Thriving in the Face of Uncertainty

It's nearly the end of 2011, but in many ways if feels like 2008 all over again. The economy is rocky, unemployment figures are frighteningly high, belt-tightening has been elevated to an elite sport, and politicians continue their partisan bickering and grandstanding. For the past three years, we've been thrown tiny crumbs of hope by economic forecasters telling us that things might be looking up, only to have those hopes dashed with the next release of financial data. For healthcare professionals, insult is added to injury with the ever-present threat of reductions in reimbursement and more regulations than ever before being piled on.

How do you react and respond in uncertain times like these? Some people bury their heads in the sand, others get angry. Maybe you refuse to follow the news, or perhaps you're more tuned in than ever. I know people who are hunkered down in anticipation of a long, slow recovery and others who are taking new business risks, confident that the economy will turn around soon, or that they'll be fine even if it doesn't. Who survives during unstable times like we are in now? Or, better yet, who thrives in the face of uncertainty?

It has been my experience, in working with chiropractors for several decades, that the individuals who thrive in the face of an uncertain future possess a distinctive collection of attitudes and skills that see them through difficult times. Thriving in a changing world requires embracing continuous transition as the new norm, letting go of old expectations and mindsets, developing creative strategies and flexible systems, and being clearer than ever on how to deliver value to patients.

Practice Today

Today, many chiropractors are experiencing a high degree of anxiety about maintaining financial solvency in the face of declining reimbursement and economic instability. They're also dealing with an increasing emphasis on compliance, transparency and accountability, the demand that they improve documentation and embrace electronic record keeping, and an enhanced focus on measurable outcomes. Add to all of this questions and concerns about scope-of-practice and the constant, rapid, and dramatic changes in technology, and it's easy to see why anxiety exists among chiropractors.

In times like these, your tendency may be to become emotional and reactive. Slipping into denial about the reality of the situation is a common response, as is anger, blame, and feeling uncertain about what to do next. Procrastination and apathy sometimes take hold, making it difficult to make plans and achieve goals that would lead to a more successful future.

Practitioners who are successful moving forward will draw on past experience as they analyze and adapt to new trends in chiropractic. They will attend to the operational demands of business, while not neglecting their passion and purpose for practicing. And, perhaps more importantly, they will work toward adopting attitudes and skills that will help them thrive as upcoming changes unfold. At best, they will become change masters and will not fall into the trap of allowing external forces detract them from their reason for practicing – to deliver high quality care to patients who are interested in optimal health, while enjoying satisfying careers and successful businesses.

How to thrive

Here are eight attitudes and skills that I've found to be common among chiropractors who, no matter what external pressures they face, remain strong and committed to their purpose. These doctors are:

1. Self-aware. Uncertain times call for being more aware about how you tend to function, especially when dealing with rapid changes that demand decisions on your part. It's important to recognize the patterns that determine how, when and why you make the decision you do. See which of the following statements apply to you.

• I make plans based on past experiences. If it worked once, it will work again.
• I just work as hard as possible and hope I'm doing the right things.
• I never make a decision without all of the data.
• I plan for the worst and occasionally I'm happily surprised.
• I assume everything will work out.
• I am always on the lookout for opportunities.
• I never plan. I believe in living for the moment.
• I don't want feedback. I make my own decisions.
• I am guided by my intuition and tend to make decisions quickly.
• I make a plan and then stick to it.

The ability to recognize your usual approach to planning and decision making can help you better understand how your attitudes either limit or support your future success. Moving beyond habitual ways of reacting to challenges can allow you to identify opportunities that may be presenting themselves in the wake of change.

2. Steadfast. Practitioners who succeed even when times are difficult have a clear purpose and vision, and they stick to it. No second guessing themselves, no twisting in the wind. They know what makes their practice special and they leverage that uniqueness. Their "mission, vision, values" statements are more than something to hang on the office walls to impress patients. Doctors who, when the going gets tough, change their strategy, their goals, and their minds with each new bit of news out of Washington or Wall Street end up feeling whipsawed and exhausted, making them less able to cope with the very challenges they are trying to manage. How steadfast do you feel today? What are your grounding principles? What can you always fall back on as being true related to how you manage your practice?

