Episode 3: Navigating Clients Who Divert from Their Treatment Plan with Josh Satterlee

Kayla: Welcome back to Your Clinical Supervisor’s Couch. I’m your host, Kayla Das.

Have you ever struggled with knowing where to go next when a client diverts from their treatment plan?

This can be a particularly challenging situation, especially for new therapists.

In today’s episode, I’m sitting down with Josh Satterlee, chiropractor and owner of Trust Driven Care, who will share how to work with clients who divert from their treatment plan so you and your clients can get unstuck.

Hi, Josh. Welcome to the show. I’m so glad to have you here today.

Josh: Thanks so much, Kayla. I’m really excited to be here.

Kayla: Josh, before we dive into today’s episode, please introduce yourself and tell us a little bit about you and your practice journey as well as your clinical supervision journey.

Josh: Yeah. So, I’m a chiropractor based in a town called Henderson, Nevada, which is basically a suburb of Las Vegas that nobody’s ever heard of. But they’ve heard of Las Vegas, so I always just say that I’m from Las Vegas. I’ve been in practice for about 17 years. I’ve done every version of chiropractic from being a solo provider, to having admin, to a team as large as 15 people, some personal trainers, some rehab therapists, some chiropractors. And then the office and admin team to run that whole show.

Along that way. I’ve educated my colleagues, my peers, as far as like the rehab and the clinical. The clinical issues that arise and I’ve had the experience of working with young, young, young, straight out of school chiropractors who are encountering difficult decisions with clients and I’ve learned a lot along the way.

Recently, a couple of years ago, I had a friend pass away. Unfortunately, he went to a chiropractor with low back pain, didn’t get better, so he went to a physical therapist, said he had low back pain. Went back to a different chiropractor, different physical therapist, urgent care, orthopedist, hip surgeon, all these people, and unfortunately. The seventh person he saw was the one who discovered that he didn’t have a muscle or joint issue, he had colon cancer that had metastasized to his spine.

That kind of led me on this journey of patient communication. Why does it fail? Why is it so bad? And I looked at all the research I could find on PubMed around it, and it’s a huge hole that doesn’t get talked about enough.

But the reason I want to address it is I think it manifests its way in so many things. I mean, everything from the business side of no shows and reschedules and that patient that comes in one time and never shows up again, all the way down to the way it affects that– you know, when you’re talking about clinical supervision, sometimes the confidence that our young therapists and providers are lacking is because it’s not have a framework of how to have a deep, difficult conversation based around trust.

And so that’s what we’re pursuing now is how do we create a framework and then support it with other tools like software, but the framework that on our worst day. As our worst version of a human being, tired, you found out you have to pay taxes, you found out your kid’s sick, whatever, on that worst day that we’re still pretty good communicators. And therefore, on our great days that were amazing communicators.

Kayla: First of all, I’m sorry to hear about the loss of your friend. And it sounds like that that has been pretty much the pivotal piece of your journey to where you are today. And I am so grateful that you’re here to share your story, to share. basically, all of this information so that this doesn’t have to happen again to another client.

Josh: Right. Yeah.

Kayla: What are some of the common signs that a client has started to divert from their treatment plan?

Josh: Yeah, it’s a great question and it’s worth pursuing. And I think within that question, there are kind of two options. And I would say that we have to use a barometer of trust. Sometimes patients divert from their treatment plan because their success, and you’ve eliminated whatever their primary concern was, right? So, in my world as a chiropractor, like, hey, I have low back pain, you get rid of most of the low back pain, and then it’s like, what’s next?

In mental health, it’s, hey, I want to have an exciting relationship. You get to that point, but what’s next? And you might go deeper into fulfillment and whatnot. So success sometimes leads to this diversion. The other side is, which is worth probably pursuing more is you start seeing behavior or actions that’s incongruent with what that patient told you their goal was, right?

