The Counterfeit Practice

by William D. Esteb

At least one of the purposes of this journey called life is to fully become who we really are. Knowing who we are is essential if we are to be part of the solution, instead of the problem! Yet, by their behaviors, it appears as though the vast majority of people have a limited model of who they really are. The temptation to keep who we are a secret from others is compelling. After all, if someone doesn't like us when we reveal our true selves, where could we turn? Instead, we present a facade. It is in discovering who we are and being genuine and authentic to that vision, that we have the most confidence, influence, and power.

Not knowing who you are exposes you to the whims of the world. Many become the equivalent of the ball in a pinball machine, bouncing from one problem, situation, or opportunity, to the next. Life happens to them. They are largely reactive instead of proactive. Not knowing who you are; lacking an awareness of your own purpose, and lacking long term objectives for your life, puts you at risk for fear, frustration, burnout, and the empty, hollow feeling that comes close to a living hell. Without this foundation, without this self-awareness, without this centering, reality is obscured. Resourcefully responding to the challenges of practice and patient relationships is prevented.

Like the non-believer who opens the Bible and reads a confusing mixture of inscrutable parables and out-of-order historical drama, those who lack a clear understanding of themselves, have practices that are bewildering and unpredictable. They learn of a new practice management technique and when they apply it, it backfires. They hear of the latest new patient acquisition technique and when they institute it, it fails. They have closets full of unused materials purchased following the emotional high of countless seminars. They keep searching for outside-in solutions to their lack, and fail to see that what they actually lack is the self-understanding and focus that in more successful practitioners is hidden from view. Copy their technique. Copy their scripts. Copy their office layouts. Copy their paperwork. Copy their protocol. But ignore their self-awareness, clarity of thought, fearlessness, and total congruency, and you are doomed to failure. You have a counterfeit practice.

The apparent objective of many practice building schemes is to transplant the scripting and procedures proven to be successful elsewhere. But most management seminar attendees rarely want to surrender their sovereignty! Instead, they have a more modest goal of simply grafting certain approaches onto the trunk and root system of their existing practice. Often these grafts are rejected, never take hold, or worse, produce a mutation that is neither fish nor fowl. Lacking the self-knowledge of who they really are, many chiropractors go from one technique to the next, one seminar to the next, one management program to the next until they become so cynical they blame the usual suspects or their poor career choice.

The common denominator among successful (any way you want to define it) practitioners is that they know themselves. This knowledge did not come easy and they can describe the battle scars they acquired in the process. Most will admit they are still learning and even more will say the process is more important than the destination. Virtually all of them will tell you they didn't learn these important lessons at chiropractic college, postgraduate seminars, or by copying anyone else! There are no shortcuts to self-knowledge. Not one.

We may be created in the image of God, but each of us is different and distinct. There is the illusion of safety in the herd. But we were not meant to be a faceless number. Being unique is our birthright! But ask many chiropractors who they are and they'll tell you they're chiropractors. Anything you've ever heard about a chiropractor, that's who they are. Their highest calling? To be the best chiropractor, ever. While professional excellence is important, it's interesting that successful chiropractors rarely identify themselves as chiropractors. It's not that they deny or are embarrassed by their profession. Far from it. They are proud chiropractic warriors. It's just that chiropractic is merely the means to an even bigger end.

Few chiropractors get past this apparent paradox. Those who do are more likely to see themselves in bigger terms. I'm a servant or I'm a parent of two beautiful children or I'm a leader or I'm a change agent or something equally surprising. Rarely do they define themselves solely by their profession or their daily tent making activities. At the other end of the spectrum are those chiropractors who define themselves by what they aren't! I don't use therapy. I don't adjust on the first visit. I don't make patients come for life. Or whatever.

If you acknowledge that something seems missing, practice is an uphill battle, or you're suffering other symptoms of an unexamined life, here are some action steps to help advance your journey towards the next signpost:

Discover your beliefs. Each of us, from the most successful doctor to the most frustrating patient, operates according to a personal philosophy. Many are unaware of their philosophy, belief structure, or code of conduct. Like a computer that is merely an expensive doorstop without an operating system, many doctors remain unacquainted with the software that directs their lives.

