A writer must write; a singer must sing; and a chiropractor must adjust. These and other forms of self-expression can be powerful, driving forces in our lives. I know how it must feel to have the skills to adjust, but have too few patients. There's more than a financial bind that a lack of patients produces. It affects your attitude, your mood, your self-confidence, and worse, it produces a dark cloud that can chase away the few patients that show up in your underutilized office!
If you find yourself in this downward spiral, here are some observations and advice I've given countless doctors facing a similar plight. Perhaps these will help you to get back into the game.
First - Do No Harm
Before you can "grow" your practice, you need to "stop the bleeding" from the few patients who do show up and then flee at the first signs of relief without telling others. This handful of brave souls keeps you from helping more people, and there aren't enough of them with which to make a lucrative living, especially when they don't produce referrals. When your practice pokes along at five patient visits a day, or maybe 50 a week, getting and staying "up" for so few requires massive effort.
What is the cause of your slump? It's not your location. It's not your lack of a front desk receptionist. It's not your handshake, and it's not your adjusting technique. It's you.
This is good news! You can change yourself. It's nearly impossible to change the public, patients, and maybe even harder to change your spouse. And while changing yourself isn't easy either, the odds are considerably better in doing so.
Stop Thinking about You
Virtually every doctor I've met who is struggling to launch a practice shares a couple of common traits. The most destructive denominator is a "victim" mentality that permeates their conversations. When they describe each situation, it's all about them. "My practice is struggling." "I'm having a hard time paying the bills." "My spouse is losing confidence in me." "I'm questioning my career choice." The internal dialogue they reveal is pathetic. It's filled with "me, me, me."
Many DCs rarely ever ask, "Do you know any ways to serve more patients?" or "What are some methods to attract more people that can be helped with chiropractic care?" or "What are the processes that can be used to inform the public about alternatives to drugs or surgery?" Instead, every question, and comment is about their fears, their embarrassment, or their pitiful situations.
Your practice isn't about you. It's about patients. You are there to serve. Have you ever met someone working at a fast-food restaurant with an "I'm too cool to be here" attitude, or one of "I'm not having fun and you shouldn't either?" If that's you, then you're so focused on your creditors, the success your former classmates seem to be enjoying, or your doubt about your clinical approach, that there isn't any room for patients! Patients respond to this accordingly. They don't emotionally invest in a relationship with you. They don't comply with your recommendations. As a result, they don't get what they deserve. Thankfully, patients keep practices like this a secret.
It may require an award-winning performance on your part, but you must look for ways you can serve your patients. Act the part of a busy, successful chiropractor. In short, you must be healthier than your patients - physically, emotionally, socially and spiritually. As much as seminars and consultants would like you to believe otherwise, success is more about who you are than what you do. "Being" is the cause. "Doing" is the effect. Be the servant, and you will have more opportunities to serve.
Lack Attracts Lack
Patients can sense a "woe is me" attitude of neediness, and most are repulsed by it. There's a reason why busy practices with lots of patients have plenty of new ones. They don't act as if they need new patients! They expect new patients, but they don't need them. Their focus is on those who show up, not on those who don't. There is a sense of confidence and abundance. Everybody goes there because everybody else goes there.
If you have few patients, chances are they're some pretty interesting specimens. They're probably hanging around because though you're down, you're still more optimistic than they are! After awhile, you might think that all patients are negative and irresponsible, but they aren't. You're just attracting patients like yourself.
Perhaps you keep in touch with other doctors who aren't doing so well. Together, you can paint quite a picture of how bad business is, and how you're victims of the economy, stingy HMOs, or the other usual culprits. The reason you have found these people is because busy, successful chiropractors don't want to have anything to do with those who aren't successful.
Find some new friends. As you begin to assume the attitude and outlook of a conscientious servant, giving out of abundance and not motivated by making your car payment, new friends will find you. Your energy, optimism, and purpose will attract others, including patients. The profile of your typical patient will slowly change. You'll be on a roll, you'll have more fun, and most importantly, you'll be making a difference.
An Act of Faith
To end a vicious downward spiral, or to escape running on a frustrating treadmill, you need faith. This is where chiropractors who live in an analytical, clinical, sanitized world have a hard time.
Those who are stuck often have faith, but out of desperation. Their egocentric view of the world helps them believe they are the masters of the universe; they are in control; and they can fashion a life and practice in their own image. Their sad little practices are examples of their handiwork.
For some, this is where they stay until they are sufficiently humbled or broken by their stubbornness. Those who ultimately give up and leave the profession rarely see that their struggle was largely their own creation. Fortunately, they take their bitterness with them, and the chiropractic profession is better for it.
In the same way that chiropractic principles, when properly applied, have produced results for more than a century, there are centuries-old principles that govern relationships between masters and servants. Those who ignore or purposefully break these rules will pay a price. If you're struggling to get your practice off the dime, you may already know these expenses.
William Esteb
Denver, Colorado
www.patientmedia.com
bill@patientmedia.com
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
