A number of years ago Psychology Today ran an article about a man who committed three hours a day for 10 years to complaining.  Each day he would call, write or talk to someone about what he thought was "wrong" with the world. 

Rather than changing anything, the only result was that it made the man incrediably miserable. 

Complaining is a habit that is highly contagious, especially when people work together in an office.  When you are surrounded by complainers it's easy to become one yourself!

Here are four types of complainers:

1. The Whiner.  This person wakes up negative.  Morning is a time to "rise and whine."  The whiner's favorite phrase is "it's not fair!"  He/she feels that everyone else gets the breaks in life.
2. The Martyr.  This person's favorite phrase is "no one appreciates me."  The martyr is a pro at hosting pity parties.  When they are under pressure or don't feel well, they let EVERYONE know it.
3. The Cynic.  Sarcasm is his/her most common form of communicating.  "Nothing will ever change, so what's the use of making the effort."  They seldom make a difference and often pretend they are somehow morally or intellectually superior to everyone else.
4. The Perfectionist.  This person is hard to please. Nothing is ever good enough. Their favorite phrase is usually "is that the best you can do?"

If you or your staff go home from the office totally exhausted every day, it may be because you have spent more time complaining than using your energy in a productive way.  It's time to make changes in a positive direction...for yourself, your family, your office and your profession. 

Start TODAY!

As we start up the practice, our main focus is largely on the big things that have to happen.  Getting the build-out done, paying your loans, building your practice, managing your overhead, managing and trainging your staff, etc.  

It is very easy to let a lot of little things pass you by.  I have found that over the years, what has really helped my office, and made my life a lot more enjoyable, is to focus on the little things.  

For example, a friend of mine works for a chiropractor near where we live.  It is a small office in a small town, and it is just the two of them in the office.  She recently had a major surgery to correct a problem she let go for a few years.  The recovery is slow and she can't be in the office for a while.  

I gave her a call about a week after the surgery to see how she was doing.  Man, she was irate!  The doc she works fo, hadn't called, texted, emailed, facebooked, or anything to see how she was!  The lack of contact truly upset my friend and significantly altered her view of her boss.  

A simple phone call would have prevented serious damage to their working relationship.  Five minutes.  A little thing.

Patients will bring in food, or a letter, or some other gesture to show their appreciation for you.  What will you do in return?  What ways are you showing your appreciation for them?  

When a business contact sends you a referral, what is your process to show appreciation?  Is there a process? 

These little things add up to have a dramatic effect on the overall opinion people will have of you.  Here are some suggestions on things to consider.

• Never underestimate the power of flowers or a plant.  When someone has a family member pass, a surgical procedure, an end to a relationship, and so on; a small investment will not only bring a smile to their face but will pay back tenfold in the future.  
• Handwritten thank you notes are also quite effective, and simply cost a stamp!  These can go to your staff, your banker, your accountant, someone who grabbed your lunch, clients that helped you out, and so on.

Yes, the big things are important, but don't forget the little things!  Not only will they help your business grow, they will also help you fall to sleep with a smile on your face.

This morning, a young mother and two small children came to the office. One of the kids was in a stroller while the other toddler who was quite well behaved, sat quietly while his mom received therapy prior to having an adjustment.

This same scenario plays out all day long both in chiropractic offices as well as medical facilities around the world.

As it is not unusual for children to accompany a parent who is receiving treatment in my office, our staff is particularly careful in monitoring the kids activities especially while around both mechanical and electrical devices.

Both adults and children are naturally inquisitive about instruments and equipment and their operation. I recall being a young adult and while waiting for the dentist to appear often "playing" with gadgets and unknown nobs, while in the dental chair.

Fortunately, I never burned anything with a torch nor caused any specific damage with a drill but...  accidents can and do occur.

It is important to safety proof your office as much as possible and take particular precautions when children are around and not "fully supervised." Take an inventory of your office and implement any thing that you feel will make the facility less vulnerable to an adverse event.

And if an accident does take place-  do you and your staff have a plan and if not I would recommend that one be considered.

Happy days! 

