The new patient, a man in his late 40s, suddenly got an odd look on his face. I had been going through his case history and had just asked him, "Have you had chiropractic care in the past?" Despite his mild nervousness, he did not hesitate to offer that he had been a patient of another DC, a friend of mine, for almost 20 years.He had no complaints with my friend, and had come to my office only because his insurance had changed. I was on the new company's provider list, whereas his previous DC was not. He had chosen my office because it was near his home.
The patient was anxious for me to get his records from his previous DC (let's call him "Dr. Kruel"), since he was concerned that I wouldn't adjust him "hard" enough. "You really need to crank on my neck, Doc," he advised. "And I really need that fist-behind-the-back thing he does, when he jumps on me." I had a pretty good idea of what he meant, but off went the "request for medical records" form.
Dr. Kruel called me, as I figured he would. "John, what's that ingrate doing in your office?" I explained the patient's economic reasoning, but my friend pointed out that once the copayment "dust was cleared," his office visit was only $5 more than mine - $5! This guy left a doctor with whom he was perfectly satisfied to save $5 an office call.
I felt sorry for Dr. Kruel, since I could detect a small hurt in his voice. Abandonment and rejection are two of the most feared human emotions. In my early years of practice, receiving a request for records (RFR) from another chiropractor would easily push my ego button. It made me feel the way I did when a girl turned down my invitation to the high school prom because she had to wash her hair that night.
I've since learned that patients disappear for many reasons. They move, die, go broke, get surgery, get better, don't get better, etc. When I receive an RFR now, I don't take it personally. Yet I always wonder, "Why did they change chiropractors? What did I do wrong?" That may be because I really have used poor judgment at times.
One mistake I have made is neglect. I can think of one patient with a chronic condition that I treated regularly for several months. She had experienced chiropractic care. Both of us seemed to enjoy our conversations as I treated her, and she always reported good temporary relief. She had tried many other treatment methods, but spinal adjustments seemed to give her the best short- term relief.
Then came the RFR form. It was from the office of a DC who was well-known for slick advertising and the use of gizmos, gadgets and grandiose. I had made the error of assuming that the patient had permanent impairment, wasn't going to get any better, and that she appreciated the temporary relief. Evidently, she hadn't given up yet. I lost the patient because I was too entertained by our dialogue, and not in synchrony with her expectations.
My ego is pretty well-ironed-out by now. I can take it. I remember an old DC telling me, "If you think you can make everybody happy as a chiropractor, forget it! If that's what you're looking for, you'd be better off running an ice cream store!" But I wonder. What else can I do to keep patients happy?
Maybe I should purchase one of those waterbed tables with the moving "car wash"- type jets underneath. Maybe I should entertain them more. One of my DC friends put a flat-screen TV in his therapy room for patients reclining on roller chairs, waiting to be treated. I can imagine "Andy Griffith" or reruns of "American Idol" would be the preferable programs. (Actually, I have one of those roller chairs, and covet it intensely in my private office, since I need to take my "noon nap" somewhere.)
Or maybe, a wine bar.
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