Patient Media

 

Intelligent or Merely Smart?

by William D. Esteb

When Christopher Columbus "discovered" the new world he changed the way Europeans thought of the world. Now, over 500 years later, the reality of our spherical globe is obvious and rarely given a second thought. Yet imagine the huge numbers of Columbus' peers unwilling to accept this new model, clinging to their flat plate view of the world.

Columbus didn't return to the queen and her court and deliver a 15-minute report of findings explaining his discovery and get immediate acceptance! There were many advisors and leaders to convince. There were so many ingrained agendas to be protected. There were jobs to be safeguarded. Chains of command were threatened. The judgment and trust of religious officials came under scrutiny. There was considerable built in resistance within the social and political order of the day that opposed any change.

Yet, with time, things changed. The leaders adapted and integrated this new truth into their thinking. Those who refused to adapt became anachronisms who lost their ability to influence and lead. Those who embraced, or at least were willing to "try on" the idea, survived and became part of the new order. (It is said that maturity is the ability to hold two opposing ideas in your mind simultaneously.) It is this same ability to adapt which is needed as chiropractic confronts change on many fronts.

In chiropractic circles it is a well accepted notion that the world is organized by a universal intelligence. Most of us call this force God. It is through this intelligence and by this intelligence that our bodies perform the millions of necessary functions to create, pump, and regulate our blood, digest nutrients, remove waste, and appropriately respond to the world around us. These functions are organized by the nervous system and work perfectly if there isn't any interference. Look up the definition of the word intelligence and you'll see a reference to the notion that intelligence is the "ability to adapt." It is our intelligence that permits us to adapt to new places, adapt to new ideas, and adapt to new ways.

Don't confuse intelligence with being smart. A lot of smart people aren't intelligent! A lot of intelligent people aren't very smart. The absent-minded professor who forgets where he put his car keys is almost a cliche'. The inner city teenager with "street smarts" (the ability to adapt to his environment) is very intelligent even though he may not be able to read. Intelligence is a skill necessary for survival. Simply being smart can obscure the bigger picture and get one caught up in the minutia of the moment. It can even lead to extinction!

The full expression of an intelligent life is only possible as a result of an interference-free environment. We can ignore intelligence. We can cover it up. We can misinterpret it. We can deny it. But it is always there; immutable and perfect. For this universal intelligence to provide adaptation by providing a source of truth, there must be no interference. One of the most frequent sources of interference is in the feedback loop confirming previous action. Intelligence isn't a one-way expression, it constantly monitors the environment to insure that the intended outcome has been achieved. The brain sends the nerve impulse to the tissue, the tissue responds, and the tissue sends a nerve impulse back to the brain. As long as there isn't any interference in either direction, the homeostatic balance (adaptation) that allows us to function as we were designed to is permitted. Interfere with any part of this loop, the sending or the receiving and dysfunction results. Every time.

While this is a universal model to describe the function of living tissue, limiting this truth to human physiology overlooks the innumerable situations in which adaptability is so important. Is your management approach merely smart or truly intelligent?

Patient education. It's smart to have a systematized patient education program in your office, but it requires intelligence to assure that your patients understand the material. It takes intelligence to adapt the material or know when to provide supplementary information. It takes intelligence to make sure that the information you're communicating is relevant. Ask your patients how they describe chiropractic to others. Then use your intelligence to correct a patient's misinformed notions.

Changing insurance climate. It was probably smart to accept insurance because it allowed an affordable way for many patients to become introduced to chiropractic. However it isn't very intelligent to ignore the writing on the wall that plentiful insurance cases with low deductibles are almost gone. It is not intelligent to continue as if nothing has changed. While the first reaction may be one of denial, it takes intelligence to adapt. What would you do if insurance was gone tomorrow? Put in place the policies and procedures today that anticipate this eventuality.

Statistics. It is smart to keep statistics because they represent certain quantitative information about what has happened in the past. However your statistics aren't your practice in the same way a map isn't the territory. It takes intelligence to interpret the data and create a suitable response. Better yet, are you tracking any "qualitative" statistics that can predict the direction of your quantitative statistics? Assign a number on an arbitrary scale of between 1 and 10 to monitor your personal satisfaction, energy level, and overall vitality. Track these daily and average them month to month and you'll see they are really the only statistics you need!

Office environment. It may be smart to keep a low overhead because it allows you to see a greater return on your investment. Yet in the long run it sabotages your success. If you intend to be in practice for more than a couple of years it would be more intelligent to invest in your practice. It takes intelligence to know when to update the colors, the furnishings, and the procedures to reflect changing tastes in our culture.

Staff. It may seem smart to pay your staff as little as possible, but it wouldn't be intelligent. Ultimately leading to high turnover, low salaries are often signs of the doctor's lack of respect for the staff. High turnover is among a patient's most frequent complaint about staff members. It raises concerns about the doctor and behind-the-scenes conduct that sabotages a patient's complete trust. A more intelligent approach would be to put yourself in your staff's shoes and see how difficult it is to give a high level of service to others if you're worried about how you're going to make ends meet.

Clearly, it's not an either/or situation. What's really required is a balance between being smart and being intelligent. When you combine the intelligent ability of adapting with the factual, pragmatic skills of being smart and add a good memory, you have something called wisdom.

Wisdom is one of the most valuable traits you can posses. It disappears when the ego renders us impatient or when we lack experience. It tells us when to yield and when to stand firm. It helps us identify principle and purpose.

Chiropractic needs doctors that are smart and chiropractic needs doctors that are intelligent. Today we especially need chiropractic doctors with wisdom. As we embark on a decade that will likely see the emergence of some form of socialized medicine, the rise of HMOs, and the elimination of all but catastrophic forms of insurance, chiropractic must seek the wisdom of chiropractic veterans. The health care revolution of the 1990's will require new levels of adaptation. It will require doctors who have a keen grip on chiropractic philosophy. Moreover, it will require intelligence to change, to modify and adapt this universal truth so that the influencers, the advisors, and the court of world opinion will accept and modify their world views. It will become a time of renaissance and discovery. Perhaps it will be the time when the public will finally discover a truth as fundamental as that of Columbus.

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My Report of Findings
Originally published in 1993
240 Pages
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