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July 2008 Archives


Have You Switched From Offense to Defense?

How many times will you fall for it?I was talking with a chiropractor who was commiserating about the decreasing reimbursement that he was receiving from his patient’s insurance carriers.

“What do you expect?” I asked. “Headaches and back pain treatment are small potatoes compared with the seriousness of heart disease, cancer and diabetes.”

While it can be argued that the neuromuscular-skeletal complaints that insurers have seen chiropractors as capable of handling are common, they hardly rise to the complexity and seriousness of the chronic lifestyle diseases that an increasingly aging population is saddling the medical profession with. That’s little consolation if you’re a chiropractor who has seen your income erode.

What can you do? Here are some suggestions.

Continue reading "Have You Switched From Offense to Defense?" »


Monday Morning Motivation

Love is not rude.

Do you impose your will on others so you can get your way?

Cutting in front of the line, or the reverse, not permitting the driver to merge onto the highway in front of you, is obviously rude. I’m sure you’re not rude in your office!

Depends how you define rude. However, examples of rudeness I’ve experienced, or patients in focus groups have mentioned, include:

Showing up late for the first patient of the day.
Allowing an emergency patient to prolong the wait of an established patient.
Making patients feel small because they just want to be pain free.
Any form or derivative of “I-told-you-so.”
Projecting the value you place on health onto patients.

Justified as the prerogative of “leadership” or the workings of a “health coach,” these overtures make you big and the patient small. This is a time-tested practice de-building strategy. Instead, make patients feel big. Anything else would be rude.


Knowing, But Not Doing

Patients know they should stop smoking.While I was on the treadmill this morning, I was listening to an interview with a prominent chiropractic leader. I had heard the lie that he uttered many times in my chiropractic journey. However, this morning it seemed to take on greater significance than at other times. Perhaps because this lie takes such a toll among chiropractors, producing needless pain and frustration. Worse, believe this lie, and you’ll never enjoy the emotional satisfaction of a stable practice and your patient communications are a repetitive, burdensome, ineffective chore.

What did he say? What did he assert that causes so many chiropractors to misdirect their patient education efforts?

“If patients knew what you knew, they would do what you do.”

You’ve probably heard this one before. It’s a lie. It’s simply not true.

Continue reading "Knowing, But Not Doing" »


Monday Morning Motivation

Love is not self-seeking.

Virtually every action, every word and every thought can be separated into one of two categories: manipulation or ministry. That is, does it serve you or is it of service to others?

Some in chiropractic teach that using any means possible to get patients to do the right thing (because it’s for their own good), is within the domain of good doctoring.

You might want to rethink that advice.

By crossing that boundary you have dishonored their understanding, judgment and free will. By overpowering them with persuasive speech or fear tactics you usurp their dignity and reduce them to mere spines; children who must be parented.

Oh sure, you can probably squeeze another visit or two out of them. But “do-gooder” overtures rarely last. Especially when the underlying motive is to make you look good. The appreciation you hope it will produce is dismissed as heavy-handed selfishness.


Foisted By Your Own Petard

What does your flag look like?As I was thinking about why so many chiropractors have such brief encounters with patients, and thus an insatiable appetite for new patients, it occurred to me that it might not be caused entirely to the myopic, instant gratification viewpoint of patients. Or even the shortsighted vision of insurance companies. I’m increasingly suspicious that it may be partly due to the “story” the chiropractor is sharing with patients.

Regular visitors here know that when I use the word “story,” I’m referring to the Four Stories: the Pain Story, the Bone Story, the Nerve Story and the Lifestyle Story. These form the basis by which chiropractors communicate their vision of chiropractic to patients.

These delineations ring more true than some of the chiropractor-created stories, which usually involve generous hyphenation. Such as “principled-chiropractic,” “subluxation-based-chiropractic” and even “patient-centered-chiropractic.” These may be convenient for distinguishing one chiropractor’s philosophy from another, but do little to help patients appreciate the purpose of chiropractic care or its optimal usage.

What if patient retention was more about your vision of chiropractic (and how you communicate it) and less about insurance companies, HMOs and the economy?

Continue reading "Foisted By Your Own Petard" »


Monday Morning Motivation

Love is not easily angered.

What does it take to get your hackles up?

Consider the patient who unexpectedly drops out of care (with six more visits on their plan). Or the patient who informs you that they’re still taking their medication and attributes their progress to it, not your care. Or, how about the patient who observes that they don’t believe in chiropractic? And don’t forget the patient you adjusted on the first visit who doesn’t return to hear your enlightening Harvey Lillard story!

Ironically, anger is a you thing. Not a they thing. You and your body create the anger. Not the patient!

Instead, love, from where all healing comes, looks past who gets the credit, looks beyond the politics, sees past the policy and rethinks the procedure. Love only sees the person. Not the shortcoming. Not the misunderstanding. Not the could-have-should-have.

What do you see?


What I'm Reading

future_internet.jpgNaturally the title, The Future of the Internet and How to Stop It, by Jonathan Zittrain caught my eye! As I spend more and more energy here on the Patient Media website and even more with our sister company, Perfect Patients, the future of the Internet is something I’m keenly interested in. With almost 100 pages of footnotes, this may be one of the most heavily researched and documented books I’ve ever read. And I’ll save you the trouble. Zittrain documents the movement from “gated communities” like CompuServe, Prodigy and AOL to the more open landscape we have today. With it has come viruses, malware, phishing, pornography, privacy issues and other unsavory dangers. The author’s concern is that we’ll retreat to these more predictable and “safe” environments and in doing so, many of the creative and collaborative benefits the web has offered us, such as Wikipedia, Linux and others will be lost.


Monday Morning Motivation

Love keeps no records of wrongs.

What many overlook is that a true chiropractic practice is about two things: referrals and reactivations. Those consumed by how many new patients they see either miss the point or have been misled into thinking wide rather than deep.

A referral is a gift. Ask for them if you wish and you may get a guilt offering or the name of someone who could benefit from chiropractic care, but a true referral is volitional. A surprise. Unexpected.

A reactivation is proof you didn’t make the patient wrong. Or small. Or feel stupid because he or she didn’t embrace your vision of health on their first exposure to it.

Since most patients don’t “get” chiropractic their first time, keep no records of wrongs. Instead, you might observe in passing, “Looks like it’s been awhile since you’ve been in. Welcome back. Let’s get started!”


Table For 11

cancelled.jpgDr. Ross McDonald, who invited a number of us to come and speak at his third annual Edinburgh Lecture program, took all the speakers to dinner last Saturday evening. Sitting down to an incredible meal (that lasted four hours) with others who share the seminar “circuit” is one of the most enjoyable aspects of being a chiropractic gypsy.

I happened to find myself situated in a most wonderful place at this table of 11. To my right, Dr. Dennis Perman. To my left, Dr. Troy Dukowitz. Sitting across from me were Dr. Janice Hughes and Dr. Guy Riekeman.

As I said, sharing a meal with others who endure the glamour of cancelled flights, lost luggage, taxis and the time away from home, is one of the most pleasurable aspects of enduring the cancelled flights, lost luggage, taxis and time away from home. You might be wondering, “What does a high octane group like that talk about over a four-hour dinner?”

You might be surprised.

Continue reading "Table For 11" »

About July 2008

This page contains all entries posted to Chiropractic Practice Blog in July 2008. They are listed from oldest to newest.

June 2008 is the previous archive.

August 2008 is the next archive.

Many more can be found on the main index page or by looking through the archives.