[pb]3. Good at research. Thriving with uncertainty requires knowing as much about matters having the potential to impact you as possible. Research can involve any number of activities, depending on what it is that you're seeking to learn, but in general, practitioners who stay on the cutting edge during times of rapid change read widely (and not just chiropractic journals), look for trends, listen to their patients in an effort to keep up with what their concerns are and understand what they're reading and hearing about health and wellness, stay engaged with trusted colleagues so as not to become isolated, and use practice statistics to better understand challenges, identify opportunities, and focus marketing efforts more effectively.

4. Strategic planners. Scenario development is a planning tool used by futurists, strategic planners, financial analysts and others who try to predict and prepare for the future. Scenarios are essentially stories about how the future could potentially unfold. To weave these stories effectively, you must be willing to suspend certain beliefs as you spin several versions of the future and try to imagine the implications of each one. By inventing and considering a variety of possibilities - ideally rich with detail - you bring forth previously unimagined plots as well as pitfalls and obstacles you might not otherwise have considered. Done at a practice retreat and/or with staff members, scenario development is both enlightening and empowering.

5. Action oriented. With good data and a plan in hand, successful practitioners move quickly and intentionally into action. When it's time to step into action, be sure that your choices will have a positive impact upon your future in the long run, rather than just taking actions that offer immediate gratification. Move forward when you feel you have a clear picture of where you are now and where you want to be in the future. Measure your progress as your plans unfold. Don't give up at the first sign of struggle, but be willing to change course if conditions change. Hold yourself accountable to do what you say you want to do.

6. Resilient. The chiropractors I know and work with who made it through 2008-2009, and who will no doubt thrive now and into the future, are resilient, change hardy, and rarely slip into victim mode. You can measure your level of resilience based on how quickly you tend to bounce back from adversity, how optimistic you typically are, and how confident you feel in your ability to achieve goals. One technique to build resilience and confidence is to take small risks, evaluate what worked well and what you would have done differently, and then repeat the process over and over, increasing the risk (and the potential reward) each time as you begin to have more successes than disappointments.

7. Engaged in learning. The individuals who suffer the most during challenging times are often the ones who have not kept up with the latest trends in technology, clinical technique, leadership development, and even investment strategy. This is particularly evident in chiropractors who are (they hope, anyway) within five or ten years of retirement. This group – "waiting it out" – is often more likely to resist learning about, for example, how social media either is or should be impacting their practice ("What do you mean, patients are giving me stars?"). Regardless of your stage in practice, it's not too late to learn about and apply new resources and strategies to your business. It takes effort, but it will serve you well in the long run, and give you something to think about other than the value of your retirement plan in the short run. Talk to colleagues, attend a continuing education course, buy a book, take an adult education class. Anything you do to stimulate your curiosity and interest in learning will be worth whatever investment of time and other resources you make.

8. Good leaders. Every classroom needs a teacher, every army needs a general, every team needs a coach, and every chiropractic practice needs someone at the helm, leading the way into the future. During uncertain stretches like the one we are in now, your staff needs to be able to lean on you, trust you to make the right decisions, and look to you for guidance. Traits of good leaders include high level of emotional intelligence, the ability to size up a situation and make a decision without undue angst, the proper balance between optimism and realism, being calm under pressure, and having a strong sense of self-awareness, presence, and patience. Some practitioners are naturally good leaders, some fancy themselves as being much better then they actually are, and most need to continually hone their leadership skills in order to keep pace with the rapidly changing field of chiropractic.

Your Practice Future

No one knows what will happen tomorrow, next month, or a year from now related to the economy, the healthcare system, or anything else. Maintaining balance between living in the present and planning for an uncertain future isn't always easy, but it's a worthy goal. Take a moment now to review the attitudes and skills described above and think about how you measure in each one. It's unlikely – not to mention unrealistic – that any practitioner would have or should have high levels of competency in all of the areas discussed here. That said, where do you know you need improvement? Where should you put your energy now? In which of the eight are you already strong, and how you can you leverage that strength?

You will make it through this latest period of financial and political instability. The question is how – with anxiety and angst, or with a sense of steadfastness, resilience, vision, and curiosity about the future? We can't control the external forces around us, but we can control our response to those pressures in an effort to uncover opportunities that may be hidden in what appear to be only challenges.