MMM Summer 2010
This year Bill tackles various "chiroisms." These chiropractic one-liners often sound true, but are they?
Monday Morning Motivation | ADIO
June 7, 2010
The beauty of this one is that it pretty much works regardless of your brand of chiropractic. You get to choose how high the "above" is.
If you're a mechanic, then the hardwired nervous system is merely what connects the end organs with the CPU of the brain. If you're more metaphysical, the "above" becomes God.
Either way, it works.
When B.J. Palmer crafted this chiroism he used it to help distinguish between the underlying assumptions separating chiropractic from medicine. The use of drugs is clearly "outside-in-below-up." Changing blood chemistry to change function may be expedient and in certain situations even lifesaving, it's not a healthy long-term solution and often reveals a profound mistrust for the wisdom of the body.
Notice that in this concise four-word statement the chiropractor isn't the hero. However, God and their God-given ability to heal from the inside-out are.
Monday Morning Motivation | Cause
June 14, 2010
"We address the cause, not the symptom."
Many chiropractors seem to be of the belief that subluxations are the cause of a host of health care issues. However, upon closer inspection it appears that subluxations are actually symptoms.
At its most fundamental, subluxations involve bones and nerves. Bones, being static structures, move only when muscles contract. Muscles contract based on commands from the nervous system. Thus, the vertebral displacement often used to ascertain the presence of subluxation is actually a neurological event!
What prompts the nervous system to command muscles to contract? Most chiropractors agree that it is in an attempt to accommodate physical, chemical or (more commonly) emotional stress.
If you're committed to addressing the cause (great!), help patients attach more appropriate meanings to the emotional realities they face. Messy? Yes. But this is where profound, lasting spinal changes can be found.
Monday Morning Motivation | Symptoms
June 21, 2010
"Symptoms are the last thing to show up and the first thing to disappear."
True. Yet, it's their symptom that prompts patients to seek your office and it's what they think is their problem!
This chiroism reveals the importance of patient education. Indoctrinated in a symptom-treating allopathic mindset before meeting you, most patients (unless enlightened by a previous chiropractor) are certain their problem is their symptom. You can fall for this symptom-based path of least resistance or use it as the springboard for some true patient education.
"What do you think is causing your headache?"
"Are you available for a different explanation?"
If you're invited to offer your subluxation-based explanation, you might follow up with…
"How will you know when your subluxation(s) have been reduced?"
Get ready for their symptom-based answer that prompted them to seek you out in the first place! This is your enemy, not the economy or insurance companies.
Monday Morning Motivation | Three Times
June 28, 2010
"Three times a week for the first four weeks, then twice a week for the next four weeks, etc."
Sorry. This one may roll off the tongues of thousands of chiropractors, but dig deeper and for many, it's a substitute for any type of significant critical thinking.
Predicting the amount of care needed beyond a dozen or so visits is bordering on crystal-ball-winning-the-lottery level psychic powers. Not only do many chiropractors make this recommendation before their first adjustment, they're clueless about the patient's willingness to make lifestyle changes or take any other proactive steps to support the initial three-times-a-week recommendations.
No, this is a form of bluffing. They may or may not need dozens of visits over the course of weeks and months, but declaring it up front, even when done with authority and conviction, is advanced dreaming. How about a progress exam somewhere along the line?
Monday Morning Motivation | Power
July 5, 2010
"The power that made the body, heals the body."
Yup. There still isn't a recorded instance of a doctor (of any ilk or discipline) healing a patient. In fact, if the truth be told, no one knows exactly how the body heals. But we do know this. For healing to occur, at least two things must be present.
First, life must be present. Dead bodies do not heal. And generally speaking, young bodies tend to heal faster than older bodies.
Second, connection must be present. End organs must be connected to the brain. And people must be connected to community. Isolation, separation and interference can hinder the healing process.
Careful that you don't inadvertently sanction the common patient perception that you and your adjustments heal the body. They do not. Nor does the physician's pills or the surgeon's knife. Taking credit is a form of stealing.
Monday Morning Motivation | Knowing and Doing
July 12, 2010
"If patients knew what you knew, they would do what you do."
This one has misled thousands of chiropractors. Repeated at just about every chiropractic gathering at one time or another, this chiroism overlooks the chasm between knowing and doing. In the same way most dental patients know they should regularly floss, but don't, most chiropractic patients know they should get regular, nonsymptomatic chiropractic checkups, but don't.
The truth is, patients do what they do because they believe what they believe.
We all act in ways to remain congruent with what we believe. Thus, doing is a symptom, result or effect of what you believe. If patients discontinue their care as soon as they feel better, it's because of what they believe, not what they know.
Turns out, if you have any hope of attracting cash-paying families interested in wellness care, you're actually in the belief changing business, not the spine-straightening-curve-restoration-pain-relief business.
Monday Morning Motivation | Caring
July 19, 2010
"Patients don't care how much you know until they know how much you care."
Imagine a patient, surveying your framed chiropractic college diploma on the wall asking, "So doc, what was your grade point average and did you graduate in the upper third, middle third or lower third of your class?" Or, "What grade did you get for neuro-anatomy class?"
Probably hasn't happened. Probably won't. Patients assume that a licensing board has confirmed you have the smarts to practice. Instead, patients are more attuned to far subtler clues the reveal your intention, confidence and certainty.
