Do you care too much?
By William D. Esteb

How far will you go for your patients? Climb the highest mountain? Swim the deepest sea? In song and in history, countless examples of extreme acts that individuals have performed show their love and adoration for someone else.

Yet none is as difficult to understand as what chiropractors do to demonstrate their concern for their patient’s health.

You probably care too much.

Yes, love your patients. Desire the best for them. Offer the best. But remember that it is the patient who controls the relationship. When you smother a patient with too much “care,” it can produce resentment, poor compliance, and other counterproductive patient behaviors — not to mention the more serious practice-limiting drain on your valuable time and energy.

A clear sign that you care too much is finding yourself dependent upon patients returning your emotional investment in them. This quid pro quo approach to relationships in which you “keep score” is toxic. Serving with “strings attached,” as in “I’ll-do-this-if-you’ll-do-that” is a sign you care too much.

OCCUPATIONAL HAZARD

It’s an occupational hazard. Caring, empathizing, connecting, and otherwise relating to patients on an emotional level can be helpful for the healing process. Yet, as with many things, moderation is the key. Remain too aloof and patients feel isolated and neglected. Overwhelm patients with your attention and you can suffocate them, producing guilt, suspicion, or both!

Finding balance is the key. It’s part of the “art” of successful doctor/patient relationships.

Is your heightened sense of caring the result of investing your self-worth in the apparent effectiveness (as judged by the patient’s subjective reduction of symptoms) of your application of the chiropractic principle?

Just remember, you are not your technique. You are not your success rate with headache cases. You are not your practice. And you are not doing the healing!

It’s incredibly affirming when someone else salutes your values, your outlook, and your “story.” When they don’t, you may be tempted to try and win them over. And if you can’t have that, at least you want them to like you. And herein lies the trap.

‘CARING CONTINUUM’

Consider the “Caring Continuum”: On the one end is caring too little; that is indifference. On the other extreme is caring too much, which is engulfment.

This is the classic balancing act. Linger too long at either end of the Caring Continuum and patient influence and your own health can suffer:

• Engulf the patient, and your fear of losing control or your inappropriate levels of emotional investment communicate a profound disrespect for their sovereignty and free will.

• Project an attitude of cold indifference and detachment, and your isolation and abandonment work against your efforts to influence patient behavior.

Besides the relational compromise that results, there is a personal cost. Care too much, and you risk burnout when patients don’t behave in ways you think they should. Care too little, and your aloofness prevents you from enjoying the soul-satisfying emotional warmth that fuels motivation and fulfillment.

Either extreme hampers the healing process. The key is to find a middle ground — which of course varies from patient to patient and changes during the course of the relationship.

Most doctor/patient relationships begin at the indifference end of the spectrum. In fact, it’s the indifference of most of your community that makes growing a practice so difficult!

Yet, as the relationship begins, that changes. Many chiropractors engulf the patient, care too much, are too anxious to help, and are too quick to accommodate the patient. Don’t want x-rays? No problem. Don’t want to pay? No problem. Want to get adjusted on the first visit? No problem. Can’t bring your spouse in for the report? No problem. Don’t want to watch our videos? No problem. Want to abuse our scheduling system? No problem. Want to disrespect our staff? No problem. Don’t want to follow my recommendations? No problem.

No problem is a big problem.

WALKING THE LINE

How do you walk the line between honoring the patient’s individuality yet maintaining respect for what you do? Here are some ideas:

1. Recognize appropriate boundaries. It’s the patient’s body, the patient’s health, and the patient’s future. Each of us still has the right to abuse our bodies and to conduct ourselves in unhealthy ways.

Make sure you don’t assume responsibility for, or invest your life spirit in things you can’t control (such as patients keeping their appointments, doing their exercises, or changing their diet.) Know what’s yours and what’s theirs.

2. Replace judgment with curiosity. When you pass judgment on a patient’s behavior or lifestyle choices, you’ve stepped over the line. Instead, contemplate what belief the patient must have about chiropractic, his body or health to prompt his actions.

Be curious. Practice this discipline, instead of imagining that your patient’s health-sabotaging behavior is the result of something you said or didn’t say, or did or didn’t do.

3. Serve for the joy of serving. When you care too much, you’ve made the relationship about you rather than them. The healthiest chiropractors acknowledge that the patients are the master and that the doctor is the servant. Be in awe of what chiropractic care can unleash, rather than marveling at the what, how, when, and where of your technique or procedures. Take no credit and accept no blame.

4. Be a peer not a parent. Never impose your standard of what a good patient is or does. Never make a patient feel that they’ve let you down or haven’t somehow fulfilled your notion of what a “good” patient does.

Let patients be “right” even if they’re wrong.

When you care too much, you reveal your bondage to outside forces beyond your control. It’s unattractive, drains your emotional checking account, and rarely produces the results you hope for.

SIDEBAR:
The 'caring' quiz

William D. Esteb has been a chiropractic patient and advocate for 25 years. He is the creative director of Patient Media, Inc., a patient communication resource company for chiropractors. Review his materials and request a free 64-page new patient catalog by visiting www.patientmedia.com or by calling 800-486-2337.