Deciding to Decide

by William D. Esteb

After six or eight years of practice the results are almost a cliche'. The staff turns over about every two years or so. Patient volume is comfortable, but not newsworthy. Compliance is satisfactory if the patient has insurance. It's a nice little practice. Family is doing fine. Nice cars.

Ho-hum.

The excitement is gone. The idealistic "I'm-going-to-change-the-world-through-chiropractic" has atrophied. The reason for getting into chiropractic in the first place has been forgotten. Now, it's a living. Your practice has become comfortable. Maybe too comfortable.

The insurance industry tamed your passion nicely.

What grabs your attention now are the legislature's attempt to change the worker's compensation coverage. Self-preservation rekindles the spirit when the state considers capping personal injury awards. The pulse quickens when your patient's insurance agent lies that their automobile insurance doesn't cover chiropractic.

Funny what it takes to get our attention. Start tinkering with our finances and suddenly there's a hormonal imbalance and we're ready to fight.

But usually it's more talk than action. All too often state associations and chiropractic societies have to beg for money. At meetings when the hat is passed, the hallways and bathrooms are suddenly full. Has chiropractic become too easy?

Looked through any of profession's periodicals recently? It's enough to cause vertebral subluxations! The ads, the claims, and the promises of million dollar practices clutter virtually every page. Every "born-again-I'm-not-like-all-the-other-practice-management-firms" ad reduces chiropractic to a financial procedure. Every editorial whines about the RAND study or the 20/20 story or the Dear Abby column. "It's unfair," someone whimpers. "They put us in a box," someone else bemoans.

This is what chiropractic has been reduced to?

For a profession that claims to be interested in "cause" and not "symptoms", there sure is a lot of symptom chasing in the profession's periodicals! When the red headline proclaims, "I'll show you how to get more new patients than you'll ever need," that's treating symptoms. Why do most practices have a voracious appetite for new patients? Why don't patients remain for wellness care? Why don't current patients refer others to your office? Why can't patients afford care in your office? Why aren't there more children and families in your practice? How come your patients can't adequately describe to others what you do?

When you get real answers to questions like these, you'll more likely stop "practicing medicine" on your practice and start looking at cause. Correct the cause and the symptoms take care of themselves. Who wants to bite the bullet and wrestle with the true cause of a less-than-optimum practice?

Even as a nation we resist the pain and delayed gratification of looking for cause. We (and our elected officials) refuse to look our bazillion dollar deficit squarely in the face. We are in denial. To get re-elected no one mentions the elephant sleeping in the living room. Every two, four, and six years the names change, but nothing really changes. Except things get worse.

The management boys have perfected this dance by looking to financial statistics or new patient volumes as an easy judge of the health of a practice. If that type of shorthand only worked! Few management organizations have the courage to tell the truth. Because if they did, the doctors might not reup at the end of their contract. And so it goes. What could be a dynamic opportunity for personal and professional growth turns into a pep rally and a "things-are-okay-at-our-office" form of group denial. Too bad.

What are you going to do after you've heard all the Zig Ziglars of chiropractic and nothing really changes in your life and your practice? What are you going to do with another "this-will-change-your-life" set of audio tapes? How many more manuals do you need? How many more hours do you need to sit on those uncomfortable hotel chairs at seminars? What's it going to take to finally realize, that like each of our inborn potentials to heal ourselves, personal and practice growth is an inside job? When are you going to recognize that practice solutions, like health solutions, don't come from the outside?

You're it!

A new narrative to extract more money from insurance companies won't correct the cause. A new seminar promising a million dollar practice won't correct the cause. A new video, a new audio, a new this, or a revolutionary that won't correct the cause. Only you can correct the cause. And it starts in the deciding. You must decide to confront the sometimes ugly and the sometimes embarrassing truth about you.

For many, this is a difficult decision. Some will wait until circumstances force the required change. Others will prolong the decision to the very last minute. Others will endure what they call their lives, from the cradle to the grave, without ever making the decision. Many will prefer to avoid the introspection required to confront their own lies. (Remember, the truth sets you free. Every time!)

Decide.

Careful! The ramifications of deciding are serious. Deciding will prompt changes. The people around you don't want you to change. It challenges their belief structure. It may cost you a friendship. It may cost you a lifestyle. It will cost. For some, this cost will prevent the personal and professional liberation necessary to have a great life and a great practice.

Decide.

Decide what you want. Decide what you need. Decide who you are. Decide what you want on your tombstone. Decide your purpose for being in chiropractic. Decide to get real and confront that dirty secret or that debilitating fear of yours. Decide to be an example of a "get real" life.

If these types of issues were being tackled at practice management seminars there would be little need for more than a once a year get-together to celebrate everyone's success. No reups. No new forms. No rah-rah. No corny jokes. No bragging. Once you know who you are and decide to live an open life, answers to questions about what forms to use and how to get new patients are embarrassingly obvious.

This isn't intended to be a "cookbook" for how to decide, but here are some observations that I've noticed in those I've met who seem to make decisions effortlessly:

Purpose. It all starts here. If you don't know why you've been put on this planet, you're destined to wander aimlessly without making a real impact.

Values. If you're having a hard time deciding, you're probably not in touch with your own personal value system. How do you conduct yourself when no one is watching? What would you die for? What are your limits? What are your standards?

Outcome. What do you want? What measurable result or impact do you want to accomplish because of being in practice? Until you visualize (and that's important), the outcome you want, you are merely surviving.

Find a mentor. Even the president and the pope have advisors. Are you spending time with people who have the values and outcomes you want? Stop whining and commiserating with the little people. Find someone who will tell you the truth and push you to new limits.

High energy. Deciding can be hard work. It takes energy. Stop watching television and reading the newspaper. De-media your life. Start exercising. Get adjusted more regularly. Eat better food. Walk 30% faster.

Faith. You must believe in a power higher than yourself. Not as a crutch but as a benchmark for your spiritual growth. Seek out others that believe the same way you do. Worship. Get involved.

Notice that none of these aspects have anything directly to do with money. Instead of looking for the best tax-free municipal bonds, it means investing in yourself. You spend so much time and energy serving others and caring for your patients (even taking the disrespectful ones home with you at night) that it's time to invest in yourself. Remember, it's an inside job.

A successful life or a successful practice is a symptom. It is the result of many things. Until you are in touch with the cause of these attractive symptoms, satisfaction and personal growth will forever elude you. Before you become cynical or think chiropractic "did it to you" decide to take back your life. Decide to be selfish just long enough to find out who you really are. The first step is simply to decide to decide. The world will be a better place because of it.

Buy the book
My Report of Findings
Originally published in 1993
240 Pages
US $24.95

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