The Patient Adherence Communication Triangle

In my book I discussed the 3-legged stool of a thriving practice that sits on a foundation of communication. Having effective communication improves all aspects of your practice, including the patient’s outcome and experience in your practice.

Communication helps with your patient outcomes because not only do they listen to your advice more, it will also lead to better patient adherence to their treatment plan, which in turn improves outcomes.

The Patient Adherence Communication Triangle will ensure that everyone involved in that patient’s experience is in the loop and communicating effectively.

The Communication Triangle

1.Doctor to Patient

The first step in the communication triangle is for the doctor to clearly and confidently communicate with the patient on their diagnosis, indirect causes of the diagnosis, treatments recommended, treatment frequency and duration.

Report of Findings

Here is an excerpt from my book, Doing It Right: Modern Chiropractic Marketing where I discuss an ethical and concise patient encounter and report of findings that is storybranded.

“Mr. Jones1, you currently are presented with impingement syndrome of the right shoulder2a1. During our evaluation and biomechanical assessment, we found that you lack proper scapular stability (you can break this down for them in more lay terms)2a2. I didn’t find any red flags that require imaging or orthopedic consult2b. We can have you playing catch with your son in no time with the conservative care we offer here2c.

I know it can be frustrating to have this pain, but our team here will guide you along the way to resolve this condition and see that it doesn’t come back.3

Our treatment plan for you will include (insert treatment methods and treatment frequency and duration here)4. I am recommending you follow this treatment plan and for the time being, avoid any overhead lifting, throwing, or swinging. I want you to do the corrective exercises we prescribed for you once daily. Please implement the proper ergonomics we covered for your workstation to avoid over-using that right shoulder when typing and using the mouse.5

Mr. Jones, if you follow this treatment plan, I believe you will recover from this shoulder pain and get full activities back6. We will keep an open line of communication during each visit to make sure we are progressing as desired”. 7

1: Hero/Character

2a1: External Conflict(Direct cause/diagnosis)

2a2: External Conflict (Indirect Cause)

2b: Philosophical Conflict

2c: Internal Conflict

3: Guide

4: Plan

5: Action

6: Avoided Failure

7: Success

Communication each visit

There will be multiple times during the treatment plan that your patient will need guidance and expectations of their progress. The more frequently you communicate with them on their concerns, progress, and re-exams, the better they will understand the different phases of their treatment plan.

One common scenario is when the patient is out of pain early on in the treatment plan but you have yet to resolve the functional deficits that led to the condition/pain. This is a critical time to discuss this with the patient.

Re-evaluations

Having these “check-points” in your treatment plan are great for obvious reasons, but it is also great to show them their progress and communicate their improvements or slower than expected outcomes.

2. Doctor to Front Desk

Pre-Shift Huddles

Before each shift, spend 5-10 minutes going over each patient’s treatment plan and any other pertinent care info. This will get the entire team on the same page before the patient gets to your office.

Slack Messaging
We use slack messaging between all computers in the rooms and communicate anything needed regarding the patient’s experience. Sometimes changes to the pre-shift huddle plan is warranted and this is an easy way of communicating such.

Walk the patient to the front
If your office/practice is designed in such a way to walk the patient to the front without impeding patient flow or getting you off task, this is a great option.

3. Front Desk to Patient

Scheduling treatment plan in advance.

The ideal way to schedule your patient’s treatment plans is in advance. The data shows that when a patient schedules all of their visits in advance, the patient adherence improves significantly.

If you start the process of implementing the communication triangle in your practice you will see a noticeable shift in your team continuity, patient adherence and outcomes. You can bet on it.

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About the author, Kevin

Dr. Kevin Christie is a Chiropractic Physician and Certified Ergonomic Assessments Specialist (CEAS II) who dedicates himself to treating his patients’ symptoms and physical dysfunctions, whether it’s a professional athlete, a weekend golfer, or an office worker.

Dr. Christie received his B.S. degree from the Florida State University in Exercise Physiology and was an assistant strength & conditioning coach for FSU athletics. His education and desire for learning continued at Logan College of Chiropractic in St. Louis where he received his Doctor of Chiropractic and Masters In Human Biology degrees.

Dr. Christie is currently the CEO of Health-Fit Corporate Wellness which provides On-Site Chiropractic and Ergonomics for corporations such as Royal Caribbean, ADT Security, Tyco Integrated Systems, World Fuel Services, Strategic Coach, Frito-Lay, and others.

In 2016 he launched The Modern Desk Jockey Podcast, which provides healthy solutions for the desk worker.

Dr. Christie has been the Chiropractic/Sports Medicine Physician for multiple football academies in South Florida. He is currently the Sports Chiropractor for XPE Combine Prep Program in Boca Raton, FL. This role includes treating the college football players during the NFL Combine Prep Program and the NFL Combine in Indianapolis. He also has worked on over 500 NFL, MLB and NHL players for these strength & conditioning companies during their off-season Pro NFL/MLB programs.

In November 2009, Dr. Christie was appointed by Governor Charlie Crist to the Board of Athletic Trainers as the Chiropractic advisor. This appointment is through the year 2017 and will include working with and advising the Board of Athletic Trainers on maintaining and improving the quality of care for Certified Athletic Trainers in the state of Florida.

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