SCREENING MANUAL

TABLE OF CONTENTS

PURPOSE OF CHIROPRACTIC PUBLIC HEALTH SCREENINGS ................................................................ 3

SCREENINGS STILL WORK! ................................................................................................................................. 5

WHY DO SCREENINGS: A TESTIMONIAL ........................................................................................................ 6

SCREENING SEQUENCE AND OUTLINE............................................................................................................ 7

SCREENING PROCEDURE ..................................................................................................................................... 8

APPOINTMENT PROCEDURE .............................................................................................................................. 9

SUCCESSFUL SCREENING PROCEDURES ...................................................................................................... 11

50% PUBLIC RELATIONS - 50% TECHNICAL SERVICE FLOW CHART ................................................. 13

SCREENING BOOTH MANAGER ....................................................................................................................... 13

SCREENING BOOTH MANAGER ....................................................................................................................... 14

SCREENING OPERATIONS: SET UP, SUPERVISION, TAKE DOWN ....................................................................... 14 SET UP/START UP OF THE SCREENING BOOTH ............................................................................................ 15 STANDING OUT AT A SCREENING BOOTH ................................................................................................................. 16

EXAMPLE OF SIMPLE BOOTH LAYOUT ........................................................................................................ 17

SAMPLE BOOTH LAYOUTS ................................................................................................................................ 18

BOOTH MANAGEMENT DURING THE SCREENINGS .................................................................................. 19

CLOSE DOWN/TAKE DOWN OF THE BOOTH ................................................................................................ 21

SCREENING TECHNICIAN TRAINING CHECKLIST ..................................................................................... 22

PRACTICE SECTION ............................................................................................................................................ 23 APPLICATION SECTION ..................................................................................................................................... 24

SCREENING SUMMARY SHEET ......................................................................................................................... 25

SCREENING SUPPLY & EQUIPMENT INVENTORY FORM ......................................................................... 26

SCREENING SITES: SCHEDULING AND MAINTENANCE ........................................................................... 27

WHAT TO SAY ...................................................................................................................................................... 27 TAKING CARE OF YOUR SCREENING SITES .................................................................................................. 28

SCREENING EVENT CHECKLIST ...................................................................................................................... 30

SIGNS FOR SCREENINGS ..................................................................................................................................... 31

PRE-APPOINTMENT COURTESY CALLS ........................................................................................................ 32

MARKETING DEPARTMENT PURCHASE ORDER REQUEST FORM ....................................................... 33

SCREENING SCHEDULE SHEET ........................................................................................................................ 34

SAMPLE HEALTH CARE CHECK ...................................................................................................................... 35

SAMPLE LETTER: THANK YOU ........................................................................................................................ 36

SAMPLE LETTER: CONFIRMATION OF SCREENING ................................................................................. 37

SAMPLE LETTER: REQUEST FOR SCREENING ............................................................................................ 38

SIMPLE PROCEDURE FOR MEDICAL (MD/DC) SCREENINGS .................................................................. 39

SAMPLE REGISTRATION FORM FOR MD/DC SCREENINGS..................................................................... 41

LETTER TO SET UP OSTEOPOROSIS SCREENINGS .................................................................................... 42

IN-STORE OSTEOPOROSIS SCREENING ......................................................................................................... 42

ADDITIONAL NOTES ON OSTEO SCREENINGS: ........................................................................................... 42

LETTER #2 FOR OSTEOPOROSIS SCREENINGS ........................................................................................... 44

PURPOSE OF CHIROPRACTIC PUBLIC HEALTH SCREENINGS

Definition: Screening - Preliminary procedure, such as a test or examination,

done in order to detect the most characteristic sign or signs of a disorder that

may require further investigation.

- Mosby's Medical and Nursing Dictionary A screening is a public service provided by health care professionals designed to physically check a large number of people for specific health care problems. The term is derived from the word "screen," as if by passing people through a certain type of grid, everyone passes through the screen except for those that may have certain health care problems. Given the above paragraph, the purpose of a screener is obvious. Purpose of a health care screening: To get everyone in the community with spinal disorders (subluxations) treated through chiropractic adjustments. To check or test as many people as possible for spinal problems by locating any characteristics or symptoms which may originate from a spinal disorder, and getting those individuals that do have such characteristics to the most appropriate chiropractor as soon as possible for a more thorough examination and treatment, if indicated. The key points to the screenings are then: 1. Having lots of people to screen. 2. Checking them in such a way as to look for and locate any possible signs of

spinal disorders. 3. Making the person who is screened aware of the problem, or possible problem

such that they understand:

a) what the problem is, or may be. b) what the harmful effects would therefore be. c) what the consequences of non-treatment would therefore be. d) that therefore, they need to have the possible problem looked into, as

necessary, and handled as quickly as possible. 4. Scheduling the person for a more thorough examination. 5. Getting them to the examination.

Screenings can be very effective as a promotional procedure. Where they are not, one or more of the above five points are not being done properly. More fundamentally, if screenings are not proving effective, those performing the screenings may misunderstand the definition or purpose of screenings. For example, if someone with a sales background is performing the screening, they may be more interested in selling and closing the person being screened for a free exam at the doctor's office than on locating signs of a spinal disorder and educating those screened on what could be the cause. As a result, they may make a lot of appointments, but realize a very low percentage of kept appointments. On the other hand, many staff are more effective at screening than some doctors. Many younger doctors can become so technical in explaining chiropractic to people being screened that they can get carried away, and never make an appointment for the people who may need to be seen. Properly done screenings are truly a humanitarian public service. They require a tremendous amount of genuine care and concern for each person being screened. The degree that the screener cares about each person being screened greatly determines how effective he or she will be in achieving the purpose of a screener.

SCREENINGS STILL WORK!

Screenings still work! The problem with screenings over the years is that the old posture analysis machines, whether made out of PVC tubing or flashy chrome, have been used by two or three chiropractors at every outdoor summer event since the mid 80’s. This has a tendency to get boring if not annoying to potential screenees. Additionally, with closed panel insurance plans, the office that screens a potential patient is often not a provider for the insurance plan of the person whom they are screening. So, it can be tougher than it once was. Despite this, we have offices that still produce new patients from screenings.

