Investing Without a Reasonable Return

Posted by Bill Esteb on Jan 15th 2021

Whether we invest in the stock market or our child’s education, we expect a return on our investment. Similarly, when we invest in our small business or a new relationship, we expect our energies to be reciprocated.

We have the expectation of reaping what we sow.

However, some investments don’t produce the return we expect. Or are unlikely to do so in the time frame needed to sustain our interest. Still others are unlikely to produce the increase we seek or are so spotty that it makes it unwise to risk our finite resources.

In chiropractic practice there are several opportunities that are of this latter type. Many chiropractors must first become seduced by them before learning to avoid them. Among the more common are these:

Attached to an Unpredictable Outcome

When a chiropractor adds energy to a patient’s spine at opportune times and places, it is done with an intent. The danger is when that intent is to relieve the patient’s symptoms. Besides being the practice of medicine, for which you are not licensed or insured, how a patient’s body will respond, or how quickly, is out of your control.

Worse, you have no power to choose what the patient does, what they think, what they consume when they are out of your sight.

Healthier would be the intent of reducing nervous system interference. Accompany it with a curiosity about what effect it might produce.

If would be helpful to enroll the patient in a similar perspective.

Owning the Patient’s Health

When a patient doesn’t value their health as much as you value their health, it’s tempting to pour your energy into trying to make sure that they do.

This is pure folly and a common mistake.

What prompts this incursion into the patient’s territory is the incorrect belief that what a patient does or doesn’t do is a reflection of the practitioner. That poor results, hindered by a patient’s lack of interest or discipline, will somehow sully the chiropractor’s reputation.


Your reputation is far more vulnerable by trying to wrest control of their health and in the process make the patient feel incompetent or ashamed. Realize that there is nothing you can say or do to change the priority a patient places on his or her health. Sure, you can manipulate them with fear or guilt, but the effect is temporary and produces the result you were trying to avoid.

Conducting Reverse Arbitrage

Then there’s the patronizing that occurs when patients express their inability to pay for their unplanned bout of back pain. That’s when the lights brighten, the theme music is launched and the announcer introduces Let’s Make a Deal.

This produces a chaotic array of fees and special arrangements.

Naturally, you should accept credit cards, join ChiroHealthUSA and enroll in CareCredit so you have a full range of options. And instead of cutting your fee in half, buy a visit when the patient buys a visit to maintain the value of your care.

And by all means, plan on an appropriate amount of pro bono care.

Moreover, if the time to stop accepting insurance assignment hasn’t arrived, it’s around the corner. Being the financial middleman means you’ve “co-signed” an agreement to assume the loss if the carrier balks at reimbursing you for care you’ve already delivered.

Chiropractors who trade care with a colleague are most susceptible. If you don’t have to spend money for your own care, it’s far easier to accept when patients don’t either.

The Patient Head Fake

Many chiropractors can be deceived by patient behaviors. Especially at the beginning of care when patient follow through is letter perfect. It’s tempting to imagine that they are doing so because they understand and embrace your chiropractic explanation.

Patients know when you’ve made this assumption. That’s one reason why many are reluctant to announce their last visit. Instead, it’s easier and far less emotionally confronting to simply make future appointments they have no intention of keeping.

Problem solved.

Doing It Yourself

Probably the most tragic emotional and financial investment chiropractors make is in underperforming employees. In particular, those who either won’t consistently adhere to written procedures, or do them so poorly as to dissuade you from making the request in the first place.

You may have found yourself thinking, “If I want things done right around here, I have to do them myself.”

When the people you pay don’t have your back and fail to embrace your vision and anticipate what needs to be done, you have the wrong people on your team.

Perhaps they don’t have the courage to seek employment elsewhere. Maybe they know how to do things that you don’t. Or worse, you’ve hired someone you think you can’t fire. (You can. You just must determine if your frustration with the status quo has eclipsed the pain of hiring someone else.)

The Predictable Result of Unreciprocated Investments

Make these unrewarded emotional investments long enough and the natural response is predictable. Maybe even familiar.

1. Anger. It starts here. It can begin as mere annoyance and frustration that blossoms into full-fledged anger and resentment. Patients are problems. You feel victimized. Your patience wears thin. You’re seeing fewer patients as you become increasingly ineffective at hiding the dark cloud above you.

2. Resignation. Professional burnout has moved in. Why care? No one else seems to. The emotional detachment is a protective mechanism that keeps further disappointment at bay. But it also extinguishes all trace of joy. You’re hoping someone will put you out of your misery. But no one does.

The emotional fatigue and lack of energy isn’t from the physical exertion of adjusting the dwindling number of patients. But rather an overdraft on your emotional checking account.

Thankfully, there is a way out.

First, you’ll want to set more precise boundaries. That means clearly identifying where your responsibility (ability to respond) ends and each patients’ begins.

Grab a piece of paper and draw a line down the center. Label the left column My Job. The right column Their Job, meaning a patient’s job. Then list a dozen or more items on each side of the line.

Then, from now on, never cross the line!

Two Strategies For Escaping Burnout

If you find yourself in the clutches of burnout, or you want to avoid this expensive cul-de-sac, here are two action steps after establishing clearer boundaries:

1. Discover your purpose. Your purpose isn’t to adjust patients. Adjusting patients is merely a means to achieve something else far more meaningful and significant. If you don’t know what that is, it would be worth the investment to uncover it. The key is to commit to something larger than your practice and its challenges. To recover greater joy in your life requires that you discover how to contribute to a worthy cause larger than merely surviving. I don’t know what that is for you—but you do. And if you don’t, you should.

2. Become a student. It’s time to become consciously incompetent. It’s probably more profitable when you choose to become a student of some aspect of health and healing. Maybe learn a tonal technique. Perhaps develop an expertise in extremities. Or pediatrics. Or internet marketing. The key is to stimulate personal growth and curiosity. Only as you grow will your practice grow.

Want to explore more dynamics to professional burnout? Commit to going through the free Escaping Burnout curriculum.