Dear Bill | Control Freak

Posted by Bill Esteb on Jan 16th 2020

Dear Bill

I am a control freak and need your help. I have built a very successful practice, but live with the fear that if a patient doesn't keep their appointment or do their stretches that they will blame me for not getting better.



One might make the case that if you live in fear, then you don’t have a successful practice. But, setting that aside, I see two issues in play here.

The first it appears that you mistrust patients. That probably emerged from taking on the responsibility to “fix” patients and rescue them from their symptoms. This is a rather courageous thing to do since you little control over what your adjustments will do, and how quickly. Once you assume the role of heroically solving the patients problem, then yes, you have to ever vigilant to make sure patients don’t sabotage your ability to deliver on your promise.

The second issue is related. Control issues are either about 1) wanting to be God or, 2) wanting to look good. Either way, you’re making the patient relationship about you, not them.

This self-imposed stress could be eliminated if you were to take on a more honest role with patients. Acknowledge that they do the healing not you. Accept that adjustments don’t treat their symptoms; they merely help reduce nervous system interference. That they control the speed of their recovery, not you. And, what they do between visits (which is out of your control) can have a profound affect on the efficacy of your care.

Does every patient know that?

You are not responsible for their recovery. “But Bill, if they don’t improve, they’ll leave and blame me.” The key is not to accept them for care on the basis that you’ll be treating their symptoms. At the consultation:

“From what you’ve described, it sounds like you would be an excellent candidate for chiropractic care. But we don’t treat back pain. Don’t get me wrong; we’ve helped a lot of people with back pain. It’s practically routine. But we don’t treat back pain.

“Taking a drug to fool your body would be treating your back pain. We use a different approach. After a thorough examination that reveals spinal distortions or misalignments, we use a series of adjustments to retrain your spine and reduce nervous system interferences. As your spine assumes a healthier pattern, your body will no longer have a need to express the symptom of back pain, and symptoms usually diminish.

“Now, since you and your body are doing the healing—not me, I can offer some general estimates, but you control the speed of your recovery. Your recovery time is based on what I do on each visit, and what you do between visits. This partnership approach produces the best results in the shortest amount of time. If you choose to proceed with chiropractic care I think you have every reason to be optimistic. I am. Shall we get started?”

Make the words your own, however, the key is to reframe the relationship at the very beginning. Establish appropriate boundaries and make sure every patient understands their responsibilities— if they want optimum results. (Many don’t want to lift a finger. Don’t take it personally!)

If, after clearly explaining what you do and what they need to do in their mother tongue, and they choose to blow off their exercises or other home care recommendations, you’re off the hook.

Simply put, when you invest your life spirit in outcomes you are powerless to control, such as what patients do or don’t do, you set yourself up for burnout. The ego seeks out opportunities to claim credit for the success you see around you, but you are merely a servant; a conduit. The patient is the master; you are the servant. They hire you. And many eventually fire you. Try to reverse these roles or overlook this fundamental fact and you fight an uphill battle and never have the confidence and certainty that patients find attractive.

Thanks for the question!

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