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March 2009 Archives
Since problems are rarely solved with the same level of thinking that created them, it’s vital that you show up healthier, more resourceful and with more clarity than patients who seek your help. This is difficult to do if you’re being seduced by the same cultural hypnosis that they suffer from.
It used to be simply being a chiropractor was enough. As chiropractic has become more mainstream, to remain spicy, salty, influential and a “free thinker,” you’ll want to disengage from the media.
Those who watch television don’t watch. They stare. Very impolite to stare. The fixated eyes and zombie expression are signs of a drug being administered through the eyes. Hijack the mind and the body follows. You see it in the symptom-treating, germ-fearing, disembodied patients who show up in your practice.
Disengage. There’s nothing on. It’s designed to create fear, breed uncertainty and induce a herd mentality that steals your uniqueness.
Before Y2K (remember that?) and before the dot com bubble burst (the other most recent economic downturn) the practice of chiropractic was different. Insurance reimbursement was on the decline, and phase two, known as the post-review audit hadn’t become so widespread. (One more reason to begin the process of Converting to Cash.) It was also before chiropractic supporter Arnold Swartzenager bailed on California chiropractors by effectively cutting them out of the state’s worker’s compensation program.
A lot has changed in 10 years. Chiropractic hasn’t changed. But how it is practiced certainly has!
Yet, countless chiropractors continue to practice as if it’s still 1999 or earlier. Do you make these common “adaptability” mistakes?
Continue reading "Practicing Like Its 1999" »
The confusion, lack of clarity and disorientation pale in comparison to the feelings of “stuckness” that are often experienced by those scrambling to right themselves after being struck by waves of change or the undertow of being no longer relevant to the marketplace.
Pulling out of this death spiral requires a new way of being.
Deceived into believing that success is something you do, rather than something you are, those who are going through a rough patch needlessly exhaust their limited resources by pursuing procedures, equipment or scripting that makes them increasingly inauthentic, uncentered and unattractive.
Real success is about being fully you, not becoming a cheap imitator of someone else. Beware of those who suggest “do it like I do it.” Modeling others only seems like a convenient shortcut. And anointing a mentor practically invites exploitation.
If you’re afraid that being fully you would chase patients away, change you.
From time to time, (last week was one of them) I learn of chiropractors who are suffering from cancer or some other serious disease. Or who die at some unreasonably young age. Sometimes it’s the spouse of the chiropractor who has been afflicted. Whether chiropractor or chiropractic spouse, both have usually been long time beneficiaries of chiropractic care. In other words, they received chiropractic care and surprisingly, got cancer.
Based on the incredulous tone in which this revelation is made, it’s almost as if the chiropractor believes that receiving chiropractic care was, well, a guarantee that such a malady would never strike them. The shock of learning that they have cancer is compounded by the evidence that their chiropractic rabbit’s foot has failed them. As you might expect, this produces a crisis of faith in the principles that they have been applying to patients.
While I lend a more-than-compassionate ear, I suspect their sudden disillusionment with chiropractic is based on some wrongheaded beliefs about what chiropractic is and isn’t, and what it can and can’t do.
Continue reading "Losing Faith" »
Perhaps one of the most influential books I’ve read (pun intended) is the classic book by Robert Cialdini, PhD entitled Influence, Science & Practice. His newest book, Yes!: 50 Scientifically Proven Ways to Be Persuasive is a collaboration with two other social behaviorists, Noah J. Goldstein, PhD. and Steve J. Martin. The 50 practical applications of his original principles are short, to the point and immediately usable in a chiropractic practice. For example, suggestion #16. A simple change in languaging at the front desk from making a request to asking a question as in, “Please call if you have to cancel.” to “Will you please call if you have to cancel?” can reduce no shows from 30% to 10%. Suggestion #17 is equally valuable in improving your kept appointments statistic. Instead of the front desk staff writing the next appointment(s) on the back of your business or appointment card, hand the card and pen to the patient so they make their appointment commitment in their own handwriting. The book is filled with little nuances like these that will easily return your investment.
Healthy doctor/patient conversations are like a tennis game between two evenly matched, fully engaged players.
Instead, many chiropractors have a brutal serve. So imposing are the assertions or convicting observations that follow the usual pleasantries that many patients are unable (or unwilling) to attempt a return. Interactions degenerate into monologues, force-feeding some well-intentioned chiropractic trivia into the earlobes of defenseless, facedown patients.
Inaccurately called patient education, these one-sided affairs rarely produce the wanted result. Instead they distance you, making you appear self-absorbed, irrelevant or infatuated by things that matter to you, not the patient.
