How to Optimize Your Consultation for Less Stress and More Enrollments

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. Hello and welcome to the Practice Builders Podcast. Really excited to have you today. My name is Dr. Vince Leone.

And I'm Dr. Kyle Penknen. We're grateful to have you with us today in our growing and exciting podcast.

Yeah, and it is growing. And so please, if you're— if you like the show, if you're getting value out of it, please consider giving us a 5-star review and share it with a friend or colleague who you feel like it could help as well. That's the only way we grow. We're not growing this thing. We're not running ads or anything to it. But good news is we are growing. And today's topic is how to optimize your consultation So that you can reduce stress, increase efficiency, and increase enrollments. And, you know, Dr. Kyle is really— you got this thing down pat, sir. So why don't we kind of dig into some of the key points on your side of what has helped you, um, you know, process so many new patients effectively? Um, and, uh, I know you have a great team, and, um, but I know you wouldn't be able to do it without you know, these systems that you're using in place?

Absolutely. So, let's just share a few of the things that I do, and then I know Dr. Vince has lots of good points to share too. Obviously, the first, it always starts, you got to have that person who answers the phone has to be top-notch. They have to be—

Absolutely.

People person, a schmoozer, however you want to phrase it, that can really connect with people. And, Make them seem like this is, this is the right place. I made the right call here. And they have to be knowledgeable, especially if this is a potential niche patient. They're gonna usually have some questions about, especially if they've been a marketing patient, about the potential niche of decompression or neuropathy or chronic knee, whatever that might be. So they need to be trained up to be able to answer some of the most common questions. With that said, the most important thing is to get this patient on the appointment book. And once that is done, then a lot of those things can be— questions can be answered at a later time. So, always want to get them to the close of getting the appointment made first. Okay?

Yeah. And I'll just add to that. That's an excellent point because when you think about your receptionist, Typically, this is a very low-paid individual with very little training. Now, when you think about that, this— your receptionist, I like to call them ambassadors because that's really what they are. They're representing you and your office basically to the community. They're the first face they see. They're the first voice they hear on the phone. So you really should be treating your phone like it's gold-plated. And they're, you know, first of all, like Dr. Kyle said, they should be You know, they should always have a smile on their face, right? They should be smiling into the phone. Patients really sense that. And you should be tracking your stats. In other words, how many patients called, um, you know, inquiring about scheduling, and how many people actually scheduled, and how many actually showed. So it starts with the data to figure out how effective is that, because you can't optimize your consultation if you don't have any consultations. So that's number one in terms of optimizing your consultation is focusing on that front desk and getting them trained up. Like Dr. Kyle said, they should be able to answer the frequently asked questions on the phone. Is this covered by insurance? If not, how much is it? What happens on the first visit? What the heck is spinal decompression? What does this doctor do? How long they've been around? All those things should really— the staff members should be able to answer those questions quickly. Efficiently and confidently in order to get that patient onto the schedule and into the office.

100%. Absolutely. And then the next thing going beyond that is then once they've agreed to come in, they're on the appointment book, then the paperwork. Okay. What we do now is we pretty much most of our patients, we text them a link. To the paperwork that they can access. So they can— we tell them, get this done ahead of time if at all possible, so that when you come in for your appointment time, we are ready to meet you and to get going. We don't have to waste any time. And if they are somebody that would rather fill it out in office, then we always tell them to come about 30 minutes ahead of their appointment, because some people are just flat slow in filling out their paperwork. And so You want them to be done with it by the time their appointment time arrives. So, and also make your paperwork— you got to have some detail, but you got to narrow it down to the most essential details. If your paperwork is too long and too lengthy, boy, some people just about give up right from the get-go and won't even come in because of it. Are they Or they're gonna complain about it. So, keep it concise as possible to give you the information that you absolutely need.