The most important ingredient to any successful screening is the attitude of those doing the screening. Are they upbeat, forward, friendly and talkative, motivated by a strong sense that people need to be free of the stresses that your office can remedy? The second most important ingredient is a thorough objective and/or subjective screening done with excellent communication. And of course, third, where appropriate, the scheduling of the appointment.

To update your screenings, and make them more productive:

You can bring in other testing tools, such as SEMG, Metracom, etc.

You can also offer different and more services. Consider “flexibility testing,” computerized range of motion or “joint mobility testing,” back and neck analysis, etc.

You can also offer a free “pressure point” check, a five-minute massage for all local community members who get a posture analysis, a drawing for a free ice pack for anyone who receives a complimentary spinal screening, etc.

You should also try to do cooperative screenings with other chiropractors if you can find out ahead of time who is planning to participate in the event.

You can also set up alliances with other chiropractors, or other doctors such as podiatrists, dentists, etc., while at the event. These alliances can also serve you long after the screening event is over.

But most importantly, invest in the people doing the screenings. Their skill and commitment is more important than testing machines. Limit screenings to 4-5 hours maximum per staff, if possible. Keep it fun. Make sure there are enough people to help, and set up a training or rehearsal time beforehand to go over and practice, if necessary, the screening procedure. (We can help with the training.)

One other note: Screenings are both direct and indirect marketing. That is, although you should work to get appointments made for a complimentary consultation and exam at your office, you should also use this time simply to network and hand out cards. Nothing works better than face-to-face marketing in our media saturated environment. Even if the person does not come in immediately, if they had a good experience with a friendly person, they will be more likely to see you in the future. We have seen people make appointments months later from screenings, or from other sources such as patient referrals, that said they had also talked to the doctor or staff at a screening event.

WHY DO SCREENINGS: A TESTIMONIAL

A message to staff and doctors: Why Do Screenings? Read the following unsolicited testimonial from a patient.

“Thank you Doctor. ...I no longer have lower back pain.”

SCREENING SEQUENCE AND OUTLINE

1. GREETING

Friendly greetings to people walking by: “Hello.” [Smile]. “How ya’ doing?”. “How’s your back today?” Maintaining a “welcoming” attitude.

2. OFFER

“We are doing posture screenings today, checking for problems with the spine. It will only take about 5 minutes. There is no charge. So, what’s happening with your back?”

3. SCREENING

Fill out questionnaire; verbal screening (getting info. on symptoms, health problems); objective screening (use of analyzer, twin scales, palpitation, etc.)

4. AWARENESS OF

HEALTH PROBLEM

Review information obtained, give a brief education on what might be the problem, relate to symptoms, possible causes, effects, and possible consequences if untreated.

5. SCHEDULING AN

APPOINTMENT

Recommend a professional check up if needed. “I would like to see you (or my doctor, Dr. __). There would be no charge for the initial consultation. We have some times set aside for these services…which would be best, mornings or afternoons?”

Your Success Is Determined By:

a) Numbers – how many screened.

b) Positive Mental Attitude.

c) Level of your interest and care for each person screened.

d) Willingness to be overt.

e) Willingness to control people.

f) Degree person screened is made aware of possible health problem, and a desire created to improve it.

g) Degree you want to succeed.

SCREENING PROCEDURE The following are additions to Steps 1-5 on "SCREENING SEQUENCE AND OUTLINE" and should be done as routinely as possible:

1. Greeting. When contacting people that go by, acknowledge that person by looking

at them, smiling or waving. 2. Offer. After you have presented your offer to a potential screenee, and they have

indicated that they would be interested, ask them to have a seat. Try to have them sit facing away from other booth traffic. Give them a clipboard and pen, and ask them to fill out our Registration Form. Walk away. If they are hesitant, fill it out with them.

3. Screening. After the screenee has filled out the registration form, go ahead with

the screening. Get information about their symptoms. Get a brief health history. Go over their Registration Form with them. When you have an idea of what the problem is, do the physical part of the screening, utilizing the posture analyzer, SAM machine, twin scales, palpitation, whatever you can do. Also, if appropriate, touch the person's area of complaint so that they know that you know where their problem is located. The sequence of this can be reversed, where you obtain the objective (SEMG, posture, etc.) information first.

4. Health Awareness. On step 4, review the information that you have obtained so

far. Explain what looks to be the cause of their problem and why. Use the plastic spine and educate them on what may be their problem. You can also get more information about their problem, its history, degree of severity, etc. Get them to tell you how it affects them in life, at work, etc. You can tell them what might be the problem, such as a “pinched nerve”, but there is no way of telling without further testing. Emphasize “might”, or “could be.” This is important. Educate them on what might be the consequences, if this is the cause of the problem, if left untreated. Do this only until you know the person wants help. When you know this, go to Step 5.

5. Appointment. A good closing for a doctor for scheduling an appointment is: "I'm

pretty sure we can help you, but I need to do a thorough exam to find out for sure. That's what I'd like you to do - come in for an exam!! There's no charge when you bring this coupon. Will you come in and let me see if I can help?"

This could be changed for a non-doctor to: "It certainly looks like you may have a spinal problem. I am not a doctor, and this is just a screening, but I think that you should get that checked out professionally, just to be sure. Chiropractors specialize in the location and correction of spinal problems. Their approach is natural and not surgical. If they feel that the solution to your problem cannot be helped naturally, they will refer you to a specialist. Do you see one now?” “No” “No? OK, then I would like you to see my chiropractor, Dr. ____. She will perform a thorough

chiropractic examination and consultation, and should be able to tell you what is going on here with this problem. She has set aside some times for people who are participating in this screening, and there is no charge for the initial examination. Since she has limited times set aside, I would like to make an appointment for you if that is all right. Based upon their complaints, history, the preliminary screening findings, and your care and direction to see a chiropractor, they often are happy to schedule an appointment.

Once they have indicated that they would like to see the doctor for a more thorough exam, use the following appointment procedure.

APPOINTMENT PROCEDURE

1. Write the appointment in the schedule book with the screenee's phone number.

2. Fill out the Health Care Check. (Fill out the stub only if you didn’t screen the person and are just making an appointment or have no Screening Registration form for your files.)

3. Make sure to write in the appointment time on the Health Care Check, as well as the check itself, and the location of the appointment.

4. Give the screenee a copy of his/her screening results, circling the location where the appointment will be, and also on the Health Care Check.

