Have you noticed lately that there is an ever-increasing number of challenges that you face as a doctor of chiropractic?
ICD-10 implementation, EHR changes, increasing overhead, decreasing collections, higher patient co-pays and deductibles—it can all seem a bit overwhelming. As difficulties mount, the tendency is to change your focus from patient-centered care to doctor-centered practice management.
Self-focus as a primary value in your practice can be devastating to your patient outcomes as well as your bottom line. So how do you navigate the current marketplace?
There are four elements of chiropractic practice that can ensure your ability to move forward in uncertain times with absolute certainty of success.
Certainty is the first key element. Are you certain about your abilities as a doctor of chiropractic? If not, your patients will never be confident about your care or recommendations. There is a difference between an arrogant physician and one who is certain. As a doctor with certainty, you can establish the legitimacy of your expertise and trustworthiness by listening to and understanding your patients. They want to have their situation validated. You can only do that if you know them and their condition.
When you give your report of findings or recommend care plans for your patients, are you confident it is the best approach for resolving their health concerns? If not, you need to be. Confidence will enable you to give patients some control in their treatment. For example, offer them a good, better, and best option. Almost all patients will choose the “best” treatment option, because they want the care you know they need.
But not every patient who walks in the door is a great candidate for your services. Determining who is a qualified patient for your treatment will help strengthen your certainty. Use tools such as the Fear-Avoidance Beliefs Questionnaire (FABQ) to help you better identify those who may not have good outcomes regardless of the care rendered.1 In many cases, physical or objective findings are not good predictive factors in determining a patient’s potential for a successful outcome.2
Compassion is the second key element. Your patients must have a sense of your compassion for them, as well as your passion for chiropractic. Is your role as a DC a career or a calling? Patients can sense the difference. In fact, some studies suggest up to 80 percent of believability or sincerity is communicated nonverbally.3-7
Kindness is a forgotten virtue. Be pleasantly accommodating and practice generosity. You can’t give away your services, but you can provide a high quality of care that creates value
to your patients. Are you in practice strictly for the purpose of making money or are you committed to “whatever it takes” to care for your patients? It may seem like a paradox to focus on compassion as a means to success, but financial rewards typically follow those who are passionate about their work.
Your values dictate your actions, which in turn produce the results you experience. No one sets out to have poor results. However, if your values are conflicted, there is no doubt it will impact your effectiveness as a DC.
Keeping it clear
Clarity is the third critical element. You need to communicate clearly with your patients, because most issues that arise are related to a lack of clarity in chiropractic patient care. It is difficult for patients to commit to a solution when they do not understand what the problem is in the first place.
It has often been said that no one plans to fail, they just fail to plan.
Establish with every patient a plan of care. Be clear about the length of time, number of visits, date of re-evaluation, and the expected outcomes. Whether you have a pain-focused practice or a large wellness practice, every patient needs a plan. Periodically perform assessments to ensure that the plan is still reaching the patient’s intended goals.
It is also helpful to use third-party endorsements such as patient video testimonials to further establish clarity. Patients often see their situations as comparable to others. When they see that you have helped people with similar issues, they accept that you can help them as well. Facts rarely trump personal experiences.
Many people realize that research or science can often be tainted by those who interpret its meaning. However, it is harder to argue with an eyewitness account of something that happened. If you have 10 patients saying you made a huge difference in their health through your care, it validates your care and creates clarity for the patient.
Credibility is the final element. When people in your community see your practice name or your brand, what comes to mind? Do they think of quality care, valuable services, and a reputable doctor? Or do they think of free exams, discounted services, or an untrustworthy provider? Perception often becomes reality, so manage your credibility.
DCs have not been able to establish the cultural authority that MDs have in the last 100 years. It is important to acknowledge where we may be weak and build on our strengths by remaining true to what we do best. Often we are pulled off our mission in practice by things such as hair removal, weight loss, and other services that do not integrate well with our core skill set.
Look for modalities that compliment your practice model. Great additions such as spinal decompression, laser therapy, posture rehab, nutrition, or massage therapy can stimulate growth.
Challenge your current capabilities by reimagining your practice. Just because you have always done something a certain way, doesn’t mean it will work in the future. Be proactive instead of reactive. If you are really struggling with your overhead, add another DC or look for modalities that complement your core values.
If you focus on practicing with certainty, compassion, clarity and credibility, you can face an uncertain future with the absolute unwavering belief that you will succeed.
Timothy J. Burkhart, DC, BCIM, has successfully treated thousands of patients with acute to chronic neck and back pain since 1984. He is an authority on the integration of NSSD into clinical practice. He is a member of the ACA, MAC, serves on the Davenport University Health Professionals Advisory Board, and is a regent at Sherman College of Chiropractic. He also developed the Hill DT Solutions certification program. Learn more at hilldtsolutions.com.
1 Cleland JA, Fritz JM, Brennan GP. Predictive validity of initial fear avoidance beliefs in patients with low back pain receiving physical therapy: is the FABQ a useful screening tool for identifying patients at risk for a poor recovery? Eur Spine J. 2008;17(1):70-9.
2 Leboeuf-Yde C, et al. The Nordic Back Pain Subpopulation Program: Clinical Predictors for Outcome in Patients Receiving Chiropractic Treatment for Persistent Low Back Pain. JMPT Ther. 2004;27(8):493-502.
3 Mehrabian A, Wiener M. Decoding of inconsistent communications. Journal of Personality and Social Psychology. 1967;6:109-114.
4 Mehrabian A., Ferris SR. Inference of Attitudes from Nonverbal Communication in Two Channels, Journal of Consulting Psychology. 1967;31(3):48-258.
5 Mehrabian A. (1971). Silent messages. Wadsworth, California: Belmont.
6 Mehrabian A. (1972). Nonverbal communication. Chicago: Aldine-Atherton. 7 Knapp ML, and Hall JA. (2002). Nonverbal Communication in Human Interaction. Crawfordsville, IN: Thomson Learning.