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January 2006, Vol. 16, No. 1
Table of Contents
CBP® Non-Profit Matches Dr. Bill Harris' $25,000 Research Grant • Counter Point Round III • Dr Deed Harrison is the Most Published Chiropractor in the Index Medicus • Flawed Thinking • It's Don's Opinion • JCCA Publishes CBP® Structural Rehab Protocol • More Studies to Confirm the Validity and Reliability of PosturePrint™ • Thriving in the New Health Care Marketplace • Organic Chiropractic • Patient Education • Point Round III • The Purpose Driven Practice • Radiation Hormesis • Research Corner • Subluxation Update • System Failure • Ten New Year's Resolutions for Your Practice • Chiropractic: A Useful Component of Traumatic Brain Injury Rehabiitation • Triano is a Chiropractic Pariah •
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Flawed Thinking
by Mark Radermacher, DC,
President Total Practice Management Int'l, LLC
Dr. Radermacher has been a chiropractor for the last 25 years and has been coaching some of the largest, most balanced and profitable practices nationally and internationally for the last 17 years. He is the author of: The 5 Minute Report Of Findings©, The 5 Minute Pre Consultation© (including the invaluable Life Impact Points©), The Dynamic Micro Report© (communication with patients during adjustments), The Fade and Fade Response©, The Minimization and Minimization Response©, Cluster Scheduling© and The 24 Hour Per Week Mega Practice©. He is currently the leader in coaching chiropractors in patient communications and practice building.
He couldn’t stand the pain. For three weeks now, his low back was throbbing. Every breath sent a hot knife he was sure was searing flesh. Every move a chore and every chore an impossibility. No bending over to shave, no putting socks on, no swinging a leg into a car... and worst of all, no sleep. “If anyone,” he muttered to his wife, “had a pill, a potion, a lotion, some sort of solution to kill this pain, I’d do or pay anything to get it.”
Fred Johnson is 42 years old. He has lived in the same house for 16
years, driven a pick-up truck since high school and worked his-way-up at a local factory over the last 15 years. His back never “went out” like this before. It would hurt most of the time but it was never “a problem.” He is an active guy. He bowls, he goes hunting and fishing. He plays poker, with the guys, every Friday night and has a small woodshop in his shed where he produces picnic tables he sells on the side.
“They don’t have the money” Dr. Smith whined to a friend while on
the telephone, “They don’t want all this structural long term care, either.” In a slump of defeat, one hand holding the phone and the other hand holding the opposing side of his head up, the look on Dr. Smith’s face was confused and desperate. The last thing he needed after six years of challenging practice was to go belly up. Every ad he ran, every flyer he sent out, every workshop he attempted, offered limited success at best. Even the patients who occasionally referred other people to the office would usually end up making excuses as to why these people never wanted to come in. Most of the new patients who did wiggle through the key hole to get in his office either quit right after the pain subsided or dictated the parameters of their own care frequency and payment.
Michael Smith was a trustworthy, conscientious well liked individual. His above average grades in school didn’t come easy, but he never quit studying. He is an athlete, well read and wants to become well traveled once he can afford to. In school, he always wanted to know “why.” In chiropractic school, he asked most of the questions in philosophy class, most of the questions in technique classes and he was always asking why chiropractic works. His practice started out slow, he was seeing 15 visits each week in his third month. After two years in practice, collection was just enough to pay the bills...and he asked “why.” “Why don’t I succeed like some of the other doctors I hear about? Why doesn’t chiropractic catch on in this community? Why don’t people care about their health? Why doesn’t anyone have any money? Why do insurance companies scrutinize and cut bills when care is needed?” Why, why, why.
Dr. Smith’s office is two miles down the street from where Mr. Johnson lives. The two have never met
and even though it is a small community of 15,000 people, they may never meet. Each person, Dr. Smith and
Mr. Johnson, is caught up in flawed thinking. Both are upstanding reasonable individuals living in their own
world creating their own reality. It is probable that Mr. Johnson would respond to care in Dr. Smith’s office, but if Mr. Johnson somehow ever entered Dr. Smith’s office, he probably wouldn’t stay to get the care he needed anyway.
If you were to analyze this flawed thinking — point by point could be addressed, reasoned with and the
right conclusion would present itself. The problem is: neither patients in pain nor doctors who are desperate use common sense to analyze much of anything. Instead, their responses are knee-jerk in nature. Mr. Johnson,
through no fault of his own, was raised on the medical model. Dr. Smith is still asking “why” because he has no model. Simply knowing that chiropractic works is no substitute for an alternative care model that Mr.
Johnson would seek out.
Mr. Johnson has very identifiable and understandable knee-jerk responses. He always suffers with a low-grade pain but tries to ignore it. Now that the pain is excruciating, he makes key survival statements such as: “If anyone had a pill, a potion, a lotion, some sort of solution to kill this pain, I’d do or pay anything to get it.” This is a very powerful statement that can be taken for face value. He’s serious!