How do patients know if you care? By simply observing you and how you show up. Are you a listener? Are you curious? Are you authentic? Are you transparent? Are you optimistic? Are you present? Are you invested?
The key is to care, but not care too much! When caring become carrying you've crossed the line.
Monday Morning Motivation | Doing
July 26, 2010
"If you keep doing what you've always done, you'll keep getting what you've always gotten."
Dream on. In a static, never changing world, this might be true. However, these days it's a full-time job adapting to the changing practice environment. This has made chiropractic practice disorienting for many.
Assume that everything you know about what patients want, what motivates them and what constitutes success is obsolete. Because it probably is. Especially if you practiced in the 80s and 90s, were heavily dependent on insurance reimbursements and have resisted the Internet.
The solution? Ask more questions. And then listen as if your very livelihood depends on it. Because it does. Rediscover what it's like to be a servant. Rethink the "my-way-or-the-highway" dogmatism that barely worked when there were countless new patients waiting in the wings. Become softer. Let patients be right. Become a student again. In times of change, the learning never ends.
Monday Morning Motivation | Guilt and Shame
August 2, 2010
"Are you leaving someone at home to develop the same problem you have?"
This one, from the how-can-we-guilt-or-shame-patients-into-bringing-their-family-in-for-care department, generally falls on deaf ears. Largely because regardless of what you tell patients, most subscribe to the "if-it's-not-broken-don't-fix-it" school of thought.
This reveals that for many patients, taking preventive measures before symptomatic episodes emerge is seen as a needless luxury. This myopic view is echoed by financial institutions who report that most Baby Boomers are not saving for their retirement.
So, don't take it personally!
Instead, take a more subtle, long-term approach. Make sure that every patient is aware that chiropractic helps with countless other issues than the one that prompted him or her to begin care. And secondly, provide ample clues throughout your practice environment that you see children. These strategies may not be as gratifying, but they avoid the use of guilt or shame and are considerably less manipulative.
Monday Morning Motivation | Chiropractic Adds Life
August 9, 2010
"Chiropractic adds years to life and life to years."
If this were true, it would probably give an incredible boost to the popularity and utilization of chiropractic. Those patients and DCs who are of a more mechanistic bent see this sort of claim as overreaching, bordering on hyperbole. It's the price paid for having reduced chiropractic to a low-tech treatment of headaches and back pain for the last two decades.
While it stands to reason that a better performing nervous system, improved balance and increased flexibility would extend one's life and enhance vitality, there seems to be little objective proof of this.
Even so, my experience has been that those who need proof rarely get enough of it, or of high enough quality to be satisfied. As for me, I will continue to receive nonsymptomatic chiropractic care until the very end. And without a parallel universe, we'll never know for sure.
Monday Morning Motivation | Chiropractic Pays
August 16, 2010
"Chiropractic doesn't cost, it pays."
For chiropractors who generally get their adjustments without taking money out of their pocket or purse, this is relatively easy to say. However, for most patients of modest means, over-extended with a second mortgage and all the rest, this chiroism is right up there with "A penny saved is a penny earned."
More fascinating are the countless studies showing the reduced prescription drug costs, lower absenteeism, few days of hospitalization, reduced worker's compensation claims and the like when patients seek chiropractic care first.
This reveals that chiropractic produces an emotional response, not an intellectual pursuit based on objective critical thinking.
More telling is a quick poll among your most coveted once- or twice-a-month patients. Ask them why they show up regularly. Few, if any, will suggest that it's to save money or to return their investment in the form of better health and vitality in their senior years.
Monday Morning Motivation | Missing Appointments
August 23, 2010
"If you miss an appointment, you'll need to make it up."
Really? Can you actually "make up" an appointment? That would mean that if a patient were on a three-times-a-week schedule and missed one, the following week they would need to be seen four times.
My guess is that the patient might lose some momentum, they might prolong the recovery process or--they might not. After all, most chiropractors regularly reduce visit frequency as their patients' spines strengthen. And just what do most chiropractors use to determine such a reduction? Rarely is it an objective finding. More commonly, it's something subjective; instinct, experience or the passage of say, 12 visits.
No, I think this chiroism is more about wielding power and patient control than anything clinical. Might want to rethink it before using it as a trump card to keep patients on the straight and narrow.
Monday Morning Motivation | Big Idea
August 30, 2010
"Get the big idea and all else follows."
This is probably one of the most profound chiroisms of all, attributed to B.J. Palmer who was a collector of aphorisms, epigrams and pithy one-liners.
What is the big idea?
Some believe it's our self-healing, self-regulating capacity. Others believe it's the universal intelligence that runs the universe and its counterpart, innate intelligence that runs us. Still others believe it's about reductionism versus deductionism. Or how a lack of ease ultimately leads to dis-ease, the precursor of disease.
Regardless of which one(s) resonate with you, contrast them some of these "small" ideas. Like the germ theory. Small germs. Big fear, but small idea. Or symptom-treating. Big expense, but small idea.
Once you have a grasp on the significance of chiropractic, and as B.J. put it, "The Bigness of the Fellow Within," fear drops away, practice procedures simplify and patient communications are more direct and powerful.