Monday Morning Motivation | Exceptions to the Rule

Posted by Bill Esteb on Apr 27th 2024

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When is a standard operating procedure not a standard operating procedure?

When there are so many exceptions it’s mostly a suggestion.

This can be confusing, even dispiriting, for your support team.

The effort to anticipate the chiropractor’s expectation can occupy a significant amount of energy. Not only is it stressful, it creates a tentativeness that undermines their confidence.

It can even infect patients.

Having clearly defined procedures is absolutely critical for a high performing practice. Every action and spoken word must be congruent with the purpose and values of the practice.

Purpose: This is the intention for being in practice. Is it generous? Noble? It’s far more than simply being busy or adjusting as many people as possible.

Values: These are the moral and ethical principles you’ve singled out that you want obeyed for every decision and action in the service to patients.

Your purpose and values drive every procedure.

Naturally, the culture you create affects patient satisfaction, but even more importantly, the commitment, fulfillment, and security of your support team.

Authors Paul Spiegelman and Britt Berrett explore this and related issues in their book, Patients Come Second. While they use examples derived in a hospital environment, the principles are immediately transferrable to private practice.

A poor, even toxic culture, can lead to the modern concept of quiet quitting, defined as “doing the minimum requirements of one’s job and putting in no more time, effort, or enthusiasm than absolutely necessary.”

This can manifest as staff members who won’t perform assigned duties or who simply lack motivation.

Remember, you can train skills, but you can’t train values such as trust, curiosity, exceeding expectations, compassion, and other examples of emotional labor that make up one’s character.


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Bill Esteb has been a chiropractic patient and advocate since 1981. He is the creative director of Patient Media and the co-founder of Perfect Patients. He’s been a regular speaker at chiropractic gatherings since 1985. His 12 books explore the doctor/patient relationship from a patient's point of view. His chiropractic blog, coaching program, patient focus groups and consulting calls have helped hundreds of chiropractors around the world. Since 1999 Monday Morning Motivation has been emailed to over 10,000 subscribers each week.