With all the discussion about what kind of patients we want (e.g. regular, lifetime families), the fact remains that for most people health is not a priority in their life. They may claim that it is, inasmuch as most surveys list health as one of the three most important things in peoples’ lives. Yet it is clear that it is not a priority. Look at the people walking around the malls and see how many have weight problems. People take medication to treat the effects of medical problems rather than addressing the cause, knowing full well that the medication has harmful side-effects. We chiropractors know better than anyone that health simply is not a priority. How often do we hear patients say “I know I should be in regularly but…”? No matter what excuse follows, the bottom line is that taking care of their health by having subluxations corrected is simply not currently a priority in their life.
There is a certain school of thought within the straight chiropractic community, held by some very respected people, that says these type of patients should be dismissed. If their health is not a priority, as failing to get chiropractic adjustments would suggest, then they should be told to hit the road. There are arguments pro and con. For many chiropractors, telling patients to hit the road is not practical. They simply cannot afford to chase patients away, they have bills to pay. So the chiropractor thinks he is compromising because he takes care of patients who he knows are using chiropractic as a treatment. He does not like himself, his patients or his practice and may even throw in the towel saying “why bother educating anybody?” Well, I am not about to try to dissuade anyone from anything, however, I would like to share a few insights.
Let’s understand what we are rejecting or dismissing them for. We are not really dismissing people because health is not a priority to them. If we were to do that, we would have to dismiss everyone who was overweight, who smoked, and/or who admittedly did not get sufficient exercise or rest. What we are doing is dismissing them if they do not seem sincere about our concept of regular chiropractic care. In other words forget health, forget human performance, forget potential. The issue is, will the patient listen to you, the chiropractor? Will the patient come when and as often as you want them to? If not then kick them out. I realize that sounds very selfish and that is because it is! Here is the point. We should want what is best for the patient not what is best for ourselves. It is best for the patient to come, every week with the entire family and never miss. That also happens to be what is best for us. But suppose the person does not want what is best for him (weekly care) and wants what is second best (sporadic care). Who benefits from our kicking the patient out? We may be able to stand up at a chiropractic seminar and say “I throw patients out if they don’t come weekly!”, but I submit that everyone loses in that situation. They don’t get care, you never get another opportunity to educate them. They probably go to a chiropractor who will take care of them for their condition, at best underming everything you have told them and worst making them think you are pulling a big con, getting them under care they do not need. Sure, a few may be browbeaten into being regular by threats, but if they are coming because of fear (of being dismissed) we are no better than the internist who has patients come for a prostate exam every six months out of fear of prostate cancer. People should come because of an understanding of chiropractic, not because of a fear of the chiropractor. We need to show compassion for people who have a lack of understanding or having an understanding are unable to follow through with a committment. That does not mean we make a doormat of ourselves. No one can make a doormat of us. Being a doormat or being taken advantage of exists only in our own minds. If a patient comes once a year to me and doesn’t even pay me, are they taking advantage of me? Only if I think they are. If my purpose in chiropractic is to give chiropractic care and make a decent living and I can take care of a patient or some patients once a year and still make a decent living then I am fulfilling my purpose. I may not be totally fulfilling my purpose with that particular patient in one sense but in a greater sense I am. You see, in fulfilling our purpose in life should not be should not be dependent upon others’ actions. My purpose is to make chiropractic care available to a certain number of people a year, to make a decent living and to present information about the ADIO viewpoint of life and health in as intelligent and timely manner as possible. How often a patient comes is based on the understanding I give them. But it is also dependent upon factors in their life, factors I have no control over.
Don’t misunderstand me. I am not suggesting that we discontinue our patient education programs, or that we tell patients they can come whenever they want. The point is that how often a patient comes and patient education are two different issues. Granted, they are related, but they are not dependent upon one another. A patients understanding of chiropractic and our accepting him for care may very well be unrelated. Oddly enough, it seems to me that the idea of “my way or the highway” is something that we may have taken from the medical profession. That’s ironic! In order for medical care to achieve the little success that it does, strict compliance by the patient is a necessity. Conversely, a chiropractic adjustment is beneficial to a patient even if given once a year, although not as beneficial as if given every week. Perhaps a yearly adjustment is as beneficial if given to a non-smoking, exercising, health-food “nut” as a weekly adjustment is to a two-pack-a-day, junk food, couch potato. I don’t know. No one else does either. Sure, we must educate patients, either to the point of them getting sick of hearing us say it or until it sinks in and they comply. Meanwhile, and until the time comes that they all get the big idea, besides continuing to educate, we must show some compassion, some understanding, and some forgiveness for their failing to be good patients. And all patients need a large helping of love as well, not just the good but the bad also (okay and the ugly too!) v14n1