Every day there is another incident where the lines cross between professional and social relationships.  The blurring of boundaries is creating a huge issue in law and medicine.

The innocent violations of HIPAA, confidentiality, Protected Health Information (PHI) and a host of other breaches of confidentiality are almost too numerous to mention. 

While it may seem unlikely that we will go back to a world without Facebook,Twitter or LinkedIn, it is increasingly more difficult to escape from the horrors of early lapses in judgment that occurred during a moment of euphoria which clouds long-term judgment.

• Employers are increasingly going on Google searches with prospective employees or associates.
• Board of examiners and malpractice attorneys are looking up clients on these social networks.
• Patients and prospective patients are turning to social networking to look up their doctor and often uncover unprofessional photos and comments that can never be erased from the web.

Doctors can avoid these problems by discussing patient/doctor, patient/staff and doctor/patient boundary issues ... and by emphasizing the importance of privacy, confidentiality and adherence to HIPAA rules and regulations. 

The waters of the virtual world are turbulent and can create significant problems for the unsuspecting.

It was clear at this point in our conversation that Dr. Z had ideas about getting involved in community organizations and networking with local businesses.  But how does this translate into new patients in the practice?

Dr. Z plans to leverage the contacts he makes within the community.  He is going to focus on groups that have not had interactions with the practice in the past and join organizations with members he doesn't know and are not already patients.

You see, the thing is, Dr. Z needs to be the point of contact for the patient.  It factors into his compensation whether the patient is his or not and if they came to the practice through his efforts.  So keeping track of where the patients heard about the practice is really important.

Clearly, community involvement is an important component of Dr. Z's marketing plan.  But I asked if it was important for him to be involved in organizations in which he had a passion for the organization's mission.

This gave Dr. Z pause.  I'm not sure he had thought of that aspect of it.  "I guess I need to think about that.  I've been thinking about this from my perspective and not from the perspective of the organization and the other volunteers involved."

We talked about this for a bit and I shared my perspective as a volunteer leader with a few non-profit organizations in my community.  I told him that if he is not sincere in his motives he will likely not put in the effort expected by others involved.  Also, if he finds organizations he has a genuine interest in, it will be less like work and more productive.

I think this was a good lesson for Dr. Z.  I know from my experience, if a volunteer is only involved to promote their business, the volunteers like me who are genuine about the mission will be resentful and insulted....and not very likely to be supportive of the business being promoted in the first place.

Dr. Z thought for a moment and replied "I never thought about it like that, but that does give me another way to think about my involvement."

As we get ready for the new year, be prepared for quite a few patients who will have new insurance cards and possibly new plans.

For years now, I have used a form that I made up which the front desk uses when there is a new patient or new insurance card.  When they call to verify coverage, they ask a few more questions while they have an actual HUMAN on the other line.

Here are the specifics:

• Chiropractic manipulative therapy codes covered
• Evaluation and management codes covered
• Limited visits in a calander year and if so how many
• Is a treatment plan required and, if so, after the first visit or how many
• X-rays and MRI coverage and if they need to be done at the hospital or in our facility and is a pre-authorization needed
• Therapies covered in terms of Ultra-sound/EMS etc...
• Deductable and how much
• Verify that we are considered a specialists in terms of co-pays and in or out of network

With these questions asnwered, there will be no surprises to the patient and they will understand their financial responsibilities prior to treatment. A lot of times, these cards will look the same and have similiar plans but I like to verify anyway.

Happy Holidays to ALL!!!!!!!!!!!

The ongoing interview we had with Dr. Z opened up a series of situations that new doctors often experience but never fully expect ... even though all of the educational institutions expose their students to them in one form or another.

For instance, NCMIC returns yearly to every campus with our Starting into Practice seminars that give students tools and ideas they will need for future marketing. For example, we speak about the necessity of getting to know your community.

Here, Dr Z explains in his own words how he plans to increase his exposure to his community now that he's had several months to "get acquainted" with his town. These are all principles taught in the Starting into Practice workshop.