5. Give the screenee any pamphlets that may be helpful, or relate to their symptoms.

6. When giving the screenee the Health Care Check, tell him "It is important to bring this (the Health Care Check) in with your appointment. We are setting time aside for you, so please try to be on time. Someone at the office (try to use the staff person’s name if you know it) will call you the day before your appointment to confirm it and to make sure you know the best way to get to the office. Thank you so much for your time. I am glad that you made an appointment (or stopped by)...I think it’s the best thing for you.” Thanking the future new patient for their time, and complimenting and validating their decision to see you (or another chiropractor) is important.

7. Place a copy of the Screening Registration Form in the folder for the office that the person screened will be going to for future follow up.

8. Fill out the screening summary form.

9. Straighten up the booth, if needed.

Remember that during a screening, whether at a County Fair, Health Fair, Lifestyle show, or just in a mall or store, people are going to see many exhibits, displays, etc., and have lots of distractions. You must impress on them, in a short period of time, that;

You are interested in them, individually.

That they MAY have a problem that could get worse, but that might also be able to be fixed or improved.

You care about them.

You believe you can help.

You want to help.

The person should come to you or your office for help.

SUCCESSFUL SCREENING PROCEDURES After reviewing past successful screenings at various locations, including county fairs, in malls, etc., the most successful screenings had the following in common:

1. A very cheerful, friendly, and outgoing "Greeter" effectively and actively directing

traffic into the screening booth. 2. A legitimate and valuable public service professionally represented. 3. A high quality professional and technical service actually provided. 4. The results of this high quality service professionally and effectively communicated

to the public individual. 5. A cheerful and professional assistant effectively scheduling the public person for

an appointment such that the new person actually arrives at the clinic.

To help ensure that these occur, the following steps should be followed:

All screenings must actually perform a professional and high quality valuable

technical service. That is, screen. (The definition of a screening is: "Preliminary procedure, such as a test or examination, done in order to detect the most characteristic sign or signs of a disorder that may require further investigation." {Mosby's Medical and Nursing Dictionary})

Use the posture analyzer. Doctors can also palpate and do basic range of motion. Also, when available, use of the twin scales to check weight differential in should be used.

All screenings must be represented as professional and high quality valuable services. Staff and doctors must dress professionally. Also, staff and doctors should wear name tags. The public does judge you by appearance, at least until they can judge you by your service.

All booths must look clean, neat, and professional. This does not mean that we need lots of expensive equipment, but it does mean that more attention to the setup of the booth needs to be made. Clean and neat posters (without Scotch tape stuck to the outside), signs, charts, and even a vase of flowers or two.

The public must be professionally and effectively educated on the results of their screenings. Give each person screened a copy of their screening registration form showing the readings of their tests, along with a pamphlet, whether or not they make an appointment.

Probably most important, the entire screening procedure must be initiated by a focused, cheerful and effective effort to greet people and direct them to the screening service. When the screening is completed, if the screening has revealed a potential health disorder, an effective effort must be made to have the person screened make an appointment.

Where appropriate and possible, try to schedule two people per screening, one for the PR/Sales functions, and one person to provide the valuable technical service. It does not matter who does what function, just that each function is actually being done. Many times one person alone has performed a productive screening, but only by ensuring that each function is excellently done.

SUMMARY

An effective public screening, lecture, and any promotional event is 50% public relations/sales, and 50% high quality technical service, that follows the five steps mentioned above. The success of our promotional programs depends only upon how well we do each step.

2. Registration form completed.

3. Verbal Screening

4. Objective Screening

5. Report of findings and

recommendations

50% PUBLIC RELATIONS - 50% TECHNICAL SERVICE FLOW CHART

Public Relations/Sales Valuable Technical Service

Person to be screened

1. Person greeted and

directed to screening

6. Scheduling those in need

for an appointment as soon

as possible.

7. Person just screened,

leaving with a copy of

registration form, coupon,

and any relevant

pamphlets, AND

HAPPILY LOOKING

FORWARD TO SEEING

THEIR

CHIROPRACTOR.

Folders for front desk staff at

different offices

Marketing Dept.

for follow up.

PAPER WORK

Summary Sheet

Registration Form

Appointment Sheet

SCREENING BOOTH MANAGER

SCREENING OPERATIONS: Set Up, Supervision, Take Down

Every screening has three basic activities. These are:

1. The ongoing administration and maintenance of the screening booth. 2. The promotional and public relations functions of the booth. 3. The technical functions of the screening booth.

At larger screenings, such as those during county fairs or health fairs, there is usually a great deal of traffic. A well organized and efficient booth can be three times as effective as an unorganized booth. In busy fairs, a hundred people can rush by your booth every fifteen minutes. With such a high volume, the likelihood for disorganization, wasted opportunities, and frustration can be high. A well organized booth has a certain flow where all the people who are being screened and all the resultant paperwork gets smoothly, properly and quickly routed. (See the following diagram.) The Booth Manager is simply a title given to a number of duties that pertain to a screening booth other than the actual screening procedures themselves. It is usually done by one of the people screening while the screening is taking place. It is a role that can be shared, transferred, and delegated to other staff or doctors.

The Booth Manager's job is to put up and maintain an effective and good looking booth throughout the duration of the scheduled screening. This will allow those doing the public relations and technical functions of the screening booth to concentrate on the people with whom they are working, and not on the maintenance of the booth itself. As you will be able to see below, this includes everything from keeping the balloons blown up, to making sure that the appointment books are kept current.

SET UP/START UP OF THE SCREENING BOOTH

____1. Read the contractual agreements with the fair organizers or mall administration to ensure that all rules are being followed.

____2. Ensure that the booth is set up and ready to go at the time stipulated in the

contract. ____3. Well before the first day of screening, check over your materials and make

sure that you have sufficient equipment and inventory for an effective screening. Review the graphic on “Simple Booth Layout.”

____4. Make sure that you have any special equipment that may be needed for this

particular screening to ensure that your booth "fits in" and is appropriate with the particular function. For example, a sign indicating that "Chiropractic Reduces Health Care Costs" at a business exposition.

____5. Make sure that your posters, stands, tables, chairs, etc., are in good working

order. If not, please do the proper maintenance. ____6. Make sure that you have enough banners and signs that would be appropriate

for this particular event. ____7. Make sure that you have current appointment book schedules for each office,

as well as necessary doctor cards, coupons, screening forms, pamphlets, posture analyzer, twin scales, x-rays and view box, hand outs, tables and table cloth, flowers, chairs and stools, stands for posters, posters, fans, etc.

