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July 2009 Archives
Law of Fair Exchange
In every transaction, there must be an equal exchange between both parties. If not, expect a short-term relationship and an unsustainable business.
Countless chiropractors break this law when establishing or administering their patient financial policy.
At one extreme is the practice that allows patients to run up high, outstanding balances in which the debt, or a large portion of it, becomes uncollectible. They think by not insisting on payment that they are somehow doing the patient a favor.
At the other end of the spectrum are practices that force annual care plans, seducing patients with low, amortized visit fees which (in the fine print) are withdrawn should the patient discontinue care early.
Fair exchange is part of the healing process. And referrals! You'll rarely get referrals from patients who leave owing large outstanding balances. And if you do, those they refer know that you don't respect yourself enough to expect payment.
I see that one extreme end of the spectrum of your Law of Fair Exchange below is the annual care plans. My fiancé and I are newer chiropractors, and we were suggested the annual care plan by our mentor. We do not force it on every new practice member, but do offer it.
I've had some reservation about it, but we've found that a few members wait to choose it until after they start to see result (clearly, our ROF is not where it needs to be yet).
Could you elaborate on why the annual plans are not a fair exchange? Maybe this is at the root of my hesitation.
Hesitating in Calgary,
Dear Hesitating in Calgary,
There is nothing intrinsically wrong with annual care plans. Patients who “get” that chiropractic care can be an adjunct to a healthy life, rather than only a short-term “diet” for pain relief will usually appreciate the savings and convenience of an annual care plan. As such, if I were in practice, I would offer an annual care plan, but patients wouldn’t be eligible for it until 60-90 days out, or if they understood the lifestyle implications because they had been under chiropractic care previously, and they were nonsymptomatic, they could start immediately.
My angst about annual care plans is the heavy-handed “selling” of them in an attempt to get the patient to do the “right” thing—at least in the eyes of an enlightened chiropractor who plans to get adjusted for the rest of his or her life. Since most patients enter a chiropractic practice after a lifetime of symptom treating at the hands of medical doctors, the sales overtures amount to talking about kids and marriage on the first date. Or, patients are seduced by what they see as a lower-cost-per-visit, ignore the fine print and begin care with little or no interest in embracing a chiropractic lifestyle.
And not sure what you mean by “our ROF is not where it needs to be yet.” When you report your findings to the patient and offer them choices for acting on what you’ve found, where does your report need to get? You probably want to be careful about turning your report into a sales session. In fact, mixing your clinical findings with overt or covert attempts at getting the patient to do one thing or another, starts to take on the odor of manipulation.
Law of Opposites
We live in a universe of duality. Day and night. Winter and summer. Birth and death. Good and evil. Boom and bust. One cannot exist without the other. In fact, it can only exist because of the other!
Imagining that you can have the crest of the wave without the bottom of the trough ignores this simple reality. Expecting that your practice can grow and grow and grow and expand forever, while the focus of many chiropractors' dreams, is impossible. Expansion without contraction is actually unhealthy. When this happens in the body we call it cancer.
Whether success or failure, realize that this shall pass. It may not seem that way at the time, but it's true.
If you're in a trough now, first be grateful. Then, faithfully prepare for the upcoming crest. Because it's coming. Clean. Organize. Repair. Reinvent. And if you have enough faith, use this time to rest.
I find it hard to present choices in an objective way when I obviously want them to choose the healthiest path.
I sometimes feel my ROF comes across as, "Here's a choice, or if you’re a total idiot you can choose this.”
So I get a lot of acceptance at the ROF, but then I have a dropout rate the same as others. How would you suggest making patients feel comfortable choosing short-term relief or corrective care. Or lifetime care for that matter?
Continue reading "Dear Bill" »
Law of Attraction
Much has been written about attracting what we want into our lives. But consider an aspect that may have been overlooked, even with all the buzz surrounding The Secret and What the Bleep Do We Know?
Ever see a magnet with just a north pole?
A magnet is powerful because one pole completes the other. Just like your spouse completes you, your staff completes you and even your patients complete you. Without this completion, we have the equivalent of a free radical.
If you show up in your life or your practice with the need to control, then you'll largely attract emotionally-draining patients who must be managed. In fact, it's the primary type of patient you attract since self-responsible individuals find you overbearing and well, unattractive.
If you don't care for the people or circumstances showing up for you, show up different before you can expect to attract completions that are more pleasing.
Law of Conservation of Energy
We are energy. The chair you’re sitting on is energy too. Granted, in a different form, but energy all the same. Based on the First Law of Thermodynamics we know that energy is never created or destroyed, it merely changes form, taking the path of least resistance.
When you adjust a patient, you’re adding energy to the patient’s body. What the patient’s body does with that energy is out of your control. Perhaps their body is still in defense mode; the stressor still being present in their life. Imagining that you can control or regulate how someone else’s body uses energy is as foolish as thinking you can lose weight for someone else.
Energy always moves from high concentration to low concentration; from high vibration to low. This process of dissipation can make your reaction to certain patients a drain. But remember, it’s not them. It’s your reaction that’s draining!
Seeing the delays that our summer evening storms produce for flights leaving and landing in Denver, I opted to take an earlier flight out of Denver on Sunday. The original flight offered a mere one-hour layover in San Francisco to connect up with the once-a-day flight to Sydney and then on to Auckland, New Zealand for the first leg of my journey. My revised flight would give me a comfortable three-hour window to change planes in San Francisco.
However, a mechanical problem with the aircraft delayed its departure from Denver. These things happen. With a three-hour cushion, I felt reasonably sure that my intuition to take an earlier flight would still prove to be wise.
However, as our wait continued and approached (and then passed) the departure time of my original itinerary, I received an insight that I’d never considered before.
Continue reading "Day 1" »
After sleeping in to a luxurious 8:30 AM, I enjoyed the “free” breakfast included with my $49 room at the Grosvenor Best Western Hotel, just north of the San Francisco airport, compliments of United Airlines.
While it’s convenient to knock the airlines and draw broad assumptions based on a particular incident or airline employee, my perception is that airline travel has been largely commoditized. In other words, the logo on the tail, the color scheme of the interiors and the uniforms of the flight attendants are about the only distinction these days. Let’s face it, competition for seats has turned most airlines into upscale buses. In fact, many airlines fly aircraft manufactured by a European company called Airbus.
Once again, I was reminded that there is no such thing as a coincidence. Since I was still on the ground and not over the Pacific somewhere, I was able to answer some emails, solve some problems and do some writing. Then, my brother picked me up for an afternoon at the beach. Little did I know that more airline problems were still ahead.
Continue reading "Day 2" »
The flight from Honolulu to Auckland was about 9 hours. The plan was to sleep on this leg so I would be fresh for my Conversation Debrief scheduled to begin an hour and half after I arrived. Naturally, sleeping makes the flight considerably shorter. However, with the exception of about two hours of fitful sleep, most of the flight was spent attempting to get comfortable.
The Auckland Debrief was held in the boardroom at the New Zealand College of Chiropractic. It was a diverse group. Among them were two college faculty members, an experienced chiropractic veteran of 33 years and a newbie in practice a mere three years.
Thursday, the following day, was a 6-hour presentation to the first and fourth year students of the college. Wow. Attentive. Respectful. And they asked great questions. Such a very different experience than I often experience at chiropractic colleges in the states. Further proof that not only does New Zealand have the purest form of chiropractic, the future of the profession appears to be in good hands.
This page contains all entries posted to Chiropractic Practice Blog in July 2009. They are listed from oldest to newest.
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