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The Hard, Narrow Path

rock climbingAs I consult with chiropractors, I’m increasingly hearing language that suggests many feel responsible for a patient’s recovery. Naturally, this will hobble attempts to grow a practice and help more people. Instead of explaining to patients that the purpose of chiropractic care is to revive their ability to self heal, these patients (and chiropractors) think that the adjustments are “treating” their headache, back pain or other named ache or pain. Overlook this critical distinction, and besides frustration and misunderstanding, you’ll find yourself emotionally drained by imagining yourself responsible for things that you are not able to respond—such as what a patient’s body does with the energy you add at opportune times and places along their spine.

“But Bill, you don’t understand,” I can almost hear you say, “If I don’t help them with their problem they’ll leave.”

Really? Is that true?

Those who believe this are probably chiropractors who fail to establish a clear boundary at the beginning of the budding relationship, outlining what they’re responsible for and what the patient is responsible for.

Without setting this boundary, patients simply apply the social contract they’re most familiar with: their experiences with medical doctors. Which usually means one or more of the following, ever so slightly exaggerated to make the point:

Doctor Big. Patient Small. Instead of collaboration, most patients assume a subservient position, relying almost entirely on the doctor. Relinquishing one’s personal power to another, even a well-intentioned doctor, is dangerous and practically invites abuse. When a patient feels like a small helpless victim, it can hinder the healing process.

Doctor’s Orders. Many patients are not inclined to question the recommendations of a doctor—at least out loud. And while such power and cultural authority has eroded, many patients will eagerly surrender their responsibility to a doctor, especially one who seems certain and authorative. “Take my headache, I don’t want it!”

Doctor as Hero. Doctors are often seen as heroic figures, relieving pain, suffering and saving lives. Racing the clock. It’s only natural to revere someone who has been so significant and helpful. And few doctors are inclined to demurely brush off the anointing’s or correct patients so inclined.

Doctor/Drug Responsible. Patients are likely to credit the doctor, the surgeon, the drug, the hospital or some other outside agent rather than their own God-given ability to heal.

If you practice in the so-called “developed” world, you can reasonably assume that most patients, especially those who are chiropractic first-timers, drag one or more of these beliefs in with them when they begin care. It doesn’t take much imagination to predict some of the resulting patient behaviors. Do any of these sound familiar?

1. The expectation that you’ll “fix” them without them having to lift a finger or make changes to their lifestyle.

2. That it will take no more than a couple of visits.

3. That like resolving an infection, the “fix” you’re providing, after years of neglect, will be permanent.

4. Impatient with the speed of their recovery, as if something about your adjustments controlled it.

5. Remarks like, “Whatever you’re doing it’s really working!” and you find yourself taking the credit.

6. Blaming you with assertions like, “I’m not getting any better,” and finding yourself becoming defensive.

All this because you neglected to clarify what you’re responsible for and what they’re responsible for. Because chiropractic is different than medicine. Because it was more tempting to show up as a doctor instead of a chiropractor. Because that’s what how you were taught.

These are just a few of the dangers of practicing chiropractic medicine instead of practicing chiropractic. Yes, it takes greater communication horsepower. Yes, it’s more work. Yes, this distinction will be lost on some patients (and chiropractors). But did you think taking the hard, narrow path of being a chiropractor was going to be easy?

Comments (1)

Juan-Carlos Portillo:

Bill,
I appreciate you firm and clearly stated comment. Chiropractic is different than Medicine! Are you sure you don't want to become a chiropractor? Thanks.

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From January 30, 2011 9:13 AM

This page contains a single entry from the blog posted on January 30, 2011 9:13 AM.

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