Bedside Manners
by William D. Esteb
It is unlikely that Doctors of Chiropractic will ever be replaced by computers or some high-tech, pneumatic-driven, robotic manipulation machine. The delivery of quality chiropractic care will almost always require the training, intuition, and creativity that only the complex human mind is capable of providing. While a certain level of job security is afforded in this observation, this security can easily be sabotaged by a doctor's lack of social skills, poor rapport-building techniques, flawed communications, or unattractive personality. These non-clinical aspects of providing patient care create one's "bedside manner." In chiropractic we might call it one's "tableside manner." This is the personality purposely projected to, or inadvertently perceived by, patients during the consultation, examination, and day-to-day adjusting procedures in your office. It holds back a great many otherwise excellent chiropractic clinicians.
Certainly personality is an important aspect of building a successful practice. Ask any doctor who has attempted to duplicate the results taught by many practice management specialists who were themselves dynamic practitioners. Many of these procedures make sense only when they are combined with the originating personality. Without it, the procedure or communication model becomes an empty shell and takes on the appearance of a gimmick or an insincere form of patient manipulation. Chiropractic delivered without a personality is like watching television without the sound. It lacks depth and character.
It's unlikely personality transplants will ever be perfected.
Some claim that fundamental personality development occurs by age six or seven. Isn't it the Franciscans who say, "Give me a child for his first six years and I'll own him for the rest of his life"? Does that mean you're hopelessly stuck with your current personality forever? I don't think so. People can change. I've seen it happen.
In the years I've done seminars and conducted in-office consultations, I've met countless doctors with attractive bedside manners. Here are some common denominators which describe these most successful doctors.
Energy. Doctors with effective bedside manners have a high level of two different types of energy. Their psychological energy translates into passion for what they do. They communicate their high level of commitment by this enthusiasm. The other type of energy is physical energy. They have endurance and stamina so they don't tire easily. They are doers. They're still going strong at the end of the day and have the capacity to devote still more energy to their family. They are at their proper weight and, simply put, are quite healthy themselves.
Action step: Become passionate about your work. Find others who are passionate and discover what "revs" them up. Confront your greatest fear about your technique. Take a few post X-rays to confirm that the application of your technique is making structural changes. Start a work out program. Get fit. You must become healthier than your average patient!
Rapport. Doctors with responsive patients who refer others are skillful in establishing rapport with patients. These doctors get along equally well with time-conscious Type A personalities, skeptics, grandmothers, and uncooperative children. Their versatility projects a non-judgmental atmosphere in which all types of patients feel comfortable and welcome.
Action step: Come closer to matching the pace set by your patients. If they speak quickly, you speak quickly. Match their use of language by listening carefully to their cues. Do they make decisions based on facts or feelings? Make sure you speak their decision-making language. Accept patients for who they are. Assume the role of a coach and a mentor. Avoid the "healthier-than-thou" or "do-as-I-say" posture that is so tempting. Be thankful they have entered your sphere of influence. Celebrate their success. Congratulate and affirm their positive behavior such as keeping their appointments, doing their exercises, referring others, etc. Smile.
Time. These doctors run on time. They are keenly aware that a patient's time is valuable, too. Not only is the day well-planned and organized, the doctor is in a "real time" consciousness. He or she knows what time it is and is focused on the moment. This doesn't come off as a rushed form of preoccupation. Just the reverse. Because of good scheduling and a clear purpose, the doctor can truly "be with" the patient in mind and body. Patients sense this focused presence and it raises their self esteem and makes them feel important.
Action step: Run on time. Don't allow walk-in patients to sabotage the relationships you have with your more considerate patients. Teach your staff proper scheduling to avoid conflicts with reports, new patients, and routine adjusting by color-coding patient's names in the appointment book. Make sure your patients know they are buying your skills, not the time they spend with you. Realize your patients have a life and that chiropractic isn't its focus!
Communication. The best practices are run by the best communicators. The more esoteric your adjusting technique, the more responsibility you assume to explain it and generally over-communicate with your patients. An organized and systematic patient education program is just the start. These doctors jump at the chance to talk about chiropractic to groups and regularly conduct lay lectures and orientation sessions for their new patients. Patients know where their doctor stands on a variety of health issues and they find his or her knowledge and openness to be quite appealing.
Action steps: If you do leg length checks tell the patient which leg is longer or shorter. On every visit! Volunteer information in advance. Use language the patient can understand. Don't wait for the patient to ask. Assume every patient wants to know what you're thinking today. Because they do. Keep a running database of what patients tell you on their travel card or SOAP notes so you can refer to these topics on subsequent visits.
Appearance. It may not be fair, but our first and most lasting impression of someone is formed in the first three to five seconds. Successful doctors are sensitive to this fact and are extremely aware of their personal appearance. Their clothing is fashionably current without being faddish. They project an optimistic, upbeat outlook with a polished, button-down attention to detail. They wear natural fabrics, avoid polyester, and have their 100% cotton shirts and blouses professionally laundered.
Action steps: Plan to consistently look a notch better than your typical patient. Men should consider the cost of ear rings, a Mr. T neck chain starter kit, and trendy accessories on the image they project. Make sure your breath always passes muster. Have regular manicures--your hands are your scalpel. Pay extra for good looking comfortable shoes and make sure they're polished. Wash your hands frequently throughout the day so you don't inadvertently transfer a patient's perfume or cologne to someone else, communicating a lack of cleanliness. If you're still smoking, stop. Breath mints don't cover up the odor.
Purpose. This is the most important. Having a clear understanding of one's purpose can compensate for many other shortcomings in one's bedside manner. Doctors who lack the charm and communication skills of an outgoing personality, yet have tapped into the universal power of recognizing their purpose, have a distinct edge. What is your purpose for being in chiropractic? What would you do if money were no object and you were certain to succeed? What would you do if they outlawed chiropractic?
Action steps: Get in touch with your fundamental purpose for being in chiropractic. Take a stand. Make a list of the reasons why you decided to get into chiropractic in the first place. Recall the idealism and optimism you had in chiropractic college. What would it take to rekindle it? Find a mentor who's doing what you'd like to be doing or has a practice like you'd like to have. Pick his or her brain.
You are an extremely attractive and interesting person. You must be if you were called to chiropractic! Only extraordinary people get involved in a profession they were told no one wants. It is only the rare, discerning individual who constantly seeks the truth--and is comfortable with it. Your mission is to take the risk necessary to discover who you really are and make sure it is communicated to your patients. You must be a living testimonial to the value and quality of a chiropractic lifestyle. Are you hiding your lamp under a bowl?
Buy the book
My Report of Findings
Originally published in 1993
240 Pages
US $24.95
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