Honing your people skills
The number one reason that wellness providers like chiropractors, acupuncturists and physical therapists don’t get sued as often as medical doctors is that they’re safer. That’s pretty obvious. When you aren’t dealing in dangerous drugs or invasive procedures, you aren’t putting your patients at much risk.
The next most important reason for the relatively low malpractice lawsuit rate is that people tend to have a more personal rapport with their non-medical health care professionals. These are the people who actually spend time talking with them, getting to know their health issues, and show a genuine interest in them and their families.
That rapport alone can help prevent problems like lawsuits and board complaints. Lawyers have long known that if patients like you, they’re less likely to sue you even if you mess up.
“Plaintiffs’ lawyers report that 70% of malpractice claims are brought because of physician-patient communication problems or as a result of the physician’s attitude,” said Paul S. Sanders, MD, and Debra L. McBride, RN, JD in an article for Minnesota Medicine.
Researchers publishing in the Archives of Internal Medicine reviewed 45 malpractice cases and found that, in 71% of them, plaintiffs had a bad relationship with their provider. More than a third (31.5%) said they felt “deserted” by their doctors, and nearly that many (29%) said they had trouble contacting the doctor directly.
The image of the friendly family wellness provider (the kindly neighborhood chiropractor, the sage old acupuncturist, the sweet and caring nutritional counselor) is fading. Today’s high-tech environment, competitive health care arena, and emphasis on keeping our “professional distance” have given our offices a harder edge, a less personal touch.
The result? More stress for you and your patients, more lawsuits and complaints – and less effective care.
The solution? Hone your personal skills (verbal AND nonverbal) just as rigorously as you update your clinical knowledge.
Here are some specific tips for improving your “tableside” manner:
- Give patients/clients your full, undivided attention.
- Be aware of your nonverbal communication.
- Apologize if you’re late for an appointment, or if there was any other problem associated with the visit.
- Train your office staff to pay attention to patients and show them respect.
- Learn to listen to patient/client complaints without reacting with anger or impatience.
Watch your non-verbal communication as well.
- Maintain good eye contact. Don’t be constantly looking elsewhere or reading from your chart or notes.
- Watch your facial expressions. Match your “face” to your feelings and don’t be afraid to smile when appropriate!
- Be alert to body language. When talking with a patient or client, don’t be checking your watch, tapping your fingers on the counter, or shifting your feet impatiently.
If people skills aren’t your strength, take a course such as one of the famed Dale Carnegie training programs (http://www.dalecarnegie.com/search_courses/select_subject.jsp?courseSubject=CIS) or one of the offerings from the American Management Association (http://www.amanet.org/training/seminars/communication-skills-training.aspx)
Many courses are available online. Just a few hours spent leaning the basics of interpersonal relations can work wonders for your practice!
Reaching out to other segments of the population
By Terry A. Rondberg, DC
It’s no wonder that the medical and pharmaceutical industries have such a lock on the health care system — people are brainwashed from childhood to “visit your doctor.” Regardless of age, color, religion or other socioeconomic factors, going to an MD for anything from checkups to cancer “care” is accepted as the norm.
Until recently, non-medical alternative health care providers haven’t done a lot to reach out to the broadest spectrum of the population. We’ve tended to focus our attention on those people who either have enough money to pay cash for our services, or who have good insurance plans.
That explains why a University of Michigan Health System study found that, while 1 out of 3 patients with chronic pain reported using complementary and alternative medicine therapies such as acupuncture and chiropractic visits for pain relief, most of these patients were older white adults.
According to lead author Carmen R. Green, MD, the reason for this usage pattern is either that alternative care therapies usually attract individuals with higher education levels and income or there are significant differences in insurance coverage.
She also noted that older people tend to have to deal with chronic pain more often than younger people, so they’re more likely to seek alternative therapies. Personally, I also think that older people have learned through experience that medical treatment is often ineffective and risky.
The study, published in Pain Medicine, focused on chiropractic or physical therapy procedures, biofeedback, and acupuncture.
Of the 5,750 adults tracked over a six-year period, 35% reported using at least one form of complementary and alternative medicine therapy with 25% using “manipulation techniques,” 13% using biofeedback, and 8% acupuncture.
Those of us involved in “alternative medicine” must continue reaching out to the general public so we can increase the 35% figure overall, but we also need to make concerted efforts to get our message to those segments of the population that are underrepresented in our patient base: younger people, people of color, and those at the lower economic levels.
Remember this whenever you give a community talk, put photos on your website, place ads in local publications, or create public information material.