So maybe they’re not coming in for visits as often or they’re delaying. They’re like, Hey, I really want to focus on my marriage, but I’m going to reschedule four weeks in a row and it’s like okay. So then are you really, really interested in the therapy you’re talking about? And I think in all forms of health care there is that I want to lose weight, but I got to wait for everything to be perfect to go to the gym or start my nutrition program. These are all incongruencies.

I think what’s worth it for this is if we can talk more about the incongruent side, the success side is I guess a good problem to have, right? You’re finding success, and that results in what’s next is often what do you want to add into your practice, like upsells or other services that help them get to their ultimate goal. But for sake of this, I think it’s worth talking about the incongruent behavior.

Kayla: Why do clients differ from the treatment plan, especially if they come in and they say, this is my goal. And then you start realizing that maybe it’s not their goal. Where are these congruencies coming from and why do they exist?

Josh: Yeah. We’ll never understand humans perfectly. But I will tell you what I’ve learned from the research and my own experience. And I would love to hear what you’ve learned. One of the situations that we get into as healthcare providers is we have to understand and deeply speak to this patient, and we’re expected to do that in the first five minutes of ever meeting him, right? There’s no other social situation where that would occur.

Imagine that if you and I were dating and I took you to dinner before the bread ever comes out, I’m already asking you the deepest, hardest, most difficult questions. Socially, that’s not how humans interact. It’s just not. And so one of the things we try and do with our software is. And I would tell everybody you should not rely on the first visit as the time to build trust in a perfect world. You’d already be swimming in trust through messages and emails and the story of you and all those things before that person steps into that first initial visit because we’re going to have to ask very difficult questions.

So I always say in health care it’s the only situation where you have to ask high trust questions in a low trust environment. So for me, as a chiropractor, I have to ask you about like pain or numbness. Is there any blood in your stool? These are difficult questions to ask. And when do I ask those red flag questions in minute three of the first time I’ve ever shaken your hand and looking in the eye. Like, show me another place where we do that as human beings. It doesn’t happen, but we’re required to ask that in healthcare.

So now let’s take that. When I ask you, what are your goals of treatment or whatever, the assumption is that you’ve been totally honest, and I’ve asked the right questions to lead to what your goals are. Well, that’s already a horrible assumption, right? Again, what situation would you ever get into where 14 minutes into our meeting, you are truly honest about what you want to do.

And I think every experienced therapist, and I would guess you’ve heard this, Kayla, how many times have you gotten six weeks into care, and the person’s like, Hey, um and they kind of pause for a second, they look a little sheepish, I didn’t want to tell you this on our first visit, but my real goal, or what I really want to work on is X. Right. What I think is happening is you’re just happening to have a split second where that person now trust you enough and you kind of exceeded that level of trust to where they’re going to admit to you the real goals. If you pursue those what I have found is they’re much tighter to their treatment plan. The other stuff is kind of the fluff of, I don’t trust you enough to really tell you that I really want to lose a hundred pounds, or I really want to start dating again, or whatever the thing is.

And so I would say, why is there incongruent behavior? Because we’re talking about, the wrong goals. We haven’t got to the real goals yet because we haven’t created an environment to do so.

Kayla: I really appreciate that and I agree with you 100%. In my therapy practice, I have worked with so many clients who came for workplace stress issues, which was my area of practice, but like you said, 6, 7, 8 weeks in, well, it was just safer for me to talk about that. But this is the real reason I’m here. And I think that that’s really important to acknowledge. The trust and the safetiness, right?

Sometimes we’re even as humans, it’s difficult to admit to ourselves why we’re truly here, going back to kind of the relationship example. If someone is having difficulty with their partner. They probably don’t want to say it out loud yet. They probably haven’t come to a conclusion that maybe I want to get a divorce or maybe I want X, Y, and Z. But once that trust is built, then they feel more safer to actually verbalize it out loud. Even though they may come under the guise of workplace stress or whatever their original reason for coming in is.

