The Chiropractic Identity Crisis Pt 1

So I'm not talking about traditional philosophy, I'm not talking about traditional vitalism, Didi, BJ Palmer, all those guys, that's not really my jam. I'm not going to talk about what it is you're actually doing for patients. You're going to be lost. And I think we all need a philosophy. If you don't like that word because it's loaded with baggage and chiropractic, think of it as your chiropractic. Why? Your reason for doing this, whatever it might be, the things that really underpin you. And I do believe you need some core principles. And through this series I'm going to share what my philosophy is. Not because I think everybody should do what I do. I think having a range of philosophies and concepts is actually a strength overall. But I want to share mine because some of them, many of you, if you don't have anything, it might be helpful to at least latch onto some kind of coherent idea that I have while you develop your own. And at the very least, it would get you thinking about, well, what are your truths, what are some of the things that you believe and that you stand by as a chiropractor there. So obviously one of the core things for me, the one I'm going to focus on, this video won't be a surprise, is patient centered care. You know, ethical, patient, patient. First principles are obviously a huge part of what I do because that's what I spend most of my time teaching practitioners as well. And for me, one of the key parts of that is respecting patient autonomy. So in a physio or an osteo, and it's being fueled a lot by research, the research that's coming out now suggesting that manipulation isn't unique. There's other professions who are using manipulation. Physios are really training in spinal manipulation now. We're sharing techniques. So what really makes us us, Because I think if we can't answer that, we're all going to feel like we're generic MSK practition. And that's a problem, not just for our own sake, but for our patients, because you can't really build patient trust and you can't really develop confidence if you don't know what it is that you do. So your own confidence in yourself, that you project to patients, that patients pick up on and use to trust you, requires you to have a good understanding of who you are, what you do and how you help people. So you need to have that clarity. Otherwise what happens is you don't really Know what you're doing. There's one chap in particular I was chatting to, he'd worked a lot of this out himself. He was a little bit lost, didn't know where to go. But he was like, well, I know what philosophy I don't want, but I don't really have one. All the research shows is 6 sessions of manual therapy is pretty good for pain relief. And he goes, well, if they're feeling better, then what? He didn't really know where to go from there. And he was second guessing himself. You know, he was feeling quite lost. And it's a feeling that's common to many, many practitioners. So this is almost certainly not going to be one video. I think it's going to be a couple of parts to this. I want to talk about chiropractic philosophy for the rest of us. One of my truths, one of my principles is. So I never try to persuade patients. I sometimes catch myself wanting to do it and I catch it and stop it as soon as I can. I don't try to persuade or convince patient to do anything. What I do is I inform and I offer. Or if you prefer the term invite, maybe I might invite them to take a certain action, I might offer a certain treatment plan, but I see myself as a consultant. They come to me with a problem. I use my expertise to work out potential solutions. I then offer those solutions back to the patient and I let them make the decision. If they turn around and go, thanks, Chris, but I don't really want that, I'm going to do something else instead. As long as I can feel like they have understood the choice, I'm going to go, fine. I'm not going to bother chasing, not going to bother doing anything like that. And this isn't something that just the high volume scarecare guys do. This is something nearly every chiropractor does, is that we think it's our job to educate patients to make them do what we want. Not in a manipulative way, but make them do what we think is best. That's what the purpose of our education is. Is that really underlying it? There's a level persuasion that we think that if we, if they know what we know, they do what we do. And that's just simply not true. So I do believe in education. I believe in informing my patients so they can make the informed choice there. And when I offer treatment to them, I will offer them something and they can tell me if they want it or not or if they go, you know what, Chris, I do want that, but that isn't going to work for me. I can't come in that often. It's a common one we hear. I will go, okay, well in that case let me offer you something different. And I might offer them two or three plans. As long as they know what to expect, then I'm completely happy with that. So I very much see myself as offering care and letting them make a choice. And I'm not attached to their choice. The irony is when you do that, you come across as more confident because patients can tell they don't, you don't need them, you don't have this neediness about you and they will feel that you must really stand by what you're recommending