2017 Spring Convention

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Kristina Cummings
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1 2017 Spring Convention New Patient Flow Presented By; Mark A. Davini, DC, DABCN

2 CEU Credit 1 Please scan IN at the start of class Please scan OUT at the end of class You must attend the entire session to earn your credit for this class

3 Mark A. Davini, DC, DABCN 1981 graduate of Palmer College of Chiropractic 24 years in active practice Diplomate in Chiropractic Neurology Certified Chiropractic Industrial Consultant Past Chairman of the MA Board of Registration of Chiropractors Mass Chiropractic Society, Vice-President of Public Information and Education Mass Chiropractic Society, Chairman of the Ethics Committee Lecturer for various state and national associations continuing education programs to include chiropractors, nurses, dentists, the Council on Licensing, Enforcement and Regulation for the Commonwealth of MA, and 2nd and 3rd year medical students at the University of Massachusetts Medical School. Dr. Davini co-developed and teaches the Chiropractic Assistants Procedures Program (C.A.P.P.) Co-Developer of TOP Education, LLC Active in the defense of chiropractors involved in malpractice litigation. Compliance Auditor/Clinical Monitor as well as a pattern practice analyst Awarded 2 U.S. Patents on the M-Brace for Carpal Tunnel Syndrome Chiropractor of the Year by the Massachusetts Chiropractic Society in Doctor of the Year by the Worcester County Chiropractic Society in 1987

4 Patient Re-Positioning Does anyone disagree with the statement? If patients knew what I know they would want chiropractic care forever.

5 Patient Re-Positioning Give them what they want so you can give them what they need. Dr. James Parker Although most patients innately want what is best; often they don t know what that is.

6 Just don t call me late for dinner Who are you? How does your staff say your name? What do you want your patients to refer to you by? They need to be the same. If asked by the patient how do you want me to address you? Answer, Whatever makes you comfortable. If the office stays consistent they will come around to what you project.

What to do, what to do Backdrop: Decide on your office s message, e.g. wellness, symptom, injury. There should only be one overriding message. Do not contradict your message.

7 What to do, what to do Backdrop: Decide on your office s message, e.g. wellness, symptom, injury. There should only be one overriding message. Do not contradict your message. Five Sense your office with your message in mind. Are what the patients seeing, hearing and feeling different from the message. Example: Are your pamphlets, posters etc. all pain/conditions

8 Hold the presses The paperwork: The forms (paper and electronic) are front line when it comes to making an impression. Consistent. They all should look alike, same letterhead titles, etc. Professional. Do not cheap out with faded, crooked copies. Attractive. Easy. Don t overdue. Remember it is still a doctor s office. 6th Grade.

9 What are you doing here? Know your patient: Pain relief only. Pain relief => Correction Pain Relief => Correction => Wellness Wellness only

10 Type Casting Assertive and Responsive Usually draws attention. Wants acceptance but will direct as needed. Assertive and Non-Responsive Bottom Line. Non-Assertive and Responsive Will not confront Initially yes to everything. Wants you to like them. Non Assertive and Non-Responsive Needs Information, lots of it.

11 What did you say? Speak their language: NLP: Visual. Loves the pictures Auditory. Hates the pictures Kinesthetic. What pictures. Need to feel it

12 Smorgasbord of information Something for everyone: Build in all the elements so you don t have to think about it. Thorough Efficient Informative Confidence Directive Authoritative Competent

13 A room with a view Consultation Room/Area: Credentials/awards/memberships Light box and/or flat screen Models Charts

14 Talk Amongst Yourselves Consult: Establish connection, visually, orally, and kinesthetically. Shake their hand, look in their left eye and as you shake. Move closer to them but not too close and say I reviewed your file, how can I help? Do not say why are you here? Sit down, knee to knee if possible.

15 Talk to Me This means listen to me: Now focus on CC. Connect CC to other parts, systems & secondary CC (chronic). Let them talk first then ask your questions.

16 Now its your turn Move discussion to the concept of body is more than a sum of parts. The nervous system controls all parts. Expand need for service to whole spine not just CC. Explain that as a DC we examined the spine for subluxations. Give your one line definition of subluxation, keep it simple: Misaligned vertebra Causing interference with the nervous system Resulting in altered function somewhere in the body Are there others in family with same issues. Ensure them that you will do everything within your ability to help. Complete consult by telling them what will and will not take place that day, e.g. adjustment or not.

