One Doctor’s Report of Findings

There are plenty of opinions about the report of findings, commonly referred to as the ROF. The length and the content should surely be determined by you, the DC, and I encourage you to follow your intuition and refine your ROF as your career progresses.

There are a few suggestions I have for you, which I have gleaned from my 22 plus years of hard knocks. My ROF has gotten progressively shorter, now approximately 5 minutes. I’ve learned to focus on the patient’s immediate needs and carefully gain their confidence and trust; so perhaps later, I can introduce some concepts for prevention and overall health maintenance. The days of an arrogant, all-knowing doctor issuing orders to a patient are long gone. Nowadays with health information so readily available, such as through the internet, the patient may very likely know more about their problem than the doctor. Think of yourself more like a team member or coach.

When I meet up with a patient after their initial exam/x-ray, whether it be that same day in acute cases or within a few days, the first thing I do is ask, “Do you have a few minutes so I can show you what I found, and how I can help you? If you choose to, we can start some treatment.” This is important to ask and will put them at ease because patients are more strapped for time than ever before, and are probably expecting treatment as soon as possible. In the rare cases when they say they don’t have time, I proceed to treat them, explain minimally as I go along, and arrange a little more time next visit.

Showing pictures, diagrams, or plastic models goes a lot farther than just talk. I always show a spinal nerve chart, circling their areas of disturbance. I also always show the x-rays, briefly pointing out the areas I’ll be working on. Even though they probably won’t notice what you and I see, other than metal fillings or large curvatures, they do appreciate being shown. Don’t overwhelm them by getting into any philosophy or dogma.

When I give recommendations for a treatment plan, I offer options. Patients love that! It takes most of the pressure and stress off both the patient and doctor. Usually 2 or 3 options, ranging from brief relief care to a full corrective care plan, are appreciated. You’ll find most want the more thorough choice. Whatever they choose, be supportive. If you sense hesitancy, explain that they can decide as they go along, because all the options start out about the same.

I notice they like when I explain any risks. In typical cases I say something like this, “There are no significant risks in the treatment I’ll be providing to you. You might experience some soreness initially and as your structure changes. This is usually quite moderate and temporary.” Isn’t that a great way to be honest, put them at ease, and “cover your butt” all at once?

Another thing that puts them at ease is when I say, “I’m optimistic you’ll do well if you have a little patience. If you don’t improve as we anticipate, I’ll be sure to guide you to another professional.” In other words, the initial care is a trial period.

Put yourself in the patient’s shoes, and you’ll see that the first few contacts you have with them are about gaining trust. Being respectful of their time. Allowing them some control to choose and addressing their fears will create a pleasant experience for both of you.