Stop Making Your Patient Drive The Car!

Are you making your patients drive the car? This is something that came up from a conversation I had just the other day with a chiropractor I've been mentoring. He's been out several years and is struggling with something that all of us struggle with. And it's often seen as a new grad thing. But I know many, many experienced chiropractors, even myself a few years ago, who still struggle with this as well. And this is about trying to seem like an expert and being authoritative without being authoritarian. So what I mean by that is authoritarian is what we think of when we think of doctor centered care. It's doctor knows best, doctor's orders. You just lay down and do what you're told and I'm going to do it all for you. And the doctor's the hero. The patient has no autonomy, they just the damsel in distress. Very, very passive. We know that doesn't lead to great outcomes. Patients don't like it. Frankly, a lot of practitioners don't like it. It's all the pressure on us and it doesn't really work that well. But what many of us then end up doing is going well. I want to be patient centered, so I'm going to be the opposite of a doctor centered chiropractor. And I have this image in my head of what they're like and I go completely the other way. Your patients don't want that because that might make you become very empathic, really care about the patient, find out what's important to them, find out what their values are, find out what their goals are. And that's key. But it's not enough, because if that's all you do, you're just a good friend. They have people in their lives probably who are like that already. You need to have the empathy, but you also need to have the expert knowledge to know them, how to get them past this problem. They need to look at you and see this is a practitioner who is an expert. That's what's required for trust. You may have seen the training videos I've done already on the trust equation. If you haven't, trust equals empathy. You need that plus authority. Otherwise you're just a nice person. If you don't have the empathy, you're an arrogant so and so you need to have both there. So you want to make sure when you are giving your recommendations and when you are giving your advice to patients, you do it with authority. Don't shrink away from that because you're afraid of being seen as bossy. There's a phrase I heard a while ago. I came across it in some notes the other day. I really like this. There's nothing enlightened about playing small because you're afraid that your lights will upset other people. I think I've mangled it there. But that's the basic idea, that shrinking back a little bit and not recommending the best thing for that patient because you're afraid of how they take it, that's unethical. That's putting your own insecurities in front of the patient's needs. If you think it's going to take 20 visits over three months to get this person better, if you think it's going to take not just chiropractic, but some massage and they need to get some rehab kit and they need to buy some orthotics, whatever it might be. If you think that's going to get them to their goal quicker and more effectively, you have an obligation to share that with them. That does not mean you try and convince them that's not your job, but you have to share it with them and say this is the best way to get you where you want to be as quickly as possible. Now, many patients may not want to do that. That may be too much treatment, it may be too much time, it may be too much money. Fine, have a plan B. Okay, if that's too much, then we could remove this and we could space this out a bit more. It'll take you longer. Or you might have one or two more flare ups along the way. Whatever you think the extra risks might be, share that plan with them and then let them decide. That's what you do. But too many of us right away, put the patient in the driver's seat and go off to you. You're in charge here. Just come back whenever you want or come back when you feel you need it. Or here's some other things you can do them or don't do them, that's up to you. The patient doesn't know the way they're coming to you because they don't know how to get from here to here. And you sitting in there going, I'm a patient centered practitioner who's really nice and is all about creating, getting rid of dependency, creating autonomy, active copas, that's what we want. You got to meet them where they're at. They're not always ready for that. They need someone who's an expert over time. Can you help bring them up, share your expertise with them? Absolutely. But putting them in the driver's seat from day one. It would be like your first ever driving lesson. The driving instructor turns up, puts you in the seat and says, right now we're going to drive down 10 minutes over this way. You're not ready for that. You need them to show you how the gears work and how the clutch works. And then you need to probably practice in a car park, just stopping and starting and going five miles an hour to try and drive down the road immediately. No, that's not a good idea. Could we get them there long term? Absolutely. That's going to help them drive. But you've got to meet them where they're at. And the best way to do that is by demonstrating your authority. Not being bossy, not being arrogant, not being stern, but just sharing with them confidently. This is the best way to get you from where you are to where you want to be. And if that doesn't work for you, this is the next best way. And then it's totally over to them. But doing that, you'll find A, patients will appreciate that and respect you more, B, they're more likely to follow it because now you've shared something with a little bit of confidence they can trust. This is the best plan for them. And C, it actually starts to become true for you. You start to build your own confidence. So if there's anyone watching this who is shrinking away from sharing the best possible plan with patients, I challenge you to try and reverse that. If you want some help with that, I'm here. Obviously, a lot of the training I do is around how to communicate these sorts of plans very well with patients. I'll be launching a new program in a couple of months time that I'll share with you here as well. So I'm here if you want more help, but give this a try. In the meantime, just think, what's the best possible plan and how can I recommend that in a way that feels okay to me? You're not over treating. You're not saying, I think you need 30 visits when they only need 15 or 20, but you're just sharing it in a way that they can feel. I trust this person. So if you struggle with that, give it a try. Practice it with a friend or practice it with a colleague as well. But don't shrink away because you're afraid of the patient's reaction. That's putting your insecurities in front of their care. That's still a bit Dr. Centered. Just because it's not arrogant and domineering, it doesn't mean it's okay. So have a think about that. As always, get in touch if you've got any questions. And I'll see you next week for another video. Take care.