Dr. Smith also has very definable and understandable knee-jerk responses. His practice has always been suffering, producing a level of irritation. He asks himself “why” on a series of points and comes up with the same fairly typical knee-jerk responses that many other chiropractors come up with: “They don’t have the money,” “They don’t want all this structural long term care, either,” “Why don’t I succeed like some of the
other chiropractors I hear about?,” “Why don’t people care about their health?” Dr. Smith’s knee-jerk
responses become no more than affirmation of his questions. He soon believes people don’t have money, don’t want care and don’t care about their health. He also makes a huge flaw in thinking that most other chiropractors succeed to the extent which they espouse.
In these cases of flawed thinking, Dr. Smith’s the only person who could provide any meaningful solutions. Mr. Johnson only understands a small part of the medical model. He has absolutely no knowledge of the chiropractic model or what the definition of health happens to be. Therefore, Dr. Smith will need to be the
person who is pro- active. He must first define the chiropractic model he will use in his office, then he must
learn how to communicate that model and finally he must reach out to the community in order to bring them in to learn and benefit from his model.
In defining the chiropractic model, Dr. Smith will need to use a technique that has definable and defendable parameters. This is crucial. There is a huge difference between legitimate confidence and magical charisma. To use a technique that is both definable and defendable can provide a solid foundation for confidence. To use a technique that is neither definable nor defendable necessitates charisma be used instead, by the doctor, and in place of a solid foundation. When it comes to proving what you do — for patients, insurance companies and a court of law, charisma can get sliced and diced where confidence stands true.
Next, Dr. Smith must learn how to communicate his definable and defendable model. This isn’t an easy
task! In fact, learning how to better communicate is dynamic; an ongoing journey that continues to challenge
but often provides rewards. Whereas the magical charismatic doctor will use smoke-and-mirrors on patients to
get and keep them in care, the confident doctor will learn how to listen to patients, match their personalities,
customize responses and always talk in simple understandable terms. The latter approach allows patients to understand and make their own informed decisions. The biggest challenge Dr. Smith faces is learning how to better communicate. If he fails in his attempt to “remake himself,” it is in communications that he will fail.
To learn how to successfully communicate with patients is to offer them a level of critical thinking. This critical thinking will often replace the old knee-jerk response patients used to use instead. For example, when Mr. Johnson said he would “do or pay anything” to “kill the pain,” he was serious. Pain is a great motivator. But, Mr. Johnson didn’t have all the critical information needed to make the best choice. He has been suffering with pain in his back for years and has done nothing about it. His entire focus is on his “intense” pain of late. He actually believes that the pain is the problem and if the pain went away, the problem would go away. If he did start care in Dr. Smith’s office, he would quit soon after the pain was sufficiently relieved. Once again, this isn’t Mr. Johnson’s’ fault... it’s all Mr. Johnson knows. It would take Dr. Smith communicating effectively with Mr. Johnson in order to see Mr. Johnson get the care he needs. Dr. Smith has to be careful not to get fooled by patients seemingly making promises or commitments to care. People will make strong statements, often committing to anything when they’re in pain...once the pain is gone, so too are the commitments.
After Dr. Smith defines his model of chiropractic he is offering and after he learns how to communicate better, then he must reach out to the community. The cart before the horse analogy is so accurate. Some of the ads, some of the flyers, and many of the workshops Dr. Smith had so unsuccessfully done in the past failed
because he was so sure patients wouldn’t stay for care even if they had responded to his promotions. The horse before the cart dictates that the model and the communications are set in motion first. That’s not to say that every failed ad or flyer will now produce large numbers of pre-qualified new patients, but some will perform much better when the doctor is aptly prepared. Dr. Smith, with his newly defined model and the beginning of an ongoing communications system will now find some confidence. With this confidence, he will comfortably make more sense when speaking to patients and perspective patients. This will see not only more new patients come to his office but, more importantly, more new patients start and stay with meaningful care. Dr. Smith would now be on a new and sustainable road to success.
Flawed thinking is not a crime; flawed thinking is, however, keeping many people from becoming patients. Doctors in chiropractic must realize flawed thinking is a reality in both the patients and the doctors’ minds. Doctors must also realize that they must break the cycle of flawed thinking instead of waiting or expecting the patient to make the first move. Models of care can become very deeply engrained and powerful. The medical model has proved that point in most of the western world for decades. If chiropractors expect the same power out of the chiropractic model, they will need to eliminate the flawed thinking in their own minds and then reach out to patients and perspective patients attempting to decrease or eliminate the flaws in their thinking. This will take time, effort and discipline but with people’s health at stake, it’s necessary for us to do.
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