I couldn't agree with you more. I remember when we changed dentists for my daughters, and for each daughter, I had to fill out about 10 pages. It was on an iPad. It didn't work very well. It was arduous to get through the paperwork. And like you said, I almost walked out. Because I was so frustrated, and I spent about 20 minutes, 25 minutes just going through that. So, you know, 100% what Dr. Kyle said. I mean, you obviously got to get the primary details, but, you know, make it as efficient as possible. Because here's what you don't want to do is you don't want to burn 20 minutes of your consultation with the patient going through health history. I mean, you really should be— and Dr. Kyle will go into this in a second— is really just— Just verifying. So I see it's— this is the condition, this is how long it's been going on, uh, you know, all the OPQRST stuff, right? So you want to get all that stuff out of the way. And, um, you know, if, if not, if it's not done prior, then there needs to be a firm, you know, script where they need to show up 20 to 30 minutes prior to their appointment with you so that it's taken care of. Before you walk in the door.

Yes. Next step then is I— as we have us— when they're greeted warmly in the office, hopefully they come in, they just literally hand the paperwork. If we need to make a copy of their insurance card, we go ahead and do that. And right away, one of my CAs takes them into a consult room. And the first thing we do in our clinic is we scan their feet because we want to establish that the feet are the foundation. And then they sit down with them and they go right through their— any specific regions of complaint that they have, and they do O, P, Q, R, S, T, U on each region of complaint, which usually a lot of these cases there's maybe just one region, sometimes there's multiple. But the bottom line is you want, if at all possible, a CA to get that stuff out of your way and get that done. So that by the time the patient then goes from the consult room to the exam room, then I walk in and greet the patient warmly and ask them a little bit about themselves. But then that— all that information has been put into our computer and it's literally up on the screen and I can just come in and read, okay, low back pain, right side. 6 out of 10, dull, aching, constant, radiating down the right leg, all those things, it's all there pulled up for me. And I have their paperwork in front of me with their health history. So all I literally gotta do is walk in the room, review that, ask maybe a few pertinent follow-up questions if there's some detail that I feel is missing. And usually, I'm already to my exam within about 3 to 5 minutes.

Hmm.

Once you— once you can cut to the chase pretty quickly, because most people, they don't care about a whole lot about you as a doctor. They want to talk about themselves. So I keep the focus on them and their condition and what they're coming in for. And then the big thing you want to establish with patients when you're reviewing them Is what is this condition taking away from your life? Or what part of your daily life or your routine is this most affecting that you can't do that you want to get back? And if you can get that done, more importantly than I have this pain, they want to fix what it is that this pain is affecting. in their life. And that's the connection that you want to make with the patient.

Excellent point. I like to call those the trigger. And, you know, we want to tie— first of all, we want to change lives, right? I mean, it's great to get patients, correct the condition, get the patient out of pain. But what's more exciting, or was more exciting to me in practice, was, hey, patient walks in, I was able to play 18 holes with no pain. I was able to play with my grandkids. I was able to go back to work full-time. I was able to sleep through the night. Like, those are the things that That people emotionally are tied to. That's ultimately what drives patients into the clinic a lot of times is they're so— it's upset their life so much, the condition and the pain. They've lost something, right? Something that they really, really enjoy. For instance, like, if I wasn't able to play golf, I mean, and someone was, and I was able to solve that, that would be a big deal. So that's what we're trying to find in the consultation. And once you uncover that, now you're at a deeper connection with the patient. You have a very clear target of what you're trying to accomplish outside of just correcting the pain and the condition. And it really sets it up for an easier enrollment because, again, it's not so much about the pain, it's more about getting rid of the pain.

Yeah.

Let's get back to doing whatever it was that you love, but you lost. Hey there, it's Dr. Vince. And if you're getting value from this episode, please make sure to hit that subscribe button so you never miss an episode. And if you know another doc who's ready to grow their practice, share this with them. It might be exactly what they need right now. Thank you in advance. And now back to the show.

