Chiropractic Blogtag:www.patientmedia.com,2012:/blog//52012-05-17T01:43:48ZMovable Type 3.33When Patients Blame Youtag:www.patientmedia.com,2012:/blog//5.6802012-05-17T01:31:59Z2012-05-17T01:43:48Z“So, what do you know for sure,” I asked Gene who had arrived to clean our windows. “What I know for sure is that I only have nine teeth,” he replied with toothless grin. “Wow, that’s not very many teeth,”...Esteb
“So, what do you know for sure,” I asked Gene who had arrived to clean our windows.
“What I know for sure is that I only have nine teeth,” he replied with toothless grin.
“Wow, that’s not very many teeth,” I observed stating the obvious. “What happened?”
“I’ve had two really bad dentists.”
“What a string of bad luck,” I commiserated.
I suppose there is the possibility that this 56-year old had had two “bad” dentists in a row who were inclined to pull his teeth, but the more I thought about it, it occurred to me that his answer was simply a cover up; a rationalization and justification.]]>
think of missing a visit!”), the high level of patient accountability (“Are you drinking more water like I asked you to?”) and their inclination to care about the patient’s health more than the patient does (because they think their reputation is at stake), create at least two unfortunate pathologies:
Patients who are afraid to announce their last visit.
Patients who seek care elsewhere when their problem returns.
Tragically, these often serve to affirm the chiropractor’s spine-fixing mentality! Since so few patients announce their last visit, these chiropractors don’t see patient relationships ending without a goodbye as normal. For the same reason patients are afraid to announce their last visit, fearing they will be shamed into still more care, when they have their inevitable relapse, they look for alternatives rather than face the imagined “I-told-you-so” from their previous spine-fixer chiropractor. And, since patients don’t seem to return for more care later, the spine fixer imagines that he has, in fact, “fixed” the patient’s spine!
Wow.
Meanwhile, spine fixers rarely enjoy the reactivations and referrals that should easily sustain a practice that has been around for a decade or longer.
I know. Insurance companies want you to “fix” spines and improve functionality. Which chiropractic seems to routinely do. And sure, the pull is strong. But resist! Help every patient understand that if there is going to be any fixing, they will be the one’s doing the fixing.
Naturally, this flies in the face of most patient’s inclination to give you and your amazing adjustments the credit for their health restoration. But it’s a trap!
You can take the credit. In fact, most patients are quite willing to give you the credit. But don’t take it. Instead, make the patient big. Make their ability to self heal, big. Make their judgment to buck the cultural bias against chiropractic and begin care in your practice, big. Make their perseverance to continue care without the instant gratification of relief from a drug that numbs their ability to feel, big. In other words, let them and their ability to self-heal installed by God be the hero. Do that long enough and consistently enough and you’ll have an enormous practice of people who will pay for the opportunity to be around you because of how you make them feel.
Big.]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6792012-05-14T13:00:23Z2012-05-14T13:20:50ZWhat has been the defining moment in your life? When you think back over the years of childhood, adolescence, college, courtship, marriage, family and practice, what event or circumstance prompted you to draw a line in the sand and make...Esteb
Monday Morning Motivation.]]>
Germs! Germs! Germs!tag:www.patientmedia.com,2012:/blog//5.6772012-05-07T15:50:36Z2012-05-07T23:27:45ZAfter you’ve been in as many hotel rooms as I have, you pretty much know what to expect. Electronic card opens the door. Closet. Bathroom. Bed. Television. Chest of drawers. Worktable. Sitting chair. Lamp. There seems to be about 4-5...Esteb
After you’ve been in as many hotel rooms as I have, you pretty much know what to expect. Electronic card opens the door. Closet. Bathroom. Bed. Television. Chest of drawers. Worktable. Sitting chair. Lamp. There seems to be about 4-5 floor plan permutations, but that’s pretty much it. And how much you pay for the room in which you spend most of your time with your eyes closed doesn’t seem to change that.
So I was surprised, even amused, when I checked into my hotel room Friday night in Sioux Falls to conduct a special Debrief for The Conversation and found something that broke the pattern. Next to the telephone (both of them) was an alcohol prep pad. Something one might use to sterilize an area of the body prior to giving an injection.
