How To Explain Disc Injuries So Patients Actually Understand

Hey there, and welcome back. I'm Dr. Vince Leone, executive producer and co-host of the Practice Builders Podcast. With my partner in crime, Dr. Kyle Pankinen, we deliver proven strategies to help you grow fast, specialize with confidence, and build profitable staff-run practices. Let's go ahead and dive into today's episode now.

Hi, I'm Dr. Kyle Pankinen. Welcome to today's episode of the Practice Builders Podcast. I'm gonna do a solo mission today. Dr. Leone and I like to break it up once in a while, and sometimes scheduling just gets in the way where he's available to do one and I'm not, or vice versa. So we're gonna do a solo run today. Um, I think this will be a meaningful topic for you. We're gonna go with the title of How to Explain Disc Injuries So Patients Actually Understand. And this is important because a lot of patients, we need to communicate to them very well if we want to get them from the prospective case, a prospective decompression case, to actually getting them on the table, right, docs? And we need to communicate to them on levels that they understand. So this is A little bit clinical today, but it's practical for building your practice because the more and better we communicate the problem that the patient has to them in a way that's meaningful to them, in a way they can understand, the better. So one of the biggest reasons patients don't move forward with spinal decompression isn't Always money or fear or skepticism. Those can all come into play. It's, it's confusion. A lot of times we don't do a good enough job of explaining what's wrong with them. And, and the, the problem that a lot of doctors get into, and I've been guilty of this over the years too, is we get a little too Technical. We use language that patients, they, they get that what I call the deer-in-the-headlight look, right? They, uh, they, their eyes gloss over and you can tell that nothing is getting through to them. So when we talk about things and we're explaining to them why they may be a good decompression candidate, We say things like— so we show them their report, MRI or x-ray, or their images, and then we talk about things like degenerative disc disease or disc protrusion, annular tears, foraminal stenosis, nerve root impingement. And most people have little to no grasp of what that actually is or means. So I always do, when I do report findings with patient, I always tell them exactly what's wrong. I give them what would be their technical diagnosis. And then I also, sometimes I'll actually read, like say in their MRI report, it might say a right foraminal zone Disc herniation compressing the L5 nerve root. And I'll say to them, now I will explain that to you in English. And they're like, oh, thanks, Doc. It almost comes as a relief to them because to them those are big words, confusing words. Sometimes they're frightening words. But I do think it is good to at least acknowledge the technical component, but you can't leave it there because the reality is really simple, docs. Confused patients don't buy, but confident patients do. So I've had many patients over the years where we explain their MRI report to them in Everyday language that they can understand. So they've been to their— maybe their medical provider, their spinal surgeon, their orthopedist, maybe their physical therapist, whatever, and they've had imaging findings. And I'll ask them sometimes, has anybody ever sat down and really explained your X-ray or MRI findings to you in a way that you can understand? And you know what I hear about 8 or 9 out of 10 times? Well, not, not really, not really. So they've been, they've been told what's wrong with them, but they really don't understand it. So it's less about telling them technically what's wrong or teaching them about anatomy. You know, really, they, they really care about 3 questions, right? Patients and This is common report of findings things, but they want to know what's wrong, but they want to know in a way they can understand. They want to know, can you fix it, right? And they want to know roughly how long it will take, and then probably fourthly, how much it's going to cost. Those are really the big 4 things that most people want to know. But, you know, If you can do a really good job of explaining what's wrong with patients in a way they understand, and then how in practical vernacular you can explain to them how you can actually help them or to improve it or fix it. I don't like the phraseology fix it. I like the words improve, help, uh, Facilitate healing, things of that nature. I think it's not a good idea in report of finds to tell people, I can fix this. I think improve or help are better ways to promote it. So let's just go into some common analogies that I use when explaining disc problems, spinal problems to patients. And this first one, you— most of you probably have used this or heard of this before, but the analogy of the disc is— I'll say, Mrs. Jones, think of the disc like a jelly donut. And so if you think about that jelly donut, what the outside is, the crust, that's the firm part. And a lot of times when I'm using this, I use these disc Model, so one-level disc. And so we encourage all of our doctors that do report findings to use these little— well, it's a pretty big disc model. But I'll explain to them how the outside of the disc is like the, the crust or the bread part of the jelly donut. It's firm. And, uh, then on the inside, that's the jelly. Mm-hmm. And it is interesting if you've ever seen the annular, uh, or the nucleus pulposus material, it almost does look like jelly to some degree. And so we explain to them the jelly donut and how that sometimes things like on their MRI say they had an annular tear or an annular fissure— that's the correct technical word. So I will explain to them, well, an annular fissure is like a little crack or tear in the outside of that jelly donut. And when that happens, the jelly from the inside of the donut can leak out or seep out, and that can create irritation in the nerves on the outer part of the disc or the nerve roots themselves. That is a common analogy I'll use. The, the other thing is that the jelly in the donut can sometimes push out, and that would be like a bulge or herniation. And so they get the jelly analogy, jelly donut analogy, quite well. The other analogy that I really like to use when I'm talking about discs is the concept of the A sponge, especially when you're showing x-rays of their, their disc and showing them disc degeneration. And the analogy of the sponge— so if, if you had a sponge, I'll tell them, if you have a degenerated disc, it's kind of like having a dry, shriveled-up sponge. And that sponge, just like the disc, is— it's dehydrated. It's lost its water content. And they get that analogy. And then a healthy disc would be like a sponge that is engorged with water, and it's at its full height, and it's, it's vibrant, and it's healthy. The sponge analogy works very well. So when explaining discs, think of a jelly donut or a sponge. The other analogy I use is a Tired. And sometimes— so for instance, I had a patient the other day. She's had 2 low back surgeries and fusion from L3 through S1 with those surgeries. And now we have an MRI report and she's got a disc herniation at T10-11. T11-12 and T12-L1, so upper lumbar, lower thoracic discs. But she has a 14 millimeter short leg on the right. In other words, her alignment, her balance, her biomechanics are all off. So I use analogies, uh, and we did a scan of her feet. And it shows her arches in her right foot are dropping more than her left side, and her arches are flattening. So I use analogies like, Mrs. Jones, your tires are flat, or mostly flat, and they're crooked.