Josh: Right. And now that’s you saying that, and that’s me saying this as experienced clinicians. So, imagine if you’re two weeks out of school, two months, or you’re within your first year, to those people who are clinical supervisors, how do you create a framework and a situation where you can tell that young therapist, “Hey, here’s signs that they’re not really being honest with you?” but you’re going to bet the house on that. You’re going to build your treatment plan off it. You’re going to go to your supervisor and say, here’s the blah, blah, blah. And then you’re going to fail at it. Not because of anything you did wrong. We bet on the wrong pony here and it’s okay. And it happens, but how can we do that?

And that’s a difficult situation. Because I think that young therapist wants to be successful. They’re driven to be successful. They’re getting out of school. They’re the most excited they’re ever going to be about the profession at this point, right? And yet they’re going to encounter negative feedback going, this person never rebooked and they’re going to take it as a reflection possibly on themselves, not on, listen, no one could have been successful. The person was dishonest about their goals. No one would have been successful regardless of it. So, I think that’s why it’s appropriate for the clinical supervisors is you got to remember we’re humans dealing with humans and you’re supervising another human. This isn’t robots.

Kayla: I appreciate that. I don’t know if this is similar to chiropractor, but I know when I was in school, there was this underlying thought process that you have to keep yourself at the door. Basically, you don’t bring yourself into therapy, you don’t bring yourself into sessions. If you’re a clinical supervisor, you don’t bring yourself into that clinical supervision session. However, like you said, it’s humans supervising humans who are working with humans. We aren’t robots and we can’t a hundred percent keep ourselves at the door.

Of course, there are those boundaries and that’s probably an episode in itself. So won’t dive too deep into that. But in saying that you are still human. You are someone who is working with humans. And as a result, there’s going to be not so linear processes within the treatment plan or the process.

Josh: Yeah. Give them grace and give yourself grace. If I provided a framework. If we have time for that, I’d love to give a framework and if you could go through with that young therapist and check off those boxes, we can say, listen, we did everything on our side, right? We did all the actions that would result in a good outcome rather than them feeling like there’s no measuring stick. You don’t want them thinking. Well, the only possibility is I didn’t do enough or I didn’t do it right.

Kayla: Well, let’s dive into this framework, because really my next question was, what are the steps and strategies that a therapist should take to bring their clients back on course when they divert from the treatment plan?

Josh: Yeah. It’s great. And we’re trying to take a master’s level or doctorate level education and shove it into the next three minutes of this podcast. But here’s what we’ve developed. When we looked at all the research after my friend died, I dove into PubMed and I was like, I’m going to understand patient communication and why it failed. And he said a lot of things to me. So, when he finally got a diagnosis of metastatic cancer, he only had about eight weeks after that, that he lived, unfortunately. And it was one of those situations. Had he got the accurate diagnosis day one, we probably could have fought it. It would have been caught it at stage one or two and fought it. Right. And unfortunately, we didn’t get that.

But anyways, I remember talking to him, and I said, like, Ryan, what symptoms did you have? And he said, well, you know, I was taking a bunch of ibuprofen because of the pain, and, you know, that’s why I had blood in my stool. And I was taking so much ibuprofen, I really wasn’t hungry, and that’s why I lost 32 pounds in four weeks. And nobody really could find what was going on, and that’s why I had pain that wouldn’t go away at night.

Well, blood in stool, you know, unexplained weight loss and pain at night are red flags for cancer, blatant red flags. And I said, why didn’t you tell them that? And he goes, well, you know, they were busy, I didn’t want to slow them down, I didn’t want to get in their way. They had a lot of people to see that day, blah, blah, blah. And I remember him taking it on himself and I was like, what? This is not the way patients should be.

So anyways, I dove into the research and a lot of it aligns with what he said. Patients are often scared to tell you how they feel, meaning the emotional load, but they’re usually ready to tell you what they feel. But if you can kind of get out how they feel, their fears are. Their anxiety about this issue. It’s back pain. Is it somebody that makes their living as a landscaper? And therefore back pain means zero dollars of income like these are all concerns, right?

