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Sharing the Big Idea: Communicating Chiropractic with Patients and the Public

APRIL 10, 2001 -  When Sherman College Associate Professor Bill Decken, D.C., ’86, opened the door to Family Straight Chiropractic on a pleasant August morning in 1987, effective communication was definitely on his mind - the construction crew who had just installed his new outdoor sign wiped out phone service for the nearby neighborhood.

Decken took advantage of the crossed wires when he went door-to-door to introduce himself and his new practice, with a ready-made example of the negative effects interference can have on an organism’s communication system.

Even though he knew intellectually that his success in practice would rest largely on his ability to communicate to people that chiropractic is really about helping your body work better, not neck aches and back pain, that late summer day gave Decken his first glimpse of just how challenging that communication could be.

Although chiropractors can look to recent surveys that show growing use of alternative health care approaches (including chiropractic), such studies also support Decken’s gut feeling that communication is the key to turning one-time testers into regular practice members. A recent Complementary and Alternative Medicine Internet survey by InterSurvey, Inc. shows that 37 percent of Americans have tried chiropractic, but only 15 percent see their chiropractor regularly - even just once a year.

These findings raise important concerns for the chiropractic profession: Why aren’t the remaining 85 percent of patients under regular care? Are chiropractors missing the mark in educating patients about the lifetime value of chiropractic care? What can chiropractors do to better educate and retain lifetime patients? And what can chiropractors do to reach a larger segment of the population?

To succeed in practice and further advance the chiropractic profession, chiropractors must learn to communicate their message clearly and effectively. Informed and satisfied patients who understand the “Big Idea” will talk to friends, family members and acquaintances about the importance of correcting vertebral subluxations. Of course, helping patients understand the purpose and importance of chiropractic is often much easier said than done.

The most successful and satisfied practitioners are usually excellent educators who depend on referrals for their livelihood. Many of them have a unique method of educating patients.

Some spend several hours each week in their communities giving lay lectures about health and chiropractic. Others may get pointers from a mentor or coach, and many successful chiropractors learn their “secrets” while studying at Sherman College.

Perhaps some of the following ideas from successful private practitioners and Sherman College faculty and students can point the way to improved patient education in your office. Excelling in patient education will not only benefit your practice by increasing referrals and lifetime patients, but it will also help increase awareness and acceptance of chiropractic worldwide.

Raising the Subject
To create opportunities to share the Big Idea with patients, community members and acquaintances, chiropractors must learn how to successfully initiate conversations about chiropractic. Decken teaches students how to turn every day conversations into an opportunity to introduce the concept of chiropractic. The idea, Decken says, is to get students in a chiropractic mindset, so they have a familiar list of examples and analogies on the tip of the tongue they can apply in various situations.

“B.J. Palmer said the difference between a good chiropractor and a bad one is that the good chiropractor has a long list of analogies up his sleeve - and he was absolutely correct,” Decken says. “People often grasp the concept of chiropractic more easily when you can relate it to something familiar and tangible. Decken challenges his students to do this by having them contribute an item from their purse or pocket to create a “grab bag.” Students pull an item out of the bag and discuss on the spot how it reminds them of chiropractic. “This exercise makes students think creatively, and they start to build a library of analogies that will help them in the health center and in practice. Creating an analogy that people can easily relate to helps build a better understanding of chiropractic.”

Carla Diana, an eleventh-quarter student and chiropractic intern at Sherman College, suggests other ways to initiate conversations about chiropractic. “One thing I do to strike up conversations with strangers is carry a thoracic spine key chain,” she says. “At least once a day, someone will ask about the key chain, and that gives me the opportunity to talk to that person about chiropractic.” Diana also wears a spine charm on her necklace and won’t be caught without a stack of her intern business cards.

Building Understanding
Talking to friends, family and people in the community about chiropractic is one of the best ways to get people into your office, but it will take effective communication and a strong commitment to patient education to convert them into lifetime patients.

