In this case we’re not talking about Montagues or Capulets, the name of the game for today is a “Report of Findings” – and what does it contain? A Report of Findings for us is the middle step – it comes after the assessment but before the treatment. It’s a conversation that we have with our patients to make sure that we’re on the same page. There are a few major sections to a ROF: the diagnosis, its differentials, the plan, prognosis and the risks. Let’s go through each section, and I’m going to tell you exactly why we talk about each one.
The first major part of our ROF: the diagnosis. This is what I call the million-dollar question after the assessment. People want to know what’s going on and sometimes it can be helpful to put a name to the sensations or pains that they’ve been feeling. Knowing the name of a diagnosis can help you research the condition if that’s your thing, or it can just provide you with a deeper understanding of your condition.
The second major component: differential diagnoses. This is what I refer to as the backburner. I don’t always have “a differential”, but every once in a while, I’ll finish an assessment with one or two. These are conditions that I’m still considering at the end of your assessment; and that can be for a few different reasons. Sometimes, conditions can take a while to develop – weeks, months, some conditions even last for years – so it’s hard to tell exactly which condition it is on the day of the assessment. Other times, I don’t necessarily have the tools in our clinic to decide if it’s a certain condition. To rule in or rule out certain conditions I might need X-rays, bloodwork, or any number of other things. That’s why we have the backburner!
Of course, one of the major things we also talk about is the plan: what are we going to do about it?! We want you to feel fully informed of what it’s going to take to get you better. How long we think it’ll take for you to feel better, how often you have to come in, what kind of treatment methods we’ll use, and everyone’s favourite: how much homework you’re going to have.
After the plan, we talk about the risks associated with our treatment. It’s an important part of making an informed decision, and every healthcare practitioner you see should be discussing the risks of their proposed plan. There are risks with any treatment – whether it’s manual therapy, medical procedures or medications, or any other healthcare procedure you can think of. In our case the most common risk is a temporary worsening of symptoms. Sometimes things get a little worse before they get better, or you feel a little sore after treatment. Of course, depending on what the plan is, the risks can change a bit.
These four sections are what I would consider the major parts of a Report of Findings. It’s an important part of making an informed decision and it’s something that we as chiropractors perform at every visit. We want all of our patients to feel heard and informed – so that they’re truly in the driver’s seat when it comes to their care. So, what’s in a name? well sometimes quite a lot!