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Dynamic Chiropractic – June 3, 2009, Vol. 27, Issue 12

Four Myths and a Challenge

By Shelley Simon, RN, DC, MPH, EdD

According to Webster's, one definition of myth is: "A popular belief or tradition that has grown up around something or someone; an unfounded or false notion." Synonyms for myth include legend, fable and falsehood.

Myths are not based on hard facts, empirical evidence or even our own direct experiences, yet they persist. They prevail because at some level, we want them to be true. Such is the case for many chiropractors when it comes to what they believe about practice success. I say it's time for a reality check.

What if much of what you've been told over the years about growing and managing your practice isn't true anymore? It's time to debunk four of the more common myths related to chiropractic success and propose an alternative point of view for each of the four. I challenge you to read with an open mind. If your practice isn't as robust, easy to manage or enjoyable as you'd like it to be, then it may be time to leave the tired myths behind and begin to incorporate personal and professional development (for both doctor and staff) as essential components of your practice management plan.

Myth: Practice Building Is a Fast, Linear, Progressive Process

The reality is that practice growth tends to be cyclical. This is true even when the economy is relatively stable, which is certainly not the case now. The myth in practice management is that growth occurs in a linear fashion - work harder and longer to earn more, grow bigger year after year, and continually add new services and revenue streams to stay competitive. Over time, this approach is unsustainable, not to mention exhausting. There is a cost to making decisions based exclusively on a linear-growth model, particularly in uncertain economic times and especially when the results are subpar.

I recently worked with a client who had experienced a nice jump in practice volume. His first question to me after he noted the gains was about how he could increase patient volume even more. My advice to him was to take a deep breath, enjoy the newfound success and work on making sure his practice systems would support the new volume in a sustainable way. Only then would it be time to work toward another growth spurt.

Acknowledge that your practice will (and should) grow in a cyclical manner, with ups and downs, growth periods and plateaus. Cycles are normal in all businesses and today, many are facing flat or declining growth. In this environment, rather than measuring success based on year-after-year volume and revenue increases, focus on growing your practice so it is in alignment with your values and based on a model for long-term success. Work to ensure that each new growth increment is supported with corresponding adjustments in policies, systems and staffing.

Seeing your practice through a cyclical lens will allow you to include both short-term and long-term perspectives in practice growth, weather the inevitable ebb and flow in patient volume, and resist buying into the fallacy that success always means "more." In today's economy, "more" is relative and continuous, rapid growth may be unsustainable. Slow and steady may indeed be the best mantra for these times.

The good news is that current conditions provide an opportunity to develop and leverage your clinical and management skills for long-term business viability. Chiropractors who continue to be successful as health care evolves will incorporate solid business acumen, professional ethics, cutting-edge techniques and technology, and superior relationship and leadership skills into a patient-centered approach for healing.

Myth: One Size Fits All

The cookie-cutter formulas many practitioners use today were designed a long time ago to solve a few very specific problems, many of which are not relevant to today's practice. When practitioners apply these outdated methods to their current challenges, the results fall short. Failing to question the assumptions and logic behind any particular model can lead to frustration, automatic behavior, and disciple-like devotion. The idea that generic mission/vision/purpose statements, packaged systems, marketing plans, and scripts can be adopted successfully by practitioners across time, geography, personality type, and practice style simply does not hold up under scrutiny or stand the test of time.

For example, too many chiropractors continue to train their staff to use scripts, convinced that consistency above all else is necessary for practice success. Consistency they may get, but it's at the expense of not having staff members who are able to think on their feet and resolve patients' problems and concerns in the moment. Too often, scripts disempower staff and limit their ability to develop their own skills, particularly those related to encouraging patients to take more responsibility for their part in the care equation.

Instead of relying on outmoded systems, take the time to scrutinize your practice - the one you've created, the one you work in every day, the one your patients experience. Evaluate what makes your practice unique and different from every other chiropractic office in town. Take an honest look at what needs to be improved in order for your practice to remain successful as health care continues to evolve.