Patient education should begin during the first visit and never cease, says Peter Kevorkian, D.C., who will present &#x201Communicating the Big Idea” at Sherman College Lyceum 2001. “When I meet with new patients, I tell them that I want to create a lifetime relationship with them,” he says. “It’s my responsibility to educate patients and give them the necessary information so they can make that decision.”

During his first visit with a patient, Kevorkian focuses on the spine. “First-time patients should leave the office knowing that they need to take care of the spine, much like the dentist explains to them how to take care of the teeth and gums,” he says. Over the next few visits, Kevorkian helps patients understand the true sense of vitalism and chiropractic philosophy. “I want them to realize that they should take interferences out of every part of their lives to enhance potential and performance. Some are ready for that on their first visit, but many have to get used to the idea before moving on to that.

“I try to impress upon my patients that health is more than just feeling good, that the body has a magnificent inborn wisdom given to us by nature that creates and maintains health, that controls and coordinates all functions of the body,” he says.

Len Schwarz, D.C., Penn Straight, ‘93, incorporates chiropractic philosophy from the first visit as well. “I educate patients about philosophy by using an educational video and by explaining it to them in simple terms,” he says. “A solid foundation in philosophy is the crucial ingredient in creating a successful doctor-patient relationship that lasts for life.” Schwartz helps patients build a solid foundation in philosophy by using analogies and visual explanations and by implementing his own 30-visit patient education system, ChiroPower, Inc.

To be effective, patient education has to be an ongoing process, says Nalyn Marcus, D.C., ‘90. “Education has to come subtly, not by lecturing,” she says. “Many times I repeat short phrases. I’ll use something simple, like a nine-word phrase: ‘Health isn’t how you feel, it’s how you function.’ When you use short phrases like that repeatedly, patients will get the message.”

In his private practice, Decken relies mostly on 30- to 60-second talks that he refers to as “table talk.” He continues teaching chiropractic in little snippets each time a patient is on his adjusting table. “Many times, the only place people hear about chiropractic is when they are in our offices, so we should be trying to give them more information each visit.”

Schwartz agrees. “I educate each patient every single visit about chiropractic. Consistency helps patients get that paradigm shift in their head. Then they take that information out to friends and family because they want to share their knowledge with others. Armed with a solid understanding of chiropractic philosophy, patients will take the opportunity to educate others and bring them into the office.”

Connecting with Kids
Just as you would use different approaches when talking to members at a local gym and workers at a nearby factory, you need to tailor your communication methods when sharing chiropractic with children. Helping children understand the complex concepts of chiropractic can be challenging, but those who do it well find that it can also be extremely rewarding. Many chiropractors not only educate the children in their practices but also branch out to kids in their communities by visiting local elementary and middle schools.

“Kids and young adults can be your biggest advocates and educators once they have a solid understanding of chiropractic,” Marcus says. “I have teenage patients who come into the office to get checked before their SATs and other exams because they understand the importance of being subluxation-free and functioning at 100 percent.”

“I love working with kids because they are so open to new ideas,” says Diana. “Most of them have a clean slate, with no misconceptions about chiropractic.”

Diana and Patricia Kuhta, D.C., ‘94, assistant professor and director of the x-ray department, recently spoke with a group of kindergartners from the local Village School about x-rays and subluxation.

Diana talked to the children briefly about the spine and the nervous system, then asked them to form a single-file line. She explained that the child at the head of the line acts as the brain and the other children in line are the vertebrae that make up the spine. She had the children pass a yellow rope between their legs to represent the spinal cord, then moved one child out of line.

“This shows them how a subluxation interferes with the spinal cord’s ability to communicate with the rest of the body,” Diana says.

More than Just Talk: Creating an Atmosphere of Learning and Celebration
Regardless of whom you might be talking to, effective communication isn’t solely based on the words you speak. “Sometimes it’s not so much what you say, but the way you say it that makes communication effective,” Decken says. Non-verbal cues play a big role in communication, and trust is crucial.

