By William D. Esteb

Are you still at the nodding-acquaintanceship stage of developing a relationship with your office computer? What used to be an almost endearing, anti-technology blissfulness is now starting to work against a growing number of chiropractors.

If you have resisted using software to run your practice, the growing opportunity to educate your patients through electronic media may seem even more overwhelming.

But soon, very soon, it will come close to replacing many of your low-tech patient communication overtures.

Relax. You can’t crash the Internet.

ACTIVE OR PASSIVE?

Before exploring how to best use the Internet to educate and cultivate new patient relationships, it is important to understand a critical distinction in patient education.

Regardless of the technology — the folded paper in your brochure rack, weekly lectures, or Web site — patient education comes in two flavors: active and passive.

Just as chiropractic care is more effective when the patient plays an active role, the same is true with your patient communications. The passive, “fix me” approach is not only time- and energy-draining, it rarely prompts the changes in a patient’s beliefs or behaviors that it intends to produce.

Active patient education (and patient care) is engaging. It is a healthy combination of efferent communications, followed up by afferent, inside-out feedback. This is why asking a question is so powerful. It is what you ask patients that produces change.

Asking causes the patient to reveal, sometimes for the first time, his or her behavior-shaping beliefs and perceptions — something that telling and teaching (rhymes with “preaching”) are unable to accomplish.

The sidebar “Cyberspace interactive learning” gives you a hint of how an Internet-based e-learning program can coach patients to a new level of understanding — something a brochure just cannot do.

Will patients go to your Web site and participate in these e-learning sessions? Most will — especially when you add a healthy dose of humor and entertaining images.

A critical factor will be how relevant and entertaining your site is. Few patients bolt for the door in the middle of a report of findings. Instead, most patients listen politely. But on the Internet, something more exciting is just a mouse click away.

So, you won’t be able to bore patients into participating. You’ll need a healthy mix of entertainment with your information. You’ll need to take a stand and be candid. A little self-deprecating humor can go a long way.

SAY GOOD-BYE TO PATIENT VIDEOS

I was at the birth of the first video-based patient education back in 1981. Since then, video has provided a convenient, but passive, tool for communicating basic chiropractic principles.

By saving time and ending some of the most repetitious explanations, video has been a workhorse for many practices. The Internet may soon make video-based communications obsolete.

But before you retire your patient education videos or DVDs, you’ll need to secure some space on the Internet. Get a domain name, establish a Web site, and use it to get and keep new patients, enhance the referral process, and supply a place where an apprehensive new patient can “check you out” without the obligation of crossing the threshold into your office.

WEB SITE BEST PRACTICES

If you recognize the need for a Web site, beware. Preying on the fears and technological naiveté of chiropractors, countless resources are ready to help you establish a virtual presence on the Internet. These range from largely passive “brochure ware” sites and those with flashy animation “eye candy” that ignores the engaging interactivity that is now possible.

If you already have a Web site, congratulations. Just make sure it measures up:

1. Use fewer words. Because a computer screen offers relatively low resolution (compared to paper), reading a computer screen is about 25 percent slower (that is, it is more difficult to read on a computer than to read a paper). Use half the words or fewer that you would normally use in print.

2. Design to browse. The software used to navigate the Internet is referred to as a “browser” for good reason. A recent study revealed only 16 percent of people read every word on a page. Instead, Web pages should be designed to facilitate scanning.

3. Use short sentences. Bold key words or phrases to improve the ability to scan and offer hyperlinks for those who want more detail.

4. Use images. The Web is a visual medium. In this way, the Internet is much like television. Because of the inclination to scan, make sure every image is accompanied by a caption.

5. Avoid bragging, exaggeration, and subjective claims. Forcing visitors to separate truth from hyperbole tests their patience and reduces your credibility.

6. Keep it personal. Set aside political correctness and “corporate speak.” Keep your Web site personal, in the first person. Poke fun at yourself or the myths about chiropractic. In this way, the Internet is similar to the intimacy of radio.

7. Keep navigation simple and intuitive. Prevent visitors from getting lost! Design by the maxim, “Don’t make me think!” Remember, something more interesting could be a click away.

8. Engage and inform. You can accomplish this by offering interactivity and entertainment. Offer little quizzes, e-learning modules, voting, and polling functions. Create an environment of self-discovery by posing questions, testing beliefs, and creating doubt about the mainstream symptom-treating healthcare establishment.

EARLY TRUMPS LATE

Have you ever typed “back pain” into your favorite search engine? If so, you have already noticed that the drug companies “get” the Internet as an educational/marketing tool for their wares and ideology.

Research shows that seeking healthcare information is the third most frequent use of the Internet. This may not reflect your usage, but patients have probably confronted you with a stack of articles printed out from Web sites they have visited.