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Why do you think that your discs in your low back keep, uh, being injured or, or having problems? And then I relate, your discs are like tires on a car. If you drove your vehicle and the tires were Flatter than they should be, or not inflated correctly, and they were crooked, what would happen to the tires on your car? Well, they would, they would wear prematurely, they would wear unevenly, and what would happen eventually to the tire? It would, it would blow. You would blow a tire. And they get that analogy because this was what happened, why you keep having Recurrent disc problems. Your balance and alignment is all off, your tires are crooked, and the tires are blowing. So jelly donuts, tires, things like that— those are analogies that people can really relate to. The other one I sometimes use is the example of when explaining the difference between A bulge or a herniation is an ice cream sandwich. So when I'm using my disc model, I'll explain. A bulge is like if we were to push down and it would expand out or bulge out all the way around. That's like a disc bulge.

Okay.

And a herniation though, instead of it bulging out all the way around, is more like one area of it outpocketing. That is a herniation. And so I use all of those analogies when I am talking to patients, and you'll hear statements like, you know, I've never heard anybody explain it quite that way to me before, but you explain it in a way that makes sense. So start thinking about utilizing those types of analogies in your reports, Doc. It'll, it'll, it'll clear up confusion. It'll help patients get a picture in their mind of what is wrong. And then the final analogy I would, I would say is when we're talking about nerves. So the disc, you can explain the disc with all those different things I talked about.

Mm-hmm.