____8. Before the screening starts, make sure that the booth is swept, dusted, and

generally cleaned up. Make sure that all liter is in garbage cans and that people have put their personal items under tables and out of sight. Discard any old cups, soda bottles, etc. Be at the screening site to do this at least 1/2 hour before the screening is schedule to begin.

____9. Make sure that you and others are wearing name tags, and if available,

wearing your professional shirts. Make sure that you and anyone else who is starting out the day, looks professional, and starts out with a cheerful and ready attitude to work with new people.

____10. Make sure that the appointment books are clearly marked with which office is

which. ____11. Make sure that the placement of the registration forms is clearly marked and

known by everyone screening. Make sure that all screening materials at the booth are neatly located and that everyone at the booth knows where they are.

____12. Make sure that you have an extra "stand by" staff member, in case of an emergency.

____13. Make sure that there is a sign that indicates that the booth is from your office,

such as "Palmer Chiropractic Care Centers". ____14. Make sure that balloons are blown up and ready to go.

____15. If appropriate, arrange for a carpet to be placed in the booth.

Standing Out at a Screening Booth

Free pencils, pens, balloons, food, and other items.

A sign that says “Barney will be here at 3 p.m.” Rent a cartoon character costume

and show up a few times handing out balloons and treats to kids.

Fresh popcorn (check with fair management).

Animals. Rent a colorful lizard or some other animal.

New electronic screening equipment (implying a valuable service).

THE BEST: Friendly, gregarious (outgoing), attractive people being nice to everyone that goes by and being interested in them and encouraging them to come in for screening.

EXAMPLE OF SIMPLE BOOTH LAYOUT

Traffic Flow

Greeter &

“Appointmenter”

Flow of people into and out

of booth

Posture analyzer and

scales.

Table with pamphlets, spine, free pencils,

table cloth, etc.

Table for

office folders,appointment

book,

clipboards.

Doctor or ScreeningTech.

Palmer Chiropractic Office

Poster Poster“Free Posture ScreeningsFlexibility Testing”

Back Drop

Stools forreports of

findings andappointment

consultations

Stools forpeople to fill

out

registrationforms

Standard 10X10 Booth

Sample Booth Layouts

BOOTH MANAGEMENT DURING THE SCREENINGS

_____1. Obviously, and most important: Ensure that there are always sufficient screening technicians and/or doctors on hand during the screenings. Have an emergency phone number sheet ready in case you need to get a hold of some extra help.

_____2. Handouts. Do not put out the entire stock of pencils, rulers, etc., out on the

table. Keep most of them under the table and ensure that there are always a few to hand out on top of the table.

_____3. Throughout the screening time there is a tendency for litter to accumulate.

Make sure that cups, food, personal items and clothing are put away and out of sight. The booth should always look neat and clean, just like a professional office.

_____4. If there are balloons, make sure that there are enough to hand out when

necessary.

_____5. Ensure that there are enough screening registration forms and pencils/pens set up and ready to go.

_____6. Make sure that the tables and chairs are neat and clean.

_____7. KEEP THE FLOW FLOWING: Ensure that the screening job functions are being done. That is, make sure that people are being greeted and set up for screenings; that the screening registration forms are being filled out; that the posture analyzer is being used; that effective report of findings of the screenings are explained to everyone being screened; and that appointments are being effectively set. On occasion, there may be a line of people waiting to be screened while a doctor is doing greetings. In a case such as this, it would be appropriate to request that the doctor do some screenings, rather than greet. While those doing the screenings do need to take breaks, ensure that personal discussions do not become so common as to get in the way of performing the screening job duties.

_____8. Make sure that the screening personnel are fresh and up-beat. This may

mean that the screeners take a break every now and then so that they can become better focused on their job duties when they come back.

_____9. Make sure that all the paper work is current and completed, such as

appointment books and Screening Registration Forms, and that they stay in the booth during the day until you can distribute them later.

_____10. At least every two days, update the appointment books.

_____11. Make sure that the Screening Registration forms are routed as follows:

Original to Office

1st NCR copy handed to screenee at the end of the screening

2nd copy for screening coordinator

_____12. Maintain friendly relations with those people passing by that do not wish to be screened, with those that are screened but do not want to make an appointment, with other venders near our booth, and with the fair, mall, or business management. In short, increase the good will for your office.

CLOSE DOWN/TAKE DOWN OF THE BOOTH

_____1. Make sure that the booth is manned as long as is stipulated in the contractual agreements with the fair or mall administration. In other words, do not cut out early.

_____2. If the booth is open the next day, make sure that anything valuable, such as

TVs, model spines, etc., are taken out of the booth and brought back the next day. Depending upon the security overnight, other materials may need to be taken out and brought back the next day. Usually, most of the material can be left out or put into plastic bins and stored under the tables.

_____3. Each evening, or as indicated by the screening coordinator, distribute the

completed registration forms from those people who have made appointments, to the offices where they will be seen. Also, drop off the appointment book schedules so that the front desk can schedule in the new patients appointments.

_____4. New patients that are scheduled for the next day are to be personally, by

you or as agreed upon by the screening coordinator, called up that evening to confirm their appointment for the next day. This is important as, often the confirmation call needs to be made before you are able to inform the front desk CA about the scheduled new patient.

_____5. When the evening is over, make sure that all the material gets put back in

the same location from which it was taken.

_____6. Make sure that the banners are rolled up neatly with the letters showing on the outside.

_____7. A pamphlet inventory sheet should be used for each screening. After the

screening is over, recount the pamphlets and update the inventory sheet.

_____8. Check all of the equipment for damage. Clean and repair all equipment before you move on to future screenings. Note any damaged equipment or supplies that need to be repaired and submit a purchase order to fix it or personally repair it yourself.

SCREENING TECHNICIAN TRAINING CHECKLIST The following items need to be completed before the Screening Technician can receive any bonuses. The bonuses can be earned, but not paid, until all items have been completed. Use a different sheet of paper to answer the questions, and place numbers by each answer corresponding to the item on this checklist.

Please initial and date each item.

