Chiropractic practice is a very different experience for each individual doctor of chiropractic. For some, it is a clinical and business wilderness for which they feel themselves ill-prepared. For others, its just a job at which you work hard sometimes and at other times, you let things slide a little. For me, and for many of my personal friends and colleagues, it is a career and a calling that we love.
These are very tough times for all health care professionals. For chiropractic, this is a gross understatement. Beset with new and daunting challenges, the DC, especially the new practitioner, faces an uphill struggle every day. How then can the individual find the focus, determination, will (and perhaps I might add, humor) to build a successful practice? There are many different paths to success in a chiropractic practice. I would like to talk here about one of them that has served me very well throughout my professional life.
My path is a positive path. It is an ethical path. It starts with a recognition of the elements of professional life over which I have no personal control, and of those that are completely in my own hands. It involves my complete focus and attention to things which I can impact, and the seeking of collective action in concert with colleagues through professional organizations to address the greater issues.
Looking at the elements of practice over which one has personal control can be a bit unsettling for some. Inherent in the recognition of control is an appreciation of the fact that on many elements, you are very much on your own. As individual practitioners, we have control over and are responsible for our clinical knowledge and skills. We alone control our human and communication skills. We alone are responsible for the attitudes we bring to practice. And here is a key that is very often overlooked in the practice equation. On the business side, we have responsibility, but we also have the opportunity to obtain advice and help from the excellent range of practice management consultants and organizations, as well as legal and organizational support. Still, we are the decision makers, and that represents a very heavy load of responsibility.
Clinical excellence is the foundation for practical success. Being the best doctor one can possibly be requires a commitment to never stop learning and never stop studying. Chiropractic science and the body of literature we have at our disposal is growing and maturing at a dramatic rate. Awareness of this growing body of facts and findings represents real power in the professional world. The practical direction in techniques of patient evaluation and care delivery are one half of this empowerment equation. A recognition that the wave of new findings validates and amplifies the effectiveness of chiropractic science is the important other half.
I believe in the power of chiropractic science. This is a belief that starts with faith, is solidified by personal and clinical experience, but a faith that warmly welcomes scientific literature that validates the components of this belief system. There are challenges in this endeavor to learn that involve a great deal of time and an intellectual focus, as well as ideas and techniques of practice that may differ from the way you have gotten used to practicing. Here it is important to constantly keep in mind that our personal comfort level should never be a barrier to importing the clinical services we deliver to our patients. It is also important to recognize that the key to being a good educator of the public about chiropractic and the state of your professional art is for you to be in possession of a strong and current understanding of all aspects of our science, particularly those elements that explain and validate what we do.
Constant re-education renews the stream of both information and motivation. It reinforces what I like to call the chiropractic mind-set. It helps you interpret the world of health and health care, both personally and for every patient, in terms of chiropractic. This idea is based on my personal experience of study and practice. I have learned the hard way that chiropractic understanding is a very elusive quality. The combination of knowledge and skill must continue to grow and expand to maintain power to direct and motivate one as a practitioner. There is no fixed set of facts or concepts that once you get it, you have it forever. Chiropractic's timeless principles require constant study to provide for maximum power and effectiveness in their application.
Clinical knowledge and skill and the confidence this brings to our communications efforts allows us to also be better salespeople for our profession and our practices. There are about 5,000 people in the United States for every doctor of chiropractic. I have advised young practitioners that all they need to do to launch and sustain a successful practice is go out and project the chiropractic story to their 5,000 people. This is not silly advice at all. We are in complete control of this communications flow, and despite any and all external issue or the business or insurance environment, in this mix of people are sure to be enough individuals willing and able to obtain your care, and many more who urgently need it.
Never before in our profession's history has the public been more receptive to chiropractic's message. The natural, drug-free approach we offer has strong appeal on many levels. As we improve our personal understanding of chiropractic and resolve to communicate that understanding in better and more effective ways, we grasp the reigns to our own success.
The cost-effective resolution to people's health care needs is how we demonstrate what we believe and communicate in rhetorical terms. This is how we make believers out of patients. This is where your clinical skills and knowledge meet the public. Here is where you stand or fall. This is also where you can employ the power of your mind set and add its strength to the healing process in a very real way.
All of these elements provide a basis for me to effectively teach my patients about chiropractic. Teaching should never stop. Part of being an effective healer lies in one's ability to generate understanding and appreciation for the care the patient receives. In recent years the need for the DC to engage in this constat educational process was reduced somewhat by insurance acceptance. Now, with managed care and other elements impacting on patient access, the teaching process becomes more and more important.
Make chiropractic thinking the center of your practice. This is not as easy as it sounds, and requires thought and focus. With medical/legal considerations so much in our minds, with patient experience so often centered on a medical approach, and with our own self-imposed limitations, many cases are never fully put to the chiropractic test, and the results are unclear or mixed in the patient's mind. My chiropractic mind set brings the maximum power of chiropractic science to bear on the needs of each one of my patients. I am always mindful of contraindications, the need to refer or consult, the possible meanings of symptoms and patient histories. I take all those elements and their implied or express responsibilities very seriously, but never at the expense of applying my best chiropractic skills to each and every patient. Because of this view, I am able to correct a lot of cases that others may have given up on and still never cross the boundaries of sound professional behavior: because I kept all appropriate professional and clinical considerations in mind, not hesitating to refer, but not neglecting to attend to the spinal needs of those patients. Often it is not an either/or situation. But at least it always is a chiropractic situation. Every patient has a spine.
We have to work hard at every business and practical dimension of our practices. We must work to secure full patient access to our care, to secure chiropractic inclusion in all insurance, and our personal participation in every insurance and managed care plan we can. This is life today. But with that competent, confident chiropractic mind set, where we never stop teaching because we never stop learning, and are pushed forward by the power of that two-sided experience, we never need feel we are completely at the mercy of forces beyond our control. No barrier stands between us and the chance to educate potential patients to a level of understanding at which they are willing to commit the personal and collective resources necessary to secure chiropractic care. Education is the basis on which chiropractic becomes the care of first choice. That job is solely in our hands: with it, a path to the future.
R. James Gregg, DC, FICA
Garden City, Michigan
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Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
