Do You Have Any Questions?
By William D. Esteb, Patient Media, Inc.
For most of us, it can be traced back to second or third grade. You may even remember being told, “There’s no such thing as a stupid question.” In fact, we were further admonished that the only “stupid” question is the one that goes unasked! Trusting the teacher, we tried out this new freedom and were greeted by judgmental expressions, exasperated murmurs or overt laughter from our classmates. Apparently, there are stupid questions. And if you ask one, you’ll be laughed at and ridiculed. From that moment on, with our fragile self-esteems on the line, we vowed never to be ridiculed again by asking a question.
Today, that promise manifests itself in your office, in your examination room, at your reports, in front of your X-ray view box and even on your adjusting table. This invisible barrier prevents patients from fully embracing chiropractic and resolving the fears and doubts they quietly harbor as you work on their spines and nervous systems. The tragic effect are patients who enjoy results from your chiropractic care, yet rarely give up their blood-focused, germ-fearing, symptom-treating, pill-popping philosophy about health.
Chiropractors are wounded in the same way. Today, those second- and third-graders congregate in the back rows of seminar audiences. Avoiding eye contact, hoping to preclude any forced participation in the proceedings that might risk a repeat of the humiliation from elementary school, they seek refuge in the rear. Yet, these are the same chiropractors who, without thought, put a bow on the end of their report of findings with by asking the patient, “Do you have any questions?”
While it’s entirely possible that you’re a brilliant communicator, anticipating every patient concern and neutralizing every patient fear and they truly don’t have any questions, I doubt it. Chiropractic, for most patients, is such a radical departure from the medical model they’ve grown up with, that it would surely prompt some type of question. But seemingly, they don’t have any. How come?
Consider some of the possibilities:
It’s not safe. Have you created a safe environment for the patient to ask questions? Is there privacy? Will others hear their question? Have you communicated a nonjudgmental tone? Does a patient question make you defensive or on guard, as if they were questioning your validity or philosophy? Countless subtle, nonverbal clues are picked up by patients that can either serve to make them wary of asking questions or give them the green light to reveal their uncertainty or concerns.
Not interested. Many patients fall into this category. They’re just not interested in embracing a new model of health and healing and are in your office to have you “fix” them so they can resume their life. These are often folks who have disconnected their brains from their bodies and lack the skills to listen to their bodies. They tend to assume a passive role in their care and do little outside of your office to enhance or facilitate the healing process.
Rejecting your message. One reason patients don’t ask questions is they think you’re crazy, an extremist or the quack their friend told them about. They have no interest in chiropractic other than that of a drug-free form of pain relief that a third party will pay for. They don’t “believe in chiropractic” and look down their nose at those who do. Asking you a question would be a sign of engagement, encouraging you to further extol your chiropractic philosophy!
In a hurry. The patient may be in a hurry to get on the proceedings. Questions will just make them even later for picking up the kids or getting dinner on the table. Or the chiropractor may be in a hurry. They may find themselves a victim of the appointment book, pressured by waiting patients, communicating a “this-better-be-really-important-or-don’t-ask-it” tone to the patient. Either way, questions aren’t asked and opportunities are missed.
Expect the company line. Ironically, many patient questions aren’t asked because the patient already knows how you’re going to answer it! This happens in offices run by the most dogmatic, outspoken and opinionated chiropractors. In their enthusiasm, they send a message that chiropractic can solve virtually any health problem, along with bringing peace to the Middle East. In these offices, even if solicited, most patients don’t even bother asking questions. It just encourages the doctor! (These are the offices in which patients march out to the front desk, and out of your earshot, ask your staff, a “real” person, the question instead!)
So, what would be an appropriate tactic in situations where patients don’t seem to have questions? Accept their answer at face value and move on? Assume they fully understand your explanations and have embraced the implications of “above-down-inside-out” and can hardly wait to get home and clean out their medicine cabinet? You could. Or, you could pose your own questions. You could actually test the ideas you’ve shared with the patient by posing a hypothetical situation.
“No questions? Great! So tell me, you go out to dinner tonight and enjoy a wonderful meal. Two hours later, you’re vomiting. Are you sick or well?” Or, “No questions? Super! So tell me this. You visit a friend who has a pet parrot and you notice yourself having an allergic reaction. Yet your friend appears perfectly fine. Is the problem with you or with the parrot?”
The list of possible scenarios is endless. Your objective is to find out if the patient really owns the concepts you’ve shared with them and can apply them to real-world situations. Ultimately, it doesn’t matter what you say, how persuasive you are, how forceful you are or how certain you are. If the patient cannot synthesize, apply and generate the ideas you’ve explained in their own words, your communication didn’t “take.” Simple as that.
Any questions?
William Esteb has been a chiropractic patient and advocate for more than two decades. He is the creative director of Patient Media, Inc., a patient communication resource company for the chiropractic profession. Review his materials and request a free 64-page New Patient catalog by visiting www.patientmedia.com or calling (800) 486-2337.