Since I’m a student of people’s health beliefs and attitudes, I couldn’t help myself when checking out yesterday, asking the twenty-something front desk clerk to explain.]]>
The Germ Theory – After asking patients if they’ve ever heard of the “Germ Fact” or the “Germ Principle,” I’d ask them if they know when and who created our contemporary view of germs. Of course the answer is French scientist Louis Pasteur from whom we get the notion of destroying the value of cow’s milk by pasteurization Louis’s germ “theory” posited that germs were the cause of disease. That small, unseen microbes put man (and beast) at risk of disease. Ultimately, Pasteur saw the light, later recanting his germ theory by proclaiming that “the microbe is nothing, the terrain is everything.” In other words, it’s not the seed (germ) it’s the soil (body). Interestingly, Pasteur died about two weeks after D.D. Palmer delivered the first chiropractic adjustment in 1895.
Black Beans – When discussing the prevailing cultural fear of germs at seminars, I used to hold up a single black bean and observe with mock seriousness, “Scientists have done research on these little black beans and they’ve discovered that wherever you find black bean bushes, you’ll find the remnants of one of these little black beans in the soil. Thus they’ve reached the scientific conclusion that these cause black bean bushes!” Then I would pretend to sneeze, spewing the black beans in my hand at the audience. “Careful,” I would observe with feigned seriousness, “Those beans are going to germ-in-ate!” Highly unlikely, of course, in a hotel ballroom, which of course was the point.
New Lawn – “Have you ever tried to start a new lawn from scratch,” you ask. My experience has been that it’s a relatively difficult task to prep the soil, plant the seeds, water, weed and all the rest. Anyone who has tried it is well aware of the difficulties. Circumstances have to just right for seeds to sprout (germinate) and the lawn to manifest. Same with germs.
Your Mouth – Ask patients how many bacteria are residing in their mouth. If it’s been a couple of hours since they’ve brushed your teeth, it’s likely that they have more bacteria in your mouth than the number of people on planet earth. Turns out, scientists have identified more than 700 different species of microbes in our mouth. “So, how come you’re not sick right now?”
Helpful Bacteria – What many patients don’t know is that we are mostly germs. Germs help us digest our food and countless other tasks. Of the 156,000 categories of germs, only a couple of thousand of them are pathogenic. In fact, cardiovascular disease is a considerably greater threat to us than germs.
When You Die – I’m guessing that if you were to ask patients if they were familiar with John 11:39, only the most committed Bible scholar would know that it records Martha’s response to the command by Jesus to open the tomb of his dead friend Lazarus. “Take away the stone,” he said. “But Lord,” said Martha, the sister of the dead man, “by this time there is a bad odor, for he has been there four days.” Yes, with the immune system hamstrung by the lack of nervous system control (death), it was known that something (germs) were finally free to have a party, producing the stench associated with death and decay.
I’m sure there are other access points. Regardless of how you do it, you might become more mindful that germs trump subluxations. In other words, if you have any hope of getting patients to value chiropractic care as a lifestyle adjunct, part of your patient education overture should be to neutralize the fears and phobias related to germs.]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6762012-05-07T13:00:41Z2012-05-07T12:58:56ZI found myself sitting beside to two software programmers on a recent flight. After small talk about the projects they were working on and the computer language they coded in, the subject turned to something anyone could understand: complaining about...Esteb
Monday Morning Motivation.]]>
It’s Not the Economytag:www.patientmedia.com,2012:/blog//5.6752012-05-03T01:12:29Z2012-05-03T01:21:58ZWhen chiropractors reveal to me that their numbers are down, they reluctantly cite the economy as the culprit, almost as if they know it isn’t true. “People just don’t have the money these days,” they observe. Really? While it’s true...Esteb
When chiropractors reveal to me that their numbers are down, they reluctantly cite the economy as the culprit, almost as if they know it isn’t true.
“People just don’t have the money these days,” they observe.
Really? While it’s true that their $5,000 deductible insurance policy pretty much makes them a cash patient, their financial reserves are exhausted and their unexpected bout of back pain wasn’t exactly a line item in their monthly budget. (Read Financial Fragility which sums this up nicely.)
However, I’ve noticed that they’re still restocking the organic produce department at the grocery store. And I’m still seeing people putting the smaller, less attractive, more expensive produce in their cart—without expecting to be reimbursed by a third party. (The stock for Whole Foods Grocery hovered around USD $10 a share in November of 2008. Today it’s cresting over $80. Hello McFly.)
