How to Perform a High Conversion Initial Consultation

Overview

The most crucial appointments on the path of treatment is the Foundational Assessment. This appointment is critical because it allows you to both gather information about the patient, and inform them about how their care could look going forward. The Foundational Assessment is a 90-minute appointment with myself, where I describe in broad terms what the next steps of their treatment would be, and then additional follow-up appointments with both our health coach and nutritionist. Really it’s three appointments, but the broad purpose is all the same: to figure out what’s wrong and decide how to go about fixing it in the future. Now I’ll take you through what this process looks like from a patient’s perspective while describing how each step of this appointment is set up to ensure that the patient receives as much benefit from this as possible. 

Before the Appointment

Before the Foundational Assessment, you should have a brief discussion with the patient called a Discovery Call, in which you describe to them in broad terms what your organization is all about, as well as introduce the idea of the Foundational Assessment to them. If they’re interested in moving forward and decide to pay the fee, then it’s time to begin asking them for information about what specific issues they’re going through. This information is critical because it lets you as a provider know which labs to order in advance of the appointment, so that when the time of the appointment actually arrives you aren’t wasting either your time or the time of your patient. Receiving these lab results before the initial appointment is also very valuable because some patients may be in the acute stage of an illness, which may require treatment from their medical team that you just aren’t equipped to provide for them. Gathering this information is important because it aids in the process of integrating both subjective and objective information to build a comprehensive view of their problems and possible treatment. 

Setting the Stage on the Day of the Appointment

During the appointment, it’s very important for their comfortability and peace of mind to have a good understanding of the details of their case, so when during the appointment I like to have either a screen or a projection of some kind with their information visible so that they can see what you’re referring to when you bring up certain details. I personally use the program living matrix, and I find it very useful in improving clarity. When they first come in, they may also be nervous about what to expect, because most people don’t regularly have 90-minute doctor’s appointments, so just make sure that they feel welcome. Make sure to thank them for coming in, and before you begin just walk them through what to expect from this appointment.

I’ve found that people are able to listen and calm down a little bit if they know what to expect. Make sure that during this initial portion, you mention that however this appointment goes, if they choose to continue treatment, it will require a much longer commitment that could last several months at least. Mentioning this is important because it allows them to mentally prepare for that decision when the time comes, and to view the rest of the Foundational Assessment with that in mind. Now that that’s over, it’s time to launch into the meat of the Assessment.

Step One: Patient History

Once I'm finished explaining what the appointment will look like to them, I hand them the floor and ask them to tell their story in their own words. If they’re having difficulty describing it, sometimes to make it easier I’ll ask them to just describe their experience in different compartmentalized times, like elementary school, high school, young adulthood, etc. While you’re listening to their story, you should ask clarifying questions to get a better idea of their situation. At this point, you shouldn’t be trying to offer solutions, you should just be listening sympathetically and trying to get a better idea of their condition.

While you’re gaining this subjective information, it may lead you to be thinking of what tests you may want to conduct, so just keep those in the back of your mind until the time comes to talk about possible ways to move forward. Then once they're done with their history, I always ask if there is anything else that they want me to know, just in case there was something that they wanted to get to that didn’t come up. This portion can last around 45 minutes, and for some people, it can get emotional, so it’s important to always be sympathetic and understanding. Understanding the patient’s history first is very important for the next step because then you can use different elements of their past to tie into more objective data that you’ve gathered in the labs. 

Step Two: Tying their Experience to Data

After gaining an understanding of how they got to where they are, I bring in the results from the labs that were done prior to this Assessment and explain how the results of each of these tests relate to the issues that they’ve been having. While going through these results, I begin to incorporate some possible treatment options, like naming different supplements that could help with each issue. During the explanation of the lab results, I begin to allude to my thought process regarding treatment, but I don’t go into too much detail quite yet. After going over the lab results though, it’s time to go into their full Foundational Plan. 

Step Three: The Full Foundational Plan

My Foundational Assessment Plan includes recommendations regarding nutrition, movement, sleep, and stress, and it also includes ideas for baseline supplements and recommendations for additional advanced labs. When I go over the plan, I don’t immediately say what they should be doing outright, because if they’ve already been doing some of the things you advise it can seem condescending and not very useful. To combat this, rather than just telling them what to do, I instead ask them whether they’ve already taken some of these steps, and if so, I try to recognize and appreciate the amount of effort they’ve already put in. One method you can use to help get through this process is to get them to give a step-by-step overview of a typical day for them, and when you spot something that may be causing an issue, you can present a possible solution. That's what this part of the Assessment is really about, creating awareness around how their life choices affect how they’re feeling. Remember to not just give examples of how the ideal person should be living, make sure to meet people where they’re at and help them move forward. Congratulate them on the things they’re already doing right, and give suggestions on things they could do to help in areas where they aren’t doing as well.

This part of the Assessment is likely the most beneficial to the patient because it can provide them with a lot of help in changing their life patterns, whether or not they choose to continue with a membership. When doing this Assessment, you want to make it valuable for everyone who comes in, so that even if they don’t continue with a membership, they can use what they’ve learned with their existing medical team to make progress as well. In addition, if there are any abnormalities in their lab results, you should recommend that they are tested regularly every few months. Also, you should make it clear that whatever they do decide to do, they should follow up with their primary care physician in 90 days. From there, you’ve completed the Foundational Assessment, and it’s up to them whether they want to continue on to the membership.

In Conclusion

Foundational Assessments have to be one of my favorite appointments to do. Dealing directly with patients and giving them a greater awareness of what they could be doing to improve their lives is really fulfilling, and it’s always a great feeling to know you’re helping people out. Hopefully, this has been helpful for all of you reading who are trying to improve your own practices, and I hope that using my advice can help you enjoy Foundational Assessments as much as I do. 

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