The Right Way and Wrong Way to Practice: Time for a Second Opinion

A longtime colleague and friend called me a few weeks ago and told me about something that he could not believe had happened to him. He was sitting at home one night when the phone rang. When he answered it, the individual on the other end introduced herself as being part of a survey team and asked if he would be willing to participate in a short health questionnaire. Being in health care himself, my friend agreed to participate.

The interviewer proceeded to ask several questions about health care in general: "Do you or have you been to a health care professional in the past year?" "Are you taking medication and/or supplements?" "Have you ever visited a chiropractor?" "Are you currently under chiropractic care?" My friend answered "yes" to each of these questions.

After asking a few more questions, the interviewer thanked him for his participation and then, as a reward for participating, asked: "Would you like a free second opinion by a doctor of chiropractic?" My friend could not believe what he was hearing and asked the interviewer, "What did you say?" She repeated the free offer, with no obligation on his part, to find out if he was getting the "proper" chiropractic care.

When my friend called me and recounted this story, he told me:"I was so incredulous that I could not even respond in a meaningful way. I simply said, 'No, I am happy with my chiropractor and I do not need a second opinion.'"

Now let's think about this for a minute. Some local doctor of chiropractic employs a tele-marketing group to call people in their area in an attempt to solicit, or should I say steal, patients from his colleagues under the guise of participating in a health survey? I honestly thought I had seen or heard it all during my years of involvement in this profession, but I guess not.

Turning a Bad Attitude Into a Positive One:Five Questions to Ask Yourself 1. What should I keep doing? 2. What should I stop doing? 3. What should I start doing? 4. How did I develop my current attitude? 5. What should I do to change it?

I do not want to belabor the story; however, I hope if the doctor of chiropractic or the company that thought up this distasteful scam/scheme reads this column, they will be embarrassed enough to discontinue their charade, which only serves to discredit themselves and lower the credibility of the entire profession. The sad part of this story is that when I was discussing it with some of my colleagues, they said, "You probably should not write about it; you may give some groups an idea they had not thought of." I have more faith than that, or at least I pray that is the case!

Positive PR: The Value of a Real Second Opinion

Let's forget about the appalling and disgraceful example outline above and talk about the inherent value of a real second opinion. I recall a creative public-relations campaign developed about 30 years ago by Irvin Davis, president of Clayton Davis & Associates, the PR consultant for the ACA. The theme of the campaign was simple: It never hurts to get a second opinion. The huge difference between this campaign and the phone scam was that this second opinion campaign was designed to target folks who had never been to or had not given a thought to chiropractic care for their health needs.

If you have had back pain, neck pain, headaches (the list went on and on) and you are not improving under your current care, perhaps you should consider a "second opinion" from a doctor of chiropractic. That was the basic message in the ad campaign, along with information on the education, training, qualifications, and patient satisfaction rates of the doctor of chiropractic.

Unfortunately the campaign never got off the ground; economics, pressing priorities, and a host of other reasons caused the program to be relegated to collecting dust on the public-relations shelf. Too bad, because the campaign also mentioned that "it never hurts" to seek a second opinion; a clever twist in that pain is the single biggest reason for people seeking care.

The Perpetual Battle to Win Cultural Authority

I get comments, calls and frustrating letters from doctors of chiropractic all over the country. Quite often they are complaining about an article they have read in the mainstream news discussing a health condition for which chiropractic is clearly superior to allopathic care. The article usually doesn't mention chiropractic care or gives it lip service. The reporter generally contacts a medical doctor to get some basic information about the condition. It makes no difference whether the medical doctor knows anything about the condition or not because, like it or not, they are the undisputed authority.

Following the usual medical talking points, the reporter may then expand the article and demonstrate how forward thinking they are by discussing mind-body techniques, acupuncture, massage, meditation, physical therapy and even magnetic bracelets - but the word chiropractic or what chiropractors can do for the condition under discussion is typically not mentioned.

The DCs who contact me wonder, how can this be? How can this reporter/writer not mention chiropractic when they are talking about back pain, or sports injuries or auto accidents?" The answer is an easy one: It is called cultural authority, and the bias ingrained by years of continual bombardment of propaganda touting the superiority of the medical community (and funded by billions of dollars from Big Pharma). Due to these pervasive efforts, patients have been led to believe that the only real, safe and effective health care comes from medical or pharmacological approaches.

We are naive to believe that a million-dollar or even multimillion dollar annual program will overcome billions of dollars of propaganda touting medicine's importance. For decades in every manner and every media outlet, medicine has dominated and will continue to do so. But does that mean we stop trying to put out a positive message of chiropractic's value? Certainly not!

