You Talkin’ to Me?
PERSPECTIVE
Stuart Hoffman
DC
So you’ve reached a point in your practice where things are running on all cylinders, and you decide you are ready to take some of your hardearned funds and hire an investment broker.
You get a recommendation from a friend, and you decide to sit down with the broker and discuss your risk tolerance. The broker tells you that, based on your risk tolerance, you need to find stocks with a low P/E Ratio. Not exactly sure what a PE ratio is, you, of course, ask the newfound broker.
The broker quickly explains that the price-earnings ratio can also be seen as a means of standardizing the value of one dollar of earnings throughout the stock market. In theory, by taking the median of P/E ratios over a period of several years, one could formulate something of a standardized P/E ratio, which could then be seen as a benchmark and used to indicate whether or not a stock is worth buying.
The broker further explains that to calculate the P/E ratio, the earnings per share (EPS) must be known. EPS is most often derived from the last four quarters. This form of the price-earnings ratio is called trailing P/E, which may be calculated by subtracting a company’s share value at the beginning of the 12-month period from its value at the period’s end, adjusting for stock splits if there have been any. Sometimes, price-earnings can also be taken from analysts’ estimates of earnings expected during the next four quarters. This form of price-earnings is called a projected or forward P/E. A third, less-common variation uses the sum of the last two actual quarters and the estimates of the next two quarters.
Not wanting it to appear that you are a greenhorn in the world of finance, you sit there, nodding your head in acknowledgment of what the broker assumes is a very simple explanation, because he uses it all the time and no one ever appears to not understand it.
You leave your first meeting with the broker having no idea what he was talking about. Based on this experience, do you feel confident about giving this person your hard-earned dollars?
The broker thinks he did a great job handling the potential new client’s questions and is convinced he has won you over.
Because this is such an important decision, and the broker did not convince you that he understood you or your needs, you decide there is no way you are going to
‘ ‘ Interestingly enough, however, there are those who will become clients in spite of not understanding what the broker was talking about. J J
become a client. Interestingly enough, however, there are those who will become clients in spite of not understanding what the broker was talking about.
Unfortunately, some people may have a similar experience when they come to your office. A new patient arrives, you do your case history and examination, and then you do your, “guaranteed to get people to sign up for care,” Report of Findings. After all, you do this report all the time. The problem is that most of you are batting around .250, and 75% of those people who come for care don’t sign up because what they hear is as baffling as a price
to earnings ratio explanation. They may shake their head, yes, but they don’t understand what you are talking about, what a subluxation is, or what they see on those x-rays. Your “ChiroSpeak” lost you a patient.
Let’s take it a step further, because here is really where the communication breaks down.
If you have attended any of my presentations, whether on one of our Live Events, a F acebook Live or a presentation I have done for your state board, your college, or your national organization, you know I emphasize the value of Informed Consent as the perfect way to start a relationship with your patient. It builds confidence and allows them to ask questions and for you to set expectations and goals.
It is how you use that Informed Consent and how you respond to questions a patient might ask that determine how long and how effective that relationship will be for both you and the patient.
A patient asking a question about the risks of cervical manipulation does not want a price-earnings ratio type of explanation. A price-earnings ratio type of explanation for an informed consent goes something like this (according to the Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No
"Your “ChiroSpeak” lost you a patient."
Evidence for Causation):
“Our systematic review revealed that the quality of the published literature on the relationship between chiropractic manipulation and CAD is very low. A meta-analysis of available data shows a small association between chiropractic neck manipulation and CAD. We uncovered evidence for considerable risk of bias and confounding in the available studies. In particular, the known association of neck pain both with cervical artery dissection and with chiropractic manipulation may explain the relationship between manipulation and CAD. There is no convincing evidence to support a causal link, and unfounded belief in causation may have dire consequences.”
The patient may nod as if they know what you are
talking about and, yes, what you are stating is a fact, but the patient has no understanding of what it is you said, which is not a good way to start a relationship. Worse, if the patient doesn’t understand what you are saying it may put you at higher risk if he or she is ever asked, Did the doctor explain to you the risks involved in a cervical manipulation? What do you think the answer would be?
As it says right in our Informed Consent* (page 3, #4), “The conversation should be in layman ⅛ terms and the patient should have the opportunity to ask questions and gain clarification. ”
A more appropriate answer be as follows:
Chiropractors and chiropractic spend more money looking into that question than anyone else because there is so much in the media about this issue. Here is something you may not know. The great majority of strokes happen in non-chiropractic patients, people who have never seen a chiropractor. In fact, more people have strokes just doing routine things you do every day without even thinking about a stroke. This may be because of medications they take, congenial issues, accidents, playing sports, visiting their medical doctor, or doing nothing at all. Even though research shows there is no evidence that a chiropractic manipulation can cause a stroke, chiropractors have greater
training in recognizing the early signs of stroke, detecting potential strokes, screening for strokes, and knowing how to handle stroke situations than most other health care providers. It could be said that if you are potentially at a high risk for a stroke, then being in a chiropractor’s office may be the best thing you can do. A chiropractor’s skills may just save your life.
Remember this. When patients come to you for care, they are looking for a partner to develop a trusting relationship in which you can work together to solve the issues they are having. Price-earnings ratio speak rarely builds that trust.
Stuart Hoffman, DC, was honored as ICA ’s 2015 Chiropractor of the Year, previously awarded as Chiropractor of the Year from the Michigan Council, and recognized by Life University’s President Dr. Guy Riekeman for his success, leadership, and vision through his contributions supporting the mission of the President ’s Circle.
*For a copy of the most highly regarded Informed Consent in the profession, text the word “CHIROSECURE” to (480) 5006574 and we will send you our entire Informed Consent Packet.
Please direct any questions to 866-802-4476 or visit our website at http: chirosecure. com.
