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Friends or Friendly?

Friends or friendly?Take a hard look at chiropractic practices that have plateaued or have never gotten out of second gear and you'll often discover a chiropractor who gets his or her social needs met from patients. This is one of those guilty pleasures; a luxury actually, that costs the practitioner dearly. Instead of addressing this boundary issue, energy is spent pursuing other, far less significant practice shortcomings that can produce far lesser gains.

Fraternizing with patients is so common within the chiropractic profession, eliminating it rarely makes it on the "To Do" list of procedures designed to expand a struggling practice. Which is fascinating since it's one of the more obvious distinctions of high performing practices.

Ready to bump it up a notch? Then explore the complicated social tango that goes on between a patient and a chiropractor during a typical office visit.

Whether it's a highly focused couple of minutes, or a belabored 15 minutes or longer, adjusting room conversations reveal much about how the chiropractor sees him or herself.

Being Friends

Chiropractors who cross the line and get too chummy with patients may actually be of the belief that showing up as a buddy or a pal will equip them to be more influential. It doesn't. If anything, making the professional relationship more pedestrian decreases your mystique and blunts your impact. Remember Einstein's observation that "The significant problems we face cannot be solved at the same level of thinking we were at when we created them." Lowering your standing by getting overly cozy reduces the significance of your recommendations to little more than that offered by their misinformed friends.

If the subject of your conversations includes the unprompted revelation of your own problems, purchases, plans or accomplishments, you've crossed the line. Worse, revealing what you know about other patients or recounting their predicament, even if you don't divulge their name, reveals that you may not be trustworthy. When tableside conversations degenerate into gossip, many patients wisely respond by becoming less forth coming. Their confidence lessens and visits become increasingly mechanical and lack significance.

And the most obvious boundary-busting behavior is when you see patients on a social basis outside your practice. I'm not talking about a chance encounter at the grocery store. But rather invitations that you accept from patients to attend their barbeques, parties, weddings, social gatherings and the like. Careful! The upside, if there is one, is small and the downside can be significant. It's easier if you decide to never accept such invitations. More problematic is imagining that you "have to at least make an appearance" to fulfill some imagined social obligation. That's why a zero tolerance policy actually makes things easier.

Being Friendly

More helpful in a clinical setting is to show up friendly. Super friendly. Aggressively friendly. That means being approachable, inviting, accepting and curious.

One of the nuances of being friendly is the habit of speaking first. This can manifest as a self-introduction to a stranger or a simple, "What's worth celebrating today?" when you enter the adjusting room. Avoid the silence of "living in your head" that can so easily be interpreted by patients as an unavailable aloofness, moodiness or insecurity.

When you share too much about yourself, especially your own health habits, you risk showing up as "healthier than thou." Patients assume it's your way of revealing your expectations of them. Unhelpful. Instead, you want to show up nonjudgmental and curious. That suggests there shouldn't be any taboo topics. (Many of the more dogmatic chiropractors insist that patients not talk about their symptoms! As if that will somehow prompt patients not to judge their health by how they feel. Nice try.)

Being friendly means showing up interested in the patient. Being authentically curious helps. Giving patients an opportunity to reveal their beliefs, perceptions and worldview can give you helpful insights into how to best frame your explanations and make chiropractic care relevant.

It's tempting to exploit a patient's facedown vulnerabilities to describe your upcoming vacation, your child's spelling bee win or commiserate about some problem you're facing. Busier practitioners are presented with the same temptations. By establishing and fastidiously honoring clear boundaries, they rise above it, remembering their higher purpose, applying greater discipline and having a healthy number of non-patient friends.

Comments (3)

When you have patients every day that you have been putting your hands on biweekly for 35+ years & listening to them confide in you about the multitude of issues in their lives, I feel they are more than just "patients" . . . . almost friends!!


Bill, makes sense to a high degree in which I need to put up a stronger boundary personally. I will immediately work on this! I do have a question regarding invitations to various patient engagements. When does it become rude to continue to decline invitations, when we in turn are regularly asking patients to attend our multiple workshops? May be a silly question but I am unique.


WDE: In my opinion, a patient invite to a BBQ or a wedding is a far different thing then when you invite a patient to a clinically-oriented patient presentation.

Always good to be reminded of this. I do struggle with table talk some days and others not. Any resources for conversation starter ideas, and ways to make visits as impactful as possible?

WDE: Might want to ask a question to get them thinking? We supply 52 patient questions with out Socratic Sign In Sheets. (If you don't use sign in sheets, get them for the questions.) Careful that your table talk doesn't degenerate into ear raping. (Non-consensual conversation.)

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From October 24, 2012 8:22 AM

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