Apparently there are still plenty of people in your community who value their health enough to pay a premium for organic produce, grass fed beef, cage- and antibiotic-free eggs and rBGH-free milk. All this, while you’re holed up in your office yakking about the biomechanics of back pain and misleading patients into thinking that chiropractic is about bones rather than the nervous system and symptom relief rather than reviving their ability to self heal.]]>
rope-a-dope effect of being so heavily dependent upon insurance carriers is taking its toll. That does NOT mean the end is near. It simply means you need to reinvent your practice. Along with a new headspace, reinventing your practice consists of at least two critical dimensions:
1. Change how you market your practice
You can no longer afford to wait passively at your desk, looking busy, waiting for the phone to ring. You must either take a financial risk or an emotional risk if you wish to grow your practice these days.
Financial risk: This includes spending money on a website, advertising, lowering your fees, coupons and other techniques to entice strangers to begin care.
Emotional risk: This includes conducting patient focus groups, screenings, public speaking gigs, asking patients about the challenges they incur attempting to refer others and actually connecting with people.
2. Change how you communicate chiropractic
Since the human potential and self-development movement didn’t exist a hundred years ago, chiropractic got shunted off into the health care arena. No wonder since the first chiropractic recipient had a hearing issue and the second a heart condition!
The old saying, “If you find yourself in a hole, stop digging,” comes to mind. So the place to start might be to implement strategies that don’t annoy patients. And believe me, many chiropractors annoy their patients. In fact, it causes many patients to seek out a different chiropractor when they have their relapse (since they discontinued care immediately upon the cessation of their symptoms). How do chiropractors piss off patients? Here are a few ways that come to mind:
Pressuring patients to commit to an annual care plan
Nagging patients to come in for care they don’t want
Valuing the patient’s health more than the patient does
Ignoring their God-given free will to abuse their body
Amazingly, many chiropractors have actually paid to attend seminars that teach them ways to annoy patients, justified as being in the patient’s best interests.
Heads up! There are still people in your community who want what you can deliver. People for whom money is no object, but results are. Only problem is, they think of you as a back doctor hamstrung by the inability to prescribe pain medication.
There’s your real enemy. It’s not the economy.]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6722012-04-30T13:00:59Z2012-04-30T13:59:28ZSome chiropractors torment themselves because they link their self-worth to what patients do. Remember... You control which patient’s you’ll accept for care. But they control the priority they place on their health. You control the content and length of your...Esteb
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Reinventing Your Practicetag:www.patientmedia.com,2012:/blog//5.6742012-04-29T17:07:14Z2012-04-29T17:47:16ZI trusted a hunch during my talk yesterday in Minneapolis and made the assertion that “...during the last four months, some of you in this room have actually contemplated what you could do other than practice chiropractic.” After my talk...Esteb
I trusted a hunch during my talk yesterday in Minneapolis and made the assertion that “...during the last four months, some of you in this room have actually contemplated what you could do other than practice chiropractic.”
After my talk was over, one of the chiropractors came up to me and asked, “How did you know?”
“Know what?” I asked having covered dozens of subjects during my talk.
“How did you know that some of us have considered alternatives to practicing chiropractic?”
“Just my intuition based on the vibe in the room. There seemed to be quite a few chiropractors who weren’t having fun. And if you’re not especially passionate about chiropractic, when circumstances get difficult it often prompts a look around for an easier way to make a living.”
“Well, that’s where I am,” he confessed. “Only trouble is, I’m stuck. There isn’t anything else I can do that would generate the income I used to make in chiropractic. And the problem is, even chiropractic isn’t producing the income I need to make, so I’m having to dip into savings.”
There. He had just said out loud what I suspected many chiropractors have been privately thinking.
I wasn’t sure how he was going to take my next observation, but I made it anyway.]]>
Return to Practicing Chiropractic. Most chiropractors these days, especially if they have enjoyed several decades of insurance reimbursement, practice a form of chiropractic medicine. Which means patients think you treat their symptom or condition and that your adjustments are “pain relievers” whose dosage of three times a week controls the speed of their recovery. Instead, make sure every patient fully understands that all you’re doing is reviving their ability to self-heal, which will happen at a pace largely controlled by them, not you.
Establish an Internet Presence. I still meet chiropractors who think this www thing is a passing fad. They force their staff to print out their emails. The calcification reflected by an unwillingness to learn something new is actually emblematic of your current situation. This reflects the same mindset you accuse patients of having who won’t abandon their medicine cabinet or give up unhealthy habits. Learn how to operate your computer. Get a website. Join the rest of us in the twenty-first century. You can do it.
