Everyone talks (and advertises) about the personal approach of their companies, organizations and practices, but they are empty words. In the final analysis, it seems everyone is too busy to really care. The doctor is too busy, which reflects on the doctor's assistant, who thinks she's too busy and depends on the receptionist, who doesn't have the knowledge or authority to respond, even if she isn't busy. So, the calls go to voicemail, which is also busy!
Did you ever try to get through to your utility company or your airline on a bad weather day to speak to a real person? You know how frustrated you get when your electric, water or cable goes off. Well, try calling a physician's office, or perhaps your own office, and see how the process works. Sometimes, these new gadgets that are supposed to increase efficiency are really promoting antipathy.
Yes, it's frustrating not being able to communicate regarding a business issue, but it's even worse when the person has pain and has no one else to go to for relief and counsel, considering that the health care practitioner is the one with whom the patient has entrusted their life and well-being.
I mentioned receptionists and assistants. Let's talk for a moment about them. They are the very heartbeats of a physician's practice, and God bless them. I don't know what most practitioners would do without them. However, I have always believed that the attitude of an underling reflects that of the owner, boss or supervisor. As President Harry Truman used to say, "The buck stops here," meaning the person in charge has to take responsibility for what the people below them do.
Thus, if a health practitioner has an impatient, curt, unsympathetic or rude person working in their office, the practitioner is responsible. In most cases, the staff will copy the attitude of the practitioner. Show me a caring doctor, and I will show you a caring staff. Show me a doctor who is "too busy," and I will show you a staff that is "too busy." Show me a doctor who takes an "ownership" role, and I will show you a staff that takes an "ownership" attitude. Show me a doctor who recognizes their moral responsibility, and I will show you a staff that fosters professional accountability. You can't make it happen just by talking about it. It comes as a result of actual conduct through training, empowerment and the personal involvement of the physician.
I always get a kick out of companies, particularly banks, that advertise how personal they are in their relationships with their customers. Then when you call, they treat you as if you were a creature from outer space. (That is, if you can get through to a human being after being shuttled around from department to department, all the while being told how "important" you are to this bank - via recorded message.)
I am not telling you anything new about the fallacies of customer service as it is practiced by industry, particularly retailers. But what bothers me is that it has seeped over into the profession and now is manifesting in all the health professions. Perhaps it is the result of an automated society. Perhaps as computers and voice-activated electronics have made office management theoretically more efficient, they also have made communications less personal and people less accountable.
I sincerely believe that somehow, health care professions have lost touch with the public and many individual practitioners have lost touch with their patients. This is tragic because it has caused a great divide where communications, understanding and compassion are all-important as a conduit to better health.
As I thumbed through a book, The Essence of Leadership, I thought to myself, "I could easily juxtapose the word chiropractic for the word leadership." The essence of chiropractic, in its purist and most admirable form, is exactly what the author saw as the essence of leadership. Among the characteristics is having what the late Vince Lombardi called "heartpower."
Even in sports, this great coach knew it worked. He believed that when you captured the heart, you captured the person. He felt trust was closely aligned with honesty and integrity. He saw it as a cornerstone of relationships. Gaining trust, he visualized, was like filling a bucket one drop at a time with water. That trust grows by one's actions, slowly one step, or drop, at a time. Drip by drip, it takes a long time to fill, but with one swift kick, it can be knocked over, the contents spilled, and all can be lost.
So true! Except, it's not water we are talking about - it's the spirit of a patient relationship and in the final analysis, the lifeblood of a practice. I've seen young doctors go into practice and do everything by the book because they had the time and perhaps good intentions to do it. They start out thoughtful, deeply committed and caring for their patients. But then success overtakes them and their values are drowned by their expectations. Soon, they are driving an expensive car, paying for a big house, and hiring staff to do the things they should be doing themselves. They start delegating, taking themselves away from the little caring things that drew patients to them and built trust and confidence.
Suddenly, they are too busy to take phone calls, too busy to spend that extra time with a patient when needed, too busy for continuing education, too busy to contribute to the community, and certainly too busy to become active in their own profession. They're just too busy "keeping up with the Jones'" and too committed to everything but their patients' best interests and desires.
I might also add that they have all the luxuries of life and are up to their eyeballs in debt. So now, they are carrying such a burden, they can justify not having the time or interest in their patients because they've got bills to pay. The only thing that can save them now is traffic (increased PVAs), and more traffic. (And when it comes to the magic word "traffic," there are plenty of entrepreneurial gurus out there ready to show them all the tricks on how to spend less time with a patient and promote more traffic.)
Tragic, but it happens much too often. Personally, I've noticed that the two professions in which ego seems to dominate more than any other in our society are those with practitioners who rank much lower than they should in consumer trust and confidence (at least according to recent polls) - much lower than they did 50 years ago. What are those fields? You probably guessed it: law and health care.
What a pity! These are fields in which, at one time, their practitioners were put on a pedestal; held in high regard; in which their advice, counsel and ethics were unquestioned. In his book, Visions, Ty Cobb wrote, "Some of the best ways to avoid the fall-out of false pride is to keep a sharp eye on your own weaknesses as a leader, as an individual." I would add: "as a dedicated doctor and as a concerned human being." As humans, we find ourselves trying to maintain a balance between duty and desire, between strengths and weaknesses. It is not easy and often there is slippage. General MacArthur saw it in the military arena. He explained it as: "The age-old struggle - the roar of the crowd on one side and the voice of your conscience on the other."
As doctors of chiropractic, we can never stop taking stock of ourselves and our relationship with our patients. We need to check it on a regular basis. We need to check on our personnel and see how they are handling our patients. We need to review office procedures to make sure we are not creating burdens and hurdles for our patients. We need to maintain that personal touch. And we need to live by our conscience, not by false pride, nor by money alone.
Today, more than ever, doctors of chiropractic need to display an ethical standard that is higher than what is expected, clinical competence that is greater than our adversaries would like, and dedication that is deserving of patients wanting to call us "their doctor."
Plotting our destiny is a journey. We need to walk together as a profession, and that journey must be traveled on an ethical highway. Nothing will stop our advancement if we do, and nothing will matter if we do not. It is often in those quiet moments of reflection that the answers are revealed. The answer in chiropractic is best summed up by the comment: Patients don't care how much you know, until they know how much you care. By having an ethical and caring attitude, we can plot our destiny very easily and begin to turn around the more connected, albeit less personal, world in which we live. In so doing, we can assure a successful practice and a profession that gains cultural authority.