_____1. Watch 2 patient education videos.

_____2. Receive a consultation and examination from one of our doctors.

_____3. If available, attended a Spinal Care Class.

_____4. Have the doctor to tell you of at least two of his or her biggest successes with chiropractic on patients.

_____5. On a sheet of paper, attached to this checklist, define in your own words: Chiropractic.

_____6. On a sheet of paper, attached to this checklist, and using the chiropractic pamphlets, write out a brief history of chiropractic.

_____7. Using the chiropractic pamphlets, describe the difference between conventional medicine and chiropractic.

_____8. Using the chiropractic pamphlets, list at least one study that documents how chiropractic is more effective than medical techniques.

_____9. Study the article: "Purpose of Chiropractic Health Screenings".

_____10. Define in your own words the purpose of spinal screenings.

_____11. List at least one incorrect method of screening as mentioned in the above referenced article.

_____12. Using the chiropractic pamphlets, list two examples of possible spinal disorders.

_____13. Describe why you should only mention to the screenee that they "may" have, or "might" have a spinal problem.

_____14. Explain whether or not chiropractic screenings are a humanitarian activity. Include your reasons.

_____15. Explain what happens to your kept appointment percentage if you don't fully establish, to the screenee's understanding, what his/her health problem is, and its relative degree of importance.

_____16. Study the article: "Screening Sequence and Outline".

_____17. List out two examples of how you may contact people.

_____18. List out two different explanations of what you as a screener are offering.

_____19. Explain why someone would need to have a spinal screening.

_____20. Explain what are you trying to determine, or establish when screening someone.

_____21. Study the article: "Screening Procedure".

_____22. From the above article, explain the three things about which you want to educate the screenee. Why?

_____23. Explain why your genuine care about the screenee is so important.

_____24. Explain what is meant by a Positive Mental Attitude, and why is it so important.

_____25. If available, watch a video on how to do screenings.

_____26. Read the article "Successful Screening Procedures".

_____27. Read the article "Screening Booth Manager"

PRACTICE SECTION _____28. Practice with an experienced screening technician three different screenings

on three different fictitious people, going over the following points: Practice Practice Practice Screening #1 Screening #2 Screening #3

a)___ Greeting a)___ Greeting a)___ Greeting b)___ Offer b)___ Offer b)___ Offer c) Screening: c) Screening: c) Screening: ___ screenee seated ___ screenee seated ___ screenee seated ___ forms completed ___ forms completed ___ forms completed ___ info on symptoms ___ info on symptoms ___ info on symptoms ___ posture analyzer ___ posture analyzer ___ posture analyzer d) Report: d) Report: d) Report: ___ education ___ education ___ education ___ establish potential ___ establish potential ___ establish potential need need need e)___ Appointment e)___ Appointment e)___ Appointment f )___ Paperwork f )___ Paperwork f )___ Paperwork

_____29. If appropriate, study the policies or guidelines for the mall, fair, or other

location where you will be doing the screenings. "I will comply with these policies of _______________________ (Mall, etc.)." Initialed _________.

APPLICATION SECTION _____30. Go to a screening in progress:

___a) observe ___b) assist ___c) do the screening procedure while supervised ___d) do it solo ___e) make appointments

"I attest that I have completed the above actions, and am now ready to do my best to provide high quality screenings to as many people as possible such that many of those people who have potential spinal disorders will come in to see the chiropractors for further help." Signature __________________________________ Date___________________ When completed, please return to the Office Manager for a verbal review the checklist.

SCREENING SUMMARY SHEET (This sheet must be filled out for every appointment made)

LOCATION OF SCREENING______________ DATE BEGAN_____

DATE NAME PHONE SCREENED? APPT

DATE

APPT

TIME

WHICH

OFFICE?

SCREENER

1. / / Y/N / /

2. / / Y/N / /

3. / / Y/N / /

4. / / Y/N / /

5. / / Y/N / /

6. / / Y/N / /

7. / / Y/N / /

8. / / Y/N / /

9. / / Y/N / /

10. / / Y/N / /

11. / / Y/N / /

12. / / Y/N / /

13. / / Y/N / /

14. / / Y/N / /

15. / / Y/N / /

16. / / Y/N / /

17. / / Y/N / /

18. / / Y/N / /

19. / / Y/N / /

20. / / Y/N / /

Page #____

SCREENING SUPPLY & EQUIPMENT INVENTORY FORM (What is needed and where it can be found)

Event:___________________________ Dates:______________

Item: Needed? Location Need to be

Ordered:

Adjusting table

Backdrop/Case

Balloons & ties

Banners

Business Cards

Carpet

Chairs (#__)/ Stools((#___)

Clinic Appointment Schedules

Clinic Company Sign(s)

Clinic Folders

Clip boards

Dynatron/SAM

Easel

Extension Cords

Fan

Flowers

Flyers/coupons

Free Screening Sign(s)

Give-a-ways

Health Care Checks (coupons)

Mirror

Model Spine

Pamphlets(on inventory sheet also)

Posters

Poster Analyzer/ PVC

Poster Analyzer/Metal

Screening Registration Forms

Summary Sheet

Sweeper

Tablecloths____

Tables________

TV

Twin Scales

Videos

View Box

X-ray

Other

SCREENING SITES: SCHEDULING AND MAINTENANCE

Locate, by direct observation, asking patients and members of the community, looking through the newspaper and Chamber of Commerce information, for areas where there is high traffic count. This may include such locations as malls, fitness clubs, and special events where there are many people, such as county fairs. Contact personally by phone or personal visit the person in charge, and explain what you want. A follow up is often necessary, either by a scheduled meeting, and or mailing information.