Train and Retrain Your Team. In the olden days (a decade ago) when everyone still had (by today’s standards) generous insurance coverage, your front desk CA was more of an order taker and appointment scheduler. No more. These days, prospective new patients have researched their condition on the Internet, ask far more difficult questions and know that a potentially more accommodating and responsive chiropractor is just a mouse click away. You’re actually losing new patients at the front desk while you’re in the back helping people. You simply must do a better job of staff training.
Wean Yourself Off Insurance Dependency. You must make your practice more attractive to those who value their health enough to pay cash. Turning your practice over to the whims and profit motives of stingy insurance companies will not produce the income you need or deserve. The days of juicy personal injury cases are largely gone (and not coming back) and the high deductibles and co-pays make it foolish to even be involved with filing claims, much less taking assignment!
Reinstate Things That Work. Ask chiropractors with huge practices before so-called “insurance equality,” and they’ll tell you two strategies that worked then and work now. The first is regular in-office spinal care classes. The second is regular patient newsletters. I know. You don’t want to work that hard. Sorry. But you absolutely must get back to the basics.
Refurbish Your Physical Plant. Many practitioners who are seeing their practices erode, are also working in a practice that still sports avocado green shag carpet, garish fluorescent light fixtures and heavy dark paneling. An out of date environment tells patients that you’re out of date, not keeping up and frankly, not optimistic about the future, which becomes a self-fulfilling prophecy and downward spiral to mediocrity.
Don’t Plan on Retiring. Actually, you probably shouldn’t plan on retiring. Besides the difficulty of finding a young whippersnapper with loads of cash to buy your practice outright, you’re more likely to have to carry the paper yourself. That places your retirement on the shoulders of someone you hardly know who may or may not have the chops to keep your legacy going while throwing off enough cash to make payments to you. Meanwhile, you’re at home annoying your spouse. Face it. We’re not wired to sit in a rocking chair on the porch or play golf every day or whatever hallucination you think retirement is. The fact is, retirement kills far too many people. Don’t fall for it. Even if you have to change techniques, I implore you not to withdraw your wisdom and experience in favor of something far less significant.
One of the things I learned and still remember from the first chiropractic seminar I attended in 1981 when I was researching what became known as the Peter Graves video is that the ability of an organism to adapt to its environment is a sign of intelligence. Same thing here. Times have changed. And while it’s aggravating that things didn’t turn out like you planned, at least you’re equipped with the intelligence to do something about it!]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6712012-04-23T13:00:04Z2012-04-23T13:07:49ZEveryone prioritizes his or her health differently. Many chiropractors attempt to change the value a patient places on his or her health. They imagine that they can reason the patient into prioritization. Or educate a patient into prioritization. Or nag...Esteb
Monday Morning Motivation.]]>
It’s Our 13th Anniversary: You Get the Presenttag:www.patientmedia.com,2012:/blog//5.6702012-04-17T16:09:36Z2012-04-17T16:11:47ZHard to imagine that 13 years ago this Friday, April 20th I walked away from a thriving business to start over by creating Patient Media. It’s been an incredible journey and we all thank you for your support over the...Esteb
Hard to imagine that 13 years ago this Friday, April 20th I walked away from a thriving business to start over by creating Patient Media. It’s been an incredible journey and we all thank you for your support over the years.
This year promises to be a big one. We’re bringing back our How Long? brochure with a brand new look. The next generation of patient education videos are slated for release in September. Plus, our newest eBook is in production and some other cool stuff we’ll be announcing in the fall.
