HOW AS HEALTHCARE PROFESSIONALS DO WE LISTEN?

Rosalind Canham, DC

50, 60, 75, 80 percent - What is the non-verbal component of language?  Studies vary.  Peoples vary Europeans tend to actively use their fingers, hands, arms, eye brows and shoulders to emphasize their point.  Some cultures like the Navajo speak with little or no inflection, and wit little body movement.  It is easy to see the words alone are often not enough to carry the whole message.  We have been many television series that have the main character adept at "reading between the lines" so to speak.  One could learn this skill to become an equally amazing listener.  However most of us just don't have the time, so listed below are five basics to assist you to become a better listener.

• Be in the moment.  You can't do even two things well at the same time.  Pay strict attention to your patient as they attempt to tell you what is wrong.  Many will be swayed by the latest diagnosis their friend got.  Some will try to belittle the reality of their pain due to fear.  You can identify many untruths like these by the tempo and volume of their words.  In general, "stories" are told well, usually rehearsed.  Fear very often makes a person wary, quieter and uneasy.
• Be quiet.  Your actions can and often will affect your patient's ability to speak about their personal problem(s).  If you are fiddling with a pen, making notes, tapping your foot, tec. The message sent is "I'm busy.  Let's get on with it.  I know how to treat you.  What you're telling me is not important."  It may be very relevant.  If you pay closer attention a hesitation or a shift from an uncomfortable position can be the clue to you to examine an area more closely, or order a test.
• Give the patients visual cues to let them know you are paying attention.  Nod your head in agreement. Make eye contact.  Smile.  
• Repeat back.  Clarify with your patient any "not quite right" statements.  Medical terminology abounds.  Articles tell everyone about rare cases and people respond by mimicking similar symptoms.  However, if you wish to treat the whole person, body and mind, it is well to dissuade the anxiety your patient has, and sometimes disease may be caught in time to avert serious complications.  As I tell my chiropractic assistants in their training we need to care.
• Be honest.  No one expects you to be a mind reader or a wizard.  If the patient's words are common to another's it is not good to immediately lump them together and "turn off" your ears and brain to the whole tale being told.  Many different causes have basically the same symptoms.  You and your patient both will be better served to eliminate probabilities before reaching a firm diagnosis and starting a treatment plan.  A person who is told they "have such and such" will often cling to it with amazing tenacity.  Order and confirm diagnostic tests before diagnosing the patient.  Words definitely have power.
• Be helpful.  What?  Yes, as a healthcare professional we are the persons that the patients look to for help.  Help overcoming discomfort, disability, and disease.  If the patient's complaints are not related to their chiropractic condition, have a handy list of referring agencies.  Be careful though.  Perhaps all that is required of you is to be a caring listener.  You should strive to be that.

Remember a knowledgeable and understanding heart is one of our greatest tools to show patient's that we really care about them.  So practice listening, patients are the greatest source of new patient referrals in a chiropractic office.

For additional training contact Dr. Rosalind Canham (DC) to register your staff for their Chiropractic Assistant Training Course at www.ProfessionalOnlineEducation.com  

 

ERISA CLAIMS PROCEDURE 29 CFR 2560.503-1

 

(g) Manner and content of notification of benefit determination. 

 

(1) Except as provided in paragraph (g)(2) of this section, the plan administrator shall provide a claimant with written or electronic notification of any adverse benefit determination. Any electronic notification shall comply with the standards imposed by 29 CFR 2520.104b-1(c)(1)(i), (iii), and (iv). The notification shall set forth, in a manner calculated to be understood by the claimant - 

 

(i)The specific reason or reasons for the adverse determination; 

(ii)Reference to the specific plan provisions on which the determination is based; 

(iii)A description of any additional material or information necessary for the claimant to perfect the claim and an explanation of why such material or information is necessary;

(iv)A description of the plan's review procedures and the time limits applicable to such procedures, including a statement of the claimant's right to bring a civil action under section 502(a) of the Act following an adverse benefit determination on review; 

(v)In the case of an adverse benefit determination by a group health plan or a plan providing disability benefits, 

(A)If an internal rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination, either the specific rule, guideline, protocol, or other similar criterion; or a statement that such a rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination and that a copy of such rule, guideline, protocol, or other criterion will be provided free of charge to the claimant upon request; 

(B)If the adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the determination, applying the terms of the plan to the claimant's medical circumstances, or a statement that such explanation will be provided free of charge upon request. 