So anyways, as I dove into the research You could really clump it into five major areas and here’s the framework for those listening: five major areas, the easy way to remember it is It’s the PATCH framework. P A T C H, like Patch Adams. Who’s like the most empathetic communicator in all of healthcare, right? If you can check off that you addressed all five of these things, you could say, I did my part. Or you could help that young clinician to say, you did as much as you could.

So, here’s the five. Number one, the P, is Patient goals. Do you clearly understand the patient’s goals? Not just our goals of treatment. So like if you come in and you have cancer, we might see we need to treat it with this chemical and then we’re going to radiate it and this and that. But their goals are, I want to know how long I can take care of my kids. Are we clear about the patient’s goals, not just the goals of treatment?

Then A. A is autonomy. Offer them to be a participant in their care, even if it comes down to, Kayla, would you rather do three times a week for four weeks, or two times a week for six weeks? Now, it’s still 12 visits to your chiropractor, but you get to choose, and therefore you’re a participant.

And if I give you rehab exercise, Kayla, I will give you rehab exercise, but what of these do you think you could actually do at home? Okay, it might not be perfect, but when you choose, you are much better of a participant in it, right? So that’s the A.

T, P A T C H, so T stands for Tailor Your Communication Methods. If somebody doesn’t speak English, don’t yell at them. Use a whiteboard. If it’s a difficult to understand cycle, like the ovulation cycle to a 14-year-old girl, could we use a PowerPoint presentation that kind of has some images or something? If it’s talking about a meniscal tear for the knee, how about handing you a joint model? Like, this is how it works. It’s tailoring to the person in front of you, right? If somebody has hearing aids. Let’s talk slower, change the pace, and look them in the eye. So that’s the T.

Then C is communication basics. Making sure we do the basic things like make eye contact, shake their hand, face them chest to chest, or I always think of like Iron Man, you know, he has that like, reactor. Is my reactor shining on my patient? Or is it going around them? And I’m sure we’ve all dealt with patients. It never faces us, right? Do we use their name? I mean, your chart has this amazing thing where it tells you the fricking person’s name. So use it. And do we introduce ourselves by our name? Because have you ever had that experience? You go into a doctor’s office and somebody comes in and take your blood pressure and you’re like, are you the doctor? Oh no, I’m just the medical assistant. Well, I don’t know that you’re not wearing a name tag. It doesn’t identify. Then another person comes in. Are you the doctor? No, I’m the nurse. Okay, like I have no reference point, right? So coming in and saying, Hey, I’m Josh. I’ll be your chiropractor today.

And then the last thing is humility. That’s the H is humility, right? That patient is hiring us to be the smartest person in the room. They want you to know the solution. But you don’t got drive it down their throat and rub it in at how smart you are. And I think we can all think of a surgeon we’ve met, they’re typically the cockiest people. And how do you know someone’s a surgeon? Because they’ll never stop talking about it, right?

But I will give you this. If you’re somebody that’s like, I want to see more patients and I want to have better Google reviews, which seems to have nothing to do with patient care, the highest score for patient satisfaction is when a doctor makes a small mistake, realizes it, and corrects himself in front of the patient.

So, if I come in and I say, Oh, hey, Katie, it’s good to see you. Oh my God, it’s not Katie. I’m so sorry. It’s Kayla, it’s so good to see you. Those scores are the absolute highest patient satisfaction scores to the point that that same group of researchers who found that said, could we manipulate this? Could we force the doctor to make a mistake? And would it result in the same? And they found out. Yes, no other version of healthcare gets that high of patient satisfaction. So, I know that’s a long explanation, but P A T C H, PATCH, gives those people a framework. If you do all those things, if you’re humble, you communicated well, you tailored your communication, you provided some sort of autonomy to the patient, and you addressed their goals, I think you can reliably say you did your part, it’s the patient side of the equation that’s not working out here.

Kayla: I find that very interesting that the H. I mean, I think as practitioners, we can say that humility is good to have in practice, but to also understand that there’s research behind that it improves patient satisfaction is so interesting and important. I don’t know about any other therapist out there, but almost every client I ever had come say, okay, tell me the answers now. I just want the answers and let’s move on. However, that’s not how it works. And certain professions, it might be like you said, if you see a surgeon, they’ll probably have all the answers for you.

