Blog, Chirosecure Live Event January 29, 2023

How to Have Uncomfortable Conversations with Patients

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Today we’re gonna talk about How to Have Uncomfortable Conversations with Patients. This is Chen Yen, your 6 and 7 figure Practice Makeover Mentor at Introverted Visionary, your host of the ChiroSecure Show today. So wouldn’t we just love it if patients would follow through with care, show up on time,

always pay on time and never mess up our schedule too by showing up later, canceling and rescheduling and things like. So that would be amazing in a perfect world, but it doesn’t always happen. And so what can you do when you end up finding yourself in these situations and then you feel like. You don’t like to have you’re not confrontational.

You don’t like to have uncomfortable conversations with your patients, and, but then there’s a part of you that feels annoyed or frustrated and what do you do in that situation? So let’s talk a little bit about. Three common situations. This kind of an uncomfortable situation can happen for un for you experiencing it as a doctor, as a practitioner.

So the first thing is have you ever had people who reschedule and then some, sometimes they’re chronic reschedulers. They are they. Reschedule once, and then they always try to reschedule very late, very close to the appointment time, and either you have a policy in place or not, but then they still end up rescheduling really close.

So perhaps you have a policy in place and they just reschedule every single time or many times frequently that it just cuts it so it’s not outside of your policy. Like cancellation fee or I mean reschedule fee or things like that. But then it’s still hovering around that timeframe where it ends up affecting your workflow.

It affects other patients from not being able to see you in the practice because, They had, that patient had taken up that time and now is rescheduling, right? So it could happen. The rescheduling could happen with cancellation situations or no shows. That’s one kind of a situation of uncomfortable situation.

We’re also gonna talk today about. A payment issue. So where people end up not paying you, but you continue to treat them and then what happens? Or if they request to maybe you, you offer packages or treatment plan and then they request to back out. Like those kinds of uncomfortable situations for either you as a doctor or your front desk or whoever is supporting you.

Patient care. Coordinator who’s supporting you with that conversation or the third kind of common scenario that where uncomfortable conversations can come up or uncomfortable situations that would be good to have a conversation about would be seeing. Sometimes seeing patients not follow through with their treatment plan, but then they have these expectations that they should be getting better by this point in time and that they’re not really following it, your recommendations, but they still expect.

Results and fix them overnight, right? And then they get grumpy and then you feel frustrated because it’s because they aren’t following their treatment plan. But how do you really communicate that in such a way that they feel like it’s.

They feel good. You feel good and it lands for them. So let’s talk about the three kinds of common uncomfortable situations. How best to deal with in conversations? So as far as the re rescheduling or cancellations or no-show situations, one of the most common things I hear about this is that there, so the first thing I ask about,

If there are those kinds of situations that tend to happen cancellations and no choice do you actually have a policy in place around that and that the patient signs? So many times I hear this that no, I don’t actually have them sign anything, but I’m annoyed about this because it keeps happening.

And then sometimes I also. Docs say I do, but I don’t enforce it. And so then part of it is about setting those, do you, the first question to ask yourself is, do you have boundaries? And are they clear from the start? Because what can happen is that perhaps someone does it and they don’t realize it’s that big of a deal.

For as an impact to the clinic and to the practice, or to you for that matter. And they just think oh, I was, a little bit late, or, oh, something really happened in my life and I need to take, I need to do this. I need to do this other thing instead. So let me just reschedule when it’s more convenient for myself.

And they don’t think about the impact of it on the practice itself. Loss in revenue or your time schedule being messed up and someone else not being able to see you because of that. And so part of it is are you bring that upfront when a patient starts at the beginning of care. So this is happening.

Not in the, when they start doing this thing and you get annoyed, but rather the very first visit, do you go over it with them or someone in your office goes over it with them and then have them sign it so they’re very clear that this was like an important thing that they even needed to sign from the beginning.

And then part of this is what do you say in the cancellation policy, and I can share with you a. A few phrases from a cancellation policy of a practitioner. And then if you would like more of the full sample of this, you’re welcome to message me and happy to give it to you. For example this one starts out saying, we consider each appointment made to be a promise and expect this agreement to be honored.

So notice that it starts off With the context of the importance of keeping agreement, including, making appointments and although we understand that events can occur unexpectedly, this policy ensures that we can keep our doors open and upholder our end of the agreement made by each appointment.

And then they set the The expectations as far as, if you don’t show up then what do you do? So do you have, in your cancellation policy, what do you do? Like you give verbal agreement or written, verbal or written notice about it at least x timeframe in advance, whether it’s a day in advance or what that kind of thing.