 

(h) Appeal of adverse benefit determinations. 

(1) In general. Every employee benefit plan shall establish and maintain a procedure by which a claimant shall have a reasonable opportunity to appeal an adverse benefit determination to an appropriate named fiduciary of the plan, and under which there will be a full and fair review of the claim and the adverse benefit determination. 

(2) Full and fair review. Except as provided in paragraphs (h)(3) and (h)(4) of this section, the claims procedures of a plan will not be deemed to provide a claimant with a reasonable opportunity for a full and fair review of a claim and adverse benefit determination unless the claims procedures-

(i) Provide claimants at least 60 days following receipt of a notification of an adverse benefit determination within which to appeal the determination;

 (ii) Provide claimants the opportunity to submit written comments, documents, records, and other information relating to the claim for benefits; 

(iii) Provide that a claimant shall be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimant's claim for benefits. Whether a document, record, or other information is relevant to a claim for benefits shall be determined by reference to paragraph (m)(8) of this section; 

(iv) Provide for a review that takes into account all comments, documents, records, and other information submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. 

(3) Group health plans. The claims procedures of a group health plan will not be deemed to provide a claimant with a reasonable opportunity for a full and fair review of a claim and adverse benefit determination unless, in addition to complying with the requirements of paragraphs (h)(2)(ii) through (iv) of this section, the claims procedures-

(i) Provide claimants at least 180 days following receipt of a notification of an adverse benefit determination within which to appeal the determination; 

(ii) Provide for a review that does not afford deference to the initial adverse benefit determination and that is conducted by an appropriate named fiduciary of the plan who is neither the individual who made the adverse benefit determination that is the subject of the appeal, nor the subordinate of such individual; 

(iii) Provide that, in deciding an appeal of any adverse benefit determination that is based in whole or in part on a medical judgment, including determinations with regard to whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate, the appropriate named fiduciary shall consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment; 

(iv) Provide for the identification of medical or vocational experts whose advice was obtained on behalf of the plan in connection with a claimant's adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; 

(v) Provide that the health care professional engaged for purposes of a consultation under paragraph (h)(3)(iii) of this section shall be an individual who is neither an individual who was consulted in connection with the adverse benefit determination that is the subject of the appeal, nor the subordinate of any such individual.

CHIROPRACTIC ASSOCIATE/CLINIC DIRECTOR WANTED: We are an integrated health facility that is looking for a great leader. If you want to be part of a great team, please apply. Salary based on experience. We offer health benefits, 401K and bonuses. Contact drwall@afcmed.com

  

WANTED ASSOCIATE DOCTOR WHO IS EAGER TO LEARN AND EARN IN AZ: North Scottsdale AZ.  Must have at least 2-3 years of practice experience. Would like candidate to have some experience with AK, muscle testing, Brimhall protocols, laser, percussors, etc., but not an absolute MUST SEND RESUME to drchris@valleyspinalcare.com . Website  www.thescottsdalechiropractor.com                 CS

 

EXCITING OPPORTUNITY WITH TREMENDOUS GROWTH POTENTIAL. 
We are seeking a motivated, ethical DC to run one of our established clinics in the Phoenix area.  We provide all office, marketing, billing and support staff for you.  The doctor focuses on patient care!  Arizona PT license and experience required.  COME JOIN OUR TEAM! Competitive base salary plus generous bonus package. Email resume to omida@injurychiropractic.com.                       SM

 

ASSOCIATE IN A PRACTICE with significant amount of professional athletes amongst family practice. Need only apply if highly motivated; extremely extroverted; and health, fitness and sports are a huge part of your life. Send resume to backinshapeaz@yahoo.com. 
 

