Building Patient Satisfaction: Outstanding Entry Procedures

By: Dennis Perman, DC

If you want your practice to grow, you have to make sure your patients are satisfied with your services. Unfortunately, many patients come to our offices with little or no exposure to the Chiropractic point of view, so they tend to behave as they would in other professionals’ offices, unless we train them to the policies and procedures we select.

The foundation of this ‘basic training for patients’ is the entry procedure, the way a patient is processed upon beginning care in your office. The proverb states that “well begun is half done,” and you will find that your patient compliance will skyrocket and your stress will diminish significantly when you design and implement an effective entry procedure for all your new patients.

The Entry Procedure

Actually, there are at least nine parts to the entry procedure, and here are some specific tips to improve them in your office:

1. The patient’s first call and the CA’s greeting. Making a great first impression sets your office apart from the usual, and whoever answers the phone has the responsibility of establishing that great first impression. When the phone rings, take a breath, smile, and answer in a pleasant, professional voice. The prospective patient deserves courtesy and respect, so answer by the second ring, and use a preplanned script to streamline and turnkey the process.

2. The collection of information. Buy or make a ‘new patient pad,’ a tear-off book of new patient phone intake forms, with all the pertinent entry information you’d need to prepare the new patient’s file in advance. The one asking the questions is the one in control, and you want your CA to be the one in control, to reduce squandered time and demonstrate your excellent office procedures right from the start. Let the form guide the interview, entering personal details like name, address, contact numbers, etc., and also the source of referral, the type of case (injured on the job or in an auto accident?) and any other specialty information you may need for your particular style of practice. If your office uses insurance, you may collect insurance information as well, to prequalify and handle the financial part of the report expeditiously. Complete the interview with a quick review, making sure to spell and pronounce the patient’s names properly.

3. Making the appointment. Offer choices: “Which is better for you, Mr. Patient—today or tomorrow? Morning or afternoon? 3:30 or 4:30?” Make sure the patient knows where you are located, and any public transportation or parking information. Finish by repeating the appointment time: “So, Mr. Patient, we’ll see you tomorrow at 3:30,” etc.

4. Receiving the patient and preparing to see the doctor. When patients arrive at your office for the first time, they are uncertain and insecure. The CA should notice their arrival and come out from behind the desk to greet and welcome them. “You must be Mrs. Patient. Please have a seat here, we’ll help you fill out a few forms, and the doctor will be with you soon.” Collect all the information and check to see that all forms have been completed properly, and receive the paperwork back from the patient graciously, helping to finish any spaces left blank. Reassure the patient that the doctor is wonderful and does a terrific job, and that most patients are extremely pleased with the care they receive.

5. Release to the doctor for the consultation-history-exam. Take the patient back to the appropriate room, and release to the doctor with an encouraging comment of some sort: “I leave you in the best of hands.”

6. Doctor performs consultation-history-exam. Be concise, and spend most of your time on your major outcomes. Remember to trade at shoulder level with the patient – patients come to you for a reason, and if they don’t feel heard or understood they won’t continue. In your interview, listen for key values – patients aren’t coming to you for their problem, they’re coming to you because their problem is interfering with some aspect of their lifestyle, and they want their lifestyle back. Ask questions to this effect, and gain insight into the patient’s real benefits of your care, not simply his/her current condition. Tell the patient you’ll put together what you’ve learned and present it in a thorough Report of Findings next visit. Invite the spouse or significant other to participate, both to support the patient and to introduce Chiropractic care.

7. Release back to the CA to make the appointment for the Report of Findings. Once again, the doctor makes supportive comments and the CA offers choices on the appointment.

8. Receiving the patient prior to the Report of Findings and release to the doctor. Once again, a warm greeting and any additional insurance or information collection is handled, and then the patient and spouse are taken back to the Report of Findings area.

9. Doctor performs the Report of Findings. There are three chunks to the Report of Findings. First, you must answer the four questions all patients need answered for them to hear anything else you say: Can you help me? What’s wrong with me? How long is this going to take? How much is this going to cost? Second, you must explain your program of care, so the patient knows what to expect. They’ve usually been raised in a different model, so you must simply explain the concept of subluxation, outline your program of care as to the frequency and duration of their visitation schedule, and describe the common phases of care, so that they have a foundation for your patient education. Third, you must get a commitment from the patient to follow through on the program of care: “Now that I’ve explained the benefits of our care and what you can expect, I need to know that you really want to do this, that I don’t care more about your health and well-being than you do. Can I count on you to follow through on the program of care as I described it?” Look in their eyes, extend your hand palm-up for a hand shake, and make sure the patient accepts your recommendations before you go any further. Once the patient says yes, the care formally begins, and they can get their first adjustment and be released to the CA for multiple appointments and/or a financial consultation, if appropriate.

Using a well-designed entry procedure will increase your patient compliance and reduce your stress, since a well-oriented patient can get the most out of your services, leading to better relationships and more referrals. Improve your entry procedure, and you’ll build better patient satisfaction and a busier practice.

About the Author

Dr. Perman is the co-founder, with Dr. Larry Markson and Dr. Bob Hoffman, of the personal and professional development company The Masters Circle. This organization is dedicated to helping Chiropractors find success and fulfillment through practice mastery and personal growth, through seminars, coaching, teleclasses, and audio-visual support materials. Dr. Perman can be reached at at