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Caring Too Much

Have you become too thin skinned?One of the common themes of my most recent speaking gigs is the idea that many chiropractors get into trouble by caring too much. It’s the occupational hazard of being a professional caregiver.

Caring too much produces a variety of practice pathologies, among them, taking patient behaviors personally, thinking their headache is your problem, resenting patients for poorly prioritizing their health and ultimately burnout, in which patients become the “problem” of practice. So, my advice has always been, “Care, but don’t care too much.”

Last night, just as I was about to drift off to asleep, I was struck by the thought of caring as a continuum, with three general types of caring.

Careful. This is the “caring too much” category of caring. When we’re being careful we are super alert. This vigilance is used to detect the most subtle nuances of the person we’re caring for in the hopes of getting helpful feedback or avoiding disappointing them. In its most extreme form it’s an aspect of “walking on eggshells.” Underlying this hyper-caring is fear. Fear of loss or fear of abandonment. Obviously, it’s not a healthy place for a caregiver to be. It’s exhausting and keeps your practice small.

Caring. Appropriate caring is a function of recognizing clear boundaries between what is yours and what is a patient’s. In gross terms, think of the last time you went to the hardware store to find a part you needed to make a repair around the house. If the checkout clerk asked, “Did you find what you were looking for?” and you reveal that you were unable to find the ‘thing-a-ma-jig’ you were in search of, the clerk may make a reasonable effort to alert someone to find it for you if he or she thinks they stock it. If not, because they don’t stock, nor ever intend to stock, left-threaded-chromed-metric cap screws, the clerk will quickly forget your request (and your disappointment) in about 10 seconds. “I can help the next customer...”

An extreme example to be sure, and it’s hardly comparable to the deeply personal service you render. The point is, the clerk didn’t take personal responsibility for the fact that the store didn’t have some esoteric piece of hardware. And certainly won’t stew about it for the rest of the day and take the incident home to further discuss around the dinner table! Appropriate detachment is the key. Care, but don’t care too much. Make a note of it, adapt if you see a trend, but don’t question your competency or career choice!

Careless. At the other end of the spectrum is not caring enough. When you’re being careless you make patient visits about you or what’s going on in your life. (If you’ve seen patients as a car payment, you’ve probably encroached into this area.) You make assumptions and take a patient’s appearance for granted—just part of the day’s patient volume. When patient’s detect you are no longer emotionally invested in them it makes it easier to justify dropping out of care. “I won’t even be missed,” they think to themselves. “Plus, I’m feeling good enough. Why bother?” And they slink away, becoming another inactive that needs to be replaced by a new patient. And so it goes.

Seems to me, a healthy caregiver is one who can avoid the two extremes and remain steadfast in their ability to care, avoiding being too careful in the beginning and avoiding being careless as the patient’s symptoms resolve. Either extreme upsets the Law of Fair Exchange, jeopardizing you and your practice.

Do you care too much? Take this 10 question quiz and find out!

Comments (2)

Your comments are right on. I concur. I have found that "caring more than the patient" only builds guilt in them and produces a co-dependent relationship.

Bob Wagner:


How does your chiropractor benefit from having you as a patient? I mean, in your relationship how do you as an observant patient forgive the transgressions that we all are guilty of such as careful-careless-caring personalities or mindsets?

WDE: How does my chiropractor benefit from me showing up as a patient? Great question to ask him, I suppose. Please note, that the work I do with Lou is not your normal chiropractic! It’s an experimental technique that doesn’t have a name yet, but it’s a fascinating and very powerful hybrid of AK, N.E.T. and intercessory prayer. Weekly visits last an hour.

That said, here’s my guess.

Intellectually. Since I live and work in the world of ideas, my guess is that Lou benefits by the ideas I bounce off him as I develop them. I’m assuming our intellectual relationship is mutually satisfying.

Mentally. Since I bring a lot of rigor to language, my guess is that the precision that I use, benefits him as well as his relationships with other patients.

Emotionally. I’d assume that since I bring a high level of respect for chiropractic and health principles, and have high confidence in Lou’s skills and insights, he obtains encouragement and affirmation by me showing up for the soon to be fourth year.

Financially. Obviously, there’s a financial exchange.

Those are the most obvious benefits that come to mind.

As for the nine chiropractors that I’ve consulted over the years? Each has been flawed in some way. Comes with being human! “Forgiving the transgressions” of a chiropractor is no different from extending grace (unwarranted favor) to anyone else. I don’t expect chiropractors to be perfect. I point out my observations in the hopes of inspiring greater excellence.

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From April 20, 2007 7:39 AM

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