Do You Care Too Much?

How far will you go for your patients? Climb the highest mountain? Swim the deepest sea? In song and in history there are countless examples of extreme acts that individuals have performed to show their love and adoration for someone else. Yet none is as difficult to understand as what chiropractors do to demonstrate their concern for their patient’s health.  

You probably care too much.

Yes, love your patients. Desire the best for them. Offer the best. But remember that it is the patient who controls the relationship. When you smother a patient with too much “care,” it can produce resentment, poor compliance and other counterproductive patient behaviors. Not to mention the more serious practice-limiting drain on your valuable time and energy.

Caring about a patient’s health more than they do is an unhealthy co-dependency that sets you up for burnout. How can you tell if you care too much?

Truthfully answer these 10 questions:

1.    I feel a twinge of anger when patients miss an appointment or disregard my care recommendations.

[  ] Yes [  ] No

2.    I adjust a new patient on the first visit to please the patient.

[  ] Yes [  ] No

3.    I get frustrated when I see patients engage in health-sabotaging behaviors.

[  ] Yes [  ] No

4.    From time to time I’ll change our office procedures if I suspect the patient will complain or leave.

[  ] Yes [  ] No

5.    When a patient mentions that they’re unhappy with their progress, I find myself becoming defensive.

[  ] Yes [  ] No

6.    When the patient delights in the results they’re enjoying, I’m inclined to accept the credit.

[  ] Yes [  ] No

7.    When patients unexpectedly drop out of care, I suspect that it’s because of something I forgot to say or do.

[  ] Yes [  ] No

8.    I make myself available evenings and weekends in case patients should need me during non-office hours.

[  ] Yes [  ] No

9.    I allow patients to run up large balances because if I demand payment they will discontinue their care.

[  ] Yes [  ] No

10.    I refer to them as “my” patients.

[  ] Yes [  ] No

Up to five “Yes” answers and you’re definitely on the clingy side. More than five “Yes” answers and you’re allowing an unsustainable draw on your emotional checking account that will bankrupt your well-being.

A clear sign that you care too much is when you find yourself dependent upon patients returning your emotional investment in them. This quid pro quo approach to relationships in which you “keep score” is toxic. Serving with “strings attached,” as in I’ll-do-this-if-you’ll-do-that is a sign you care too much.

It’s an occupational hazard. Caring, empathizing, connecting and otherwise relating to patients on an emotional level can be helpful for the healing process. Yet, as with many things, moderation is the key. Remain too aloof and patients feel isolated and neglected. Overwhelm patients with your attention and you can suffocate them, producing guilt, suspicion or both!

Finding the right balance is the key. It’s the social part of "...optimum physical, mental and social well being" true health.

Is your heightened sense of caring the result of investing your self-worth in the apparent effectiveness (as judged by the patient’s subjective reduction of symptoms) of your application of the chiropractic principle? Just remember, you are not your technique. You are not your success rate with headache cases. You are not your practice. And you’re not doing the healing!

It’s incredibly affirming when someone else salutes our values, our outlook and our “story.” When they don’t, we’re often tempted to try and win when them over. And if we can’t have that, at least we want them to like us. And herein lies the trap.

Consider the Caring Continuum:

continuum.png

 

 

 This is the classic balancing act. Venturing too far at either end of the Caring Continuum and patient influence and your own health can suffer. Engulf the patient and your fear of losing control or your inappropriate levels of emotional investment communicate a profound disrespect for their sovereignty and free will. Project an attitude of cold indifference and detachment and your isolation and abandonment work against your efforts to influence patient behavior.

Besides the relational compromise that results, there is a personal cost. Care too much, and you risk burnout when patients don’t behave in ways you think they should. Care too little, and your aloofness prevents you from enjoying the soul-satisfying emotional warmth that fuels motivation and fulfillment.

Either extreme hampers the healing process. The key is to find a middle ground—which of course varies from patient to patient and changes during the course of the relationship.

Most doctor/patient relationships begin at the indifference end of the spectrum. In fact, it’s the indifference of most of your community that makes growing a practice so difficult! Yet, as the relationship begins, that changes. Many chiropractors engulf the patient, care too much, are too anxious to help and are too quick to accommodate the patient. Don’t want X-rays? No problem. Don’t want to pay? No problem. Want to get adjusted on the first visit? No problem. Can’t bring your spouse in for the report? No problem. Don’t want to watch our videos? No problem. Want to abuse our scheduling system? No problem. Want to disrespect our staff? No problem. Don’t want to follow my recommendations? No problem. Don't want me to adjust your neck? No problem.

No problem is a big problem.

How do you walk the line between honoring the patient’s individuality yet maintaining respect for what you do? Here are some ideas:

Recognize appropriate boundaries. It’s the patient’s body, the patient’s health and the patient’s future. Each of us still has the right to abuse our bodies and to conduct ourselves in unhealthy ways. Make sure you don’t assume responsibility for, or invest your life spirit in things you can’t control (i.e., patients keeping their appointments, doing their exercises or changing their diet.) Know what’s yours and what’s theirs.

Replace judgment with curiosity. When you pass judgment on a patient’s behavior or lifestyle choice, you’ve stepped over the line. Instead, contemplate what belief the patient must have about chiropractic, their body, their health or the future to prompt their actions. Be curious. Practice this discipline, rather than imagine that their health-sabotaging behavior is the result of something you said or didn’t say, did or didn’t do.

Serve for the joy of serving. When you care too much, you’ve made the relationship about you rather than them. The healthiest chiropractors acknowledge that the patient is the master and that they are the servant. Be in awe of what chiropractic care can unleash, rather than marveling at the what, how, when and where of your technique or procedures. Take no credit and accept no blame.

Be a peer not a parent. Never impose your standard of what a good patient is or does. Never make a patient feel as if they’ve let you down or haven’t somehow fulfilled your notion of what a “good” patient does. Let patients be “right” even if they’re wrong.

When you care too much, you reveal your bondage to outside forces beyond your control. It’s unattractive, drains your emotional checking account and rarely produces the results you hope for.

 

Originally posted May 7, 2006