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Hope Management

Are you invoking hope?There's been way too much energy applied to managing patients and way too little thought given to managing a patient's hope. Hope is an essential ingredient of the healing process that is often overlooked by those inclined to relish the technical aspect of when and where to adjust. Naturally, this reduces patients to mere spines, cases, insurance policies and practice volume statistics.

Patient hope exists on a continuum. At one extreme you find the "malingerer" and hypochondriac who receive too much secondary gain by not recovering. At the other extreme you see the patient who enters with the spoken (or unspoken) belief that they will experience a one-visit miracle cure. Somewhere between those two extremes are the patients who have "succumbed" to consulting a chiropractor and show up hopeful, but wary. Left and right of this middle range is where the majority of patients find themselves.

False Hope

If we agree that hope engages the mind and harnesses the power of the mind/body connection, what is the patient hoping for?

Hoping you’ll fix them. Accustomed to consulting medical doctors who often produce an unhelpful level of patient detachment, many patients remain passive, hoping you’ll assume the necessary responsibility to make the needed repairs. Like taking their car in for an oil change, they disassociate from their body and are quite happy to turn it over to you. Of course, this is a trap, but many chiropractors fall for it since it is a way to be the recipient of ego gratifying patient admiration that so often follows.

Hoping it won’t take a lot of time or money. The front desk staff encounters this type of hope on the telephone. “Are you on the list of approved providers?” These are folks for whom how their bill is paid, is more important than who is doing what to them! That’s okay. If the tables were turned, you’d probably look for a practitioner who would accept your policy as well. Hoping that their little spine problem won’t break the bank can be a powerful factor for many patients.

You’re part of the hope management equation too. Patients are just as keen in their ability to detect what your hopes are. What are they?

That your technique will “work.” This lack-of-certainty piece can actually sabotage the patient’s hope! Your ability to show up doubt-free is paramount. It’s what can be so instrumental in invoking the patient’s healing potential. You seem confident, so they figure it’s safe for them to be confident.

That the patient will be patient. When you make the relationship about you, you become consumed by what patients do, as if their behaviors are a poor reflection on you! But patients aren’t your children. If they “misbehave,” it doesn’t reflect poorly on your parenting (doctoring) skills. If they lose patience with the speed of their recovery it may mean that you haven’t explained the basis for healthy hope...

Healthy Hope

Many chiropractors who see subluxations as causes rather than effects, who see subluxations as the enemy to be eradicated and see subluxations rather than the person with the subluxations, needlessly take on the responsibility for the patient’s recovery.


Whether the application of chiropractic principles releases their body’s capacity to heal itself or not, is out of your control. In fact, patients have much more control over this capacity than your artfully delivered adjustments! And if you don’t believe that, try helping patients who refuse to clean up their nutrition, emotional stress or lack of sleep.

Healthy hope is when you reveal that you think they’re an excellent candidate for chiropractic care. (If they are.) Healthy hope is when you indicate that chiropractic care has helped many patients with problems just like theirs. Healthy hope is when your body language communicates confidence and resolve.

Healthy hope is when patients “get” that you’re not doing the healing, the fixing or the pain relief. If there’s going to be any of that good stuff, their body will be doing it, not you. Oh sure, you know how to deliver a “nudge” designed to help their body “right itself,” but whether it will happen in one visit or 100 visits can not be accurately predicted. In fact doing so, while pleasing to the patient, puts the responsibility back on your shoulders. Where it doesn’t belong.

Comments (1)

Tony Russo:

Very clearly presented. Very essential to a stable, streess free practice Very infrequently done. I tend to fall into the ego filling group, even though I tell each patient who extoles my healing powers, that it's them doing the healing, it still feels good. And then, you're right, when they don't heal, they blame me. "You fixed me in two visits last time" is what I hear. I know you're right Bill, but just feels so warm and fuzzy when you do get the complements. What I can say though, is that I now know the demon and am equiped with the tools to march ahead and recognize the camouflaged pitfalls that keep mine, as well as many offices, at ground level.
Thanks again Bill,
Tony Russo

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From December 7, 2007 11:15 AM

This page contains a single entry from the blog posted on December 7, 2007 11:15 AM.

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