If we all do that, in time we’ll be reaching the majority of people in every socioeconomic group, and medicine and drugs will become the “alternative” to US!
Does your e-mail address look ‘unprofessional’?
We’re wellness providers, but we’re also business people. That means we have to look, speak and write with a certain amount of professionalism. You wouldn’t have letterhead with cutesy little bunny rabbits on the border and you wouldn’t greet patients wearing a t-shirt with a hole in it. Why, then, would you use a hotmail or g-mail account for your business mail?
I’m always amazed when I get business e-mail from a doctor and the address is dr-ralph@hotmail.com or yourdoc@yahoo.com or bestchiro@gmail.com. Using a freebie mail account for business purposes says one of three things about you:
- You’re cheap … too cheap to pay a few dollars to get a “real” e-mail address
- You’re not tech savvy … you don’t know how to get or set up a personal e-mail address
- You don’t care what impression you give … and if that’s the case, do you care about what kind of service you give?
Keep in mind that I’m not talking about having a hotmail or gmail account for non-business purposes; we all use them for leaving comments on blogs, subscribing to e-newsletters, etc. But for mail you send to professional contacts such as colleagues, patients, or suppliers, you need to upgrade your image and use a proper e-mail address.
This isn’t just my personal opinion. Here’s what other business consultants have to say on the topic:
“A common mistake I frequently see business owners make is that they continue to use generic e-mail addresses like Gmail, Hotmail or Yahoo.”
– Not So Tech-Savvy? Entrepreneur.com
“A generic e-mail address can send the wrong signal to potential customers.”
– Think twice about generic e-mail addresses – Business Management Daily
“When I see a business using a free email account, particularly a Hotmail account, I immediately think: ‘this business doesn’t care about email, or using the internet to communicate with their customers.’”
– Why is using Hotmail for my business such a bad idea?
“Stop using free email services like yourbusiness@juno.com (yahoo, hotmail, gmail, etc.) to contact current and perspective customers, conduct business and network. Using your own domain, like info@yourbusiness.com adds credibility to your small business. As an added bonus, you are also promoting your brand.”
– 3 Easy tips to INSTANTLY transform the perception of your business
Combine all this with security and privacy concerns voiced by many experts and you have some very compelling reasons to STOP using generic e-mail addresses and invest in a unique domain and e-mail address.
Perception might not be <B>everything,<B> but it’s definitely important in today’s ultra-competitive world!
Being ‘Green’ & Healthy
For the past few years, the emphasis of most American businesses has been to become “green” (or at least look green). Environmental consciousness was seen as a vital characteristic in any business — including chiropractic practices.
Now, trend watchers say health consciousness is the new priority among consumers. The general public expects businesses to be involved in health in ways that go beyond the health of their employees, according to a survey conducted by Edelman, the world’s largest independent public relations firm.
“Health Engagement Barometer 2010″ found that nearly three-quarters (72%) of people trust companies that are obviously engaged in health and two-thirds (65%) either recommend or buy products from those companies.
Three out of four people polled said it’s as important to protect the public’s health as it is to protect the environment. More than two-thirds (69%) pointed to the role business could play in doing this, saying it should put as much effort into maintaining and improving personal and public health as it puts into the environment.
“Business has gone ‘green’ — now it’s time to go ‘health,’” said Nancy Turett, global president, Health, Edelman. “For a company to be prosperous and relevant in the future, it has to factor health into its business strategy, not only to fulfill its social contract with all stakeholders but to realize its full market potential.”
They aren’t talking only about health benefits, but about creating new products or services that maintain or improve health, educating customers about health topics, taking steps to address obesity, and basically being engaged in activities that help increase overall wellness.
Also, take note that they are NOT talking about “medical care.” The public is specifically focusing on health and wellness. In fact, when asked about what the biopharma and medical products industry should do, the majority of respondents said the key priority should be creating new products or services that maintain or improve health, not “new drugs” or so-called “miracle cures.”
This is really good news for chiropractors and all other wellness professionals. By maintaining our strong position as leaders of the wellness “revolution,” we already have a giant advantage over the medical and drug industries, which are becoming increasingly irrelevant to the public.
We can further our lead by continuing to offer the best possible chiropractic care AND by offering related services and products to patients, including everything from stress reduction training to nutritional supplementation. If we do, the medical and drug guys will turn green with envy!
Cutting calories helps rats (and humans!)