And then in the event that they cancel, what is your policy for that? For example, for some clinics it’s where allowing a one time, good faith, and there’s no penalty that will be incurred the first time around. And then after that then there, there would be penalty in terms of either a cancellation fee that is partial or even all of the expected visit fee.

So then this is just an example. A few phrases from a cancellation policy of a practitioner. Again, you can message me if you’d like to have the abreast of this ory in a template format. Now, as far as a sample now, the so sign that, that have the patient sign that cancellation. Policy from the first visit, it’s itself.

And then the next thing is that are you, the second thing is, are you putting those boundaries in place because you get what you tolerate? Meaning that for one, do you, okay, so number one, so you have boundaries. Number two, are you putting those boundaries in place? Number three are you, and actually tied into number two is, is.

The, your tolerance of the boundaries is what I was going to say about that actually, cuz you get what you tolerate and that comes both energetically of how you show up for yourself. Are you on time also? Because if you are running late all the time, then what the patient observes is, oh, I guess it’s okay to be late.

So I’m gonna start showing up a bit later because, I don’t wanna be wasting my time and so in the office, so I’m just gonna show up later too. And then it creates this culture of showing up late, right? So part of enforcing boundaries and is also you living up to your standards of boundaries as well.

And then being firm about the boundaries. Sometimes we could feel bad, we could feel really bad that oh, I don’t wanna, especially those of us who are people pleasers, like I know myself, I’m, I tend to be more of a people pleaser and then I will feel bad and then I’ll.

I’ll think, oh okay, I’ll just let it slide this one time. And I, I guess it wasn’t intentional. And or saying things like, oh, that’s okay when you don’t really mean, that’s okay , so it’s about being authentic with what you really mean about that too. You could say, I understand your second traffic, so I totally get it.

And thank you. I really appreciate you. Moving forward and, showing up on time. So it’s being respected both of our times and you get your full treatment, right? So it’s about how you frame it and then in a positive way, in a loving and caring way as well. . And then the third thing has to do with have you surprised your patients before?

So as it relates to overall boundaries, so I’m talking about this applies to cancellation or schedules and that kinda thing, but it does apply to matter other matters like payment issues and other kinds of things too, which we’ll talk about coming up here. So for example, have you actually surprised your patients and they got caught off guard and.

What do I mean by this? Related to boundary kinds of things. So I confess, I it happened one time in my life when I was seeing this dentist and it took me an hour to drive each way there and for, and it was so it was a holistic dentist office, right? But then when I went there, there were a couple times when I went there and they put a filling in and then it would pop out.

Like this happened several times. And then I Anyway, I still went to this place because it’s a holistic dentist office, and I wanted to go to a holistic dentist and then I was bad. Like I would actually show up late. I’m actually someone who’s very spot on time with my client appointments, client calls, client prospect calls, all kinds of things.

I’m on time for, because I’m in respective of time with that. But then I was, Not showing up on time and because I, I was driving and stuck in traffic cuz I don’t drive that often that way. And then I get stuck in traffic and then forget the next time around that. Oh my gosh, it actually takes a lot longer to get there.

So this happened I believe through maybe two or three times and . And then one day I showed up to the clinic. I got taken outside by the practice manager, and basically she fired me from the practice. She just said, I it’s just a reflection of you. You’re not taking this seriously with your health and everything.

And I was thinking to myself, good for you for firing me. That was one of my first thoughts. And then I thought, because I also respect boundaries and I, so for that part of me I thought, good for you. And then the other part of me, I thought, how would I feel as a patient though if I really were feeling into how I feel?

I was completely caught off guard. It was literally taken outside and just told see you later. We can’t see you as part of the practice, and. And so I think part of it is that it caught me by surprise because I wasn’t told that, Hey you’re late this time and I would really request you to be on time next time, or, because X, Y, Z, right?

It was like I had my three strikes and then all of a sudden I was kicked outta the practice. I deserved it, but still, right? But that’s where coming from the patient perspective, it can feel. , I can feel like someone just took me by surprise. I thought this is totally okay.

This kind of a boundary is okay, right? And and not boundary. This kind of action is okay. So you get what you tolerate and if you don’t explain to people and also move, shift them back towards what is. The what your values are and what boundaries you have as part of the practice.

If you don’t take that opportunity to communicate that. Even if it might feel uncomfortable, to let them know that, and then you ended up get, end up getting upset about it one day and be like, screw it. I’m not gonna. accept this patient anymore, and you say goodbye to them we don’t want you as part of this practice.

They’ll be really surprised. . So I know I shared an extreme example of myself with it, but still that’s the kind of thing that a patient could experience if they continue to push boundaries and then you don’t end up you don’t end up reinforcing or reeducating or them about your values and boundaries.

now, it’s still really important no matter what in this situation or in any situation, to really come from a place of care and love for them too. And so I think sometimes if we might feel like something is an uncomfortable conversation, it’s because we are afraid of what we might think. Other people will react or we might judge them for how the, like we.

