How to Create Effective Chiropractic Case Notes for Better Patient Care | Podcast Ep. 190

Foreign hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langme. Today we are going to break down case notes. We're going to showcase why they are the foundation of how you can build referral relationships. The four criteria you want to have on every single case note that goes out your front door, every additionally we are going to talk about when to send those notes and much more. This is a jam packed episode and it is going to give you the information where you can send out case notes, start bridging the gap in building relationships which is what it's all about. So if you want to cut to the chase, I'm going to leave a link in the show Notes where you can get a case notes template. This is one we utilize with all members of the Evidence Based Chiropractor and it basically can be your guide to getting out case notes quickly and effectively from your office. But on the episode today I want to break down the importance of that, the criteria behind it and how you can really be effective in your outreach. So when we take it from the top with case notes, I always like to give the caveat. Case notes alone never flood anybody's office with referrals. They are an important foundational layer within the evidence based chiropractor we talk about with our membership. We talk about three ways to reach out. Each one does a different thing. Case notes, research and meetings. All three legs of the stool are important. That's what we coach on, that's what we train on. That's where we see a ton of success. But case notes is the first one in that, right? So case notes is one of those three legs, which is why they are important. So let's talk a little how and a little why. Why send case notes? Sending case notes is the social proof that your clinic exists. It's the social proof that you actively co manage with these docs, which is super important. And I like to think of a case note differently probably than you've heard in the past. It is your patient centric testimonial. If you're getting Google reviews, if you're getting Facebook reviews, that is awesome. They're super important. Those are B2C, right? They're business to consumer. They're your patients talking to other prospective patients. But that's only half the story. What about the physicians that are also treating that patient? Do they know the results that the patients are getting in your practice? If I ask you the question, hey, on an average, you know what percentage of individuals who come in to see you leave your office happier and healthier than when they came in, you'd probably say 90%. And then when I say how often have you shown that off to their primary care doctor? The answer is probably 5% of the time or zero. That is a huge, huge missed opportunity that you need to start taking advantage of immediately. For a lot of docs, the hang up with case notes comes by way of, well, they take, I don't know what to put on them or they take way too long to get out my front door. That might sound like you. You might be saying, oh my gosh, that sounds just like me. I've sent some in the past, but it kind of fell off my plate. Cause I didn't quote, unquote, see much from it. You need to think about case notes differently. You need to think about them in terms of patient centric testimonials and you need to think about them in terms of quality through quantity. So you want quantity of case notes going out your front door. So when I say that, what do I mean? Let's talk about cadence of sending. We recommend and have seen success sending case notes on your examinations or evaluations, the initial visit, your reexaminations or re evaluations and your discharge from active care. They might go into maintenance wellness, they might go into a fitness program. That's between you and the patient. But they're kind of over that initial complaint that brought them into the office. That's what I mean by discharge from active care. So basically, anytime you're billing a nine nine something, right? A nine nine two zero two. A nine nine two one two. A nine nine two two zero four. A nine nine two one four. That's an indication that it's an eval day. Right. And that's an indication that you need to send a case. Now case note out for that patient. Now what do you include on that case note? Right, so this gets to the secondary portion. Okay, that's great. I know when to send them out. But what the heck do I put on these things that can actually make an impact? My advice to you is to keep it simple. There are four items that you want to make sure you have on a case note. Patient name, date of service, diagnosis and treatment plan. I'll say that one more time. Patient name, date of service, diagnosis and treatment plan. Those are the four keys to having an effective case note. I always use this example. A primary care doctor doesn't care about what size screw a surgeon uses in a surgery. They care about did the surgery happen or not the same thing holds true for your practice. They don't care about the 80th time that you did Kemp's test, whether or not there was some mediocre positive finding they care about. Who's the patient, Patient name, when did you see them, the date of service, what did you find? Your diagnosis, and what are you gonna do about it? Your treatment plan. Keep it simple. In an ideal world, your case notes should be leaving your office as a one page document. And I say that for pragmatic reasons. When I was working in large scale orthopedic groups, we'd get case notes reverse style. We'd get case notes from the primary doctors all day, every day, or we get them from cardiologists. If we sent out for, let's say, a heart examination, et cetera. And those case notes, unless they were an emergency, the doc, the case note would come across the fax machine or fax to email, it would go into the chart. Unless it was an emergency, the doc would not look at the case note right then. So when you send this to a primary care doctor, they're not gonna, like, they're not waiting on the other end of the fax machine for your case note, of course, but what happens is they're gonna look at it. Unless it's an emergency, they'll look at it right then. But if it's not an emergency, they'll. They'll look at it the next time the patient is in their practice. Could be next month, could be next week, could be two months from now. And if York is walking down the hall, they open up the chart and they see the case note attached to the patient record, if that case note is like single spaced and 18 pages, they're not gonna read it. That would take way too much time. It's just not really gonna happen in the real world. But if they can cleanly and clearly see, you saw John Smith two weeks ago for a sciatica, and we're gonna take care of them on a trial of six to 12 visits, or four to six visits, whatever it might. And they can read it that easily. That's what you want. That's the win. They see your name, they see the patient, and it's much higher. There's a much higher likelihood that now they're gonna open the door and say, hey, John, how's it going over at