100% agree with that. Amen to that. Big thing is making that connection. And it doesn't take long to do it if you ask the right question. And that's the right question to dig into. Then once you establish that history, you've reviewed that, they know that you understand what's going on with them. That's what they want to relay to you, what's going on. But your CA can do most of that for you. And so then we go into the exam. And as soon as I'm ready for the exam, the CA comes right back into the room again, and then I begin my exam. And, you know, through specialized practice, we teach world-class cervical, lumbar, knee neuropathy exam. You can get through a high-end world-class exam in literally 5 minutes if you're really good at it. And so the CA comes in the room, Start exam flow. And as I'm examining, I'm dictating my exam findings, all the tests and everything I'm doing to the CA. And she's just click, click, click, putting it all on the computer, typing things as we go. And usually by the time you get done with the exam, one, you usually figured out what the pain generator is. Number 2, patients are like, wow, are you speaking a foreign language? And 3, they're usually pretty wowed by it in the sense that nobody has ever done that detailed of an exam on them, and they say it all the time. I've been to other chiropractors, I've been to other medical providers, nobody's ever done an exam like that before. So what does that do? It sets you apart as the expert, and it helps them to understand that they're probably in the right place for getting help for whatever they're coming in for. And once you establish that, then whatever recommendations that you may give them going forward, The odds that they're going to say yes to it goes substantially up.

I mean, 100%. And Dr. Kyle calls this CA his scribe. And what the goal here is to create a wow experience. If someone comes into your clinic and you're running late and everything looks the same, they're not greeted with a great big smile and enthusiastic response, and it feels like every other clinic Well, then they're going to expect to pay what they do at every other clinic, which is their copay, right? So we need to create a wow experience. And, you know, look, if you are a traveler and you go to a Motel 6 or you go to a Ritz-Carlton, it's a very different experience, right? If you go into a Honda dealership, you're going to get someone to come help you in a bad suit. If you go to a Rolls-Royce dealership, You're going to be offered bottled water, sparkling or flat. You know, it's a totally different experience. And so your goal is to create that wow experience. Now, I'm not saying you need to go renovate your office, although you could. But the point being is you, you need to do everything within your power to create a wow experience that's super efficient and that someone is going to start gaining trust. with you and be impressed by not only you, but your team, the surroundings of the office, how, you know, the expertise of your exam, all of those lead to someone trusting you with their money and their time. So there's no silver bullet for the ROF. There's lots of trainers out there that you think you can say all these magic words. It all comes down to trust, and it starts in the consult.

Yeah, most day 2 problems really are just day 1 deficiencies. You didn't do what you should have done on day 1, and so then you got all these questions and doubts that you have to address on day 2. If you, if you have a great day 1, that will take care of most of your issues on day 2. And then by the end of that consultation, history, exam, then you know, is this a Is this a niche patient or not a niche patient? If it's not a niche patient and they're more just gonna be a chiropractic patient, well, most days I— most of the time I start them with treatment on day 1. But if they're a potential niche case, we definitely set them up for a day 2 report of findings, 'cause a lot of times we get imaging or we need to order it. Either it, Do our own imaging or we need to order imaging they have maybe had elsewhere if we have not gotten it already. And then we always send the patient, the potential niche patient home with a report. So it will either be Dr. Pankinen's Guide to Chronic Neck and Back Pain, Dr. Pankinen's Guide to Chronic Knee Pain, Dr. Pankinen's Guide to Peripheral Neuropathy. You get the idea. Whatever condition is that you are niching in. And that questionnaire or that report is going to detail their condition. It's going to talk about medical options, and then it's going to go over our protocol, and it's going to go over frequently asked questions and answers so that they take that home, they read it. When they come back for day 2, you go over your report of findings. Most of their questions about what you're going to do with them— And the the protocol stuff, they already know the answer to it. They've already read it, and we've talked about this a little bit before. But you want to really reiterate to them: You need to read every word of this. You need to go through it thoroughly, slowly, and if your spouse isn't here today, you need to make sure your spouse reads this too, or that you at least relay to them what is in here, and that. Those procedures on day 1 will solve a lot of problems for you on day 2, and day 2 many times can be quite simple.