But in mental health therapy, that’s not the way to go even if we think we know it. But in saying that it’s okay not to always have the answers. And I think that that’s one thing that many new therapists. And I know when I first started, I struggled with this too, is that you think you know all the answers. I remember when I first finished my bachelor’s I was like, okay, I’m ready to take on the world. I got all the answers. And then I sit in front of my first client and I’m like, I know nothing, right?

Josh: I’ll give you an example from my own life, like my first two years of being a chiropractor, the number of referrals I made was so low. And I look at that and I go, oh, because I thought I was the solution. When really, a healthy practice of any sort in healthcare is when you don’t have the answer, referring is the answer. But when somebody doesn’t refer, they’re like, oh yeah, I can keep treating that. I can keep going. When you have a client now, I’m sure you realize like, yes, this is a mental health issue, but I’m not the person to solve it. And therefore, I want to send you to my colleague or my peer or somebody across town, or, hey, this is a mental health issue, but without pharmaceutical assistance, it’s almost going to be impossible.

Sending for that referral, I think as part of that humility. And I would say as a general rule, younger therapists, younger chiropractors, younger doctors refer less than more experienced because it can be perceived as a judgment against them. Oh, you weren’t able to do it. Therefore, we’re going to send it away from you. And that’s not at all what it is. It’s good healthcare is assisting everybody in finding the right solution.

Kayla: And I also want to add something that you said, like we’re talking about younger therapist, but I’m even thinking the word is new therapist, because even if you’re a therapist who maybe this is your second career, and maybe even in the helping profession, you were trained in a specific area. And now you’re 40, maybe even 50 years old. And you’re like, you don’t want to be a therapist is where I need to be. It’s a total different ballgame, right? A lot of it’s transferable skills, but it doesn’t necessarily mean you’re going to know it all. And I don’t even think, to be honest with you, anyone knows at all.

Josh: Right. Again, it goes back, we’re humans doing this with other humans supervising humans. The likelihood of 100 percent success in that is zero. It’s zero. So we need to do the same thing and be humble enough to say, we need to improve as well.

Kayla: I agree 100%. So we sort of touched on this, but I think that one of the most challenging aspects for many therapists, specifically new therapists, is navigating those difficult or uncomfortable conversations that come with treatment plan diversions. How can therapists navigate these uncomfortable conversations so that they can better help their clients to get back on their treatment plan, as well as improve the client communication.

Josh: Yeah. I think there’s two specific places where opportunities often arise to this. And I’ll tell you the research backed answer to this question, and then I’ll tell you my experience.

The two areas are, number one, on that first visit, did we actually listen to the patient? And if you didn’t listen, you don’t know what’s going on. The second one is, when you see that misalignment, going back and I would say, like, refocusing the lens, maybe?

So let me start at the first. There’s really good research around, it’s called the spontaneous talking time of patients at initial encounters. I don’t know if you’ve ever looked at this research, but it’s basically if I ask you an open-ended question, Kayla, how can I help you? How long will patients speak for if they’re not interrupted? So, if I just encourage and nod and smile, how long will you speak for? So, when I ask this at like our seminars and whatnot, people will say like, 10 minutes, 30 minutes, oh my god, they go on for an hour, blah, blah, blah. The research is clear. The average that a patient will start talking at their initial visit. And this is with a GP, a primary care doctor, is only 92 seconds. It’s only 92 seconds. So why is the number one complaint in health care, no one ever listened to me? If it only takes 92 seconds to do that.

Well, luckily another group of researchers looked at, on average, how long does it take for a doctor to interrupt their patient? Take a guess at that.

Kayla: I’m going to say a minute because I’ve had that happen.

Josh: You are being very generous to us health care providers. It’s 11 seconds on average. 11 seconds. So, no wonder they don’t feel like they were listened to. They wanted to go on for 92 seconds. And we cut them off at 11. Now it’s not that we’re saying, okay, I’m going to stop you, Kayla. What interruption looks like is if I ask you Kayla, how can I help?