17 Table for One Exam Room: Clean and sanitary. Mirrors facing front and back of patient. So that patient can always see you. Where gloves Yes this one time... Exam instruments in a drawer if possible. Tissues, jar of cotton squares with alcohol, tongue depressors. Clearly instruct what to take off and leave on. For women best to have a gown and shorts. Men shorts only. Have the gown and/or shorts waiting on the exam table; message-we are prepared for you Inform them you will be right back and tell patient a signal to let you know they are ready, e.g. crack open the door.

18 Can I have this Dance Choreograph your Exam: Have a scale in space they are changing. Have CA complete Ht. and Wt. Move patient to exam room or space. The patient starts out sitting on the table. Begin here:

19 Face Value Patient Exam Sitting Face to Face: Create sequence for exam that flows and appears in control. Reinforce CC area(s), but tell them you are going to exam their entire spine. Have CA in room and verbalize and document exam. (can use recorder) 1. Vitals Bilateral BP and Pulse (CAs can also complete) 2. Auscultate carotids and vertebral arteries 3. Cervical ROM 4. Hold both wrists palpating pulse. Raise up above shoulders then extend. 5. Val Salvo s 6. Eye Tracking => facial muscle 7. Use ophthalmoscope and check pupils => mouth => tongue => gag => ears 7. Shrug shoulders and resist 8. DTR s 9. UE Motor 10. UE Sensory 11. Palpate front of neck 12. Static and Motion Palpate Cervical spine

20 Back Talk Patient sitting doctor behind patient: 1. Palpate back of neck. 2. Perform remaining cervical orthopedic tests.

21 Stand at Attention Patient Stands Facing Away from You: 1. Check posture back and side. 2. Thoraco-lumbar ROM. Same time performing Adam s. 3. Perform Kemp s. Patient Stands Facing You: 1. Check posture front. 2. Romberg => Finger to Nose => Alternating Hand. 3. Heel to Toe Walk forwards and backwards.

22 Nap Time... Patient Supine: Orthos: Soto Hall, SLR, Fabere-Patrick (hip and SI compression at same time). Auscultate abdomen. Palpate abdomen. LE Sensory. LE Motor. Patient Prone: Orthos, Yeoman s, Leg check, etc. Static Palpate thoraco- lumbar spine.

23 Post Exam When completed, give mini report (one or two lines). Start with CC but move to concept of restoring balance to whole spine for health reasons. Tell them that you detected subluxations causing interference, and altered function, e.g. spasm, pain, tingling etc. Encourage them that it looks like you can help.

24 Post Exam This leads to the full spine rationale for next procedure, e.g. Need X-Ray to see is to know, to not see is to guess. Bring to x-ray area/room and perform procedure. If no X-Ray make referral. When completed, have them change back. If not performing any more procedure, the exam is completed. Have them change back.

Release: Home instructions in writing, e.g. ice, rest, whatever. Hand them pamphlets: Welcome to chiro/office/custom office/subluxation. Acknowledge each one don t hand as a bunch.

25 Release: Home instructions in writing, e.g. ice, rest, whatever. Hand them pamphlets: Welcome to chiro/office/custom office/subluxation. Acknowledge each one don t hand as a bunch. Ask if any questions and answer them. Give instructions what to do if something changes. Affirm appointment, remember they set up both at once. Release to front desk to check out.

27 CEU Credit Reminder Please scan OUT as you leave If you are staying in this classroom for the next session you must have your badge scanned OUT for this session and scanned IN for the next session Thank you! Mark & Paul

28 Disclaimer TOP Education & the instructors acting on behalf of TOP Education are here this weekend to educate. They are not representatives nor speak on the behalf of any Insurance Company or TOP Education, LLC. Any discussion of a specific Insurance Company is for examples purposes only. All carrier specific policy or procedure questions should be directed to that carrier

TOP Education s 2018 Synergy Conference

TOP Education s 2018 Synergy Conference TOP s Ten Risk Concerns 1 CEU Presented By: Mark A. Davini, DC, DABCN Please scan IN at the start of class Please scan OUT at the end of class You must attend the