Earlier today, I completed a one-hour telephone consultation with a chiropractor. The anger I’m feeling might be similar to what you’d feel when presented with a child suffering from vaccine damage or a patient who was maimed by a medical mistake.
Just what has produced this angst? The suffering inflicted on this coachable chiropractor at the hands of the top practice management organizations in chiropractic. Finally, I’m present to the far-reaching and deleterious effects of these well-intentioned “coaching” programs. I’m fed up with the manipulative techniques taught chiropractors that are justified by a do-gooder mentality.
It would be easy to use this space to take pot shots at this parasitic industry that has sprung up from the confluence of low self-esteem, third-party reimbursement, a lack of business training and old-fashioned greed. Instead, allow me to deprogram some of the more common beliefs that come from brushing up against these chiropractic cults.
Granted, I've never hired a chiropractic consulting company. And I consider the leadership and consulting staff of many of these groups to be personal friends. I've even spoken at many of their seminar gatherings. So, while I'm not sure about the specifics of what they teach, I do see the resulting effects! Here are seven common lies that seem to have been suggested to chiropractors and the truth that could set them free:
“3X for 4 weeks, 2X for 4 weeks, 1X for 4 weeks.” I’ve written about this and other forms of bluffing elsewhere. This is the “Take-two-aspirin-and-call-me-in-the-morning” cookbook approach to chiropractic. Many chiropractors have made this formulaic recommendation so often they think it was handed down from D.D. Palmer himself. Astonishingly, this visit schedule is usually presented at the report of findings before the first adjustment has been delivered! Just how can you predict their recovery 60-90 days out? Give me a break.
“My way or the highway.” Asking patients to mindlessly follow your recommendations or you’ll withdraw your services is such a flawed model of practice I don’t know where to begin. If your self-esteem is especially low, use this prima donna blustering and you can attract patients who have had their critical thinking skills surgically removed. However, it’s been my observation that this form of posturing may give the illusion that you’re in control, but it’s just an illusion. And it rarely produces the abundant referrals and reactivations that are the foundation of a stable, profitable practice.
“We only offer annual care plans.” Sure, having a nervous system free of interference can enhance one’s overall health and well-being. And if that’s what someone wants, an annual care plan makes sense. However, it’s rarely the reason someone consults a chiropractor. It only makes sense if you “get” the lifestyle implications of chiropractic—something most patients lack and rarely embrace on their first encounter, regardless of your “mandatory” class. Ask for their hand in marriage on the first date if you wish, but it’s a bit presumptuous and ignores a patient’s allopathic mindset that became entrenched long before meeting you.
“It’s in the patient’s best interest to… (Fill in the blank).” This parental notion has been taught to justify all types of manipulation. Besides emotionally draining (because it doesn’t work very well) and unsustainable, it exudes a profound mistrust of patients. This is the “end-justifies-the-means” mentality that is used to rationalize scare tactics (“You have diabetes of the spine”), produce guilt (“Are you leaving your kids at home to develop the same problem you have?”) or shame (“Do you want patch care that stupid people choose or fix care that enlightened, attractive people choose?”). All this to get patients to do the “right” thing. Hijacking the patient’s free will in this way may extract a few more visits, but at a profound cost to you, the profession and the patient—who vows never to set foot in chiropractic practice again when they have their subsequent relapse.
“An effective report produces patient commitment.” I’m not sure how reporting your clinical findings morphed into a sales session, but my guess is that it had something to do with fully exploiting the patient’s insurance policy. (For their own good, of course!) If you have any notion of practicing chiropractic, as opposed to chiropractic medicine, the consultation is far more important than the report.
“Don’t let the patient give up on themselves.” When patients make the slightest noise about discontinuing care, chiropractors have been taught that it’s a poor reflection on them. You blew it. It’s your fault. You didn’t say the scripts correctly. If you’ve been saddled by this guilt, I’m sorry. God grants each of us the right to treat our temple; our “soul package,” the way we wish. What you would do if it were you is interesting, but superfluous. When you make it difficult for patients to announce their last visit for fear you’ll melt into a weepy puddle or try to talk them out it, you practically eliminate the possibility of a future reactivation.
“I’m the master, the patient is the servant.” Really? Last time I checked masters hired servants, determined whether the servant did a good job and dispatched them when they were no longer needed. Sounds like what patients do to me. Once you fully acknowledge the real powerlessness you have, the sooner you’ll be able to show up as the attractive, humble servant prepared to guide, suggest, facilitate and inspire. Until then, patients have no other choice but to discipline you for your hubris and arrogance.
Is there a place for practice management firms these days? Yes.
1. If you don’t have a paperwork system or you’ve never worked in a chiropractic practice before, a management consultant can be helpful. Procedures, patient flow and perhaps even some hiring skills could round out your education. Shouldn’t take more than a year or so to acquire. If learning this justifies the $500 or more a month, great.
2. If you don’t have the necessary discipline to do what you already know you need to do, you may want to buy an “accountability partner.” If so, you can probably acquire one locally at a fraction of the cost. (Unless you have to pay a large sum to actually compel yourself into action.) In fact, by not knowing what chiropractic is, you could actually get some advice that could better help you connect with the lay public. Put an end to the genetic mutation from inner breeding! Most of the problems dogging chiropractors are rarely chiropractic problems, anyway.
3. If you don’t have a clue about ways to develop yourself as a leader, you may find that an outsider can point the way out the box you’re in or the scotoma you can’t see. Investing in personal development is among the best investments you can make. I’m assuming there are practice management groups that can help you with that.
Realize that management firms are likely to use the same manipulative techniques on you that they teach you to impose on patients. Whether long-term contracts, calling you on the carpet or shaming you into thinking you can’t make it on your own. Here's an entirely different approach if you're looking for a chiropractic consultant.
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