Doctors who seem to be struggling are attempting to operate their lives (and their practices!) with only a vague set of unarticulated standards and philosophies--some because they want to be flexible and others because they don't have the time. Decisions about even the simplest changes or action steps are painfully laborious. Staff members have to guess as to the doctor's intentions. Eventually, these doctors become chameleon-like, making recommendations based upon the likelihood of garnering continued approval or reassurance from their patients. True leadership doesn't require a poll, a positive approval rating, or even being liked. It may be helpful, but it isn't required.

One of the techniques I've used to discern my beliefs is to keep a journal. You're reading it. This process of thinking out loud on paper has been an effective way for me to identify my beliefs and to rehearse the defense of those beliefs. I am often surprised by what shows up on these pages, just as you may be when you read it. But it is the process of wrestling with these issues that gives me the confidence and strength to influence thousands of chiropractors and potentially millions of patients. Not bad for a high school graduate who was the shy wallflower who waited for everyone else to voice his or her opinion before sharing my own so I could fit in and be accepted!

Confront your fears. Many of us live in fear--if you call it living! Whatever you fear--the dark, heights, bankruptcy, abandonment, being sued, spiders, death, public speaking, or whatever, holds you in bondage. This unseen millstone results in unexplained or self-limiting behaviors.

For all the talk these days about co-dependency and enabling, fear is an even more influential and costly addiction. The willingness to avoid anything that would produce a fear response puts us in bondage to it. We literally place ourselves in a jail cell whose bars we create by our fears. Part of knowing who we are is to identify and name our fears. Just as Adam and Eve named the plants and animals to demonstrate their dominion over them, it is in naming our fears that we take the first step in conquering them. The next is in purposely exposing ourselves to the fear. This is an unnatural act--which is why so few are fearless. But the only way to neutralize one's fear is to face it head on. Confront it. Tempt it. Invite it. Toy with it. Romance it. Fall in love with it! Remember the admonition to love your enemies? Remember the advice to know your friends, and to know your enemies even better? Stare down your fears and they disappear. Again, no short cuts here, either.

Spend some time identifying what holds you in bondage. Then look for ways, small ways at first, to put yourself into situations that expose you to what you fear. Slowly build up your tolerance, a psychological immune response to that which you fear. Tame the lion. Subdue the tiger. Force the butterflies to fly in formation. You are greater than any false evidence appearing real!

Assume responsibility. This is part of the growing process to know yourself, too. Our culture promotes a lack of responsibility, so when someone (you!) comes along willing to assume responsibility for your life, heads turn!

While it's tempting to blame outside forces, when you assume responsibility for your practice, your lack (or abundance) of new patients, your income, your family, your relationships, and other dimensions of your life, you immediately feel more powerful. When we don't take responsibility, we assume the unresourceful posture of a victim, both literally and figuratively.

Wanting to assign blame is a victim mentality. Who can we sue? Who is at fault? When you know yourself, you have better discernment when it comes to assigning blame. No longer do you blame staff, patients, insurance companies, HMOs, scope of practice laws, the doctor down the street, the weather, office location, or anything else. Each of these entities has certain characteristics. No need to get angry with HMOs--it is their nature to act in certain ways. No need to get angry at patient behaviors--it is their nature to act in certain ways. You're only a victim when you lose your head, your focus, your center and abdicate your responsibility.

Knowing yourself means knowing your limitations, too. Knowing what responsibilities are yours and which ones belong to others may be one of the most liberating discoveries of our lives. If practice is a constant fight, you probably have some confusion in this area. It's impossible to truly know yourself until you know your boundaries. Clue: realize that you can only control (take responsibility for) that which is less powerful than you are. Thus, HMOs, insurance companies, the weather, skeptical patient spouses, and countless other influences are outside your control and you shouldn't take responsibility for the outcomes. Simply acknowledging and taking responsibility for all the decisions you've ever made, would be a productive first step.

Patients want an encounter with a doctor who is real, genuine, and authentic--someone who has his or her own act together enough to provide leadership, encouragement, and hope. Not only do they want to see a doctor who is healthier than they are, they want an encounter with someone who is open, optimistic, and fearless. It is often this unseen mental preparation and the resulting continual self-improvement that struggling chiropractors rarely grasp. To them, it is so subtle they think it's not important. To them it is so non-clinical they think it doesn't matter. To them, it is so personal they hope no one will notice. Fortunately, the most frustrating, challenging, and uncooperative patients don't.

Excerpted from
Looking Up
Originally published in 1998
240 Pages
US $24.95

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