If you’re a bit disoriented because things that used to work don’t, you’re feeling a bit like Rip Van Winkle, waking up after a 20-year sleep. And while chiropractic principles haven’t changed, patients and the environment you practice in has. You’re dealing with a handful of issues that must be dealt with correctly or you’ll become the equivalent of the buggy whip manufacturer of 100 years ago: obsolete and irrelevant.
Here are some of the most significant issues that have changed and some action steps to deal with them. Your ability to recognize and adapt to them is essential if you have any hope of thriving in the years ahead:
1. Changing sense of time. The instant gratification offered first by fax machines, then overnight delivery and now the Internet has created patients with less patience. Waiting in your reception room becomes a huge imposition. Repeated visits interfere with busy schedules. Short attention spans mean patients have less capacity for complex explanations or copy-heavy brochures.
2. The entitlement mentality. More and more patients are beginning to see health care as some unalienable right guaranteed in the Constitution. You or your staff may have noticed this as a growing number of patients wave their insurance card at your front desk, thinking it contains an RFID chip that grants them all the care they need or want.
3. Loss of cultural authority. Doctor’s orders are a fascinating anachronism from the past. You increasingly find yourself in the position of having to “sell” the patient your recommendations. Don’t be intimated by the sheaf of printouts from websites they wave in your face.
4. Been there done that. Turns out, more and more people have already tried chiropractic. You’re no longer working with a clean slate. Patients are asking more pointed questions and enter your practice either with inappropriate expectations (“My last chiropractor only needed one visit.”) or requests not to adjust their neck.
5. Slower results. Not only has the world changed, but so has the patient. They’re eating poorer quality food, experiencing higher levels of stress, getting less rest, are more likely to be overweight and are suffering from the mass hypnosis of the mechanistic media. Chiropractic is great, but the amazing results of 20- and 30-years ago just aren’t possible with so much working against you.
6. Lack of a clear philosophy. If you emerged from chiropractic college fearful of malpractice, worried about harming patients or overlooking some dreaded disease, you probably see yourself as merely a glorified spinal therapist. Without the context and greater meaning offered by understanding the whole-body, vitalistic nature of chiropractic, you probably lack the passion and excitement essential to attract, inspire and lead today’s patients.
7. Declining reimbursement. If all you’ve known is expunging the word subluxation from your diagnosis, taking assignment and hiring staff to ferret out the patient’s insurance coverage, these are trying times. Better coding or adding procedures that still enjoy generous reimbursement are not a viable solution. Do you see any sign that the claims cutting or lack of “medical necessity” won’t get worse?
These challenges will prompt one of two choices. It will either bring out your creativity and inspire you to make some changes, or be a confirmation that the best days in chiropractic are behind you, selling your practice to an unsuspecting new graduate and searching for greener pastures.
I hope you’ll stay and fight. If that’s your inclination, here are some strategies you might employ:
1. Acknowledge the truth. Before you can chart a course for a destination of influence and affluence, you must know where you are. Take an inventory of your resources and liabilities. Have the difficult conversation with your spouse about living beyond your means. Batten down the hatches. Get down to your “fighting weight” figuratively and in actuality. Admit that the world has changed and remember that world doesn’t owe you a living.
2. Become coachable. If you’re resistant to change, if you project how things “should” be, if you’re inclined to reinvent the wheel due to ego or pride, lose the attitude. Surrender. You have a valuable service and if you’re to remain viable, you must seek wise counsel. And follow it! It’s still breath taking to me how many chiropractors pay enormous sums to coaching firms and admittedly only implement a fraction of the advice—yet expect effortless results. (Sounds kind of like patients!)
3. Ask more questions. “How are we doing?” “How could we serve you better?” “If this were your practice, what would you do to introduce more people to chiropractic?” “What’s the most difficult thing about telling others about chiropractic?” “What are some the biggest changes you’ve seen since beginning care?” “How would you rate the first impression a new patient receives when they walk in our front door?” I could go on and on and on. That’s because I have an insatiable curiosity. Most chiropractors rely totally on efferent communications. Without the afferent, you have a major subluxation in your practice.
4. Extend your reach via the internet. It used to be somewhat endearing when a chiropractor would boast, “I don’t even know how to turn my computer on.” Cute. Dragging your feet, unwilling to learn new, 21st century skills is holding you back. Simply put, you must have a web site. Naturally, I recommend our sister company, Perfect Patients. Either way, you must embrace technology. Patients are. And they’re using the Internet to get information, find a practitioner and “check you out” prior to making an appointment. Without an Internet presence, you’re unknowingly being penalized.
5. Tell a new story. If you’re been relying on the Pain Story or the Bone Story to prompt patients to show up to use the benefits of their policy, you may want to transition to the Nerve Story or the Lifestyle Story. Reducing chiropractic to a low-tech intervention for episodes of back pain, while better than drugs or surgery, is hardly the highest and best use of chiropractic. Invent yourself as a nerve doctor rather than a glorified spine mechanic. Discover doctors Jim Sigafoose, Reggie Gold, James Chestnut and others who can give what you do the majesty and meaning you rightfully deserve.
7. Get off the dole. If you’ve allowed third parties to domesticate you, you may believe chiropractic isn’t valuable enough to prompt patients to reach into their pocket or purse to pay for your services. If you’ve “fallen in with the wrong crowd,” that is, people for whom how their doctor bill is paid is more important than who the doctor is or what the doctor does, you have a major shift ahead of you. It’s time to begin the process of converting to cash. If Wal-Mart is interested in tapping into the organic food market and McDonald’s is selling apples, you know the culture has shifted. Have you?
One of the signs of intelligence is the ability for an organism to adapt to its environment. If you’ve had your head down for the last decade or so, you have some “adjusting” to do. No problem. All of us at Patient Media would love to be a resource for you as you reinvent, renew and rekindle your passion for chiropractic.