Are you Blocking Patient Compliance?

Oct 18, 2012

Without patient compliance, a Naturopathic Doctor, no matter how honed their clinical skills, has virtually no chance of helping a patient get well. Whether it has been recommended that the patient drink more water, follow their protocol or avoid certain foods, inspiring patients to want to change chronic patterns is key in unlocking chronic cases.

• So, why do patients comply?
• What needs to be in place for optimum patient compliance?
• Are we spending enough time honing this valuable skill?

The Blueprint for Incredible Patient Compliance

Educate First

In order for the patient to understand why you are recommending certain courses of action, it is crucial for them to understand their big “WHY?” This is vital, because if you can stimulate the why, then the how and what take care of themselves.

Patient education, including how the body works/heals, why they have the symptoms they do, and how your therapies can help is essential to this process.

Up until this point patient education in natural medicine has been widely practiced in a one-to-one clinical setting. For many busy clinics and patients, this has become an inefficient way to deliver information. There are a number of practical ways you can improve this.

• Offline
  • Patient advocate
  • New patient group orientation event
  • Consistent, engaging literature for the patient to take home
• Digital
  • E-Newsletter and blog
  • Sharing or creating informational products (webinars, etc.)
  • Utilizing outside content (movies, information, etc.)

Draw it Out of the Patient

Learning to ask the right questions should be a baseline skill for any health professional. It has been lost in the modern allopathic approach, where the doctor listens for just enough time to anchor symptoms to a disease.

Given that the majority of healing occurs within the 167 hours a week when your patient isn’t in your office, it is likely that a draconian or fear-based approach to patient compliance will fall flat. “Do this! Don’t do that, ya’hear?”

To ensure compliance when no one else is watching patients need to be inspired. So how can practitioners provide genuine inspiration?

• Identify patient goals (be specific)
• Clearly tie together how your recommendations will help them reach their goals
• Be clear as to what is expected of both parties (and why!)
• Leave every appointment with agreement

Make it Easy

As someone who grew up on classical homeopathy, I am more aware of the mint/coffee/food rules than anyone. I have 5 years of experience with chalky fennel toothpaste to show for it. Homeopathy or not, as a general rule, it is better to empower patients to be consistent than to have them be paralyzed with fear over what they can’t do 15 minutes on either side of their remedies.

Other ways to make it easy

• Provide a clear, easy to understand protocol sheet
• Deliver the sheet in a format they will use (paper, digital, etc.)
• Find out what tools they use to remind themselves of other events and use them
• Modern cellphones, alarms, and apps can provide excellent support
• Identify potential compliance blockages and deal with them ahead of time

Follow Up

Who has heard the phrase: “I got some gas, and so I stopped taking everything”? Especially for patients new to this type of medicine, a follow-up phone call or email 2-3 days into the program is crucial. Not only does it give much needed support to the patient, but it is typically in this time period when the protocol kicks in. Without adequate follow up, if the patient correlates any symptom as a bad symptom you may lose them early in the healing process.

Structured correctly, these follow-up sessions need not be more than 5 minutes.

• Share appreciation for them taking positive steps on their journey
• Use open-ended questions at the start. For example: “What positive signs have you seen thus far?” or “How is your water intake/sleep/regularity/etc.”
• Ask further questions and reaffirm agreements
• Guide them to next steps with alternate-choice questions

Overcome Financial Objections

Over the years, I have met many Naturopaths who have felt uncomfortable with the financial aspects of being in practice. However, if we really want the naturopathic approach to spread as a profession, we need, to get a lot better at this part of the business.

Approaching each patient with an attitude of identifying needs and providing solutions is essential, and having a mindset of confidence is also important. One way or another, you are transferring feelings to your patients; you don’t want to give them an opportunity to misinterpret your lack of confidence as a lack of knowledge or professionalism.

Those NDs who struggle with the financial aspect of practice struggle for any number of reasons, but here are some good ways to move beyond those blockages:

• Practice and role play the checkout process with an empathetic friend
• Learn how to ask alternate-choice questions
• Place value on the services of other professionals (time to stop doing your own bookkeeping!)
• Take time to gain clarity of your own feelings about money

There are plenty of people out there teaching about the keys to a successful mindset, so learn from them or find a mentor. The importance of compliance to your clinical success is so vital that this should be an area of keen focus for every dedicated health professional.

Also remember, if all of your patients feel a certain way about something, positive or negative, there is a good chance that the common thread is you. Make sure the feelings that you are transferring to them are mutually beneficial; otherwise you might unwillingly be the cause of your patients’ poor compliance.