issue, confrontations, and providing feedback that creates a discrepancy between their view of the situation and what’s really happening.
Doctor: “There we go John, your adjustment is complete for today.”
Patient: “That’s great doc. Thanks so much.”
Doctor: “There’s something else I’d like to do for you.”
Patient: “What’s that.”
Doctor: “You were in considerable pain today when you came in”
Patient: “Sure, now it feels much better, but my back is probably getting better, right?”
Doctor: “I’m going to be really honest with you John. Now, I don’t want to scare you, it’s just that when I look at your x-rays, I see that the subluxation of your L5 disc is creating a damaging bulge, and that the annular tear I told you about is getting worse…” [Consciousness raising and discrepant feedback]
Patient: “So what does that mean Doc?”
Doctor: “It means that your disc is changing shape, and that it may touch your nerves more often. What happens when your discs touch your nerves John?” [Consciousness raising]
Patient: “I feel pain, right?” [Increasing awareness]
Doctor: “As the tear and disc movement increases, how is this going to affect your pain levels?” [Increasing awareness]
Patient: “They’ll get worse?”
Doctor: “Yes, and I know that you don’t like being in pain, and that you don’t want to do things at home to prevent the pain…What I’m saying is that adjustments on their own will only help so much, and that if you want to have less pain, you’re going to have to do something at home between office visits.” [Confrontation]
Patient: “Let me think about that Doc. I appreciate your honesty, I do. I’m just not sure right now.”
Doctor: “I understand John. You might be feeling shocked about what I just said about your spine changing and the likelihood of there being more pain. And I know that you’ve felt uneasy about doing a two-minute exercise once a day. Just know that it will help to reduce your pain…I’m here for you John, so let me know how I can help.”
Patient: “Okay Doc, thanks.”
Doctor: “Jodie will take care of you at reception. See you next week.”
Although this is a short, two-minute conversation, it raises the patient’s level of consciousness regarding their pain, and makes them aware of the consequences of their present course of action. It also acknowledges that they feel resistant about self-care and accepts their decision. Instead of rushing them into action, it plants the seed and permits the patient to inquire about what to do, when they’re ready.
Learning coaching skills, such as those taught in the coaching certificate program at Life University, gives you the ability to listen and plant seeds in your patients’ minds. Your words will become a powerful ally to your adjustments, and your practice will flourish.