Consider where your business and marketing acumen needs to be bolstered, based on the size and complexity of your business. Critique your strengths and find ways to leverage your distinctive skill set, most popular and profitable services, and the talent of your best staff members. Remember that your office is not exactly like any other, and your business deserves a plan tailored for your specific needs and goals.

Myth: "You Can Be Me" Is an Effective Success Strategy

Becoming a successful version of someone else is probably the best you can hope for when you buy into this myth. Emulating the gurus of practice management is a flawed approach for adult learners and does not lead to sound professional development. For coaching to be effective, individual needs, desires and learning styles must be considered. Coaching is far more complex than advising someone to model successes others have experienced. It involves meeting each client where they are - in their practices and in their lives - and helping them craft solutions that are unique to their situations.

Whether you engage in informal peer coaching or hire a private coach, it's up to you to focus on your own growth and professional development. A good coach will strive to understand your agenda, strengths, challenges and goals, and help you create a personalized professional development plan based on what you want to achieve. Anything less than a fully customized, client-centered approach is not a good use of resources.

Also consider how this myth plays out in your practice when you convey similar thinking to your patients. Just as practice management experts are confident that they have "the answer" for their clients, chiropractors often slip into this way of thinking with their patients. As a clinician, you naturally enjoy, appreciate and adopt the chiropractic lifestyle, but it's unrealistic to expect that every patient for whom you care will follow your lead in this regard. They have their own unique goals and desired outcomes. They don't want to be you; they want to be themselves. Just as a good practice-management coach or consultant will strive to keep to your agenda for success, you can do the same with patients you coach toward better health.

Myth: Hard Work Can Overcome Obstacles, Objections and Limitations

This myth can apply to you personally and to how you use practice-management strategies to enroll patients in care plans. Based on the belief that this time, you will marshal the necessary discipline to achieve your goals, you work longer and harder, trying to do more and more. Many people react to a lack of results by pushing harder on familiar levers that have little to do with their current challenges. While there is good reason to apply yourself to achieve an outcome, there is also ample reason to consider how you apply yourself, and with what consequences.

You've probably heard the saying that doing the same thing over and over again and expecting a different result is the definition of insanity. Particularly insane is when you push to the point of exhaustion, become resentful and cranky, and drive away the very people you want to serve and care for. This is what I would call an adverse side effect. Now more than ever, with the economy throwing curve balls not only at you but also at your patients, it's time to get creative.

Instead of working harder, consider working more strategically. Chiropractors often base their practice-management and marketing activity on what someone else - an "expert" - has told them they should do. They are externally focused. If you feel like even your best efforts are not resulting in the changes you'd like to see in your practice, it's probably time to become your own best expert by turning your focus inward and paying more attention to personal and professional development: self-awareness, self-management, emotional intelligence, presence, and improving your communication and leadership skills.

Taking the time to work in these areas seems counterintuitive for many success-focused doctors who want to see results now. Chiropractors who understand the value and take the steps to work on themselves at a deeper level ultimately see results that are sustainable, not fleeting. Reframing practice management to include your own development will, perhaps more than any other single strategy, see you through the inevitable changes in the health care industry.

A Challenge

With these four myths in mind, I challenge you to take a good look at whether you may be relying on outmoded ideas about practice management, marketing and long-term success. Be honest with yourself, have serious discussions with your staff, and confer with select patients about what's working and not working in your practice and what you should do differently. Reflect on how professionalism, self-management and business ethics factor into the way you approach growing your practice. Consider how you could incorporate personal and professional development goals into a practice-management plan that will offer more sustainability than any system, seminar or series of myths possibly could. Take the time to identity and honor your own uniqueness, and then build on it. The payoff will be a more successful business and a practice you will enjoy working in for years to come.

Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.

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