Many of you are involved in helping patients lose weight so I thought you might be interested in learning about some interesting information I came across the other day
According to the report, almost all organisms — from yeast to rodents to humans — benefit from cutting calories. The benefits weren’t restricted to being thinner, but covered many wellness areas including longevity. In fact, less complex organisms doubled or even tripled their lifespan and it’s thought that humans who keep their calorie count down could routinely live beyond the 100-years mark.
The report, which was published in the April 16, 2010 edition of Science — and written by nutrition and longevity researchers at Washington University School of Medicine in St. Louis, University College in London, and the Andrus Gerontology Center at the University of Southern California — said that calorie restriction influences the same handful of molecular pathways related to aging in all the animals that have been studied.
But living longer wouldn’t be worthwhile unless the quality of those years was enhanced as well. That’s probably why lead author Luigi Fontana, MD, PhD, said he was less interested in calorie restriction for longer life than in its ability to promote good health throughout life.
“The focus of my research is not really to extend lifespan to 120 or 130 years,” said Dr. Fontana, research associate professor of medicine at Washington University and an investigator at the Istituto Superiore di Sanità in Rome. “Right now, the average lifespan in Western countries is about 80, but there are too many people who are only healthy until about age 50. We want to use the discoveries about calorie restriction and other related genetic or pharmacological interventions to close that 30-year gap between lifespan and ‘healthspan.’ However, by extending healthy lifespan, average lifespan also could increase up to 100 years of age.”
Fontana and his co-authors explained that cutting calorie intake between 10% and 50% decreases the activity of pathways involving insulin-like growth factor (IGF-1), glucose and TOR (target of rapamycin), and considerably increases lifespan in animals. Genetic mutations involved in those pathways have the same effect. Those animals have far fewer problems with diseases related to aging such as cancer, cardiovascular disease, and cognitive problems.
“About 30% of the animals on calorie restriction die at an advanced age without any diseases normally related to aging,” Fontana stated. “In contrast, among animals on a standard diet, the great majority (94%) develop and die of one or more chronic diseases such as cancer or heart disease. In 30% to 50% of the animals on calorie restriction, or with genetic mutations in these aging-related pathways, healthspan is equal to lifespan. They eventually die, but they don’t get sick.”
I like the idea of working toward a long “healthspan” rather than simply extending the “lifespan.” That’s why we must focus less on disease treatment and more on wellness; we need to make lifestyle changes that enhance the quality of life while lengthening it. Personally, I’m hopeful that we’re on the right track to do that.
Fontana doesn’t share my optimism. Because of the current obesity “epidemic,” Fontana says rather than closing the 30-year gap between healthspan and lifespan, the gap is likely to grow. It’s even possible lifespan may decrease as people develop preventable diseases such as atherosclerosis, type 2 diabetes and certain forms of cancer.
Thankfully, since so many wellness providers are addressing the problems caused by obesity, and helping patients monitor their calories intake, we are definitely on the forefront of the “healthspan” movement!
SOURCE: Fontana L, Partridge L, Longo VD. “Extending healthy life span — from yeast to humans,” Science, vol. 328 (5976) April 16, 2010.
A Texas-Sized Constitutional Battle… the Right to Diagnose
Many chiropractors have woken up to the legal battle going in Texas, but if you’re not aware of what’s going on — and you care about your right to diagnose patients — you really need to start paying attention.
And that’s not just my opinion. Look at this April 26 email message from attorney Keith Pendleton, JD.
“Last week, at the request of several ProviderLAW members in Texas, I took a look at a case that some of you may have heard about, but doesn’t seem like it has hit the national press yet. I have to tell you, as a chiropractic patient myself, what I discovered was something of a shock.”
“The Texas Medical Association – a founding member of an AMA-led nationwide consortium called the Scope of Practice Partnership (SOPP) – sued the Texas Board of Medical Examiners to remove the ability of chiropractors to diagnose. The TMA isn’t just suing the TBCE on any old grounds either. It is challenging the ability of chiropractors to diagnose based on State constitutional grounds.”
I don’t know about you, but when a lawyer says he’s “shocked” by something in the legal realm, that gets my attention. Here’s a brief overview/timeline of what’s going on:
- In January 2006, the American Medical Association (AMA) announced an industry consortium known as the “Scope of Practice Partnership” (SOPP). The consortium was originally formed by the AMA, along with six national medical specialty societies and six state medical associations, including the Texas Medical Association (TMA). The stated purpose of the group, among other directives, was to “concentrate the resources of organized medicine to oppose scope of practice expansions by allied health professionals that threaten the health and safety of the public.”