because you don't mind whether they do it or not. So that's something I think is really, really key. And the other part of that is that I genuinely believe in offering the absolute best option to patients. I do not believe in rose tinted glasses. I do not believe in what will hopefully be better. I think that, you know what, when I'm working out a treatment plan for somebody, I'm going to go with what can I be absolutely certain that I can do that would give them the best possible option? And that normally means recommending more visits than I might have otherwise. Okay, normally means recommending more visits than. To be honest, the average chiropractor who practices like me, who's more evidence based, recommends fewer visits than I do. In my experience, I tend to recommend more, not massive plans. I don't believe in recommending three month plans where we've structured the entire plan from the get go. One of my other principles, I don't believe I can predict how people are going to respond particularly accurately. I can't predict where they're going to need to be in two or three months time. So I might give them an overall idea, but I'm going to give them recommendations at start that I stand by because I would always rather reduce the plan down than try to increase it. It's a very tough sell for patients when you go, I know I recommended this, it turns out it wasn't enough. I think you need a bit more. And many of us will avoid that conversation to people, please or because we don't want to seem like one of those chiropractors after their money and we will then not do it and the patient ends up under treated. And that's one of my big other principles. I think under treating is a bigger sin than over treating. Obviously there's gratuitous over Treating where you try to sell them a massive plan forever. Not talking about that because if you're watching my videos and you know me, you know we don't do that. But I think if you under treat a patient by one visit, that is worse than over treating them by three because at least they got the result there. Anyway, talked about that in other videos there. The idea of offering to me, it's so fundamental because it avoids both the traps that we worry about as practitioners that drives a lot of imposter syndrome and a lot of fear. There's, we don't want to fall into like that pressure trap of sales and high pressure and all the stuff that we don't want to do. But equally we don't become so light touched that we abdicate our leadership and our responsibility. I see myself as a trusted advisor. It is my job to give them the information, their job to decide what to do with them. So that to me is a key part of being patient centered. It's something I've talked about in other videos as well. But this patient centered philosophy of finding out what my patients truly want, finding out how I can get them there in the best possible way, and not being afraid to offer that as an option and then changing the plans we need to, that's absolutely fine. That's a, that's a big, big part of my philosophy, my chiropractic ride. These are some of my truths that I really stand by there. And that drives my clinical decisions, it drives the way that I communicate with my patients. It drives how I shape my entire practice and it drives how I show up every day and how I define what I do to patients. Having that, having that patient centered part of my philosophy, it allows me to make the recommendations that I believe this patient needs without any anxiety, without any imposter syndrome, without any fear of getting it wrong. Because I know that if I get it wrong, we can adjust it. But I also know I'm giving them the best possible chance. And if they come back and want to do something different, we'll have that conversation again. It's not a persuasion or a negotiation or anything like that. And like I say, it's really important that you have some sort of philosophy or chiropractic wire, some truth you stand by. Because if you don't, if you have nothing, you'll feel completely lost. You will never get past imposter syndrome because you'll frankly never really know what it is you're doing. Your patience will pick up on that. You'll have a stressful career that won't be very successful. That's a tough place to be. Otherwise. What you'll do is you'll borrow someone else's philosophy wholesale, often without realizing it. This is what happens to people when they work in a certain practice and they just go, well, I don't have a philosophy. These people do. I'll just adapt that one. If it turns out to be a philosophy that works for you, great. However, the reason many new grads leave new leave practices early on is because they find out this is not a philosophy that works for me. So you really do need to think about what a philosophy is that works for you. So that's part one. Part two, what I'm doing. I'm going to look at what I personally believe we're actually doing in the room with our hands. What does chiropractic treatment involve? Because to me, understanding that allows you to explain it in a way that changes everything, that patients really understand it. It is going to be a video that some people are going to disagree with. I know I'm going to trigger and upset some people with it. I'm just sharing it as my example. So keep an eye out for a couple of days. I'm going to share more with you then.