And you start telling me, oh, I have some low back pain. It’s kind of going down my right leg and I noticed it’s worse in the morning. And I go, would you say it’s achy or numb? That question just interrupted their spilling the beans. So, it’s done with great intent. But it’s still an interruption and what I would say is I’m again going off your experience. How many times have you had a patient start out with one story and as you let him talk around the 30 to 40 second mark, all of a sudden it turns into what’s really going on their real issue. The real thing that if we talk about that. We’ll keep them on track in their treatment plan, right? But again, if they don’t trust you and you don’t let me finish my version of it, how are we going to have a treatment plan aligned with my goals? How could anybody do that. Now I think when you get more experience working with people, you can kind of sniff out when this doesn’t smell genuine, you know? And so, it’s easier with experience.

So, for a young therapist, we call it the two minute drill. Ask an open-ended question. How can I help? Or what can we help you with? And just nod and smile, and I watch the clock for two minutes. And I will tell you, anybody who wants to try this in your next team meeting or whatever, everybody in the room will get uncomfortable around, like, the 80 to 90 second mark. And they’ll be looking at you like, what do I do now? And for 30 seconds, you just smile and nod and say, keep going, Kayla. Tell me more. How can I help? And they’ll be like, I told you everything. I don’t know what you want to hear. But those same patients won’t say, No one ever listened to me. And what you’ll even see that we see this in our software, Google reviews are coming in and they say, finally, someone listened to me or you should go to this place because they’ll actually take the time to listen.

Well, the time to listen is two fricking minutes, 90 seconds at the front end of the visit. Who doesn’t have that much time to just listen and smile and nod. Just as an aside, I taught this at a chiropractic seminar and afterwards this guy came up to me and he said, you know, You’re right. And I was like, oh, well, thank you. That’s great to hear. But I don’t know why you’re saying that. I mean, it’s just research that I found. He goes, well, I’m a baseball umpire in my off time. I love high school baseball. And he said, we’ve lost over half of our umpires lately in the last five years because parents will start yelling, which is fine, but then they’ll get violent. And there’s been so many that have been beat up at these games. And he said, think about it. You’re staying at home plate. Your back is up against a fence. A swarm of people comes around and traps you there and you’re getting paid $55 to stand there and get yelled at and then beat up. He’s like who would do that? So, he said we had to stop this, right?

So, he brought in this consultant, and the guy said, you can’t stop parents from yelling. It’s a highly competitive environment. It’s their kid. But, he said, let the parent yell for 90 seconds. And then they’ll start repeating themselves. And then say, Dad, I’m going to stop ya. It was clear that he was out. Blah blah blah. He said, they still yell, they still scream. But since they’ve done that 90 second rule, no one’s gotten violent.

And I was like, oh, that’s really reassuring. Why would you not get violent in that situation? Because when you feel like somebody wronged your kid, and combine that with that person’s not listening to you, your emotions keep escalating, right? Whereas if I say, I listened to you Kayla, I understand you think your son was safe, but he was out. But as long as I listen, it’s amazing how much that just reduces that humanistic stress and not taking it to the next level.

Anyway, so, has nothing to do with healthcare, but I think it’s one of those things, if it works in angry baseball parents, it probably will work with mental health therapists, chiropractors, and about everybody else on the face of the earth.

Kayla: I agree, and in my own practices, especially when I used to be running organizations, I often used to have to intervene with violent clients or escalated clients or even a disgruntled employee. And going back to this exact concept is that we mirror off each other. So, if you yell, I’m going to yell. If you stand, I’m going to stand. If you sit, I’m going to sit. And it’s really hard not to mirror because we continue to go back and forth with mirroring. However, as practitioners, as therapists, if we can– and it’s always the most uncomfortable for the first 30 seconds to a minute, but if we can go against all of our biological urges to stand, to yell, to literally sit there. It almost always de-escalates.

