Skip to main content

Monday Morning Motivation | Mistrusting Patients

Posted by Bill Esteb on Oct 5th 2024

Monday Morning Motivation Masthead

Some chiropractors seem to mistrust patients. Perhaps they fear patients will make the “wrong” choice, not stay the course, or sabotage their results in some way.

If patients are seen as a constant flight risk, it can produce some unhelpful compensatory behaviors:

Being friends – Crossing the line from friendly to friends compromises the professional objectivity patients deserve.

Minimization – Downplaying the patient’s problem or not presenting optimum care recommendations.

Shame – Making patients feel less-than if they don’t value their health as you do.

Manipulation – Motivating patients by defining what “good” patients do.

Seduction – Limited offers or “New Patient Specials” that deeply discount your fees.

Parenting – Micromanaging or helicoptering over a patient, offering unsolicited advice.

Social authority – Using this limited resource is characterized by sentences that begin with “I need you to...”

These steal your joy, are unsustainable, and ironically, rarely produce appreciative patients who embrace chiropractic as a long-term lifestyle adjunct.

These compensatory strategies seem to “work.” Which means they probably extract an extra visit or two. And it feels like you're supplying guidance and direction. But it can make those additional visits rather expensive because they can negatively influence referrals and dampen future reactivations.

Escaping one or more of these inclinations is possible. Yet, some might consider the remedy worse than the disease:

Honor their choices – Keep in mind patients are in your practice for their reasons. Optimal health is rarely their motivation, regardless of what they say. Find out if they’re interested in knowing or wanting more than solving their most pressing symptomatic complaint. And respect their answer.

Beliefs produce behaviors – To avoid the discomfort of cognitive dissonance, our behaviors tend to line up with our beliefs. We can’t change someone else’s beliefs—only they can do that. But you can show up curious. Try to better understand what they value. Link it to chiropractic. Ask questions.

Avoid projection – It’s tempting to assume that others want what we want. That’s rarely the case. How much or little a patient values their health, and their willingness to invest in it, is something established long before you meet them. It takes far more than a snappy report or some sorry X-rays to prompt them to lean into better health.

Give up the need to be right – Abandon the inclination to prove your worldview is superior. Give up the need for reassurance chiropractic principles “work.” Rest assured, a patient’s body always works better when nervous system interference is reduced, even if their symptoms don’t improve within the arbitrary time frame imposed by their stingy insurance carrier.

Create a safe place – Make sure it’s emotionally safe for patients to tell you truth about what’s going on for them. In other words, never show up defensive. Or feeling like you have to defend your recommendations. Or even their progress. “Yes, I thought we’d be further along by now as well. What do you suppose is going on?”

It’s not about you – What patients do or don’t do has little to do with you. You can make it about you, but it’s not. Instead, patients are constantly evaluating the cost/benefit ratio of your care. Before honoring each appointment, they ask themselves if doing so is still worth their time or money. It’s really not any more complicated than that.

Think eternal – Keep your eye on the prize. Which, if I were a chiropractor would be a practice full of non-symptomatic cash-paying families. Which may require patients to start and stop care over many years. And maybe not even then. But few, other than chiropractors, embrace chiropractic for life on their first exposure to it. Consider what you need to say, do, and most importantly, be to pave the way for the coveted reactivation. Think long term.

And just what is it that makes these remedies even worse than the emotional exhaustion produced by mistrusting patients and keeping your practice manageably small so you can indulge in them?

It’s that when trusting patients and abandoning the role of a parent you're often rewarded with... a decrease in your patient visit numbers.

Yikes!

It’s often enough to prompt many to return to their emotionally-draining patient supervision. And with it, the opportunity to help more people.

It’s little comfort that the statistical downturn is merely temporary and in a month or so the numbers return to their previous level.

If you can’t weather the dip, either emotionally or financially, further practice growth is stalled. It’s counterintuitive, but you grow by letting go. As they say, it takes a loose arm to throw a fastball.


Bill Esteb Headshot Photo

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.