How to Integrate Rehab into Your Existing Clinic
REHABILITATION
Sharon Freese-Pettibon
EXPERIENCE IS THAT MOMENT IN LIFE WHEN ONE REALIZES HE OR SHE HAS LEARNED SOMETHING NEW ABOUT HIM OR HERSELF AND HIS OR HER ACTION/REACTION TO SOME EVENT. EVERYTHING SHARED WITH THE PROFESSION FROM PETTIBON IS BASED ON THAT ONE
THING: EXPERIENCE. MANY YEARS AGO, A WISE PERSON ONCE ADVISED ME TO READ EVERYTHING I COULD ABOUT THOSE WHO MADE A SUCCESS OF THEIR LIVES SO I MIGHT LEARN WITHOUT MAKING THEIR MISTAKES. IT WAS GOOD ADVICE THAT PREVENTED SOME MISSTEPS AS
I MATURED. HAVING SAID THAT, IT IS MY HOPE THAT
THE INFORMATION TO BE SHARED MIGHT BE CAUSE FOR REFLECTION AND EDUCATION FOR THOSE WHO HAVE NOT OPENED A PRACTICE, AS WELL AS FOR THOSE WHO HAVE BEEN IN THE SAME CLINIC FOR MANY YEARS.
About 15 years ago, I received a call from a couple who had completed the course work to become a Certified Pettibon Practitioner. They had all of the attributes—youth, energy, intelligence, goals, and knowledge—but what they did not have was money. They called for help in doing the best job possible for their patients in the 400-square-foot office they could afford to rent. My immediate reply was that we could make this happen by using every available space, including the walls and doors. They sent their patients out for X-rays, but needed a view box and a space to share them. They needed an entrance/ exit point that did not impede the flow, and they wanted to see 40 patients a day. We went to work. In the end, they used one Pettibon Adjusting Table, one Linked Trainer (which comes with a Wobble Chair), two wall-mounted tractions, wire-coated racks on the walls for home rehab supplies, a small TV in the entry with Pettibon Rehab Training Videos running throughout the day to educate and remind, a PTLMS and a MDT, and the Pettibon Weighting System. In a six-month period, their results were being talked about in the community and they were growing; this is what we call a “good” problem. They decided their location worked; it was intimate, open, and foil of energy, and the patients loved it. They made the decision to open another small office in another location rather than shutting down and opening a bigger office. They found the key to their success was not “more,” but it was, in fact, less.
Occasionally, I still receive calls for help for those who want to integrate Pettibon Rehabilitation into their present clinic. When that happens, I always require photos of the office and the use of space. The waste of space is always obvious. People go to a clinic for answers to their problems; they don’t want to go to a museum filled with art, or a place so lacking in energy they might be in a morgue. They stay for their care because they see results and feel that they are part of something that will yield lifelong benefits. The message here is to assess what can go and what can stay, what adds to the clinical goals and what is taking up space. One will be amazed at the myriad of things that can take up space that, if implemented properly, could better serve the corrective needs of the patient.
I realize that clinics come in all sizes and some aie ample enough to incorporate rehabilitation, but in my experience, studying the flow and ergonomics of an office is a good thing. Often, just adding or subtracting one motion can increase one’s ability to see more patients effectively. Never underestimate how important it is to cut steps a day by improving the traffic pattern in an office. One way to gauge your clinic’s effectiveness is to look at the appointment book for the day and purposefully add a new patient into the set pattern everyone has settled into over time. You will quickly know how flexible your team is and how capable you are of handling more than you do, or how ineffective and rigid your team has become. No matter how badly a doctor may want to incorporate some aspects of rehabilitation into his or her clinic, the doctor is often stopped by the sure and certain knowledge that he or she does not have the team for the job. This means the doctor will have to slip out of his or her comfort zone and work hard to educate the team or will set the idea aside as undoable.
Am I seeing the same old patients with the same old problem that does not seem to resolve? Am I falling into complacency?
The addition of rehabilitation to your present clinical setting is possible. It requires looking at your goals with an open mind.
One needs to ask him or herself some hard questions about the practice, such as: Am I delivering what I promise to my patients? Is my office growing or is it stagnant? Am Í seeing the same old patients with the same old problem that does not seem to resolve? Am I falling into complacency? When was the last time I challenged myself to change? These provocative questions can help one explore long-range goals. Often, we become “settled in” and refuse to make changes in long-term practices. The patient has the internet to check on treatment methodologies, reputations, and clinical outcomes now, which makes it critical that we deliver what we promise or live with the consequences.
For this clarification and vision of the reader, I have created a link for three floor plans for your perusal at the end of this article. Each floor plan incorporates the use of the Pettibon Rehabilitation System. Since the system includes home care, much of what is required can be done in the privacy of the patient’s home. When you review the floor plans, keep in mind the use of space. Look around your own office and determine what is taking up space and not making physical changes for the patient or that you are not making income from its use. Look at the walls and whether they have the ability to hold supplies out of the patients’ reach? Do you have huge, cumbersome adjusting tables, or are you using inexpensive, smaller bench tables that allow for more patients in a smaller area?
It is also critically important that each staff member walk through the front door and go through the exact procedures that each new patient experiences, from entry information to X-rays. One cannot sell what one does not own. I have heard of people working for one chiropractor who see another outside of their employer’s office for their adjustments. I would never allow someone to work in our office who refused to consider us for his or her primary chiropractic care. There is a certain dishonesty about it. If your staff is not with you, they aie against you. Period. Energy in your office matters. I have dealt with hiring and training in other writings, and I am adamant about the importance of the hiring process.
Often, changing one little thing will increase your ability to see patients. One clinic was set up with new patients on one side and current patients seated on another side. This may work at a veterinarian’s office for separating dogs and cats, but it efficiently segregates the new patients from important dialogue with existing patients in a chiropractic office. We put a full-length view box in all of our waiting rooms with current preand post-X-rays on them (with the patient’s name covered, of course) to show what a patient presented with and how the patient had responded to care after the acute care period. The short explanations beside the films generated discussion every single day. The energy was palpable; it did not take much to get the waiting room into discussion and we never violated HIPAA.
Practice used to be fun. Many seem downhearted because of the hoops they have to jump through to be paid. Wouldn’t it be exciting to add something to your office that has many benefits to the patient? Rehabilitation is becoming a buzzword, but Pettibon has been doing it since the advent of spinal molding in the early 1960s. When a patient can see the problem in the report of findings and look forward to conecti on of it, and, better yet, see the results in a short period of time both objectively and subjectively, then the chances of building your clinic through internal advertising soars.
This article is to stimulate ideas and conversation. It is my hope that practice is the joy it can be when one is a part of getting folks well. This series has been shared with the hopes that it will be seen as one body of work. It is about setting up, hiring, training, and building a successful clinic based on the premise that you can deliver what you promise when you accept a little help from your friends.
Sharon Freese-Pettibon, President of The Pettibon System, Inc, has been in the chiropractic trenches for 39 years. She ran a successful staff training and practice development consulting company for Pettibon practitioners. Her passion is seeing people succeed. Sharon can be reached at 888-774-6258 or [email protected]. For a complete pdf of this article, with equipment, go to http.//info.pettibonsystem. com/integratingrehab