As a small token of our appreciation, when U.S. customers place their order for chiropractic patient education products and supplies this Friday, we’ll deduct 13% from the purchase price. To place your order call (800) 486-2337 or if ordering online, at checkout enter the discount code: PM13
Thanks for your loyalty and support!]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6692012-04-16T13:00:02Z2012-04-16T13:04:18ZWhat are you angry about? It may be one of the most common, least useful, yet damaging (for you!) emotions. Your anger reveals more about you than just about anything else you say or do. Is your anger directed at...Esteb
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Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6682012-04-09T13:00:17Z2012-04-09T13:05:37ZBecause of a patient's previous medical experiences, there's an unspoken "social contract" assumed when they begin care with you. If you don't establish new, chiropractic terms of engagement, they assume you operate under the same covenant they've experienced with traditional...Esteb
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Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6672012-04-02T13:00:19Z2012-04-05T13:29:18ZHow long can you persevere, doing something new, without the gratification of seeing results? Take heart in the fact that there is always a lag between when you “do” some new procedure or adopt a new way of being, and...Esteb
Monday Morning Motivation.]]>
Is Practice Worth It?tag:www.patientmedia.com,2012:/blog//5.6642012-03-26T22:23:31Z2012-03-26T22:29:01ZI’m encountering more and more chiropractors in my one-hour consultations who are, or are on the verge of, burnout. Income is down. Savings are dwindling. Documentation is too much of a bother. Patients are problems rather than opportunities. The joy...Esteb
I’m encountering more and more chiropractors in my one-hour consultations who are, or are on the verge of, burnout. Income is down. Savings are dwindling. Documentation is too much of a bother. Patients are problems rather than opportunities. The joy is gone.
With these and related circumstances, some chiropractors are questioning their career choice. Disguising their disdain for patients and their unhappiness in practice has become an increasingly difficult acting job. Many think they’re able to successfully hide their frustration and feelings of being trapped or stuck in a practice that produces less and less joy and satisfaction. (Take this burnout quiz.)
When I work with these chiropractors, many of them are surprised to learn what underlying emotion is producing their lethargic, take-me-out-of-my-misery pity party.]]>
The Conversation.) If you find yourself a little crispy around the edges, or know someone who is, here are some techniques that others and I have found helpful.
De-mediafy. Television and other distractions are convenient ways to divert oneself from facing circumstances. This drug, administered through the eyes, not only fills the time, but also successfully occupies your time so you don’t have to have difficult conversations with yourself or others. I’ve explored the benefits of a media fast elsewhere.
Exercise. With all the time you free up from cutting the cord from your high-def television, start exercising. You must increase your emotional tolerance to stress, and one of the best ways of doing that is to embark on an aggressive exercise routine. Start getting adjusted regularly. Clean up your diet. In other words, start doing what you tell patients to do.
Journal. The benefits of writing to yourself, recording your feelings, exploring your reactions, expressing your frustrations is a time-honored technique for problem-solving. As issues come up, write about them. Why did I respond that way? Why did that make me angry? What are some other ways I could have responded? This conversation with yourself is just the introspection you need to emerge centered, grounded and stronger.
Set boundaries. Where have you invested your energy in which you can’t control the outcome? Where have you “stolen” the responsibility of others? What is the basis of your unwillingness to accept reality? Why do you want to be God? It’s time to align your fences with the property lines of your neighbors.
Remember. Why you became a chiropractor. Sure, you’re older and wiser, but the world still needs the truth. If anything, more so. And if you have the misfortune of not having had some significant personal crusade that brought you to a career in chiropractic, you’re going to need a purpose larger than your own survival to provide the fuel you need. What are you passionate about? Pediatrics? Athletic performance? Headaches? Research? What? Just remember your purpose is not to adjust or see as many people as possible. Doing so may help advance your purpose, but I promise it’s not your purpose.
Confess. This is the one that many find the most difficult, yet therapeutic, of these suggestions. There are people in your life, especially your support team, who have tried to reverse engineer your burnout-driven behaviors. “Am I going to have a job?” “Is it something that I did?” “Why should I care if he doesn’t?” In short, try as you may, your detachment has infected your team and actually worsens an already unhelpful situation. So fess up. If you’re determined to emerge from the charred remains of burnout, you need all the help you can get. Apologize. Ask for forgiveness.
Emerging from burnout takes time. The first step is to acknowledge you’re within its grasp. Because you can’t leave someplace you’ve never admitted to having been.
(Enrollment for the next Conversation concludes on Friday, April 13 when the journaling assignments begin, concluding with the Denver Debrief on May 12-13, 2012. See you at the table?)]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6632012-03-26T13:00:58Z2012-03-26T13:24:59ZNever. Always. Every. These are absolutes. As in no exceptions. As in "You never..." Or "I'm always..." These assertions are rarely true. Instead, when patients use these terms while describing their situation, they often reveal something far more significant is...Esteb
Monday Morning Motivation.]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6622012-03-19T13:00:54Z2012-03-19T12:48:28ZHave you put off a difficult conversation? Is there something you're tolerating? Is there some aspect of your life you're afraid to expose to the light? This week, have that conversation. Address what you've been tolerating. Bring out the bright...Esteb
Monday Morning Motivation.]]>