Dr. Langmaid's practice? And statistically, you know, the odds are in your favor. This is not. We do not, you know, medication is 50, 50 many times at best, in Terms of results and outcomes and things like that. I probably, I asked you at the top of this episode, hey, what percentage of people walk out of your practice happier and healthier than they walked in? It's probably 80, 90% or more. Those are really good odds. So you want to get these case notes out and you want to get them out in quantity because every doc's not gonna read every single one. But if you get enough out over time, even if you are seeing 5 new patients a month, 10 new patients a month, 15 new patients a month, when you add up your evals and your reavals and your discharge from active care, this can result in significant amount of output from your clinic. That's proactive, that's positive, that showcases we are here, we're co managing whether you know it or not. And by the way, we get great results. That is the power of case notes. If you're missing that, if you're looking at your patient records right now or thinking about them like, gosh, I've seen in my course of my career 500, 1500, 5000 patients and we've communicated on less than 1% of those. Think about the amount of positive communications about you and your practice and the results that you get that you've missed throughout your career by not sending the case note. So that's why case notes are super, super important. Your four criteria to keep on every case note, patient name, date of service, diagnosis and treatment plan. The timing or cadence of sending them should be anytime that you do an examination or an evaluation, your initial eval, your re evals and your discharge from active care. Those are really the key components. Now I will say this. Be sure to obviously be within the laws of lines of hipaa. Make sure you get patient permission before you're sending out protected health information. And I would recommend you need to obviously have their primary care doctor information to be able to know where to send a case note. So be sure on your intake forms that you have a spot that asks for their primary care physician. If you have that spot on your forms, you'll probably notice that it gets filled out 50 to 60% of the time. I'd love for you to be at 90%. So how do you do that? All you have to do is have it on your form. You're gonna expect to be able to grab that information 50 to 60% of the time. Anytime you notice it's blank, you or a staff member who's designated to do so, simply ask the patient. Hey John, I noticed you left this blank we love to have that information to communicate and coordinate your care. Do you mind if we have your primary care doc name? It's that simple. That will get you a 90% collection rate, at which point you have good data. We dive in within all members of the Evan space chiropractor, there's a lot of ways you can use that information, that data, beyond just case notes to really drive referrals into your practice, which is what it ultimately is all about. It's about patient care, it's about doing what's best for your patient, but it's also about being able to grow and be able to see more patients by keeping your doors open and having solid growth year after year. So really case notes are one of those legs of the stool. If you want to dive deeper on all of this material, then I'd highly encourage you check out what we have going on@the evidencebasedchiropractor.com Become a member. We do a 30 minute implementation call. We give you all of the training, the reports, the guides, the templates so you and or a staff member can do this process, case notes, research and meetings super cleanly, super easily. We give you customized research updates that you're able to get out to the physicians in your community. The program gets results. We've worked with hundreds if not thousands of docs across multiple continents. I was doing some addition the other day and we had, you know, something with the membership. We've probably gotten out 500,000 plus positive communications regarding chiropractic to medical doctors. And we've also been able to generate tens of thousands of referrals that probably wouldn't have happened without the outreach component of it. And that generates hundreds of thousands, if not into the millions of dollars, into docs offices just like yours. But the first steps are to say, hey, let me get processes and systems in place. Get case notes is one of them. Hit the show notes. You can pick up a template that gives you a little bit of a bird's eye view. We also talk about discharge notes and they're a little bit different. But start sending those case notes. Build the social proof that you're co managing, showcase the results that you get. And this example I always use is think about the amount of time that you spend with a patient, day after day, week after week, you're helping them get well. It could be in the hours that you spend with some patients and, and you don't spend five minutes at the end of their care to showcase those results. Think about the amount of time and effort and energy you've put into acquiring that patient, to treating that patient well, to following up with that patient, to helping them get the results they desire. To not take two to three minutes at the end to showcase the results that they've achieved in your practice is absolutely crazy. So I hope that frames the importance of case notes for you. Again, we went through also the four criteria, patient name, data service, diagnosis and treatment plan to have on every case note that goes out your door. Talked about the cadence, your eval, your re eval and your discharge from active care. And we talked about really taking the next step if you want to put that information into serious action. If you want to get out there and bridge the gap, you want to start getting more referrals in from other physicians in your community, then become a member. Join us@the evidencebasedchiropractor.com I'd love to work with you. I work with all the docs one on one. We do a 30 minute implementation call, we walk through the entire process and you're going to have all of the tools, support and systems needed to bridge the gap. Get out there, showcase your practice and improve the health and well being of the people in your community. And to me there is no greater achievement, there's no greater goal than that. Become the chiropractor that you can and should be in your community. Showcase chiropractic to new eyes, new ears and build the trust and rapport of your community by doing the right thing, doing it in an ethical way, doing it in a patient centric way and getting fantastic results. You probably have the results portion wrapped up, however, you need the processes and the systems behind it to make things sing. So I hope you have a great week in practice and I will talk to you soon. Thank you for joining us on this episode of the Evidence Based Chiropractor. If you want to grow your practice, come back for next week's episode. If you want to grow faster, visit the evidencebasedchiropractor.com and join our MD Marketing membership today. Sam.