The Art of Being
by William D. Esteb
"I educate my patients, I do regular patient spinal care classes, I give lots of talks to community groups, I advertise in the yellow pages, I don't make patients wait, and I still don't have enough new patients," recently complained a doctor. "What should I do?" he asked with an edge of desperateness in his voice. "Do nothing," I replied, knowing that wasn't what he wanted to hear. "You're already doing plenty; the question is, what kind of doctor have you become?" There was a long pause on the telephone. "What do you mean?"
Walt Disney was once asked if he was afraid that a competitor might steal his ideas for his theme park. "By the time someone sees what we're doing, we're already working on the next idea," said Disney. "Someone who copies the ideas of others is always following. If you want to lead, you must trust your own judgment and instincts." Management guru Tom Peters tells the story of the fast-food executive, who, upon touring Disney World mentioned, "I want our restaurants and our environments to be innovative like Disney's." Peters replied, "If you want to do things like Disney, you have to think like Disney." The relationship between being and doing was never more clearly stated.
As a nation, we are taught the value of doing. We are busy people, rushing from place to place in a microwave-drive-up-window-fast-food world. This overachiever attitude has even invaded our high schools, as many students consult their filofaxes to see if there will be time to fit social engagements between after-school intramural volleyball, piano lessons, and a part-time job. There is little time to simply drink in the beauty of a sunset or think about the meaning of life. Are we creating a generation that thinks security and fulfillment can be obtained in the doing of things and the fulfilling of obligations?
Take a close look at chiropractic today and this same phenomena is evident. There seems to be a fixation on the "things" and "procedures" of chiropractic. With the same energy one would reserve for the search for the Holy Grail, you can find doctors looking for the perfect recall letter, the perfect collections script, the perfect report of findings procedure, and the perfect everything. They want to make sure they are "doing" chiropractic correctly. They are mistaken by the notion that if they do it right, they will acquire the joy and fulfillment originally promised in the helping of mankind.
Interestingly, the offices I've consulted with cause me to believe that chiropractic isn't just something that you do, it is also something you must be.
Procedures versus philosophy
Oh yes, successful offices have procedures. Excellent procedures. Yet, their procedures are the result of a clear purpose and commitment to being an accurate reflection of chiropractic. They are in touch with their personal and professional philosophy. Their vision transcends patient visits and other statistics used by those convinced that procedural improvements are the only way to improve profitability and fulfillment. They don't believe in chiropractic, they know in chiropractic. "Doing" chiropractic is a way they get to live out their philosophy and "be" an influence in the lives of others. The doing comes from the being.
Virtually every practice management procedure you've heard of works. For someone. Doing a confrontational patient recall program works--for some offices and some patients. Not giving a report of findings works--for some doctors and some patients. Making spinal care classes mandatory for all new patients works--for some doctors and some patients. Treating patients on the first visit works--for some doctors and some patients. Using video to systematize the patient education process works--for some doctors and some patients. Why do some procedures work and others don't? Why do some feel comfortable and others push you to the limit?
Who are you?
When you are clear about who you are (being), the doing part of chiropractic is merely a detail. That doesn't necessarily make it easy. It simply means the answers to common procedural questions are more obvious.
In a closely-held small business like chiropractic, the practice is a direct reflection of the doctor. The doctor's strengths and weaknesses take on larger proportions and are revealed by the office appearance, staffing choices, procedures, patient communications, organization, and the countless other aspects that patients use to evaluate the office. Patients use these "moments of truth" to decide if they "like" the doctor, if they trust the doctor, and if they are going to follow the doctor's recommendations. These characteristics go beyond polished shoes, whether the doctor wears a white clinic jacket, or has a office out of the pages of Architectural Digest.
A fight with your spouse affects your practice immediately. However, the same disagreement with the spouse of CEO of a large corporation is diminished because of its size and momentum. Often it is this highly personal realm of relationships, personalities, and energy level that holds a practitioner back. Not procedures. Not location. Not the economy. It's the doctor.
How do you improve who the doctor is (being) so there can be a resulting change in the nature of the practice? I'm not a psychologist; however, here are some of the attributes I've noticed among doctors of chiropractic who appear to be "whole" and have found a happy and healthy balance between the "being" and the "doing" of chiropractic:
On purpose. These doctors know why they got involved in chiropractic and have a "mission statement" they share with staff and patients. Never is, or has been, the motive been to make money. The money is a pleasant result of being true to a higher calling and commitment to serving others. These doctors have committed their vision to paper in the form of a "Statement of Purpose," revealing the what, how, who, why, and intended result of being in practice.
In touch with reality. Because these successful doctors have a high level of self-esteem, they have created and encouraged advisors to give them the good news and the bad news about their practices. Rather than kill the messenger who brings bad news, these doctors welcome staff members to be forthcoming with patient comments and staff perceptions about the doctor and the practice. You will not find the "Emperor's New Clothes" syndrome in these offices. They hold frequent patient focus groups, use patient questionnaires, and have weekly staff meetings.
Excellent communication skills. They are in touch with their own values and beliefs and they exude a sense of confidence and approachability that patients find attractive. They are active listeners, communicating compassion and interest. They frequently tape record the report of findings, initial consultation, and other patient communications and relisten to these crucial moments with a critical eye for constant improvement.
Challenging mentors. If you want to grow, surround yourself with big thinkers. Most of these successful practitioners are members of "mastermind" groups or search out those who share big dreams. They surround themselves with other "Walt Disneys" of chiropractic. They attend and actively participate in seminars. While they are open to new ideas, their purpose and self-confidence help them avoid opportunity chasing and violent shifts in office policy. By the way, these doctors are voracious readers (or audio cassette listeners), reading books and periodicals outside the discipline of chiropractic.
Long-term vision. Successful doctors look beyond a 90-day vision of the future and look at each new patient as an opportunity to create a lifetime relationship. Office procedures such as recalls and reactivation schemes take on a different perspective among those with whom you wish to have a 10- or 20-year relationship. While they don't succeed with every patient, they attempt to create chiropractic clients out of chiropractic patients. They are willing to delay gratification.
Confront their fears. We all have personality flaws and deep, dark secrets we try to hide or cover up. These weaknesses sap a great deal of energy as we try to keep them hidden. Those who are successfully implementing their ideas of an ideal office have confronted these concerns through 12-step programs, support groups, and counseling. They emerge more compassionate and are quick to avoid the holier-than-thou attitude that can cloud a doctor/patient relationship.
Spirituality. Related to being "on purpose" mentioned above, these doctors, while not necessarily "religious," do have a spirituality about them that keeps them centered and in touch with God. Reacquaint yourself with your fundamental beliefs--what would you die for?
Honesty. Simply put, they are sticklers for honesty. Cash payments get recorded and don't find their way into pockets without a complete accounting. They bring out this quality in their staff too. Because they have an "abundance" perspective (instead of a scarcity outlook), they would much rather pay an extra dollar in taxes than experience a single sleepless night.
The bottom line is, these doctors are walking their talk. They take responsibility for the direction of their offices and are slow to blame events in the office on the economy, insurance companies, weather, location, and all the other factors that are convenient excuses. Patients find doctors with this inner-confidence and self-knowledge very attractive. No wonder these doctors have successful practices.
Buy the book
A Patient's Point of View
Originally published in 1992
240 Pages
US $19.95
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