WHAT TO SAY This is an example of what to say: "Hello. My name is ______ and I am with ________ Chiropractic Center. We have a (new) office in town, located at ____________. We provide Chiropractic care services to people who have back pain and neck pain and other problems, and also to those who just want to be healthier. [ After your brief introduction, allow some time for the other person to comment, say "oh, really!", or whatever. ] "Yes...and to help get known in the community...we are offering free community services to various business and clubs in town. [ other person may say..."you don't say", or something similar ] "Yes...we do spinal screenings, posture screenings, short talks and workshops on injury prevention, pain management, and on other health related topics. [ At this point you may want to ask them questions about their business. Get to know their business, and get to know the person with whom you are talking, as well. Be interested. ] [ Once you have a relatively good understanding about what they do, or you have asked as many questions as they are willing to answer, determine what service would be best for them. A screening, a lecture and a screening, a workshop on headaches or prolonging life and extending health (for seniors), etc. ] [ You can explain your proposal along the following lines: ] " ...is that so. Well, from the looks of it, you are doing a very good job here. “What I would like to offer you is [your proposal] that we set up once or twice a month, a spinal screening booth here for your customers. It would include a spinal/posture

analyzer, pamphlets on health care, and a screening technician and sometimes Dr. ____________. The screening takes about 5 minutes, and most people find it very informative. What we are looking for is spinal or postural disorders that may be causing pain, now, or in the future. If there are any indications, we give the person some information about his or her symptoms, and often recommend they see their chiropractor. [ pause for questions/comments ] "This of course would be a service for your customers, who would credit you for making this free service available to them in your business. Its an "extra" that you can consider yourself providing for your customers, for which they are usually quite appreciative. "As well, we would of course refer our patients to your business. Exercise is an important part of health care, and we would be happy to recommend our patients to the "Y". [ or to your business, etc. ] "Additionally, we often do press releases about our screenings, and would include your business in the press release which would be free promotion for you. [ pause for comments ] "So how does this sound? "Good, we would like to get going right away. We need about [ 3-5 hours ] per screening. When are your busier hours." [ Schedule a time. Offer him a free coupon for care, and tell him that you would also like to screen him, if it is all right - keep it very light here ] If he has to check with the head office, wants more information, or whatever, try to narrow it down to the exact steps that need to happen before you can start with your service. Don't be pushy, just be curious to see how you might help with the decision process. Send or leave him with the information he needs, and set up a future date for you to contact him. Once you have confirmed a site, follow up your meeting with a nice letter telling the person with whom you met how you enjoyed meeting him, and that you are looking forward to working with him in the future. Also, tell him that if there is ever any problem, for him to call you at any time.

TAKING CARE OF YOUR SCREENING SITES With anybody that you are doing screenings with, malls, stores, etc., always treat them very special. This would mean: a follow-up letter thanking them for the time that they

took to meet with you, and another thank you letter after your first screening. Tell them good news about how their customers enjoyed the screenings, with any cheery or interesting anecdote. For example, "...Mrs. Jones was so appreciative of what she learned at our screening, that she went and bought five more memberships for her whole family at your club." You can also send a note to the business owner or manager when our office referred someone to him. Send Christmas cards or gifts, and take him out to lunch every six months or so just to keep things friendly, and to stay in touch. Always be alert to any potential complaints, and handle any that come up quickly. Also, notice in the paper when he has done something special, and send him a complimentary note saying that you liked his ad in the paper, or the press release regarding his nomination for best business, etc. These are the little things, that in the long run, pay off.

SCREENING EVENT CHECKLIST

Screening/Fair:________________________________________________________ Dates: _________________________ Location:________________________ Address: _________________________ Booth:__________________________ Contact: _________________________ Phone:__________________________

ADMINISTRATION: 1. Contract Received Y / N 2. Contract Sent Out - Date:________________ Y / N 3. Contract Amount $____________ 4. Deposit Paid $____________ Date:____________ Y / N 5. Balance Paid $____________ Date:____________ Y / N 6. Security Deposit Paid $___________ Date:_______ Y / N 7. Certificate of Ins Needed Date Sent:___________ Y / N 8. Electricity Needed Amt$_______ Date Sent:______ Y / N 9. Parking Passes ____ Free Y / N 10. Parking Passes ____ ($_________) Date Sent:_________ Y / N 11. Admit Passes _____ Free Y / N 12. Admit Passes ______ ($_________) Date Sent:_________ Y / N 13. Schedule Completed Y / N 14. Binder Completed Y / N 15. Set Up Crew (Who & When______________________) Y / N 16. Tear Down Crew (Who & When______________________) Y / N 17. Supply (______________) Ordered Date: __________ Y / N 18. Supply (______________) Ordered Date: __________ Y / N 19. Supply (______________) Ordered Date: __________ Y / N 20. Other____________________________________________ Y / N 21. Other____________________________________________ Y / N 22. Other____________________________________________ Y / N

Special Theme? _______________________________________________________ Special Equip/Supplies: _________________________________ _______________________________ _________________________________ _______________________________ _________________________________ _______________________________ _________________________________ _______________________________ _________________________________ _______________________________ _________________________________ _______________________________ Number of Appts:_______________ Number of New Patients:___________________

SIGNS FOR SCREENINGS

Examples of Posture Screening signs that can be used.

This sign can be a banner or on a light plastic board suspended across the back of your booth. Variations include adding other screenings, such as “Flexibility Testing,” “Scoliosis Screening,”...etc. You want to represent to the public that you are providing a valuable service.

This sign can be placed on the front of your table, or underneath or to the side of the above sign. It is smaller than the main sign. The prospective patient has to come into the office for screening, but, as a public service, can make a special appointment for the no charge service there at your booth.

Schedule yourself or a friend for a

F r e e

Carpal Tunnel Screening

Palmer Chiropractic Office

Free Posture and Spinal Screening

PRE-APPOINTMENT COURTESY CALLS

If you are just completing your screening, please be sure to follow-up with “courtesy calls” to all of the people who have made appointments. They should be called 1-2 days before their scheduled appointment. For example: “Mrs. Jones, this is Laurie from Palmer Chiropractic. I am calling about your appointment tomorrow afternoon at 3:00 p.m. with Dr. Palmer. Do you know how to find the office?” Try to have a copy of the screening registration form with you when you call them, and refer to their symptoms as appropriate. Check the spelling of their name. You may want to offer to move their appointment closer in time. Be very courteous. End your conversation with something like: “Thank you for helping me, Mrs. Jones. Dr. Palmer is planning to see you on Wednesday at 3:00 p.m. I look forward to seeing you then.” Keep in mind that most people appreciate a courtesy call for their appointments. It is a usual and customary procedure. Try to contact the individually personally, rather than just leaving a message for the potential patient. Don’t harass them, but you can usually try 2-3 times before leaving a message. Try to call late afternoon or early evening when you may catch them after work. Kept appointment percentages from screenings are usually much lower compared with regular patients. Most people made appointments between booths at fairs, rides, while handling their kids, etc., and may not even recall the appointment. Don’t be dismayed if not all of the appointments come in. Anything greater than 50% is good, though don’t be disappointed if it is less. With Pre-Appointment Courtesy Calls, you can greatly improve your percentage of kept appointments, and help insure that you get the most out of our screenings.

