Chiropractors are facing change that is unprecedented in its pace and intensity, and they're not alone. In today's complex society, we all are increasingly impacted by shifts in economic conditions, politics, technology, social norms, globalization and regulatory influences. In tumultuous times, some of us embrace and welcome change. We're the cultural creatives - the early adopters. We fancy ourselves as being on the cutting edge and we thrive when our lives are in a whirl. Others among us retreat and hunker down in the face of change. Worn down by uncertainty, we long for the "good old days" and do whatever we can to maintain the status quo.
There are all kinds of change - expected or unexpected, wanted or unwanted, initiated or imposed, internal or external, superficial or transformative, or incremental or cataclysmic. No matter how you label it, all change creates a degree of stress. To complicate matters, not only is change stressful in and of itself, but for most people, being under stress makes it difficult to cope with change. It's the classic "vicious cycle." Change = stress. Stress = change. But there is a solution: escaping the spiral of stress and mastering change.
The Downward Spiral of Stress
Many of my clients describe managing their practices as being on a nonstop roller-coaster ride. They long for the steady, linear rises (or even the plateaus) of the past. They feel overwhelmed by constantly changing conditions. Yet how much of the roller-coaster experience is due to external change and how much is due to poorly managing one's reaction to change? A pattern of reactivity, resistance or generally coping poorly with change only adds to the already complex problem of managing - internally and externally - in times of confusion. Since chronic or acute stress makes coping with change highly challenging, our attempts at soothing the immediate discomfort of dealing with change quickly can result in a downward spiral of stress. Here is a short list of common reactions to help you recognize when you might be defaulting to stressful patterns of behavior or an unhelpful attitude. When faced with stress associated with change, do you:
Some of these behaviors might make you feel better for a while, but the relief is temporary at best. These coping mechanisms ultimately are not effective and do nothing to support you in developing skills to manage change, nor help you take the action steps that would make a difference. In addition, the behaviors can become problems in their own right, causing even more stress and a decreased ability to cope. A better approach is to acknowledge change is inevitable and let that awareness support you in taking a proactive stance that is healthy and effective. The first step in developing that stance is increasing self-awareness.
Self-Awareness and Becoming "Change Hardy"
Author and management consultant Meg Wheatley has said the foundation for success in the 21st century is having a high level of self-awareness and an ability to manage change. The capacity to thrive in the face of constantly changing conditions requires controlling one's response to change, a process that necessitates self-awareness. The catch-22 is that we can control our response (stress level, emotions, thoughts and behaviors) only to the degree we can see ourselves clearly enough to understand our motivations and actions.
Before we address how to more effectively navigate and master change, consider for a moment how you currently cope during times of confusion or uncertainty. When offered the possibility of a new experience, what is your usual immediate reaction? What is your typical response to an abrupt change in conditions (e.g., surprise, anger, excitement, dismay, despair, engagement, dread)? What is the consequence of this response? Do you manage your practice with an eye toward protecting what you have, or with an eye toward achieving greater success in the future (even if there is risk involved)? What do you tell yourself about change? Taking a few moments to reflect on these questions will help you build self-awareness about your patterns and tendencies and provide the foundation for becoming a true change master.
Mastering Change
Here are eight suggestions to help you make sense of change and learn to see it as an opportunity rather than as a threat. By adopting these attitudes and behaviors, you'll become more proactive and less likely to slip into a downward spiral of stress.
Expect the unexpected. Watch for signs and clues that change is in the air. Indications that change is imminent might be obvious or subtle. If you find yourself having unexplained physical symptoms, mental unrest or a creeping sense of discontent, these could be signs of impending change. When you expect the unexpected, you won't be thrown off balance by every curve ball tossed in your direction. Pay attention.
Acknowledge that change is stressful. Even change that is planned, wanted and positive can be stressful. If you've ever been on a first date, bought a new home or welcomed a baby into your life, you know this is true. When change is unplanned, unwanted and negative, the associated stress can be overwhelming. All change requires adaptation and adjustment because you are venturing into new territory. In times of change, self-care should be a priority. Look for stabilizing factors in your life and tend to the basics like eating well, exercising, getting enough sleep and not over-scheduling yourself.
