Business consultants suggest that it’s helpful to know what propels your business. When you examine your practice, what is its primary focus that motivates your decisions and direction? I’ve seen five:
Technologically driven – Technique and procedures.
Philosophically driven – The meaning of chiropractic.
Financially driven – A focus on new patients and income.
Marketing driven – Needs and perceptions of patients.
Survival driven – Staying viable to face another day.
Each driver reveals a great deal about you, your worldview and how you see yourself fitting in to the lives of patients and the world of work. If you find yourself working more but enjoying it less, it may be because you have surrendered the wheel to another driver.
Practices that are technologically driven are usually focused on the “how” of chiropractic. At the helm of these practices are chiropractors who are constantly scouring the horizon looking for adjusting techniques, procedures, scripts and gadgets that can best produce patient results. And naturally, results (generally symptom relief) is what patients want.
Often misled into thinking that excellent clinical results is all that it takes to produce loyal, appreciative patients, they are often guilty of seeing patients as merely spines; canvases on which they work their healing magic. Their diagnostic prowess, “golden hands,” cold laser, decompression unit or whatever, is exalted as the key differentiator of their practice.
Practices that are philosophically driven tend to be focused on the “why” of chiropractic and its broader implications. They often see the patient’s health complaint as a metaphor for other issues in the patient’s life. They make a critical distinction that their intervention, whether a thrust, a click, a tap or a touch, simply releases the patient’s inborn ability to heal.
Since few patients show up in a chiropractor’s practice to obtain a new understanding of health and healing, much less a desire for the metaphysical dimensions of chiropractic, these practitioners are often perceived as idealistic and out of touch by their patients. And many are. In love with the “big idea,” these chiropractors repeat mantras and make proclamations that distance them from many patients. In fact, even calling them patients is verboten and considered distastefully medical, even though their customers see themselves as patients.
Practices that are financially driven have an inordinate attachment to new patients, since they appear to be the most profitable type of customer.
Financially-focused practices recognize that theirs is first a business, and second, a healing center. Central to this practice style is a keen awareness of reimbursement protocols, insurance coding and a willingness to surrender to a symptom-treating-biomechanical model of chiropractic.
Because they rarely see the long-term lifestyle implications of chiropractic, most patient relationships are of shorter duration. And since patient visit averages tend to be in the low, double-digit range or even less, they have a voracious appetite for new patients. This is often accomplished by aggressive advertising, screenings or outreach programs.
Practices that are marketing driven aren’t necessarily big advertisers or coupon discounters. That’s advertising. Instead, they are keenly sensitive to the wants and needs of their customers (patients). And that doesn’t mean letting the inmates run the asylum!
Market-driven practices acknowledge that most patients have been brainwashed by a lifetime exposure to the medical model of health care. Without making patients wrong, they recognize their obligation to educate patients and are proud of what makes chiropractic different. They realize that the best long-term strategy is to offer what patients want and earn the right to suggest what they need. In this environment, patients feel safe to start and stop care many times over the course of many years without feeling guilt or shame. Some patients will even “get” chiropractic and embrace a schedule of periodic visits.
While new practitioners often find themselves in this stressful predicament, veteran chiropractors who haven’t adapted to the post-insurance practice environment, find themselves here as well.
Most survival-driven practitioners make practice about themselves and what they can get from their practice. And no wonder. With school loans, startup costs, the belief that they should be earning a “doctor’s salary” and the pressure from friends and family to be “successful,” it is tempting to succumb to manipulative strategies to extract money from patients. Tragically, these techniques, whether hard-selling care plans, X-raying the patient’s checkbook or more subtle, taking on a chameleon persona so they will be liked, scar the practitioner’s reputation or make them feel dark inside. Neither is sustainable.
These are the five drivers I’ve seen. What drives your practice?