MARKETING DEPARTMENT PURCHASE ORDER REQUEST FORM TO: (1)____________________________ DATE OF REQUEST:_______________

(2)____________________________ APPROVAL NEED BY:_______________

(3)____________________________ CHECK TO BE MAILED OUT BY:_______________

FROM:____________________________ CIRCLE ONE: Standard Item / RUSH ITEM

ITEM QUANTITY AMOUNT

TAX:

SHIPPING & HANDLING

TOTAL

This is a regular item:____ a new item:_____ other:____________ Provide information why this needs to be purchased or other relevant information needed for approval. Use another sheet of paper if needed. ____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

This order will be paid by: check / c.o.d. / billed / credit card Check or C.O.D. is to be made out to name:__________________________________ Address: _____________________________________________________________ City:__________________________________ State:________ Zip:_______________ ________________________________ ________________________________ Requesting signature Authorizing signature If disapproved, reason: ____________________________________________________________________________________________

____________________________________________________________________________________________

SCREENING SCHEDULE SHEET

EVENT:____________________________ DATES:____________ TO ____________

Times Monday Tuesday Wednesday Thursday Friday Saturday Sunday

/ / / / / / /

7:30 AM

8:00 AM

8:30 AM

9:00 AM

9:30 AM

10:00 AM

10:30 AM

11:00 AM

11:30 AM

12:00 PM

12:30 PM

1:00 PM

1:30 PM

2:00 PM

2:30 PM

3:00 PM

3:30 PM

4:00 PM

4:30 PM

5:00 PM

5:30 PM

6:00 PM

6:30 PM

7:00 PM

7:30 PM

8:00 PM

8:30 PM

9:00 PM

9:30 PM

10:00 PM

Note: Try to maintain 4-5 hour shifts. Two people during peak times, one Greeter and one

Screener. Asterisks next to person acting as Booth Manager. Include set up and take

SAMPLE HEALTH CARE CHECK

SAMPLE LETTER: THANK YOU The following “Thank You” letter should be used after a successful screening has taken place. Ensure the letter is personalized, and delivered in a timely manner.

October 6, 1997 Mr. John Doe John’s Health Club 2525 E. First Avenue Anytown, WI 54321 Dear Mr. Doe, We would like to thank you for all your help and involvement in the setting up of our Spinal Screening held on September 18 at your health club. It is our goal to educate the Anytown area about drug-free health maintenance. With the help you provided, we came closer to achieving that goal. Your members showed a genuine interest in our service and have benefited from it as well. Again, thank you for taking the time to make this the success that it was. I look forward to working with you in the future. Sincerely, Jane Doe Public Relations Director

SAMPLE LETTER: CONFIRMATION OF SCREENING In addition to a verbal confirmation of an upcoming screening, many prospective screening sites require a written confirmation for their records. A personalized and professional letter, detailing the specifics of the screening, should be used.

October 6, 1997 Mr. John Doe John’s Health Club 2525 E. First Avenue Anytown, WI 54321 Dear Mr. Doe, I am writing to confirm the free muscle and spinal screenings to be held on January 1, from 5:00 p.m. to 9:00 p.m. This will be a public service of Palmer Chiropractic Clinic. Enclosed is a copy of the announcement for the club. Dr. Smith from Palmer Chiropractic Clinic will be coming by to post them. I have also enclosed a copy of the press release that we will be sending to the local newspapers and radio stations. Thank you for your continuing support in chiropractic. If you have any questions, please don't hesitate to call. Sincerely, Jane Doe Public Relations Director enclosures

SAMPLE LETTER: REQUEST FOR SCREENING

The following letter should be used when the manager at a prospective screening site asks you for a written request for holding a screening at his location. If you are having a difficult time contacting the manager of a prospective screening site, or the manager’s schedule doesn’t allow for a meeting in person, this letter can be customized and used.

October 6, 1997 Mr. John Doe John’s Health Club 2525 E. First Avenue Anytown, WI 54321 Dear Mr. Doe, As we discussed in our phone conversation of October 5, here is the information regarding the free community health and posture screenings. I am requesting that we give a free health and posture check at the store front of the Big "R" store located at 1234 Central Avenue in Anytown. The date(s) that we could perform these screenings are very flexible and can be coordinated with you. When we give health screenings we use a posture analyzer that measures three points of spinal straightness - hips, shoulders, and base of skull - along with side posture. Also used are dual scales to measure weight balance. The participant remains fully clothed and the exam usually takes 2-4 minutes. These screenings are very beneficial to your customers and the public. Aside from the screening itself, it will give them a free opportunity to discuss their health concerns and different options that can be taken to improve their health. Not only is this a valuable community service in which your store can take part in, but it also serves as a promotional action for you as we advertise your store and its location to the public. I will give you a call after you have received this letter to go over any other questions and to work out arrangements to start screening. Thank you for taking the time to help us in this community service. Sincerely, Jane Doe Public Relations Director

Simple Procedure for Medical (MD/DC) Screenings

1. Purpose: Please review the article on the purpose of screenings.

2. Two Aspects of Screenings: There are two aspects to screenings. One is purely clinical, and the other is promotional.

3. Three Phases: There are three phases to a screening:

a) Greeting and being a host. b) Actual screening. c) Recommendations and as appropriate, scheduling for a follow up appointment.

4. Roles: Whether there are five people working at a screening booth, or just one, there are three roles that need to be performed for a successful screening:

a) Greeter/Host b) Screening Technician c) Registrar

5. Screening Greeter: The greeter or host has the job to get people into the booth. She has them sit down and fill out a registration form or survey. She keeps people happy, educates those waiting, and gets more people as needed. She keeps the rest of the flow moving. If the Screening Technician is caught up with someone for too long, she politely interrupts and tells the ST that there are more people to be seen, and hands the ST the clipboard of the next person to be screened. (She can also get the weight and height measurements, or other measurements to facilitate with the screening.)