Explain the nerves like a garden or a water hose and explain to them it'd be like this disc herniation, this outpocketing ice cream sandwich here. It's— it'd be like if I was stepping on a garden hose or a water hose and the water couldn't get through. And that is what this disc is doing to the nerve. And that's why you have not just low back pain, but you have pain down your leg because the right nerve impulses aren't getting there. It's getting pinched off. And that's why your foot is numb. And this nerve is pinched. It's irritated and inflamed. So the garden hose analogy works really good. And so when you do all that, then you can go into explaining in a logical way why decompression is the answer for them. So you use that jelly donut, that sponge, that ice cream sandwich, that garden hose analogy, that tire analogy, any of those, they all work. Okay, but use— pick 1 or 2 or 3 of those and use those as your disc and nerve analogies. And then in simplistic ways, go into how does decompression change what is going on there. And we talked about taking pressure off of the nerve. In other words, letting the foot off of The garden hose, and that's what decompression does because it, it helps to hydrate the dried-out sponge. And by gently pulling the spine apart, it draws fluid and hydration and nutrients back into the sponge, and we can get this disc to be healthier. By drawing fluid back into the disc, we can increase the height of the disc. And we can reduce the pressure in the disc and draw this bulge or this herniation back in. And that takes the— it's like lifting the foot off of the garden hose. And the patients start to see, oh, I can visually see that picture in my mind. And even though you're explaining this in very Simplistic everyday language to them, they're like, this doc is an expert because he or she can take a complex problem and all these big scary words on my X-ray or MRI report and put it in vernacular that I can understand. And that it— what that does, doctors, is it builds up confidence. In you. And that's what you're trying to do with these patients is to build their confidence in you. And so that's why I talk with a lot of doctors about you gotta do a world-class exam. That is a big confidence builder. And once you get through that world-class exam, you've done an exam like they've never had before. They will say that to you many times. No doctor's ever examined me like this before. Boom, that gives you one notch above your competition. You have imaging findings and you explain it to them in everyday simple terms using analogies like I suggested in a way they understand, and boom, another notch. Okay, and these are ways, doctors, that you will increase your conversion. And acceptance rates. And ultimately, what do we wanna do? We wanna help as many people as possible to avoid surgery, if at all possible. America has way too many spinal surgeries. You and I both know that. There's no country, or no country anywhere else in the world that does more spinal surgeries than the United States. And the only reason for that, according to research studies, is we have more surgeons, plain and simple. And so one of the passions of my practice is I wanna help people avoid spine surgery. Well, to do that, we need to, we need to get them on the table, right? We need to get them in our decompression program because The, the latest studies out show about a little over 90% of people with these types of problems, they're going to get better. They're going to get some significant relief. The latest study out showed that a little over 90% of people got at least a minimum of 60-61% on average relief. Some got more, some got less, but I always tell doctors, if you can help 80% of your disc cases to get 50% or greater relief, you got a pretty good protocol and you're doing a good job. And so the key is to increase acceptance. You have to do things that distinguish yourself from other providers in your area. And it's really not that hard to do. I find that very few, for instance, neurosurgeons really take the time with patients to explain what is really wrong with them. Very few neurosurgeons actually do a world-class exam. In fact, I would say none of them do. I've never seen a report from a neurosurgeon where they did an exam, where they, you know, Really listed out all their exam procedures that they did, and I was like, wow, that was a heck of an exam. They rely mostly on their imaging findings, and that's a mistake. And I've said that over and over to doctors. You have to do history, exam, imaging findings, and conditions on the ground to come to the right conclusion of what this patient needs, be it Surgery, but in most cases, non-surgical treatment. And so these disc cases that we're treating, docs, they require a little level of expertise, a little above and beyond. But if you do some of the things we suggest here with the analogies explaining it, world-class exam, have a great office environment. Use models like these DISC models, you are gonna have a much higher conversion rate, and you're gonna have patients that are gonna go through your program because they see you as the expert. And so pretty simple message today, docs, uh, not a long podcast, but I think this is one that if you apply some of these basic principles, you'll see your case acceptance go up. And this could mean the difference between a 40-50% conversion rate and maybe a 70-80% conversion rate, which is helping more people. And it's also helping you from a professional and business point of view. So if you liked today's episode of The Practice Builders Podcast. Make sure to give us a like and, and a share and just tell your, your colleagues about our episodes. We're growing and we're going to keep bringing these to you. So, um, we're— on behalf of Dr. Vince Leone, I'm Dr. Kyle Pankinen, just thanking you for joining us, for joining me for today's episode of the Practice Builders Podcast. Have a great day.

Hey, it's Dr. Vince again, and hope you enjoyed that episode. And if you're ready to grow your practice fast with high-value decompression patients, then the Decompression Accelerator could be a phenomenal option for you. This is our 90-day sprint to help you scale with proven systems, staff-driven protocols, and full marketing support, and it's all guaranteed. Spots are limited. Head to www.decompressionaccelerator.com Visit www.vinceleone.com to learn more.