Sometimes like base our lens on what we’ve experienced of that person in the past and how we think they’ll respond and we start to judge ’em about how they might respond or not, or get upset or not, or that kind of thing. And so if we end up putting the, our energy of those expectations energetically into the field, into the space of communication, then it can show up that way because you are actually project.

That and then you get what you sometimes in our lives, right? We get what we project and. It’s really important for us to UNC clutch is a powerful word I learned from a spiritual enlightened master, and I think it’s a beautiful word to your, to, as you go into uncomfortable conversations or potentially.

Your concern is that it could be uncomfortable conversation clutch from that thought of that it’ll be an uncomfortable conversation because you don’t know if it will be and why. Insert that kind of energy already starting off as a context of a conversation. Come to it with love, come to it with a place of understanding and care and communication and still wanting to help your patient and they will be able to feel that energetic energetically and your sincerity.

And That’s really important with this too. Cuz sometimes it can be easy to get annoyed, right? When people may do something that might affect your schedule, your time or, that loss of revenue from, for the practice when they decide not to show up or commonly and that kind of thing. . Now the second kind of a situation that related to un potential uncomfortable conversations with patients that may arise is related to payment issues.

So have you ever had people either Like they, they still have this bill and then they say, oh, I’ll take care of it. And then they don’t take care of it. And then or they, and you still continue to treat them or they, you don’t continue treating them, but then it’s like they just don’t pay. So what do you do in those situations?

Because it can feel uncomfortable. You have that relationship with the patient and. And you’re helping them. You come from that energy of helping them, but they’re not paying you. So certainly in an environment where you have a front desk help per kind of a person, admin person, this is going to be easier for you to navigate because you can just.

Fully focus on being the doctor and not have to have those conversations with the patient. But sometimes, especially if you’re starting out or maybe patient volume isn’t there yet enough for you to hire someone to support you. Then you might need to carry on these conversations yourself. In either of those situations, it would be about how you can navigate that in a way that ends up feeling good for both of you and that you are able to also end up collecting on the payments that for the services rendered or what was promised.

And so the. If it’s has to do with training, then it’s a matter of you having a good way of approaching it that you can train your front office staff because not every person has the same kind of level of handling it or understanding or has the context of what you value. Within the practice as far as how what’s important to, to as values in the practice and how best to communicate that warmth and love while holding firm boundaries, for example, related to payments.

And part of this is, again, being able to be loving while at the same time letting, reminding them or that their payment is due and then and then also setting timeframes. For example, let’s get this taken care of today. Okay. So just, having languaging in there that leads to resolution.

And then if they have trouble with it, then work with them on it. And again, still set very clear and firm boundaries of expectations. And this is where you may also want to consider payment policies. If people are not paying or late in payments, what happens there too as far as whether it’s tacking.

On late fees if not paid by a certain timeframe. But these things, again, really need to be shared upfront with the patient. So there’s mutual understanding of this and it’s not something you just pop in there when and they get surprised by because you just. Ended up getting tired of them not paying you for months to months.

So these are things to, to keep in mind related to he helping you if you were to have uncomfortable, if you’re concerned about having uncomfortable conversations with patients about payments. And I think one of the things that I’ve learned over the years as a healthcare practitioner is.

Being really warm and loving and then at the same time holding firm boundaries related to payments. And the truth is that the right kinds of people will align with that and then the people who are upset about it. It’s not necessarily of a a result of your policy being too firm and that kind of thing or that you are, you should do something different just because of a few people or getting upset and that kind of thing.

It’s really looking at what. , what are you seeking to attract as far as the kinds of patients you would love to work with? Would you love to work with people who value integrity? Would you love to work with people or would you love to work with people who have so many loop? In integrity, and you always feel like you end up getting shafted or Right.

So just in, in terms of being really clear about who you would really love to attract and can really help with that. And so the third uncomfortable situation that could happen is if a patient isn’t following their treatment plan and they’re frustrated because they’re expecting results, but they’re not seeing.

have you ever experienced that before? Go ahead and like it in the chat or comment below if you are, have experienced that at some point in time and so this can feel like I’m doing what I can for the patient, but it’s so frustrating that they are now putting the onus on you.

because E even though they didn’t actually follow either the timeline of the treatment plan and not coming in for visits regularly, perhaps or maybe with certain recommendations that you’ve made for in between the visits and then they don’t listen to it and, but they still expect.