- In May 2006, the Texas Board of Chiropractic Examiners (TBCE) adopted rule 75.17 regarding the scope of practice for licensed doctors of chiropractic in Texas. The rule, formed in response to a legislative mandate made in the state’s Chiropractic Act, governed two particular procedures being performed by chiropractors in the State of Texas – Needle EMG and Manipulation Under Anesthesia (MUA).
- In September 2006, TMA filed suit against the Texas Board of Chiropractic Examiners (TBCE). In its lawsuit, TMA challenged the chiropractic board’s rules for Needle EMG and MUA, saying that the rules violated the Texas constitution because they represented an infringement of the authority of the Texas Board of Medical Examiners. Further, the Medical Association challenged the right of chiropractic doctors to “diagnose,” arguing that only medical doctors have the right to diagnose patients.
- In November 2009, a Texas trial court’s “summary judgment” ruled that TBCE’s rules regarding EMG and MUA are invalid. The Texas Chiropractic Association is appealing the ruling.
- On August 16, 2010, the court is scheduled to hear arguments and testimony on the board’s rules regarding “diagnosis” with respect to Texas chiropractors’ scope of practice.
Clearly, this case is of monumental importance to Texas DCs. So, assuming you don’t practice in Texas, why is this a big deal? Let’s review: this lawsuit doesn’t just seek to prevent the expansion of the scope of practice of chiropractic in Texas. It’s an attempt to restrict what chiropractors have been doing in Texas for decades. And the battle is taking place on constitutional grounds in one of the nation’s largest states. Make no mistake: if successful, this lawsuit could have major ramifications for SOPP and DCs operating nationwide, not to mention their patients.
But don’t take my word for it. Let’s hear again from attorney Keith Pendleton.
“You may have the right in your State (currently) to diagnose….Then consider a few facts… Consider the fact that Texas chiropractors have been reimbursed for years by insurance to diagnose (e.g., state worker’s comp). Consider the fact that statutes like these are being challenged as unconstitutional. Consider the fact that they are being challenged by one of the founding members of a national consortium that is systematically challenging scope of practice nationwide and even publishes a chart of its current actions.”
Now, I’m not suggesting that anyone panic. This legal wrangling may take years to decide. But you need to be aware that the wheels are in motion, and that this is part of a bigger movement to concentrate power in the hands of those “real doctors” who already — along with the drug companies — have the lion’s share of power and influence over our health care system today. Think about it.
Forced vaccine movement picks up speed
Currently, the freedom to practice chiropractic as a drug free alternative to medical treatment and the freedom to choose our form of health care is under threat.
For years, I have been claiming this, but only to deaf ears. It is absurd that in modern times, anyone has to worry about being forced to give up his or her chiropractic practice, or compelled by law to have their children injected with risky drugs. But it is happening.
In Maryland, a school district passed regulations stating that if children were not getting all of the “recommended” vaccines, parents could face stiff fines ($50 a day) or up to 10 days in jail.
Maryland is not the only state mandating vaccines and, as Barbara Loe Fisher of the National Vaccine Information Center (NVIC) states on her blog, US Supreme Court decisions have reinforced the right for states to exercise police power to enforce vaccine laws.
More recently, under the Homeland Security Act, the Model State Health Emergency Powers Act, and Bioshield I and II, states have the power to enforce quarantine or vaccination whenever and however they choose.
As might be expected, the medical and pharmaceutical industries are prodding the states to utilize that power. “History shows that state mandates play a key role in maximizing immunization rates, enabling protection of both individuals and the general population,” wrote Erin Flanagan Klygis, MD, in a policy forum report for the American Medical Association’s Journal of Ethics.
“No vaccine is 100 percent safe or effective,” the author admitted. “As vaccination rates go up, reports of vaccine associated adverse events, both those caused by vaccines (i.e., true adverse reactions such as anaphylaxis) and those temporally associated with vaccination by coincidence, increase.”
However, Dr. Flanagan Klygis advocates forcing parents to subject their children to vaccines.
“Laws that mandate vaccination for school entry provide the best protection against disease outbreaks for both individuals and the general population,” she said.
The medical profession is clearly in favor of forced vaccines, as are the pharmaceutical companies who generate revenue by selling vaccine drugs. Backed by their multi-billion dollar political action funds, they are influencing federal and state legislators to create an even more Orwellian health care system, dictating to every man, woman and child what drugs they must take to avoid a jail sentence.
