Monday Morning Motivation | Lie #4 - Hours

Posted by Bill Esteb on Jun 21st 2020

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Lie #4: If I'm open more hours I can help more people.

At first glance, this seems true. But in practice it rarely is. This lie prompts many chiropractors to put in 10-hour workdays, broken up by two-hour lunch breaks.

Much has been written and spoken about practice hours. I've seen every permutation under the sun work. Thankfully, there are only about three issues to consider:

1. Maintaining presence. How long can you consistently maintain a healing consciousness? Hard to do with gaps between patients or worse, chatting about sports scores or some other inane indulgence. If you have frequent gaps between patients that send you to the Internet or the pages of printed chiropractic publications, you might want to rethink your hours.

2. Managing your energy. Related to maintaining your presence is managing your physical and emotional state. State management is crucial if you want to help a lot of people. That might mean your staff slips you an energy bar in the hallway or schedules an impromptu break so you can eat some fruit and collect your breath. This is about having a pit crew who knows you and knows how to support you in being your best. Which means training. This sort of thing rarely happens innately.

3. Time versus amplitude. When you are fully present, filled with certainty about the limitations of your responsibility and prepared to serve, there is no need to draw out the ceremony. In fact, drawing it out merely serves to reduce the impact of your intervention. Chiropractors who master amplitude are able to help a lot of people in a very short amount of time. Which, by the way, most patients prefer. After all, they're not living to get adjusted. They get adjusted so they can go live!

There's an important nuance I learned from a high-volume chiropractor related to amplitude. He made the observation that when it comes to adjusting, far too many chiropractors "mount and dismount" many times during a typical patient visit. In other words, they touch the patient to do say, a leg check, and then break contact to palpate say, their lower spine. And then touch the patient in an entirely different area as they go about their pre-adjustment assessment. On a kinesthetic level, this on-off-on-off connection produces "neurological noise." His advice? Once you touch the patient, stay in contact, even if you have to move to the opposite side of the table, until you're done. Then "dismount" when you're complete.

And let's not forget the most obvious, which is almost a cliche—because it's true, that work expands to fill the time. How many times you have consulted your schedule to see if you can "afford" to linger a bit longer with a valued patient? If you want to get your social need met at the practice, no problem. Just don't beat yourself up that you're not seeing the patient volume you desire.

The truth: Patient volume is linked to countless other factors other than patient hours. It's often the first right answer when first starting out, but it's rarely the constraint that keeps a practice from growing.


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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 Parker Seminars and other chiropractic gatherings since 1985. He is the author of 12 books that explore the doctor/patient relationship from a patient’s point of view. His chiropractic blog, in-office consultations, patient focus groups and consulting calls have helped hundreds of chiropractors around the world. His Monday Morning Motivation is emailed to over 10,000 subscribers each week.