Yeah, 100%. And you really— your target should be, in terms of your time with the patient, no more than 20, 30 minutes max. If you're spending an hour with the patient and you're doing all the health history, and then you do the exam, and then you're doing the x-rays, I mean, you're not going to internally believe Believe I can't see four patients in a day. I mean, that's that's four hours. Well, actually, that's true. You would not be able to process that, but you process that many patients. But on the flip side, if you're very efficient, you're you know you're surgical in your consult and the exam. You will keep your energy up. The and by the way, patients don't want to be there any longer than they have to. I mean, who wants to go sit in a waiting room for twenty minutes, thirty minutes for the doctor because he's running late and blah blah blah, and then it takes forever to get processed. No, people want an efficient experience as well. It starts off the relationship on the right foot. Now you can see more patients in a more timely manner, grow your practice, and set yourself up for a successful day 2.

Interestingly, when you, when you rely on this model where you're utilizing CAs or scribes— so I have one actually, mine are trained to actually take x-rays as well— and but if you use that model, the, the patients spend way more time with your CAs or scribes and your people that are doing the therapies and stuff on patients than they do me. You know who the rock stars in my patients' mind in our practice are? It's my staff. They love my staff. Sometimes they say that kind of like me too, but they love my staff. And, and so it's, it's— they, they can literally drive your practice. So—

We love you too, Dr. Kyle.

Well, maybe a little, but mostly, mostly the staff. I get so many feet— so much feedback on patients. Dr. Kyle, you really have wonderful staff.

Yeah.

And I say, yes, I do. And every week I thank the good Lord for them, literally do. And they will— but they will drive your practice and make these connections with patients. So Don't be afraid, doctors that are listening to this, to hire help. Don't get in the mindset, well, I'm just going to keep my overhead low and I'm just going to—

And pay them decent. Don't pay them— if the $17 is the going rate, don't try to just get at $17. I mean, you would be amazed if you pay these people like $24, $25, if they're normal $17, $18, How much, how much longer they'll stick around, uh, how much more they'll be appreciated. And, um, I remember I'd, you know, walk out to the front desk and there's balloons and there's, you know, uh, cookies and gift baskets. I'm like, oh, is this for me? Like, oh no, it's, it's for Cindy, the, the, the tech. I mean, we had, we had a bunch of techs running around, but anyways, all the guests, they weren't for me. But the point being is, mm-hmm, if you do this properly, Just like Dr. Kao said, it will run your practice for you.

Yeah, that whole thing about the treats— oh my goodness, we have patients that bring us cookies and donuts and rolls and cake and all kinds of stuff, and it's always giving it to the girls. You know, they just, they just love them. And, uh, so think about this, docs. If If you wanna keep your overhead low, you— and by not hiring good staff because you think you are saving money, you are gonna hold your volume of what you can see in patients way down and you are gonna burn yourself out. You are far better off to pay that gal $20 or $25 an hour and have more staff than even what you maybe think you need because it is gonna free up so much extra time for you to see more patients. You are gonna be more efficient and the patients will fall in love with those staff. And it will, it's a thing of beauty when it works.

Absolutely. So hopefully that has provided value for you guys. I think that if you put focus on this part of your patient processing, you will reap the rewards. You'll have less stress, you'll be able to process more patients and enroll more patients and grow your practice. So with that said, we'll wrap that episode up of the Practice Builders Podcast. Thank you, Dr. Kyle, For your insights, um, and, uh, thank you for all our listeners. Again, um, I would love to have a 5-star review. We'd love you to share this with a friend or colleague. And with that, we'll see you on the next episode of the Practice Builders Podcast. 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 to learn more.