Maintain perspective. In the midst of a major change (or even in the face of a series of small changes), it might feel like everything is spinning out of control and there is nothing to anchor yourself to. The tendency is to focus intently on the problem at hand and become blind to all of the things that remain constant and positive. This is the time to slow down, breathe deeply, examine your assumptions, dismantle the stories you are telling yourself and monitor your reactions and behaviors. What seems overwhelming today, might turn out to be the beginning of a new, positive chapter in your life. To gain perspective, ask yourself how important the current change or problem will be in a week, month or year from now.
Don't fight it; learn from it. When we resist change, all of our energy goes toward staying bound to the familiar, to what we already know or to how we want things to stay. In this rigid, restrictive state, we miss out on opportunities to observe ourselves, increase self-awareness, challenge long-held assumptions and learn from the experience. When we struggle against the flow and try to control the uncontrollable, we create more stress for ourselves and miss clues and signals uniquely designed to show us a new way of looking at a situation. Try not to fight the unexpected. Instead, embrace and learn from it.
Stay present. Life expands or contracts based on our ability to adapt and be present with whatever is happening now. Pay attention to both what is happening internally (emotions, thoughts and sensations) as well as externally (the facts, your behavior and the actions of others). In the midst of change, stress and fear, it's tempting to flee to either the future or the past. And yet, the present moment offers our best opportunity to learn, participate fully in the immediate experience and influence the direction of our lives. Staying present when it's tempting to rewind or fast-forward builds self-awareness and resilience.
Practice flexibility. When conditions feel unstable, the easiest reaction is to hold on tightly to past experiences. In this comfort zone, we grit our teeth and suffer unnecessarily. How do you respond when you're stuck in traffic? When patients don't show? When claims are rejected? When an employee quits without notice? To remain flexible, calm and centered when conditions are uncertain is a skill that can be practiced and mastered. When we do this, we become more capable of coping with the tests and challenges associated with change. Try to identify what you can and cannot change or control. Make an effort to see things from different points of view. Remain curious and cultivate a tolerance for ambiguity. This process might cause discomfort. Once you realize you can be uncomfortable and survive, staying flexible and going with the flow can become your natural response.
Focus proactively. In the intensity of a rapidly or dramatically changing situation, it's difficult to stay focused on what is most important long term. The tendency is to slip into panic mode, dwell on worst possible scenarios and spend too much energy putting out fires. A more effective approach during stressful times is to stay focused. Remind yourself of your long-term, big-picture goals and remember, "This too shall pass." Shift your attention away from the problem and look for opportunities that the current change or challenge might ultimately bring about. Stay present with what is happening, but simultaneously maintain broad awareness about the future so you can see options, openings and the next steps to take on your path to success. Focus on your most closely held values, act rather than react, and keep moving in the direction you want to go with a sense of curiosity and creativity.
Seek support. Even if you're a true "change master," it helps to have support when life feels confusing or your practice is in a temporary state of upheaval. Gather information, talk to friends and colleagues, or confide in your significant other. If you want more structured support, engage a coach who will empower you to build awareness, develop new skills and hold you accountable to achieve your objectives.
Choose Your Response: From Coping to Mastery
A common response to shifting conditions is: "I want things to be different; I just don't want to change." Change can be perceived as threatening and disorienting, and experienced with anxiety, fear and stress. Or it can be seen as an opportunity for growth, renewal, progress and innovation, and experienced with excitement, confidence and curiosity. Taking your practice beyond current conditions (not to mention effectively managing yourself and others during occasional periods of turmoil) requires a commitment to mastering change.
You can learn to proactively choose your response to change and move beyond merely coping. Keep in mind the key factors in mastering change include an ability to self-assess, be present, maintain perspective and remain flexible. Success in today's world is not about the survival of the fittest. Self-awareness and the ability to adapt to change is what matters most now. Begin to adopt and practice some or all of the eight behaviors and attitudes in this article and you will be on your way to becoming a master of change.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