DOCTOR POSITION AVAILABLE: Chiropractor wanted for a well established office in Buckeye, AZ. Looking for energetic doctor with great patient skills and a current AZ DC/PT license to join our team. Email resume to cbrown@azchoicechiro.com or call 623-572-9820 ask for Cynthia.                       CB

 

SEEKING AN ASSOCIATE CHIROPRACTOR to join our wellness practice in Queen Creek, Arizona.  Established in 1993. Questions? Call Karen 480-987-0585 Monday, Wednesday, or Friday

Please send a cover letter and resume to qcchiro@yahoo.com               

 

GREAT OPPORTUNITY FOR DOCTOR of CHIROPRACTIC: High Volume Chiropractic / PT Office.
Generous Salary, Insurance Benefits, Profitable Bonuses, Paid Vacations & Holidays, Excellent Retirement Plan. East Valley/Mesa, AZ. AZ License & PT Certificate Necessary. Must be in Good Standing with Chiro Board. Email CV to apply DrMichael5085@gmail.com.

 

AZ SPINE DISC AND SPORT is looking for a well-rounded experienced chiropractor to join our team. AZ Spine Disc and Sport is a chiropractor owned, multi-specialty, progressive sports medicine and pain management clinic. More information on the clinic is available at www.azsds.com. Contact Angela J. Christopher, DC at 480-759-1668 or at DrACDC2005@hotmail.com

 

STAFF ASSOCIATE CHIROPRACTOR POSITION.  We are an Arizona, South West Valley Chiropractic office.  Our practice is mainly personal injury and wellness based. We are currently reviewing curriculum vitae's. Requirements: F/T, M-F and Sat. AM, PT cert., Spanish speaking, heavier handed, fully proficient in Diversified, Activator Technique and drop table techniques, must be able to manually adjust 300+ pound individuals using side posture and anterior dorsal techniques, superior Customer Service and Care - High Energy. Email CV to  recruiterarizona@yahoo.com

 

CHIROPRACTIC ASSOCIATE POSITION in exciting fast growing medical clinic Phoenix AZ.  Integrated health clinic looking for great, self-motivated, enthusiastic chiropractor to join our team. Full-time position, offering training, professional development, learning opportunities with potential for growth.  Salary / bonuses offered. AZ License & PT Certificate necessary. Recent graduates welcome. Team player, Energetic, Willingness to learn. Please send resume with cover letter to: Foothillsfamilychiro@gmail.com or contact us directly at 480.460.1399.

 

EMERGENCY CHIROPRACTIC is looking for an associate doctor to join our 38+ year company. Salary position with possible advancement to become a Clinic Director and run one of our fourteen offices throughout the Phoenix area. Must be willing to work in both the Greater Phoenix and East Valley areas. Practice limited to Personal Injury. Looking for a quality, detail orientated person. Many of our Doctors have been with us for 20+ years! Job security and an excellent benefit package. Arizona license with P.T. a must. Call Anand S. Bhakta, D.C., Chief of Staff, at 602-992-8199.

 

BUSY N.W. DR.S OFFICE needs associate doctor to join our well established practice.  Please call for an interview.  (623) 878-4000.   MG
 

ASSOCIATE FOR N PHOENIX PRACTICE - Diversified, fully-equipped, 28 np/mo & 83 pv/week, collections $260K+.  Beautifully appointed clinic, great location, seeking doctor looking for opportunity of ownership.  Call Dr. Jack 480.575.8095.

 

This newly renovated office with excellent location offers 7 treatment rooms with a modern reception area at an affordable price. Take a virtual tour at http://youtu.be/xsxxrZFhHs. Call 602.618.3742 soon as this property will not last long!   DB

SOLD PRACTICE but not ready to retire...looking for independent contractor position, room to rent, vacation relief or part-time associate opportunities preferably in the south Gilbert area...call Dr. Mike at 480-639-8108.