Try this, come back, and we’ll see
Creating great treatment plans
Anew patient – let’s call her Joanna – recently mentioned that she’d been to another practitioner, but had decided to try her luck elsewhere. Her reason?
“She told me to ‘Try this, come back, and we’ll see.’”
At fi rst glance, this might not seem like much of a reason to abandon a doctor. After all, much of what is done in practice is… well, practice. Being 100% confi dent is a luxury we rarely have. “Try this and we’ll see,” simply isn’t that uncommon.
But what Joanna was upset about was not the lack of surety, or the possibility that her care was a bit of an experiment. She simply felt that there was no plan.
And she was right. Try this and we’ll see isn’t a treatment plan any more than one line on a page is a novel. Yet it’s surprisingly common.
Much of the reason stems from putting too much emphasis on treatments. e tools of our trades are deceptive – it’s easy to believe that what you do as a practitioner is about the needles or the herbs or the supplements. But an acupuncture treatment isn’t a plan. Nor is a homeopathic remedy or a supplement. ey’re treatments, not plans. And how they’re used is a prescription, not a plan.
Joanna had a prescription and it wasn’t enough. So what was she missing?
Why Plans Are Important Joanna was craving a plan. A way to understand her treatment in a larger time frame, and how it fi ts in with her symptoms and overall health. And she’s not alone. Patients love plans. Here’s why:
Plans Create Context
Joanna’s not an outlier. She might have been better at articulating her desire for a treatment plan, but she’s not alone in her desire to have one. Patients crave context for their treatment. It’s how they understand that they’re on a path from A to B, and how they manage the anxiety around their health and care.
Even if they’re terrible at making a plan for themselves, patients love when you make one.
They Help Results
The simple act of mapping out treatment seems to have a placebo eff ect of its own. It gives patients a sense that they’re in capable hands, on a journey with a clear route and destination.
Plans Demonstrate Progress
Care takes time. Not everything resolves overnight, particularly chronic complaints that are built over years. A plan provides the context for seeing the slow, steady progress that can be invisible at times.
They Help Create Successful Outcomes
Plans make for commitment, commitment helps compliance, compliance creates success, and success makes more of itself. Want better results? Make a better plan.
What a Good Plan Looks Like
From the patient perspective, a good plan is a clear map from where the patient is to where she wants to be. It’s a health care road trip, with a clear destination, a route and waypoints along the way.
Here are the key high points your plan should hit:
Goals
What are you trying to accomplish? Are you sure you know what success looks like? Better still: does your patient know? Ask them what success looks like for them and make sure you’re on the same page.
Measurement
How will you know when you get to success? What can you measure that will let you know when you’ve arrived, and whether or not you’re headed in the right direction? Objective testing isn’t just a diagnostic tool for doctors – it’s a marker for progress that is hugely benefi cial for patients.
Visit Frequency
Return visits matter, and for more than just treatment – they’re how you track the progress of the plan. But visit structure and rationale are particularly important to clarify for consult-based care.
It’s easy for patients to know why they should come back for their next acupuncture treatment: to get the treatment. But the importance of a follow-up consult may need more clarity. Clearly state the visit structure, and the why behind it.
Tools and Techniques
What are you using to get from where you are now, to where you want to be? is is the area we tend to be best at, but have you explained to your patient why you’re using the modalities you are?
Timelines
What are the timelines? How long until your patient will see results? How long until she reaches success?
Alternatives
What are the options if the proposed plan doesn’t seem to be working? At what point do you consider them? Why are they alternatives, and not part of the active plan?
Even the Best-Laid Plans
Planning is surprisingly easy, but also surprisingly prone to three key pitfalls.
1. Believing ere’s not Enough Time to Plan
It’s easy to think that describing a treatment plan this way is too complicated to work through in an already-crowded visit.
But don’t be fooled. Joanna’s plan, properly laid out, takes just a few moments to communicate. Not a huge investment given the potential return.
The following example might take two, perhaps three, minutes to clearly explain to a patient:
I suspect the root of your problem is a food intolerance. It’s creating a chronic infl ammatory response in your body and your digestive track. at result is a magnesium defi ciency, and that’s what’s causing your migraines.
We’re going to remove your reactive foods from your diet, and see you once a we ek for the next 4-8 weeks for IV magnesium to treat the headaches. If the treatment works, we’ll decrease to once a month treatments after that for a year.
If we’re on the right track, you’ll notice a diff erence within the next 4 weeks, but it’s likely going to take 10-12 months for you to fully recover.
CRP, which is a measure of infl ammation, is elevated in your blood. We’ll measure this every 3 months to make sure it’s decreasing. We’ll follow up every 3 months to discuss the lab result, monitor your symptoms and tweak your treatment plan as needed.
2. Not Sharing the Plan e most common planning pitfall among doctors is that they already think they have a plan. And to be fair, you probably do.
You just might have neglected to tell your patient.
It’s easy to forget that your knowledge and experience make most aspects of the treatment plan seem obvious. So obvious that you don’t need to mention them. Remember, though, that your patient is a) not an expert and b) possibly overwhelmed with everything else you’ve told them during their visit. ey likely can’t create the plan themselves. at’s why they’ve come to you.
3. Too Much Information
Don’t confuse plans with information. A binder full of recipes, handouts and information sheets isn’t a plan – it’s just more information, and if anything it makes it harder for patients to understand and embrace the larger context of their care.
Plans are about broad strokes. ey’re about how to get from Toronto to Vancouver, not about tire pressure or the price of gas. Err on the side of over-simplifi cation. State the obvious, briefl y and clearly. en state it again if you need to.
Plans Help Everyone
A great plan is good for you and your patients. It leads to higher success rates, greater patient satisfaction, and as a result, more referrals.
Used properly, great treatment plans can help you fi nd that unique junction where benefi ts to patient, practitioner and practice overlap – the sweet spot of professional success.
Losing patients? Try better planning. Need more referrals? Try better planning. Want to feel more confi dent about your professional skills? You guessed it…better planning.