Students in Decken’s communication classes specifically discuss the importance of developing relationships with people and communicating character. “It’s important that an audience connect with the speaker’s character,” Decken says. “That’s how chiropractors get referrals - someone else is vouching for our character and our integrity. People won’t care how much you know until they know how much you care.”

Effective communication can also take root in office décor and reading material, holiday celebrations and fun office activities. Schwartz decorates his office with chiropractic posters and has also created a video for new patients. In addition, he has special health days at his office; for example, a Spring Open House or Mother’s Day Monday. Schwartz also hosts patient appreciation days, which give his patients an opportunity to bring friends and family to the office. He offers complimentary services for the new visitors.

Marcus keeps a message board focused on health and chiropractic in her office and changes the content frequently. One message consisted of a very large number (29) with a small, more important message underneath: “Name the number of drugs that an average American family has in their cabinet.”

If she needs to leave the room for a minute or two during a visit, Marcus asks her patients to choose two chiropractic education cards to read over until she returns. The cards, created by Lauren Nappen, D.C., ‘93, contain information about vitalistic expression. Marcus also maintains a lending library and allows patients to borrow books and other items from the office.

Another of Marcus’ projects is the orange ribbon, which boasts the message, “Orange you glad you’re well-adjusted?” She asks her patients to wear these ribbons to educate others and raise awareness about chiropractic, just as red ribbons raise awareness for AIDS and pink ribbons raise awareness for breast cancer

The Power of Technology
While your current patients play a fundamental role in referring new patients to the office, technology can also do some of the footwork for you. Every day technology is becoming a more integral part of basic office procedures, and successful chiropractors have learned how to make new technologies serve them as patient education tools.

Students in Decken’s communication classes design a 20-minute PowerPoint® presentation about chiropractic, and all students present their talks to the class using the college’s new projection system. Making this presentation helps put students at ease when talking to a group of people, but it also introduces them to another avenue for patient education, Decken says. “When students complete the class, they have a health talk that they can use in their future practices, especially for opportunities such as presentations to local civic groups.”

Instructor Joy A. Gayler encourages students in her Automated Office Procedures class to make the most of current technology and to apply it beyond simply billing, creating reports and scheduling appointments.

“Technology can add a new dimension to health talks and presentations and can also be used to create newsletters and websites that promote chiropractic and your practice,” Gayler says.

Gayler impresses on her students that with a little effort, technology can become a powerful communication tool. If you have a CD writer, Gayler suggests distributing PowerPoint® presentations on CD to patients or placing them in health and fitness centers in your community. You could also create a self-running program in your office - a computer kiosk for new patients to explore.

In class, Gayler also discusses the Internet as an additional tool for communicating with patients and the general public. “E-mail and the Internet can make for extremely effective communication when used appropriately.” But Gayler is quick to caution chiropractors and students against using the Internet as a replacement for personal interaction. “Some chiropractic websites contain forms that prospective patients can fill out before making an appointment,” she says. “That’s one thing that should really be done in the office so that the chiropractor and patient can discuss specific issues and concerns.”

A Lifetime of Care
Straight chiropractic philosophy and lifetime patients go hand in hand; when your patients understand the Big Idea and want to be subluxation free, remaining under care will make perfect sense to them. “When the chiropractor focuses on correcting problems or conditions, the patients don’t know how important it is to remain under care if and when their symptoms go away,” Decken says. “At Sherman College, we teach chiropractors to educate their patients about the benefits of life-long chiropractic care - how it helps the body to function and perform at its best. Unless you get that message across, you won’t retain lifetime patients.”

“I believe that when people understand what I know about chiropractic, they will make it the same high priority I do,” Kevorkian says. “It is my responsibility as a chiropractor to make people understand the importance of regular chiropractic care.”

“It’s wonderful to watch people come in and grow up in your office,” Marcus says. “If you effectively explain what chiropractic is and why your patients need to be unsubluxated, you will see them regularly because they will want to make chiropractic an essential part of their lifestyle.”

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