The Allure of Instant Gratification
by William D. Esteb
Seems that time has become one of the most talked about commodities of the 1990s. Free time, family time, quality time, waiting time, commute time, down time; time has become the new measurement of luxury. The time to relax, time to read a book, time to "be" instead of merely "do".
There are countless books that give practical time management tips on how to get more out of each day and be more effective. Yet, the real challenge in chiropractic is not the procedural enhancements that better time management offers; it's the self-confidence and professional image that is projected to patients by one's use of time and vision of the future.
We are a culture weaned on a short-term vision of time. Every evening the air waves are filled with half-hour soap operas that suggest difficult interpersonal problems can be resolved with happy endings in about 22 minutes plus commercials.
Health clubs and diet book authors profit from those who think club membership or buying a book will automatically result in weight loss and good looks. The heaviest and unhealthiest people have bookcases full of these types of books. Expensive running shoes are discarded after four or five uses because the pounds don't come off fast enough.
We neglect to discipline or set firm guidelines for our children to avoid confrontation or hope they will "like us" in the moment, overlooking the long-term consequences of poor character development.
Patients fall into a short-term view of their health (pain relief only) and in the process preventive and maintenance care are overlooked. In fact, many doctors overly celebrate the achievement of symptomatic improvement and as a result affirm their patient's short-term vision of health as a destination. Patients end up riding a roller coaster of a series of acute flare-ups. Their monthly visits are mistakenly categorized as wellness care as they continue to invent symptomatic reasons to involve their insurance company.
Wrong tactics
Counterproductive short-term strategies abound throughout chiropractic. Advertising, mall shows, pseudo-research projects, and other schemes look for temporary gains at the expense of professional image and the slow, progressive repositioning necessary to effect real perceptual (and utilization) changes by the public. Whether advocates of these ploys are oblivious to the danger, merely opportunistic, or both, is hard to say. While the motivation to share something as powerful as chiropractic with the world is compelling, the tactics are wrong. Meanwhile, the professional image of chiropractic as a serious health care resource deteriorates.
Some of the chiropractic offices I have visited seem to have about a 90-day vision of the future. Looking around the office, you sense that with a couple of hours and half-dozen U-Haul boxes, the space could be vacated for immediate use by an ear, nose, throat specialist. Upgrade the carpet where the path leading to the sign in sheet has been worn? Heavens no! We only have a three-year lease. Replace the cheap reception room chairs (purchased years ago when price was the major consideration) with something more comfortable? Oh no! That would cost money. Recover the worn adjusting table fabric? Impossible, we're too busy. The aesthetics and impact of these image-sensitive furnishings are often overlooked by those who would rather try a shot at the lottery or invest in the stock market than invest in their own office. The return on investment in your office, while not instantaneous, will always be higher than the best rated tax-free municipal bond.
What is your vision?
What is your vision for the future of your practice? How long do you expect to see your patients? Ten visits? Twenty-three visits? Fifty-three visits? A lifetime? Your expectations affect the way you treat your patients and their perceptions of chiropractic. Things you do (or don't do) to a patient you expect to see only 12 times won't necessarily sustain a long-term relationship. Medical doctors (who are seen only rarely) can get away with 45-minute waits, whereas chiropractic doctors (who expect many visits) must keep the waiting time short. It's the expectations of the relationship that set the standards.
The positive dimensions of fostering a long-term relationship are especially obvious in Carl Sewell's book, Customers For Life. Carl Sewell owns the largest Cadillac dealership in the world. Sewell Village Cadillac in Dallas has perfected the art of creating long-term relationships. In fact, the typical first-time Cadillac purchaser at this dealership returns to buy seven more Cadillacs over the next 22 years. Thus, each first-time customer represents almost $225,000 over the course of a lifetime relationship. Obviously, customers who walk onto the showroom floor are treated differently than at the Ford dealership down the street with a sales force interested in simply making this month's sales quota. A $15 misunderstanding in the Sewell Village Cadillac service department becomes less of an issue when the desire is to create a long-term relationship worth thousands of dollars. If the service department manager has a short-term outlook, he might "win the battle" of collecting the disputed $15 and "lose the war" of keeping a lifetime customer. You can't win an argument with a customer, client, patron, or patient.
Similar opportunities are seen in restaurants. The "order taker" with a short-term vision of the future is worried about tonight's $5.00 tip. The career-oriented "wait person" is aware of the positive word of mouth and the hundreds, perhaps thousands of dollars that may be lost in the years ahead that are jeopardized by one experience of poor service.
Living in this short-term world has infected almost every aspect of our culture. Our most popular television fare is an often unacknowledged accomplice by feeding us the images of conspicuous consumption. Are we so shallow that we allow ourselves to judge ourselves and others by what we can buy? The most visible result is a heavily leveraged lifestyle put at risk at the slightest economic downturn. The question is, are you serving the public to service your debt, or are you serving because of your debt to the public?
Spending problems
Spending five percent more than we make each month has become the American way. We are less impressed with the methodical growth of compound interest and more interested in a "win the lottery" strategy. Forget the million(s)-to-one odds. Somehow we think we can escape our lack of discipline and self-created financial predicament by some unexpected windfall. Yet, the squandering of millions by the winners in state sanctioned gambling has almost become a cliche. Most financial difficulties are spending problems, not earning problems.
If you'd like to adopt a longer-term vision of the future and reap the benefits of delayed gratification, here are a few suggestions:
Nurture long-term relationships. Think of every new patient as the start of a 20-year relationship--with or without chiropractic being part of it. Is every staff member you've ever had still returning to your office for care?
Set goals. How many times have you heard it, but haven't yet done it? Still only a fraction of the people I meet have set short- and long-term goals for themselves and their careers.
Patient development. If you're inclined to do mall shows, public lectures, and other public events in your community, frame them in your mind as outreach opportunities, not as new patient gimmicks. See yourself as a sower rather than a reaper.
Visualize outcomes. Not having a clear picture of the result of your efforts is one of the greatest oversights. Imagine the outcomes of faster staff training and better organization of having a procedural manual. Imagine the outcomes and benefits of having a systematized approach to rewarding referrals.
Work with more children. Are you doing your part to prepare the next generation of chiropractic citizens? Attract more children and you can experience the affirmation and almost instant gratification of quick recovery while laying the foundation for a healthier future.
Abandon statistics. At best, statistics are a rear-view mirror look at your past. If you look in your rear-view mirror long enough, you will hit the curb as times change. Recognize what statistics can and cannot tell you, and don't be alarmed by the macro (and usually inaccurate) view that many statistics offer.
Record your expenditures. Spending problems are more easily detected when you record every penny you spend for a couple of months. You'll discover your lack of financial health isn't the result of $200 and $350 purchases, but lots of $12.50 and $25.00 purchases. The little things are what get you.
When you consider the universality of the chiropractic truth and the timeless infallibility of the nervous system (if there isn't any interference), it makes sense to adopt a long-term vision of the future. Because chiropractic will survive the insurance crisis. Chiropractic will survive the state legislature tampering with worker's compensation laws. And chiropractic will even survive the short-term-medical-eliminate-the-symptoms approach of the most short-sighted doctors of chiropractic.
Buy the book
A Patient's Point of View
Originally published in 1992
240 Pages
US $19.95
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