The, that kind of results or expectations, whatever kind of expectations that may perhaps you had set or not set. Like maybe you didn’t set expectations about results and then they just expect it to be better after a couple of visits or adjustments or, so then it is really important for, again, to.

Look at it as a way to educate. This is where it’s going to be so helpful to educate before the first visit even, and before. Choose to become a patient when they become a patient, but before their first visit and then during the visits at every single visit, how can you continue to educate them about why it’s still really important to, to stick with their treatment plan or listen to what your recommendation and one thing to think about could be like, To share with them is what are the consequences of not following the treatment plan?

And to just continue to educate and remind them. I know what it can feel like if you feel like being a broken record at times. But this is something that will be very beneficial for your patients. And then they will slowly start to understand more and more. Cuz remember you’re coming from a place of a lot of clinical knowledge and they’re coming from a place of a typically, Less, a lot less clinical knowledge than you.

So you automatically have a high baseline of clinical understanding. They might not have that baseline of understanding. So even when you fill in the cup with that kind of knowledge and teachings like they might only res. Feed a little bit of it because they just can’t it’s already too much overflowing.

Like you even, you give them a little bit and it’s already overflowing, right? The cup’s already overflowing. It’s like too much for them to take in. So then it just look at how can you consistently. Educate so that they end up following their treatment plan and and have realistic expectations about results.

Also, part of what’s worked really well for our chiropractors is having a do you have visuals that you could show your patients that, that really show the progression of their care. It’s not just oh here is the sciatica and what it looks like, and then here is this is better.

It’s not just like the two images of. For example, right? It’s do you have ways to really show visually the progression of what’s really happening and how it’s supporting their care? And that can be very helpful for a patient’s understanding so that you don’t have to feel like you have to get to that point of an uncomfortable conversation when someone’s feeling like you didn’t really help ’em in the way that you, they thought that you would.

So bottom. It really starts whether, any of these situations of the three that I’ve shared with you, whether it is the the rescheduling, cancellations, no shows is the first kind of potential uncomfortable conversation situation, second payment issue or payment matters, or third people not following their treatment plan, but then expecting those results.

Then being upset about it. Is that like bottom line? It starts from the beginning how you communicate actually even before they come into the practice. Like how are you marketing your practice? How are you communicating both energetically? and in what you say about the kinds of patients you’d really love to attract, because even like I mentioned earlier about attracting patients with integrity, if you are showing up energetically with integrity, if you are also walking the talk of integrity, you will likely also attract people in more, in alignment with integrity will be a hundred.

it may not be a hundred percent, but it will start to, to align more and more to that. And then also it’s not just energetically because you could energetically be an integrity yourself. And by the way, integrity is word with yourself and with others too, in the sense of do you keep the word your word to yourself?

Do you tell yourself, I’m gonna get up in the morning and go to the gym, and then you sleep later because you decide you. Sleep later, and because that is still being out of alignment with integrity because you told yourself you would do that, right? If you didn’t tell yourself you’d do that, then that’s not breaking word with yourself.

But if it is then you’re breaking word with yourself. . And how is that lining up for yourself? How is your integrity with other people what you say you will do? Or do you do it, do you, or what about the agreements that you sign when you sign them? Do you try to back out of agreements?

Do you try to cancel, do you try to reschedule? Because if you do these things energetically it, it also attracts like you might attract people who mirror that in you too. Again, it’s not all the time. Just, it’s just an opportunity to look in and see if there’s opportunity for cleaning up our own integrity and alignment with Word.

And and I will say I’m not always perfect. with this too, either, right? But it’s in terms of how can we look at these things as an opportunity for how can we look in and realign ourselves integrity wise, because then we will track less of this coming up too. And then . And so how you show up energetically, what you say about the kinds of patients you accept and like we accept patients who are really, who are serious about their health, right?

Like even the kinds of languaging that you use instead of oh, we accept just about everyone. It like, it, just notice what you’re saying, notice what’s put on social media. Notice what’s, what you put on your website. Is it is it never really talked about? It’s just more. Letting people know how you could help.

But are there actuals is there actual languaging describing the characteristics of a kind of person you would love to attract? In terms of again, aspects of them. Like they’re serious about their care and they. They tend to see holistic options. They, they see holistic options whenever possible.

So just think about what could in be included in the languaging, what could be communicated. In your marketing even before they become a patient of yours. And then when they do come to your practice, how you communicate your values, your boundaries and then your care for them.

So if you would like that cancellation policy sample you’re welcome to message me. And then for more, if you found this helpful for more six and seven figure practice makeover. And free free tips and you can go to introverted So to you, having more, being able to attract people you really love working with and also having these boundaries in place and that way you’re feeling good about it, they’re feeling good about it and then you’re, you also are really able to focus on helping your patients the best that they can.

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