Show up curious. Ask more questions. Not as a set up for your treatise on nociception, but as someone genuinely interested in their life, not just their health. As you get more serves returned, intimacy deepens, influence grows and your sense of fulfillment expands. Oh, and your practice grows. A nice side effect, as side effects go.
First there was Facebook. Then Plaxio. Linked In. And now Twitter. Will it ever end?
How can we be that interested in someone we see once a year at seminar? Is this a sign that we need a life of our own, rather than eavesdropping in on the goings on of someone who feels significant enough to take the effort to leave 140 characters about what’s going on for them?
Perhaps. Maybe this is the personal, decentralized version of American Idol, Australian Idol, British Idol, etc.
Too soon to know for sure. But there’s something going on here. Ready to play? Joint the rest of us who are apparently self-absorbed enough to document it on line! www.twitter.com. I’m billesteb. Tweet me. If tweeting is a verb. I think it is. Or at least it is now! Let's see where this goes.
There’s a difference between what you believe and what patients believe. You may have noticed that. This discrepancy is what is used to justify the patient education overtures in most chiropractic practices. Granted, most so-called patient education is merely ineffective outside-in patient “teaching,” but the objective remains the same: cause patients to acquire a new meaning for their symptoms and the value of using chiropractic to address them.
By failing to see subluxation as a short-term survival strategy; a defensive posture resulting from the body’s best efforts at accommodating threatening levels of physical, emotional and chemical stress, far too many chiropractors have fallen for symptom treating. They address the subluxation and rarely investigate the cause of the subluxation.
This corresponds nicely with the patient’s beliefs: “I’ve got a pinched nerve in my back. Will you move the bone and take the pressure off the nerve please?”
And the trap is set!
Continue reading "Find It and Fix It" »
You speak a foreign language. It's called "Healthcare" and more specifically, a dialect known as "chiropractic."
You're much more aware of the distinctions between chiropractic and medicine (or should be!) than patients. And while it's tempting to ignore these differences, be sure to translate if you want patients to grasp the full significance and meaning of chiropractic.
One of the key distinctions is the heretical notion that it's not the doctor or drug doing the healing, but the patient and God. Start there.
Granted, it takes some courage to plant that flag. And it may assign more responsibility than patients want when they decide to consult your practice. But ignore this one and you'll have confused patients who see you as a "fixer" and your practice will never get out of second gear. More troubling, you'll be seen as merely a spinal therapist, hamstrung by the inability to prescribe pain medication.
The highways are still clogged. I still have to wait for a table at my favorite restaurant. And on Saturday mornings I can’t find a parking spot at the mall. Seems that all that the fear mongering of the media about the current economic climate is doing is forcing patients to clarify what’s most important to them. And by the looks of things, many chiropractors seem to have attracted people who don’t value their health that much. After all, if patients will only avail themselves of chiropractic care if a third party picks up the tab, it doesn’t say much for the priority they place on their health!
Chiropractors who recognize this priority issue, expend enormous amounts of energy trying to get patients to more highly value their health. Most find this not only ineffective, but it distracts them from far more resourceful ways of investing their time and energy.
Turns out, there is little you can do to get patients to more highly prioritize their health. Scare tactics only last until the patient feels better. Annual care plans push away far more patients than they snag. So-called patient education (mostly yakking at patients) simply produces polite nodding. And the “ounce of prevention is worth a pound of cure” chat rarely manifests in the “twice-a-month” maintenance/prevention/wellness visits many chiropractors dream of.
Allow me to remind you of what does cause patients to reprioritize their health.
Continue reading "Clarifying Values" »
Dennis is a great interviewer and each time I get to speak for The Masters Circle, I can count on a follow up interview that usually turns into a delightful Vulcan Mind Meld with a fellow analytical. (You can listen to my previous interview with Dennis here.)
Hope you enjoy the interview. Leave a comment and let me know what you think.
The moment you deliver a patient's first adjustment, your influence either increases or plummets.
"Will adjustments actually "fix" my problem? How many should it take?" "How many will it take?" patients ask themselves.
While it's true that what you say may not override what they feel, it reveals the vital importance of at least some type of rudimentary patient education to give your adjustments context, while assigning appropriate responsibility for who is doing the healing. Without this essential "meaning making," you force patients to make judgments solely on how they feel.
This is the danger of first-visit adjusting. After the paperwork, consultation and examination, what passes for patient education can be woefully superficial and inadequate. The result? You're seen as merely a "bone cracker" and the neurological and potential whole-body health effects of chiropractic care are obscured. And while your purposeful mechanistic intervention may please an insurance company, you'll have traded vitalism for mechanism.
This page contains all entries posted to Chiropractic Practice Blog in March 2009. They are listed from oldest to newest.
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