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Patch Job

patch-job.jpgFrom time-to-time, I encounter chiropractors who get indignant when merely describing patients who call and just “want to get cracked.” Or get tense simply thinking about patients who reveal that they just wanted a “patch job.”

Why so easily offended? Does a patient’s unenlightened language diminish you? Does a patient’s poor choice reflect on you? Do you believe their shortsighted outlook threatens you? Or that their behavior somehow tarnishes your reputation? Is your self-image that fragile?

Oh, I know that the “my-way-or-the-highway” attitude feels empowering, creating the illusion that you can control patients, but think about it. Imposing your health values onto patients in the hopes it will engender respect or a change of heart flies in the face of how a patient would come to adopt a healthier consciousness. (Clue: it isn’t by threatening them or using your social authority to get them to do something—even if it’s in their best interests.) Pushing potential patients away because they don’t “get” what you’re about may make you feel righteous, but it doesn’t create respectful, appreciative patients. In fact, it’s rather self-indulgent and probably works against your desire for a more influential practice.

Why scorn a patient simply because they had the courage to admit they just wanted symptomatic relief? (Or do you send patients signals that smart, attractive people always choose “fix” care?) Sending them away to a more humble chiropractic servant, rather than doing the hard work of cultivating trust, communicating the big idea in a relevant way and planting seeds that could take years to mature is not only egotistical, but as shortsighted as the patient’s attitude you’re trying to change! And if you think you’re somehow “protecting the sacred trust” by shunning such patients, you’re delusional.

Are patients with wrong-headed ideas about health too much of a bother? Too much work? Are you expecting people to show up committed to finally addressing the underlying cause of their problem, while you’re unwilling to get out of your office and tell your community about the larger context of chiropractic?

Why isn’t one visit better then them popping an Advil instead? Why turn your nose up at a patient’s request for the minimal amounts of care to relieve their symptoms—which during these encounters you can explain the larger context of chiropractic? Why turn your back on patients who won’t sign up for a yearlong contract? (Before you’ve even helped them with their presenting complaint!) For a profession that is proud of its unconventional approach to health, releasing the patient’s potential to heal rather than suppressing their symptoms, why is there such an interest in controlling and imposing your wishes onto patients?

Clearly, I’m missing something here. Would you let me know what it is?

Comments (3)

Jeremy Ste. Marie:

It is important to remember that patients who are in pain will seem very attentive during your ROF, but are they really getting "the big picture"? Our approach has been to meet patients where their health consciousness is at, and as we slowly build trust with them, open up their minds to bigger and better things. It's worked well so far.

Mark Herman:

I am confused. Your blog post speaks to a part of me that says, "at least one adjustment is better that nothing" or "at least they are coming in for an adjustment once in a while". The other part of 'me' reminds me that the purpose of the chiropractic adjustment is not simply relief of the most recent 'bloopitis', but in elimintating interference of the nervous system and allowing the body to operate at optimal function. I also have to be honest in admitting that the regular office visit affords me very little time to educate and share my view of health with the people in my practice. The end result seems to be that people who seek only pain relief are not getting the message and I am rekindling more of the same for them every time we adjust.
I have changed our office procedures to ensure that when we get another opportunity with this group of people, we take time to share information and try to educate them regarding the power of their body and how chiropractic can facillitate improved function and better health. We then stand at the cross we share a common vission and can we agree to common goals around their health care. I recommend regular chiropractic adjustments and regular check ups to ensure that we stay on track, both physically and to recheck our goals regarding their care. At this point to say to someone, given all this I am willing to move forward on a 'Patch it only' basis or a 'symptom' only appoach seems very incongruent.
The confusion comes from my desire to make them happy and be the 'patch it' guy in the short term and my desire to help people make meaningfull changes in their life (which takes committment and long term thinking). I am finding it harder and harder to agree to short term symptom based care, when I know that it does very little to help them and in the end helps keep them stuck . When I refer to another chiropractor for symptom only treatment, it is to honour both the patients needs and stay true to myself.
Mark Herman

WDE: Naturally, it's your call. Perhaps all of this could be solved by never adjusting on the first visit, and always insisting upon a new patient learning the folly of symptomatic care before adjusting them. Seems to me if you do that, you should be able to enjoy a clear conscience.

Bob Wagner:

After 22 years, I've been through all facets of presenting care to practice members. After attending The Conversation, I had to confess my presentation sins and get back to the basics. If it's one visit then so be it! There is a my way or the highway practice right up the street from me. He even puts on seminars to teach others how to do the same thing. I'm not slamming him for his beliefs but I don't see this as a way to promote a great profession such as ours. Keep your expenses low, live within your means, and don't spend all the rest. If you try this your need to sell will diminish and people can start to see chiropractors as professionals and not dealmakers.

Bob Wagner

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From July 27, 2007 7:11 AM

This page contains a single entry from the blog posted on July 27, 2007 7:11 AM.

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