The Decentralization of Chiropractic
by William D. Esteb
John Naisbitt (Megatrends) referred to it as decentralization. Tracy Popcorn (The Popcorn Report) called it cocooning. Whatever the nomenclature, what these two accurate soothsayers of the future agree on, is that as a culture we tend to be moving away from institutions and central authority and towards separatism, diversity, and a sense of turning inward. The "me" generation of the 80s has become the "free" generation of the 90s. More and more people are less willing to define themselves by what group they belong to, the things they buy, or the beliefs they hold.
The trendsetters of our culture who have the resources to act on these feelings, first moved to seaside Malibu to escape the oppression of L.A. When that lost its uniqueness, the Rocky Mountains of Aspen became the magnet. Now Montana and Idaho seem isolated enough to reflect this urge to drop out of the mainstream. Who knows the next locale that will appeal to the desire to escape.
The trend called cocooning, which plays heavily into Popcorn's observations can be seen in the recent rise in videotape rentals and decline in movie theater attendance. More and more restaurants are offering delivery and take out service. Microwave popcorn and home security systems are growth industries. More and more people are finding it unsafe or unsavory to go out. Instead they're staying home. Products and services that are growing are often those that reflect this growing sensitivity to matters of family, security, and local convenience. Home remodeling is in. Buying a bigger house is out. Pizza delivery is in. Eating out is out. Savings accounts are in. Foreign aid is out.
At a time when the United Sates is thought of as the only super power and the policeman of the world, we want to turn inward and protect our jobs and educate our children at home. An isolated superpower is an oxymoron. What's it going to be?
These same attitudes are being felt in the area of health care. The centralization of health care (hospitals) are losing out (or spawning) the highly popular "doc in a box." Hospital administrations, seeing the trend, are now getting into the business themselves, claiming the best of both worlds; "neighborhood convenience backed up by the largest hospital in the city..." The message is clear: adapt or die. A growth sector for today's hospitals? Same-day outpatient surgeries.
Perhaps pharmaceuticals are the most decentralized of all. Yes, they are initially purchased at a centralized location, but as a treatment, most drugs and medicines are highly portable. They can be taken into the cocoon. If you're unable, many pharmacies have a delivery service. Perfect!
How does chiropractic fare in this new cultural order? Does chiropractic need to make changes to adequately respond or take advantage of this new reality? You decide.
Like elective, same-day surgeries, patients must go to a somewhat centralized location. Your office. Fortunately for you, your office is probably more convenient, located in a safe suburb instead of a decaying downtown location. However, unlike drugs, chiropractic cannot be stored up or easily transported. In chiropractic there is simultaneous production and consumption. It can never be a commodity--it is a service. Domino's can store up pizzas, but Domino's can't store up its delivery!
Because this is an uncharted area, some of these ideas may sound impractical, expensive, or inappropriate. That's all right because after all, who can really predict the future?
Location. Location is taking on a new meaning. The question isn't just drive-by traffic count and zoning laws affecting clinic signage, but are you in a growing neighborhood or a decaying neighborhood. Prospective patients are judging you based on the character of your office location. Sadly, the inner city is often being left to the disenfranchised and those who cannot afford to move out.
Accessibility. The Southland Corporation, owner of the chain of 7-11 convenience stores, describes optimum accessibility as "on the right, right on the way home." They are the masters of accessibility. This is a further refinement of the location aspect. Not only must your office be located in the right neighborhood, it has to be easy to get to. Parking is more of a factor affecting compliance than many doctors recognize. Many patients size up the number of cars in your parking lot and drive right on by. They know that lots of cars means a long wait. Instant gratification is in. Waiting is out.
Hours. Related to accessibility, your hours of operation reveal a lot about you. Countless dentists have built successful practices serving patients between 6:00 AM and 9:00 AM or 5:00 PM to 11:00 PM. If you're in a suburb or bedroom community to a large city, consider trying some extreme hours. Are you an early riser? How about 5:30 A.M. to 10:00 A.M. once or twice a week?
Lighting. Parking lot safety is an issue critical to all offices during the winter months. Then, even the most mainstream office hour arrangement can mean that patients are leaving your office in the dark. Ask your staff and a handful of trusted female patients if they perceive your office as safely lit.
Noon lay lectures. Not wanting to leave the cocoon at night or to be delayed in getting there, consider lunch time spinal care classes. Encourage patients to bring a friend from the office. Serve a light lunch or fruit tray. Come up with alternatives to the 6:30 PM health talk.
House calls. More and more medical doctors are reviving this "new" idea from a previous generation. In the same way few patients will trouble you at home if you offer your number, few will take advantage of this extraordinary gesture. Offer anyway. It makes an important statement about your accessibility and sense of caring. (Of course it costs the patient more. But cost isn't always the issue--quality and convenience is.)
New Patient Information. Help make it easy for people still at home to get to know you and decide if you are what they need or want. Help them "pre-qualify" themselves. Put together an information packet about your office. Introduce yourself and reveal your motives for getting involved in chiropractic. Share your health attitude and your mission. Explain what generally happens on the first couple of visits. Include some simple home screening tests that would suggest the value of an in office visit. The goal is to put a prospective patient at ease and help lure them out of the security of their cocoon. Of course, let your current patients know you have this information so they can tell others about it!
Home care. While an adjustment isn't easily transportable like a bottle of pills, exercises and certain other adjunctive procedures are. This doesn't mean 100% of your patients will comply, however it helps patients feel they are in control and participating in their own recovery. Give every patient something they can do at home, even if it is as simple as sleeping with the right type of pillow or doing some simple exercises.
Some of these ideas are old ones. Others may push you beyond your comfort zone or don't seem to make sense where you practice. Just remember the world is changing. Simply doing more of what used to work is no guarantee of success in the future. Read John Naisbitt's books. Read Tracy Popcorn's The Popcorn Report. Read Alvin Toffler's Future Shock. Read Ken Dychtwald's Age Wave. Find out what people who are on the lookout for business and industry are thinking about the future. And then ultimately recognize that the easiest way to predict your own future is to invent it.
Buy the book
My Report of Findings
Originally published in 1993
240 Pages
US $24.95
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