6. Screening Technician: The screening technician is looking for any possible signs of a health disorder. To do this, he or she usually has some type of objective testing equipment, such as blood pressure, body fat, SEMG, etc. The ST obtains two different types of information: objective and subjective. Objective information is gotten from the testing, and subjective information, the most important, is obtained from the patient through questioning. To obtain the objective information the ST has to be skilled with using the testing machines. The subjective information is obtained through inquiry facilitated by excellent communication, genuine interest, and trust. Questioning the screenee’s symptoms, how long he or she has had them, any accidents, etc., usually will illicit information that could indicate a need for a more thorough consultation with a doctor. It is best to have the screenee seated away from the front of the booth while obtaining the subjective information.

After obtaining the information, the ST then gives the screenee a brief report of the testing and any recommendations. These recommendations could be:

“Based upon the information you have told me as well as our tests… a) “Keep up the good work. No apparent need, at least from our preliminary screening, to

see a doctor. Since this is just a preliminary screening, however, you may want to just to be sure.”

b) “Looks like there might be a problem but can’t tell for sure. You should get that area checked into further by a doctor.”

7. Registration for consultation with a doctor: If the recommendation is for a more thorough consultation and screening examination, the ST or another staff member suggests that the screenee can see his or her own family physician, or make an appointment to see one of ours at NO CHARGE. It is obviously better if the ST can get the agreement from the person being screened to come into our medical office for a no charge medical consultation and screening examination.

“There is no charge for this, but we do have a limited number of appointments. Our doctors should be able to tell much more accurately what may be the cause of the problem, and will be able to advise you if they think that you should have the matter looked into some more -- or not to worry. However, I am not a doctor and this is just a screening, and I can not tell for sure what the problem is. You really should have that problem looked into some more. I would like to make an appointment for you to see one of our doctors.”

Once the screenee has agreed to receive a free medical consultation and screening evaluation, the staff member acting as the registrar makes an appointment with the person in an appointment book and gets their full name and phone number. She also gives them a business card, goes over directions on how to get to the office, and sets up a time for an office courtesy call. The registrar confirms with the person that the date and time are right because: “we do have a limited number of times available and I need to make sure we don’t have a doctor waiting and no one is there to be seen”. She also suggests that the screenee come by the office ten minutes before the appointment. Lastly, she fills out the “Screening Summary Sheet”, and makes sure the information gets to the office where the screenee has the appointment.

8. Other pointers:

a) Keep the flow going. b) Don’t be rushed by a long line of people waiting. Do a thorough job on each person. c) Don’t get caught up with people who are out-of-towners, “full time” patients, debaters or

arguers, of negative people. d) Only screen and work with people that you are truly interested in. e) Keep it fun.

SAMPLE REGISTRATION FORM FOR MD/DC SCREENINGS

Letter to Set Up Osteoporosis Screenings [Letter to send out before phone call] December 2, 1998

In-Store Osteoporosis Screening Dear Store Owner or Manager,

We want to provide a free service for your customers on your behalf.

As a public service, we are offering selected businesses a complimentary osteoporosis

screening performed in their workplace for their customers.

Osteoporosis has been in the news lately, and many people are becoming more aware of

this condition. They are looking for solutions and are concerned with whether or not

they may have this condition now or in the near future.

As a new medical facility, we are interested in getting our name out into the

community. To do so, we are offering local businesses a service for their customers

including:

Electronic Bone Density Analysis

Free report for home health records

State of the art testing with absolutely no discomfort and completely safe.

As simple as taking blood pressure which takes less than one minute to perform

Bone density scanning or x-rays is the usual procedure for determining osteoporosis.

Hospitals usually charge around $300 for this screening with a large x-ray machine.

We use state of the art revolutionary technology which provides a very low dose x-ray

(less than 1/100 of one dental x-ray) to the middle finger. The procedure takes less

than 1 minute. We use the accuDEXA by Schick Technologies, Inc.

We charge $135 for this procedure, but as a public service for your customers, we will

only be charging $25.

In summary: We will provide osteoporosis bone density screenings for your customers

at a discounted rate of $25 per person. You will promote the screening, (we will

provide the posters), and give us three hours during your busier traffic periods. In

turn, we get to help people and let them get to know about us.

We will call you soon to discuss this mutually beneficial plan, or you may call our

program coordinator, Sue at our Rome office at (123) 456-7890.

Sincerely,

Dr. Joe Jones

Northern Italy Medical Centers

Additional Notes On Osteo Screenings:

We use a devise called the accuDEXA. It is a bone densitometer that estimates bone mineral density (BMD) of the

middle finger of the non-dominant hand. It is a self-contained table top unit, employing dual energy x-ray

absorbitometery (DEXA) technology. After the finger is scanned, the results are generated in less than one minute.

Letter #1

Locations:

Pharmacies

Health Clubs

Health Food

Department stores: Walmart, Kmart

Letter #2 For Osteoporosis Screenings

December 2, 1998

Kroger Pharmacy

Mr. Joe Jones

4524 1st Ave.

New Turn, WI 12345

Dear Mr. Dysert,

Thank you for taking the time to talk to me today.

As we discussed, we are offering selected businesses a complimentary osteoporosis screening performed in their

workplace for their customers.

Osteoporosis has been in the news lately, and many people are becoming more aware of this condition. They are

looking for solutions and are concerned with whether or not they may have this condition now or in the near future.

As a new medical facility, we are interested in getting our name out into the community. To do so, we are offering

local businesses a service for their customers including:

Electronic bone density analysis

Free report for home health records

State of the art testing with absolutely no discomfort and completely safe

As simple as taking blood pressure which takes less than one minute to perform

Bone density scanning or x-rays are the usual procedure for determining osteoporosis. Hospitals usually charge around $300

for this screening with a large x-ray machine. We use state of the art revolutionary technology which provides a very low

dose x-ray (less than 1/100 of one dental x-ray) to the middle finger. The procedure takes less than one minute. We use the

accuDEXA by Schick Technologies, Inc.

We charge $135 for this procedure in our clinics, but as a public service for your customers, we will only be

charging $10, as we discussed.

In summary: We will provide osteoporosis bone density screenings for your customers at a discounted rate of $10

per person. You will promote the screening, (we will provide the posters), and give us three hours during your busier

traffic periods. In turn, we get to help people and let them get to know about us.

We have immediate openings available on Thursdays, Fridays, Saturdays and possibly a few Sundays over the next

two months. We will call you in soon to discuss this mutually beneficial service, or you may call our program

coordinator, Monica, at our Rome office at __ ________ to discuss reserving a time.

Sincerely,

Dr. B. J. Palmer

Northern Italy Medical Centers

Letter #2