Latest News 

July 2005, Vol. 15, Iss. 3

Table of Contents

A Great Opportunity • Age of Confusion •

APMR Accepts CBP® Research • CBP® has 13 Published Clinical Trials • Chronic Back Pain, Your Brain, & Chiropractic •

Creating a Great First Impression • Evidence Based Exams •

Had Enough? • Lateral Head Flexion from Vestibular Dysfunction •

Letters to the Editor • Life's Rise from the Ashes •

PosturePrint™ is now a Validated Posture Analysis •

The Disease of Unrealistic Expectation • Thousands of Heroes •

When You Can't Critique CBP® in the Peer-reviewed Literature

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The Disease of Unrealistic Expectation

by Mark Radermacher, D.C., President

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

           In the past few years, a number of younger chiropractors have been suffering from a severe case of unrealistic expectation. The disease isn’t completely the fault of the chiropractors themselves, but, as in all diseases, the responsibility of curing the disease rests solidly on each who is afflicted. Unfortunately, most have been influenced to treat the symptom of the disease instead of the cause. This approach is short sighted, creates additional challenges, never addresses the real problem, and could become fatal.

           The disease, unrealistic expectation, relates to responsibility and success in practice. Blame the disease on Wall Street for naming chiropractic as the fourth best profession to enter into; blame it on the chiropractic schools for telling students they are in a very lucrative profession; blame it on the huge student loans, many of which exceed $125,000.00; blame it on practice management for not physically going to a client’s office and implementing success protocol personally; blame it on techniques, some of which get patients “better” too fast and others too slow; blame it on other chiropractors who entice with multi-million dollar homes, fast cars, and fancy trips; blame and blame and blame.

           Most younger chiropractors have no clue what chiropractic is and lack the personal responsibility of seeking that definition in order to succeed in practice. A superior academic education finds many intellectual chiropractic giants with their heads in the clouds but their practical abilities and common sense not elevating them enough to see over a blade of grass. Many of these chiropractors have silver spoons in their mouths, expecting to have practice success handed to them. Their academic education is “A, B, C” and “1, 2, 3”; and practice success is expected to be a similar “cook book” approach. Nothing should ever fail; not a promotion, not a doctor’s explanation of the need for chiropractic care, not a patient’s improvement on post-x-ray, not a staff member’s performance, and certainly not an insurance claim submitted to collect payment.

           Without even attempting to interview a chiropractor inflicted with the disease of unrealistic expectation, a bystander will hear a sad list of self-imposed limitations. Some of these include statements such as: “I didn’t become a ‘doctor’ to have to stand in a supermarket to sell myself,” or “If someone would have told me I had to go door-to-door like a vacuum cleaner salesman, I would have never gone into this profession,” or “I refuse to keep telling all my dumb patients why they should keep coming in for care...if they can’t figure it out, then tough for them,” or “I will neither ask for referrals from my patients nor try to sell an offer at the end of a spinal care class. No self-respecting doctors do this, and I won’t either.” The very words “self-respecting doctors” aren’t even understood when suffering from unrealistic expectation, self respect is not a common attribute of someone with a mouth full of silver spoon.

           The shock of starting up a practice and not having every aspect fall perfectly into place, combined with the attitude of being too good to have to do or say certain things, leads to a do-or-die situation. This is an unfortunate stage of the disease. Fear and blame drive many people when they finally admit to lack of health. Sometimes, radical steps are taken to provide short-term relief. One radical step some chiropractors take is the implementation of pre-pay plans to increase cash flow. Once this path is chosen, office statistics must be modified in order to “feel even better”; that is, only the new patients who “buy” the pre-pay are counted as new patients. The others, often 50-60%, are phantom new patients and aren’t counted statistically because retention (or P.V.A.) would drop significantly if they were counted. The next “natural” radical step to take is to add services that some insurance companies will pay for. Many of these services arguably have benefit, however, there is often a problematic pattern that places the use of these additional services in question. The pattern is simple to understand but impossible to defend, and develops as follows: the patients who “buy” a pre-pay end up paying much less per visit; therefore, to make up the difference, the patients who do not pre-pay and happen to have insurance get extra services and are charged more. Often much more. Aside from being unfair and, perhaps, illegal, this doesn’t solve any problems at all, and, in fact, eventually worsens the disease. Insurance companies are in business to make money, and when they identify problematic patterns in billing and services rendered, they often refuse to allow a chiropractor to remain as a provider in their company. After getting “booted out” of enough insurance plans, it’s easy to understand how the disease of unreasonable expectation could become terminal.

           There are a number of diseases that become terminal if only the symptoms are treated instead of the cause. Radical steps taken for symptomatic relief of unrealistic expectations is one such disease that will become terminal. The temporary relief provided by some radical steps cloud better judgment. Steps that are too easy, too quick, and too questionable to provide substantive improvement are superficial forms of symptom relief only. While suffering early in practice, short-term relief is paramount, while medium- and long-term cures are perplexing to contemplate. Radical steps taken can bring in more money, unfortunately, at the cost of developing a model which stands the test of time and would offer the balance and longevity defined as a successful career in chiropractic.

           Once enough radical steps are taken (attempting to provide short-term relief) and no real care is offered to cure the disease, unrealistic expectation will become fatal. Offices go bankrupt or are sold, and chiropractors move on to other means of making money more easily: selling real estate and becoming an investment broker are often considered as two “easier” ways to make money after having failed or burned out from chiropractic practice.

           There are no quick and easy answers in success, likewise, there are no quick and easy cures from some diseases. Every chiropractor inflicted with the disease of unrealistic expectation has some serious planning to consider. Attempt to identify how your disease began. Was it a guidance counselor who told you that your aptitude test pointed toward a degree in chiropractic? Or was it the lure of becoming a doctor of chiropractic quicker and easier than another health care profession? The original source that led you to the chiropractic profession may provide insight about the initial infection, which eventually consumed you, the host, and developed into a disease. If this is the case, then the first step to take is the re-evaluation of what it means to be a chiropractor. If you are able to discover what chiropractic care really is and how desperately people need it, then you are on the road to recovery.

           The road to recovery will require many steps and will include success and failure. You will learn that quick and easy changes in practice are often worthless, just like quick and easy chiropractic care is for patients. The road to recovery will include the decision of what type of practice model you wish to implement. That model will include how you intend to organize your office and how you will communicate chiropractic to the people. Communicating chiropractic “to the people” includes patients and non-patients alike. Chiropractic is still in its infancy, and very few people understand the definition of chiropractic and health.

           Chiropractic is not yet the well-understood health care profession many expect it is. Perhaps someday it will be. In the mean time, the disease of unrealistic expectation is going to continue to infect and destroy any chiro-actors: who blame others for the disease, who are unwilling to search for the definition of chiropractic health, who have a list of self-imposed limitations, and who are thinking short-term relief instead of long-term care. To overcome the disease of unrealistic expectation isn’t easy but is well worth doing. The chiropractor who finds it difficult and even embarrassing to speak with a silver spoon in mouth should remove the spoon and place it on a shelf as a reminder of a lesson well-learned that only needs to happen but once.

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