Now in saying that, I want to say you know your safety best, so I don’t encourage you to just sit there if you think that you are going to be unsafe. But to help de-escalate, I’ve had some potentially violent clients, as long as I created the mirror that I wanted them to have, and again, letting them yell for 30 seconds to a minute. They got what they needed out, and I didn’t interrupt. I let them yell. I let them scream. And then I would mirror what I want them to do. Basically, I would sit down, even if they’re towering over me. I would sit down and just nod my head and listen. And they would sit back down without me having to say anything. Because now they are mirroring off me and they don’t even know it.

Josh: Yeah, It’s so incredibly powerful and again going back to like the supervisor of that clinician, How many of those young clinicians will report no one ever listened to me or my supervisor didn’t listen to what happened and therefore they’re resistant to feedback because they’re like, why would you give me feedback? You didn’t even know what happened You never listened to me, right?

And I think that just that listening is strong enough to change the supervisor-supervisee relationship. It’s enough to change the patient-provider relationship. And I think it can really change healthcare. So.

I think it’s so powerful going back to your question. Like if we don’t listen though, which is the root thing we talked about. Now that I brought that up, why would we think that the treatment plan would be followed? I mean, if I didn’t listen to you, and I build you a treatment plan, why would I expect you, as a, you’re in healthcare, you understand the importance of this, you understand the biology, you understand, like, all the reasons why, but why would I expect you to follow this?

Kayla: 100 percent Josh, I know you’re a creator of a specialized, all in one software. Can you tell us a little bit about what it is, and how it can help listeners?

Josh: Yeah, it’s a software called Trust Driven Care and you can find a trustdrivencare.com.

But the reason we have a software is that really empowers us to do these things with every patient for every visit the right way. We build this patient experience that flows in a certain way. So, for example, if you want to build trust so that they trust you more than that first visit. Sending a picture of the outside of your office is so powerful. You pulled in a parking lot a thousand times. This is their first time. If on that picture, you draw an arrow, just like a screenshot and just say, use this door or take the elevator to floor two. Those things are the things we would do for somebody we truly cared about. But in healthcare, for some reason, we forget about those.

And when we come to P A T C H, the T, we tailor that to send out as a text message, because email deliverability stinks, the readability stinks, the reply rate stinks, but text is how we communicate with our friends and family. And I’m going to guess, if you have texting in your office, your patients will communicate that way primarily. And if they text, we should tailor our methods to text with them, right? So, we have those two way texts, but again, we’re dealing with humans. Sometimes they ask questions. Sometimes things don’t make sense. Sometimes they’re running late and they want to let us know. And that’s why we really want to have two-way text messaging. They can ask and I’ll respond.

I mean, how frustrating is it when you get a message and you respond to it and it goes, oh, this inbox is not monitored or please call our office. It really erodes that trust. Anyways, that’s part of what we do, but we kind of encompass all these methods of communication and all these ways to create that better experience. So, the person feels heard and trusted and they have a relationship with you before they ever come in your office.

And then after that point we use it to sign up forms for workshops, it can help you build a website, all these things that are really just inherently other forms of patient communication. So that’s what we’re all about, is patient communication.

Now I will say this, it’s like bookkeeping software. If you don’t know what you’re doing with accounting or bookkeeping, QuickBooks is not going to save you. Right? But when you do know and you do follow like the PATCH method and you do have that pipeline or framework of patient communication, our software will step in and help you do it every time with every patient, even if your front desk staff is sick or you’re not feeling your best or whatever.

And in that way, I think we can change this game around patient communication.

Kayla: I love it. So, check out Trust Driven Care at trustdrivencare.com or simply scroll down to the show notes and click on the link.

Josh, thank you so much for joining us on the podcast today to discuss how to work with clients who divert from their treatment plan.

Josh: Absolutely. Thank you, Kayla, for having me.

Kayla: Thank you everyone for tuning in to today’s episode, and I hope you join me again soon on your clinical supervisor’s couch.

Until next time, bye for now.