A Patient's Point of View

I got a cup of coffee at a Starbucks this morning. From time to time I “go off” coffee, and after a couple of months I often take up the habit again. Now, is one of those times.

It’s expensive to buy professionally brewed coffee. At least I think it is. Many people spend a hundred bucks or more a month on their caffeine fix. These are the same folks who claim they can’t afford chiropractic care!

But it boils down to priorities, doesn’t it? People have a feeling about their coffee (physically or emotionally) that is more compelling than how they feel before, during or after their chiropractic care. Which got me thinking about the 25 years I’ve been receiving my chiropractic care. What do I get out of it? How does it make me feel? Why do I keep doing it?

I got a speeding ticket on my way to the airport today. It’ll be a $120 fine and two points on my record. It’s my third speeding ticket. In 35 years of driving. With over 500,000 miles under my belt (seatbelt). Some would say that I was overdue. No matter. My pulse still quickened and I felt that sinking dread in my gut when I saw the motorcycle policeman in my rear view mirror with his flashing lights.

I think I was more angry at myself than anything. Angry because this speeding ticket occurred under the same circumstances as the other two: I wasn’t driving consciously.

If you’re one of those chiropractors guilty of caring for patients too much, you’re likely to have unhealthy attachments to what patients do. You probably take the occasional lack of perfect compliance and follow through, personally. It’s counter-intuitive, but this is usually a sign that you’ve made practice about you, rather than patients. Fearing patients who override your recommendations won’t get the results they expect and will blame you, is merely a deception. This became even clearer to me after I completed my three-hour “What Patients Do What They Do and What To Do About” presentation for the Blair Society yesterday morning in Charleston, SC.

I attended The Masters Circle Super Conference this past weekend. It is by the far the classiest, most upscale success movement in the profession. At its root is their focus on quality and excellence. For years chiropractors have often seen themselves as second-rate doctors. So when an organization like the Masters Circle shows up with such a high-class, organized event, it sends shock waves of improved self-esteem throughout the profession.

I’ve been spending some time recently thinking about why some patients embrace chiropractic as a way of life, and how others simply see chiropractic as a short-term diet for relief of their current symptoms.

What if this issue was not a reflection of each person’s attitudes about health, but their perception of time?

Consider this. There are three types of time. Past, present and future. Could it be that people who are inclined to live in the present (or past) see little need for preventive measures, and thus less inclined to use chiropractic for nothing more than their present ache or pain? Conversely, could it be that those who are more future-oriented might be more available for nonsymptomatic chiropractic care whose value is measured in one’s future health and potential vitality?

Are your patients proud of you? Do patients see their own reputations enhanced by revealing their relationship with you? What is it about you that would prompt patients to vouch for you or your practice?

If you think patient referrals come solely from the great results that chiropractic is famous for producing, then you’re simply not enjoying the new patient referrals you deserve. That would be like an airline assuming that transporting you safely from Point A to Point B should alone be sufficient to garner your loyalty and gratitude!

No, great results, like safe transportation, is on the “Expected” side of the ledger. In the minds of patients, results, along with all the other technical stuff most chiropractors hold in such high regard, merely gets you to zero. Practices that enjoy a constant flow of new patient referrals know this. They also know what it takes to inspire patients to become persuasive advocates.

I completed my 65th in office consultation and patient focus group yesterday. I’d forgotten how much I enjoy the process of sleuthing for the lynch pin holding up practice growth and providing some objective feedback for the doctor and staff. And while most offices strenuously clean up their office in preparation of my arrival (attempting to hide some of the very issues holding them back), in spite of their efforts, from time to time I get a glimpse as to how things really work. Yesterday was no exception.

Usually it’s a couple of dozen Post it notes cluttering the front desk. Or the chiropractor who has made his desk presentable by scoping his desk piles into boxes, stuffing them into a closet he hopes I won’t peak into. This time, it was the diagnostic area of the practice—the area where they use ionizing radiation and other technology to document the source of the patient’s problem.

Probably one of the greatest sources of suffering comes from resisting what is. You can tell when someone is resisting circumstances when they use the word “should.” As in, “Patients should place a higher priority on their health” or “Patients should follow my recommendations.”

Right. And I should be taller and better looking.

Besides revealing a resistance to what is, using the word 'should' admits a lack of power. Wishing things were different and stating your powerlessness does little but distract you from those areas in which you do have control.

While patients should place a higher priority on their health, many don’t. And while few chiropractors dream of basing their own lifestyle on the whims of irresponsible patients who look to their insurance coverage as a guide for how much care to receive, this is where many chiropractors find themselves.

No, you can’t control patients but you can control your reaction to them. Here are some possibilities:

From time-to-time, I encounter chiropractors who get indignant when merely describing patients who call and just “want to get cracked.” Or get tense simply thinking about patients who reveal that they just wanted a “patch job.”

Why so easily offended? Does a patient’s unenlightened language diminish you? Does a patient’s poor choice reflect on you? Do you believe their shortsighted outlook threatens you? Or that their behavior somehow tarnishes your reputation? Is your self-image that fragile?

Oh, I know that the “my-way-or-the-highway” attitude feels empowering, creating the illusion that you can control patients, but think about it. Imposing your health values onto patients in the hopes it will engender respect or a change of heart flies in the face of how a patient would come to adopt a healthier consciousness. (Clue: it isn’t by threatening them or using your social authority to get them to do something—even if it’s in their best interests.) Pushing potential patients away because they don’t “get” what you’re about may make you feel righteous, but it doesn’t create respectful, appreciative patients. In fact, it’s rather self-indulgent and probably works against your desire for a more influential practice.

There seems to be quite a buzz in chiropractic about confrontation. As in confrontational tolerance; specifically the ability, willingness or emotional fortitude to volitionally elevate the tension in the doctor/patient relationship. When you Google “confront” you get synonyms such as to “oppose,” “accuse” or to “criticize.”

And this is somehow a desirable trait?