Mastering Your Report of Findings

By Perry Nickelston, DC, FMS, SFMA

Next to the initial consultation, your Report of Findings (ROF) is the single most important interaction with a patient. At a consultation, they decide if they like you. In the ROF, they will decide if they trust you.

It can be the determining factor in conversion and retention. There is a tendency for most doctors to try and impress the patient with information overload and nonstop talking. I call this the "wait until they see how smart I am" approach. It's called a Report of Findings. But is it? Besides being too long, too complicated and mostly irrelevant, many reports seem more like an attempt to turn patients into chiropractors. Most patients want four simple questions answered: What's my problem? Can you help me? How long will it take? How much will it cost?

By understanding some universal laws of communication and following simple strategies based on human behavior, you can master the ROF and create "raving fans." Below, you will learn how to answer the four simple questions listed above and use the power of questions to drive home your message. So, let's get started by learning the core foundation of effective communication.

Universal Laws of Communication

• Human beings crave validation and appreciation.
• People don't care how much you know until they know how much you care.
• The average adult's undivided attention span is 25 to 30 seconds.
• Most people forget 95 percent of what you say within minutes of hearing your message, assuming they hear your message in the first place.
• Talk to people about what's important to them. Take every piece of information in your ROF and visualize the patient saying, "So what? What does that mean to me and my problem? How will you add value to my life?" Know the answers before you present.
• People remember pictures and stories more than facts and figures.

These suggestions can be integrated into your ROF in various ways. Practice different approaches and times for using them in your daily interaction with patients. These skills should be used as much as possible until they become second nature.

Report Suggestions

• Use the 25-to-30-second rule to keep your presentations short and relevant.
• Make sure you are genuinely interested in helping your patients. Come across as sincere and trustworthy by speaking directly, confidently and maintaining eye contact.
• At the beginning of you report, thank them for choosing your office. At the end, congratulate them on making the right decision to begin care (validation and appreciation): "Congratulations, Mr. Jones. You will do great, and you made the right decision to get help."
• Instead of boring them with jargon and definitions, tell them a success story of someone in your office with the same condition. Show a picture and testimonial right then and there. Make it more personal and emotional. Use other visuals and metaphorical representations, too.
• Don't overload the patient. Remember, they will forget most of what you say anyway. Because most patients are polite, it's tempting to take this is a sign of interest and offer too much detail. Most patients just want to see a sense of competency and have reason to be hopeful.
• Offer choices. Each patient still has the freedom to place different values on their health than you would. In reality, they are a customer and can choose to receive care anywhere they want. So don't force care plans.
• If you take X-rays, don't go crazy on the X-ray view box. Use the KISS principle. (Keep It Simple Stupid) Think back to the first time you saw an X-ray. Did you understand it? I doubt it. Trust me, the patient won't, either.
• Record your report. Record and listen to what you are saying to patients. Do you know what you sound like? This is the secret weapon for improvement in public speaking.

With a simple format, an ROF could take three to four minutes. Too short? Maybe. Just be careful what you add back into it. Too long is worse. You will have numerous upcoming visits to further educate them about chiropractic.

Four Basic Questions

What's my problem? This one is simple. "You have a spinal joint in your neck/back that's irritating nerves and disrupting the function of your entire body." The operative word here is nerves, not bones. Short, sweet and to the point. You can also relate it to other complaints. For example: "Muscle spasm, swelling, pain and decreased motion are from the body compensating for the lack of function. Our goal is to restore normal function and help you live pain free again."

Can you help me? Another easy question to answer, especially if you know the "buying profile" of the patient in front of you. After all, you are trying to sell yourself and chiropractic, so it's realistic to look at this is a buying situation.

• Tell the Commander Type, "This is a common problem we can help you with, and upon your direction, we're prepared to take aggressive action to help you."
• Explain to the Thinker Type, "This falls within the scope of our practice, and we have an 85 percent success rate with these sorts of problems."
• Mention to the Visualizer Type, "We see this sort of thing all the time, and I think you have every reason to be hopeful."
• When you want a Listener Type to understand your advice, provide more than just the desired destination. Give them a road map for getting there.

How long will it take? Interestingly, this may be the most important question. Again, it goes back to what you're selling. Your answer needs to touch on the length of typical visits, how long until they feel pain relief and how long they will need chiropractic care. I like to highlight patient responsibility: "Overall, care success depends a lot on you. If you keep your appointments and follow our recommendations for care, you have a greater chance of getting better faster. This is a partnership between you and me. I see you for 15 minutes a visit. You have 23 hours and 45 minutes left to destroy yourself. We can't beat this unless we work together." This lets them know they have the final say on how they ultimately do.

How much will it cost? Overlook this question because you're uncomfortable with your fees, have doubts or simply look to what a third party will pay, and you've got problems. The biggest obstacle here is in your own mind. Don't prejudge anyone for care. Look them in the eye, tell them the truth, and then stop talking. Do not ramble on and try to convince them. Expect them to say yes. Don't flinch. Silence is a weapon. The person who talks last holds all the power in the conversation. It will be awkward and uncomfortable at first, but do it. Wealth is a mindset. You have to put value on your services or somebody else will. If financial objections are not addressed up front, they will only need to be handled later, when the patient's account receivable gets out of hand.

Remember, whatever your solution, you need to sell it to people. Even if its importance is obvious to you, it may not be apparent to your patient. Building value is critical. No product is expensive if its perceived value is high enough. To the potential patient, a $1,000 price tag feels like 10 cents, if the pricey option will bring the proper result. Mastering the Report of Findings will establish your value. Above all, have fun and practice, practice, practice.

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