Regardless of your beliefs, your use of technology, or your grammar skills, there are still three ways you can improve your practice: better patient care, more compliant patients, and an elevated professional reputation in your community. In the first of this three-part blog series, we are going to look at better patient care and how this can truly elevate your practice. With a nominal educational refresher of the one tool that can help you accomplish all three of these goals, you can go from Dr. Ordinary to Dr. Kick Ass.
While you might already be doing well in your practice, the road to true glory comes by producing a reliable, informative, and compelling radiology report. The rad skills you need to create a radiology report that delivers more than just the obvious diagnostic imaging findings are literally at your fingertips. Mastering these skills results in a cascade of benefits, the first of which is better patient care/outcomes. For the purposes of this blog series, I am referring to digital plain film radiographs and not advanced imaging like an MRI/CT scan.
I was visiting with a former patient in a larger city about 90 miles from my clinic when the patient told me, “My new chiropractor didn’t take any x-rays. I don’t think he knows what’s going on with my sciatica.” This is not the first time I have heard this type of comment from a chiropractic patient. Patients want to know that their chiropractor, whom they are assuming is their spine care expert, has a complete understanding of their spine to better take care of their health. The adage used by some, “To see is to know” could not be truer in some cases.
Conditions such as spondylolisthesis, sacralization of an L5 transverse process, or degenerative findings[1] and arthrodesis may impact the outcome or the recovery speed.[2] These findings certainly could affect the selection of what technique or vertebral level is adjusted. Defect and vertebral anomalies may have little effect or a significant effect depending on the cause and presentation of the symptomatology. Each case is different and one global standard is difficult to apply with the many variables possible. More trust is established when a patient feels confident their doctor knows for sure what the diagnosis is and what they are trying to correct, stabilize, or improve. When the patient sees it, they know the doctor sees it, too.
Harvard Professor Michael Porter presented the six major elements necessary in a truly value-based system and evaluated and discussed the outcomes aligned with cost.[3]For example, taking plain film (i.e., digital) radiographs is usually less than $100 for a two-view region or less than $200 for five views. Some DCs using digital x-ray charge less than $300 for seven views. Clearly this is far less costly than the $1000+ for CT and MRI scans with radiologist reads combined. Patients receiving diagnostic testing for $100-$200 is extremely reasonable for the value of the information visualized and diagnosed; thus, creating patient value, trust, and a more confident care plan that is likely to be followed.
Porter goes on to suggest that outcomes for a condition are always multidimensional and include what matters most to the clinicians and patients. Patient reported outcomes form an essential component. It is not just the published literature that comprised evidence-based practice (EBP). There are three legs to the stool of EBP: published literature, clinical experience, and patient preferences; with all three having equal standing. However, you do not need all three to be as strong all at the same time.
Now that you understand the fundamentals of better patient compliance, make sure to check back for Part 2 in this series of improving your practice where we will discuss how patient education can equal better patient compliance. Stay tuned!
[1]. Dennis M. DC, MS, DACBR; Henderson, Charles N. R. DC, PhD Spine:1 December 1996 – Volume 21 – Issue 23 – pp 2747-2751
[2]Oakley, X-Ray Imaging is Essential for Contemporary Chiropractic and Manual Therapy Spinal Rehabilitation: Radiography Increases Benefits and Reduces Risks. Dose Response. 2018 Jun 19;16(2):1559325818781437.
[3]Value-based health care. Institute for Strategy and Competitiveness, Harvard Business School. https://www.isc.hbs.edu/health-care/value-based-health-care/Pages/default.aspx. 2006.
3 Ways to Improve Your Practice
