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Where Are We?

limbo_land.jpgFriday I had lunch with a nearby chiropractor who has been going through a rough patch. A divorce, staffing issues and a lack of new patients have created new, unfamiliar financial pressures. During our lunch, I heard three issues that seem to hold promise for his recovery. Whether he will have the courage to act upon them remains to be seen—after all, there is often a disconnect between knowing and doing.

The three issues were ownership, recreating the past and pride.

I’ve seen this ownership issue before. This is where the doctor compartmentalizes things so it’s easier to not look at some aspect of the practice, usually financial issues. Responsibility for this area is surrendered to a staff person or spouse. This type of delegation is a form of “zone defense” in which the chiropractor assumes that he or she can then safely ignore it in favor of work that is thought to be more “important.”

Nice try. But ultimately, you’re responsible for every aspect of the practice—even the areas you ignore, don’t like or delegate to someone else. Not only do you physically own the entire practice, it’s essential that you have complete psychological ownership—even the painful, frustrating parts you feel powerless about. No one else, especially the bank, sees this fractured reality you’ve concocted.

The second issue was the desire to recover the past. Just as the Israelites longed for the melons and cucumbers of Egypt during their 40-year trial in the wilderness, many chiropractors yearn for the good old days of generous reimbursement and 30 new patients (or more) a month.

No amount of wishful thinking will bring those days back. They’re history. If you haven’t gone through the grieving process yet, pick a convenient time and do so. Instead, you must create a clear, positive vision for the future. Not what you don’t want—but a vision of what you do want. And it has to be yours, not a consultant's or college buddy's. Until you have clarity about what you want, what it looks like and how it advances your core purpose, you’re in Limbo Land, incapacitated by doubt, fear and uncertainty.

Like patients who show up in your office only wanting to return to their “preinjury status,” it’s often their preinjury behaviors that created the problem in the first place! Same here. The artificially inflated patient volume due to insurance companies footing most of the bill is partly responsible for the disorientation that so many chiropractors are feeling. Turns out your practice wasn't as large as it appeared, since many patients were showing up simply because someone else was picking up the tab.

The third issue, and probably the underlying attitude of the other two, is pride. This is what God hates most in us. It can show up as a sense of entitlement (“I deserve to be in a better place.”) or self-importance (“After all, I’m a doctor.”) or judgment (“If you don’t value your health as much as I do, you’re stupid!).

These aren’t the attitudes of humble servants. Or busy practitioners.

Pride fuels a resistance to change. It creates a hardened heart that isolates and restrains the creativity and resourcefulness necessary to adapt to the changing practice climate. It causes one to resist “what is,” the source of most suffering.

Combine a renunciation of ownership with attempts to recreate the past, and then throw in an ample helping of pride and you have a recipe for paralyzing “deer-caught-in-the-headlights” inaction. Become proactive. Assume total responsibility for your circumstances (after all, you created them) design a clear vision for the future and dedicate yourself to being a generous, humble servant. You’ll be astonished by the path that will be cleared for you. It won’t be easy. And it won’t happen overnight. But hundreds, probably thousands are counting on you.

Comments (3)

Nice comments... and a nice sign. Where did you find it?

Creating the clear vision that's worth all the trouble seems to elude me the most. I've read the books, but can't seem to get to it. It's difficult deciding that anything in particular is all that important.

Feeling that I am on some sort of "path" that's a fit has worked for me in a lot of ways, but it still seems that I am available to help other reach their goals rather than dedicated to any particular commitments of my own.

This approach has allowed me to do my job well as a doctor, but I'm not really on a crusade to change the world or make it a better place.

Nevertheless, your comments probably capture some aspects of what's not as it could be. Certainly I recognize much of the past in what you've said.

Tony Russo:

The words you have just written hit home with probably 90% of the Chiropractors with a capital "C" in North America and abroad.
I too have fallen prey to that comfortable soiled diaper of dispair, regret and let us not forget blaming others for the condition I found myself in. And "I" of all should know better. What OHIP did to us in Ontario, horrible staff situations, and any other "reason" for not being successful, and all the while the solution was right in front of me, begging to be confronted. And when I did, it opened my eyes to the ugliness that was how far astray my practice had gotten. Climbing out hasn't been fun nor has it been easy. But I'm climbing out, seeing more people, witnessing a growing cushion that is the balance in the bank. I'm thankful to be really having a good time of it these days. I'm making bite size payments on my modest debt load and plan to be totally debt free in 1-2 years at the rate I'm going. So just like you said, I am pulling myself out too. But not without having to have had to confront the demons of reality. If I could do it, so can you. "Only the tigers will survive. And even they will have a hard time of it."
Good luck to all,
Tony

Nancy:

Your thoughts just keep getting better and better. Thank you for sharing. Nancy T

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From September 29, 2007 10:16 AM

This page contains a single entry from the blog posted on September 29, 2007 10:16 AM.

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