"I now realize that exposure within the community is vital. I know it will be necessary for me to become involved with a local community organization that I will enjoy so that people will get to know the real me. I plan to frequent more business establishments, such as restaurants and retail stores to make myself more visible. While visiting, I want to make an effort to get to know the owners and employees. If I encounter individuals who have not yet visited the office, I will offer a tour to familiarize and educate them in chiropractic. I hope to approach this situation from the aspect of, "I've seen your place of business, why don't you come and visit mine."

Dr Z is catching on to the point of needing to be "seen" in his community and understands that it's not just about being seen; it's about creating trust. People refer people to doctors they trust.

Do you have any ideas that others might be able to use concerning "getting acquainted" with your community?

I wonder if there was a need for a doctor of chiropractic, would your name be the one that comes to the top of the mind of the residents in your community?

Everyone knows that the hospital emergency room is open 24/7.  The care may, at times, be impersonal and sometimes the wait is long, but the ER is always open and that is a comfort when the need arises. 

Being available just makes good business sense and increasingly the availability of doctors during “off hours” is progressively becoming more prevalent. If you want your current patients and potential patients to have some comfort during those times when the office is not normally open but your patients have an emergency, be certain to communicate that message to them. 

Be certain your staff is on board with this policy so there are no conflicting messages when patients ask about your availability policy.  You will be surprised how little it is abused but how meaningful it is just knowing you will be there if needed.

By this point in the conversation, it was clear Dr. Z had some awakenings upon actually beginning to practice, so I asked him what advice he would give to a graduating class.  What would he tell them to be aware of before starting to practice?

First he would want to tell the new graduates to have a full understanding of their basic needs for starting a practice.  Dr. Z felt that if he had not become an associate and started up a practice on his own instead, he would have overlooked small details, while focusing on getting patients in the door.

"Once the patients were there, I would have recognized the fact that I lacked specific items necessary for proper treatment and case management.  I'm sure that would have caused me to lose patients."

Next, Dr. Z stressed the need for a basic understanding of business operations.  "I have seen in my short time here that I would not have been successful if I had attempted to start my own practice."  Dr. Z said he would encourage anyone who is planning on starting up on their own to take advantage of as many business resources as time would allow.  Resources like www.startingintopractice.com and www.score.org are great free resources to help with the business side of practice.

Finally, make sure you have the adjustive skills to properly treat the wide variety of patients who will walk through the door.  Along with that, Dr. Z said networking within the healthcare community is important so proper referals can be made if a patient has a problem outside the scope of chiropractic. Networking both before graduation and after landing in your community is important to develop those referal contacts. 

"At the end of the day, it's about the patient.  By having a strong connection with the healthcare community, I can make sure my patients get the appropriate care they need."

Continuing with the discussion Mike Whitmer and I had with a new doctor, Dr. Z,  we asked, “What do you feel has been disappointing to you concerning what you thought your “real world” practice would be like?

Dr. Z  slumped as he replied, his hands folding one over the other as though he needed further thought.

“I feel disappointed that patients don’t seem to understand what a chiropractor does in order to help them. The attitude of ‘my bones are cracked and I feel better,’ is sometimes bothersome to me.  In the office I work in, the statement was made that ‘some chiropractors do not get all of the crunches out’ meaning that unless the patient’s cervical spine did not make the right noise when adjusted, it could not possibly be effective.”

The young doctor paused, lifting his head just enough for us to see his hopeful look.

“I would like to educate the patient a little more. I think if they were to understand why an adjustment helps them, the patient would be better able to inform others about chiropractic and we would not be looked upon as such an ‘isolated’ profession.”

It’s not unusual for new doctors to feel a bit discouraged. You’ve been in a “chiropractic bubble” for years now, speaking to knowledgeable professors, and colleagues who know and understand the value of chiropractic.

Now you’re off to find your way and you are encountering people who have been fed nothing but rumors of “back-cracking” with no knowledge of what that means!

Don’t be alarmed. It only takes a short time to garner trust from your patients. As they learn to trust you, first as a person and then as a doctor, you’ll be able to educate them about the world of chiropractic and it’s benefits. From there, you’ve got no place to go but grow!

Before we continue our interview, do any of you have any “real world” experiences that disappointed you at first?