Decoding The Quiz

1. I feel a twinge of anger when patients miss appointments or disregard my recommendations.

The operative word here is "twinge." Because the anger could be so fleeting that it may not fully register as such. And maybe it's not full-fledged anger, but frustration or annoyance.

Regardless of its intensity, this propensity reveals an attachment to patient behaviors. Is a missed appointment seen for its financial impact? Or is it about patients questioning your authority or expertise? Or the possible impairment of their results? Or a reminder that you're powerless over what patients do?

Remember, each of us has been granted free will agency by our Maker to treat our body as we wish. That right isn't revoked or surrendered by consulting you. Even if they nod at just the right time during your report of findings it doesn't mean they agree or embrace your beliefs or assertions. In this way patients are much like politicians. You can't trust what they say, only what they do. Their choices are NOT a reflection of you. We explore this in far more detail during Week 20 of the HeadSpace Coaching program.

2. I'll modify my usual adjusting procedure to please a new patient or avoid conflict.

Walking on eggshells and going along to get along is often from the fear of abandonment. Or thinking that getting patients to like you will somehow increase your influence or attractability.

Maybe you're not certain that your standard procedures are ideal. So, you may be inclined to call an audible.

The other danger is that when looking to the patient for acceptance you may find yourself cutting corners, making assumptions or even exposing yourself to needless risk. When a patient reveals their intent to be in control at the beginning of their care, don't expect that to change.

Never trade something as important as respect for merely being liked.

3. I find myself a bit annoyed when patients engage in health-sabotaging choices or behaviors.

Make sure you explain the collaborative nature of chiropractic care. How optimum results are achieved by what you do on each visit—and by what they do between visits.

Explain what your job is and what their job is. This is the subject of Week 19 of the 40-week HeadSpace Coaching program.

If they lack the interest or discipline to follow your suggestions, don't take it personally. We're all incredibly disciplined when it comes to things we value. And there's nothing you can say or do to change the way a patient values or prioritizes their health.

It's tempting to project the way you value health onto patients. Avoid becoming the helicoptering parent, paying excessive attention to a patient's every move. Instead, ask questions. Be supportive. Seek to understand, as in "stand under."

Nagging patients about their weight, smoking or lack of exercise is rarely effective and merely produces shame as the patient is confronted by their apparent powerlessness to make change in their life.

4. I make myself available evenings, weekends and holidays in case patients should need me.

It feels great to be needed. But there's a fine line between offering your mobile phone number to field calls and answer questions—which is often seen as extraordinary, and secretly hoping patients will need you so you can show up heroically to save the day.

"Sorry honey, gotta go down to the practice to help Mr. Smith."

It's not your availability or willingness to serve that's in question here. It's your heart, your intent, your desire to feel indispensable and important.

5. I become defensive when patients express disappointment with the pace of their recovery.

This is the danger of accepting patients on the basis that you'll resolve their symptom. Most are quite willing to delegate their problem to you, but don't take the bait.

The path of least resistance is to permit patients to think you're using adjustments to treat their symptom—because that's what it looks like to them. But what you're actually doing is reducing nerve interference to permit their body to function more normally.

If, or when, their symptoms will resolve is out of your control. You can hazard a guess, but that's all it is.

Assuming your "prescription" of three visits a week will produce the results patients want (and in a timely manner) is risky business. How do you know what patients will do (or not do) to support their care?

The patient wants an outcome, but you deliver a process—that unfolds at its own speed.

6. When patients drop out of care early it's usually because of something I forgot to say or do.

Unlikely. Most chiropractors say and do too much!

Instead, there are other possibilities:

1. They got the results they wanted.
2. They didn't see sufficient progress to continue their course of care.
3. They lost hope that continued care held any promise.

Not to mention, they may have become disenchanted with you, your staff, the lack of parking, the wait times or an endless list of other potential issues.

When patients detect that you are overly invested in their continued care, many opt not to reveal their intention of stopping their care for fear of your reaction. Which is sad, because at the very moment everyone should be celebrating, many patients are inclined to slink away hoping not to be noticed.

7. When patients delight in their progress, I deservedly accept their praise and adulation.

One approach is to demurely decline their praise. Granted, their appreciation produces a dopamine hit, but you miss the teaching moment of congratulating them on their wisdom of choosing chiropractic care and highlighting the self-healing capability they brought to your adjusting table.

When you care too much you may be seduced into thinking you're the source, rather than the conduit. Remember, the patient brings more to your table (their capacity to heal) than what you do on the table.

8. Patients often discontinue their care without saying goodbye or announcing their last visit.

Caring too much causes the patient to imagine they're letting you down if they decide they've had enough. Fearful that you'll give them a talking too if they mention their desire to discontinue care, they leave without a thank you or a goodbye.

Sure, it's rude. Even impolite. They must imagine that you're going to deliver a major guilt trip. By caring too much, you inadvertently cause things to end with a whimper rather than resolve with triumphant closure.

Worse, they think you're angry with them for not following through. They avoid you in the grocery store, assuming such an encounter will produce a scolding or at least an uncomfortable awkwardness.

Since most patients have heard that "once you go to a chiropractor you have to go for the rest of your life," explain how to discontinue their care at the very beginning of the relationship. Assure them that you're not attached to the choices they make and you're here simply to serve.

And mean it. This is the subject of Week 37 of the HeadSpace Coaching program.

9. We permit patients to accrue outstanding balances that frequently become uncollectable.

Mismanagement of the financial implications of care is a common foible among chiropractors who care too much. It's often a sign that you need the patient more than they need you. It's based on the fear that if you demanded to be paid, they'd leave.

Do you charge a fair fee? Are patients getting their money's worth? It's impossible to collect a penny more than you think you're worth.

Failing to enforce your agreed-upon financial policy produces some counterproductive behaviors:

  • Patients who don't pay tend to get poorer results.
  • Patients who owe you money rarely refer others.
  • Patients with outstanding balances rarely reactivate. With you.

Make sure the need for a live specimen to "prove" chiropractic works doesn't obscure the importance of being in fair exchange.

Yes, regularly offer an appropriate amount of pro bono care. But an uncollectable debt is not a form of public service.

10. When speaking with friends, family and colleagues I refer to them as "my" patients.

This is a common habit, even among chiropractors who have clear boundaries and aren't guilty of caring too much.

Our word choices reveal the state of our heart. Calling them yours denotes ownership or possession.

They're not yours.

Granted they're people you've attracted. They're individuals you're helping. They're patients you're seeing. They're participants you're leading to make better health decisions. But they're not yours.

Escaping Burnout

Did you find this helpful? Do any of the explanations need further clarification? Or correction? Email me