(By the way, the Foundation for Chiropractic Progress (www.foundation4cp.com) is doing a credible job with limited resources and should be supported in its efforts to help keep chiropractic awareness as high as possible. It is a program that must be sustained for decades before real progress can be measured.)

Are You Letting the Down Economy Impact Your Practice?

Do not be deluded into assuming that "things are bad" and "everyone's going broke," because the vast majority of DCs are still holding their own and doing well. When I talk to doctors and ask how things are going, many feel almost apologetic to tell me that they are doing just fine. Some are down a bit, but an equal number are showing increases in their practice year over year.

Since I am interested in human behavior, I am fascinated by the conversations I have with doctors whose practices are down versus those who are still doing just fine. I have said this in other columns, but it is worth repeating: When doctors call to tell me their practices are down, my first question is simply this: "What aren't you doing now that you did at the peak of your most successful year in practice?"

This question usually evokes a moment of silence and there is usually a litany of things that the doctor can reluctantly recall that they stopped doing for reasons they cannot even recall. During those successful years there is an attitude that develops, kind of like the stock market increase or the real estate expansion, that "this will never end." But unfortunately, it always does. The only way you can coast in any business, and that includes your practice, is downhill.

As an avid reader, I am constantly searching for ideas and books to help keep me focused and on track. You have heard it before and will hear it again: Stop listening to the negative news. Start developing a program that you can stick with to help you remain positive. Nothing will happen until an action step is taken, no matter how positive or pumped up you are.

Every health care professional in America is suffering from the consequences of the national and global economic situation and the out-of-control health care delivery system. Who's in control? An out-of-control Congress, which is manipulated by an out-of-control media in an out-of-control environment fueling doom and despair. With that said, the bottom line is that every individual must develop and embrace an attitude of self-reliance supported by personal responsibility and positive personal commitment. That is the essence of being successful, going as far back as the time success principles were developed. Throughout time, personal success or failure has been determined by individual attitudes and individual choices.

Action Steps vs. Steps Backward: Choosing Your Attitude

When I started writing this article, I didn't intend it to be a motivational piece, but thinking about the pathetic story of the "second opinion" health survey scam has made me realize that the bottom line for those who are doing just fine and those who have resorted to desperate measures is the simple fact that one group has chosen learned optimism while the other has chosen learned helplessness.

Consider this fundamental truth from Viktor Frankl, author of Man's Search for Meaning, which documents his experiences as a concentration camp inmate: "Everything can be taken from a person but one thing, that thing is the ability to choose one's attitude in any given set of circumstances." How powerful a concept to incorporate in our lives!

Patients are attracted to doctors who are "upbeat," "positive," "optimistic," "encouraging" and "patient-centered." Attitude is like touch; you can feel the sincerity and confidence the moment you lay your hands on the individual. You cannot fake it and if you are in a funk and never uttered a word, your patients would know your state the moment you touched them.

Let me end by offering my own "second opinion" to all the naysayers and doomsdayers who cannot seem to let go of the worst-case scenarios. The future depends on many things, but most of all, it depends on you. The key is to outline the specific things you are going to do to attain your goals, not someone else's goals. Then form the habit of doing something about it, taking that action step that is the difference between a true desire and a wishful dream. You cannot be forced to do anything; you must be focused on doing what it is you have personally made a commitment to do.

There are no easy steps to success, whether in a down economy or a thriving one, but you can' go wrong if you have a focused determination to take charge of your destiny and avoid the "victim" mentality that seems to have become epidemic these days. I don't know about you, but I think that the awareness and understanding of today's enlightened consumer is leaning more toward what we as chiropractic physicians can and do offer more than any other health care provider today. They are looking for alternatives to the disease-focused care they have been receiving and are searching for the health-oriented practitioner. Nutritional awareness is at an all-time high, mind-body concepts are no longer voodoo, recognition of a healthy lifestyle is evident in almost every aspect of our society and we are beginning to recognize that environmental pollution in every form is the biggest contributor to illness.

As doctors of chiropractic we are not where we want to be because we are not where we "believe" we could be. Certainly anyone who has been around this profession for any length of time can attest to the challenges, obstacles and barriers to progress we have had to endure. In spite of all those barriers, thousands of doctors of chiropractic have been successful in their communities because they have never lost their focus. My personal "second opinion" is simply to re-focus on what has made the profession great: honest, ethical, patient-centered care that patients can truly feel and understand. Research is now telling us that if there is a secret to success, it lies in our optimistic attitude and the wise choices we make.