By Freddie Ulan, DC, CCN
The second purpose of the Report of Findings visit is to clearly ensure that the patient knows what their role is going to be in obtaining maximum possible health restoration. That’s where I spend my effort in my Report of Findings visit: making sure that the patient knows what their role is. What do we expect of them before we’re willing to accept them? What do we expect them to do? And are they willing to do this?
We want to know right up front: “Look. We think you are a nutritional case. Our experience with people who are nutritional cases is that nothing else is going to help them as much, but in order for you to get the help, there are certain things you’re going to have to do during this period while we’re working together.”
And you lay that out right up front. If the person has any questions, you clear them up right then and there. And if they have any objections, you either handle them or say, “Thank you for letting me know that you’re really not right for this practice.” You see?
The second purpose of the Report of Findings visit is to determine the patient’s role in obtaining maximum possible health restoration. And the third is: Is the patient committed to doing the program and following recommendations? This is critical.
The first thing is to make sure that they know what they’re going to have to do. The second thing is: are they actually committed to doing this? If they are, you may start. If they’re not, you have to handle it, give them more time, give them some more information, send them home, thank them for coming, do whatever you want to do, but don’t ever start a treatment program on somebody who is not committed to doing the program and following your recommendations.
You see how this changes the whole vector of your practice? If you haven’t been doing this, you’ve kind of been saying, “Oh please take these pills. And please come back for the next visit. And please be good and do what I tell you…”….as opposed to….“Okay, look. I have this big program here. It’s going to get you well, if you do your share. Here’s what you got to do…Are you willing to do this?”
Which one makes you feel better? The second example, I think, right? Okay.
Once they’ve completed that Report of Findings visit, then we go into the first therapeutic visit. What do we do on that first therapeutic visit? One, we get the patient properly started on the program. That’s it. That’s what the first therapeutic visit is in a nutritional practice. You get the patient properly started on the program.
We’ve determined that there are 3 phases of care in a nutritional program. The first phase of care is fine tuning the program. What do we do during the fine-tuning period? One: we ensure the program is correct. Two: we ensure the patient is actually doing it as we recommended it. Three: we ensure the program is working. Four: we ensure the patient is getting results and knows it. We continue the fine tuning until the following criteria is met.
In my practice it takes anywhere from 4 to 6 visits to fine tune somebody to achieve these criteria I’m about to lay out for you. But, I have some patients it took 16 visits. Average is 4 or 5, maybe 6. Important to know these things. You don’t rush things too much. I’ve never seen anybody who’s totally fine-tuned in 3 visits. They may look like it, but then the questions come up afterwards when we found out we jumped the gun.
One: the patient’s nutritional program is stabilized. What their taking is right for them and they keep testing for the same thing exactly the way you gave it to them.
Two: they’re complying with dietary recommendations. We have them fill out these diet records every week. And we go over it with them and we note what they should stop eating or change eating This is using a gradient approach, find the one thing they need to change and help them change that.
Three: they’re starting to improve and they know it. Their headaches are less, their backaches are less. They’re less depressed. They’re more energetic. They have less chest pain. They have less…whatever…..And they know it. They’re not necessarily well, they know they’re improving. And they’re fully with the program and happy to continue. You know when a patient’s fully with the program. But, I’ll tell you something, you achieve a lot more patients who are fully with the program when you do the earlier steps as I laid it out.
Once they’ve achieved that, we graduate them on to their initial 12 weeks healing and observation period. We actually graduate them. We have a graduation ceremony. We bring them out to the front and say, “Look, she’s completed her initial fine-tuning period. She’s getting better.” Have them tell the Front Desk about the fact that they are getting better. Have them start testifying about the results that they’re getting. We graduate them onto their initial 12-week healing and observation period.
What’s the purpose of the healing and observation period? These things all have purposes. To get the patient through a 12-week cycle on their fine-tune program so that their rate of improvement can be ascertained.
During the healing and observation period we monitor them, we re-evaluate them. By the way, we re-evaluate them mid-way through and at the next to the last visit. We usually set our patients up on a 12-week series. Most of them pre-pay because we offer them a little bookkeeping discount. And we offer them some discounts on the re-evaluations.
We never discount products by the way, ever. We never, ever, ever discount products. I’d rather give away my office visits for free if the patient has a problem. I never discount products. So, that’s what happens during the healing and observation period.
At the final visit of the healing and observation period we achieve the following purpose: we review each aspect of the program as previously laid out in the original Report of Findings and compare where they are now. We’ve given them a Report of Findings that lays out everything. It lays out what their initial condition is. It lays out what the plan is and what the objectives are. And now we’re at the end of the initial healing and observation period, we’re going to evaluate and see how much progress have we have made in the direction that we intended to go.
So, we determine the actual rate of progress made and then, what’s it going to take to get them realistically to the next step health-wise.
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