Segments of our profession have been influenced by this propaganda as well. Not long ago, one Canadian chiropractic governing body, the College of Chiropractors of Ontario, passed a rule stating its position on vaccines: “The College of Chiropractors of Ontario (CCO) accepts vaccination as a cost effective and clinically efficient public health preventative procedure for certain viral and microbial diseases as demonstrated by the scientific community.”
To ensure no chiropractic patients were exposed to opposing views, the CCO also stated: “Chiropractors … may not, in their professional capacity, express views about immunization/vaccination as it is outside their area of professional expertise.”
Even the American Chiropractic Association has been shy about opposing forced vaccines. The organization once placed an advertisement in the Wall Street Journal that was soundly attacked in the profession as being apologetic and timid regarding vaccines. It strongly supported immunizations, antibiotic therapy and said DCs have a moral obligation to refer patients to MDs.
Chirobase, the online arm of the so called “Quackbusters” Stephen Barrett, MD, and Samuel Homola, DC, continues to cite the ACA’s statement that “routine vaccinations have been a proven and effective campaign in the control of many diseases.”
On the other hand, the WCA has been extremely vocal in opposing mandatory vaccines. It has issued a position paper stating, “Medical and scientific research, as well as overwhelming clinical reports, have clearly demonstrated the potential for risk posed by many commonly administered vaccines. These same reports have indicated that the effectiveness of many of these vaccines has not been adequately proven… No person should be forced by government regulation or societal pressure to receive any medication or treatment, including vaccines, against his or her will. This includes mandated vaccines as a requirement for public school admission or for employment eligibility.”
Great Thinkers
by Terry A. Rondberg, DC
If your car catches on fire, would you risk your life to save it? Probably not. But if a loved-one were trapped inside, would you risk your life to save them? Absolutely. Sometimes, the sky is the limit on the actions we perform.
Great thinkers capitalize on this. While the middle-class limit their goals due to lack of knowledge on how to accomplish them, great thinkers are constantly seeking motivation.
- The employee who yearns to win the company trip to Hawaii and receive recognized in the presence of his family and peers.
- The athlete who leads her team to a new world-record, even though her stepfather told her she would never “make it.”
Successful people know the key to eternal motivation is mental strength. They decide what their needs are and why. They know in order to achieve their goals, they must exert the necessary mental energy to identify the emotion they are seeking. Once discovered, the race to create their vision begins.
Bumps on the road are irrelevant for a successful person with a vision. The average person is transformed into an exceptional performer who is adamant that failure is not an option. The power of the emotion is evident. But it is the successful person who takes the time to explore it.
Create a vision that will manifest your faith, spirit, and your endurabce. Submit yourself to God and your energy will exude.
To Be World-Class People, We Have to Think World-Class Thoughts
by Terry A. Rondberg, DC
“Wealth is the product of a man’s capacity to think.”
–Ayn Rand, Author, Philosopher, 1905-1982
Today, if you went to work because you wanted to, you control money. But if you went to work because you had to, money controls you. As a wealthy nation, 99% of the U.S. population is controlled by money. Albert Einstein said, “A problem cannot be solved at the level of consciousness in which it occurs.” Knowing this, champions raise their level of consciousness by studying how the world class creates wealth.
The middle class falsely believes higher education is a path to wealth. They earn advanced degrees but are disappointed when their academic accolades do not translate to wealth. Even those who encourage higher education know it does not always bring money. For the middle class, the formula to earn more money stares them in the face every day. Ideas – a simple concept often missed by the majority.
The lower class is focused on the past, while the middle class is preoccupied with other people. Meanwhile, the elite discuss ideas. Professionals understand that money flows in all directions. Over a century ago, Karl Marx was certain the working class would arise and overcome oppression if given the opportunity. But Marx did not calculate the poverty-driven thought process of the people. Give the “middle-class minded” person a million-dollar opportunity, and more than likely he will just remain in the middle class. His limited self-image and scope does not allow him to progress.
Question for today: “At what level of monetary success do I feel most comfortable?”
a) poverty class
b) middle class
c) world class
Our comfort zones define our current status. If your goal is to earn more money, aim high! The cause is your self-perception, and if you enhance that, the effect will take shape. Don’t attack the effect by chasing money.
Understand the Limits of Money
In pursuit of happiness, beginners seek wealth, while professionals seek fulfillment. Many believe wealth will fill a void. But no amount will satisfy because the void is completed only by fulfillment. The great professionals discover fulfillment from their daily activities. They do not chase fulfillment, and experience it just by carrying out their responsibilities. While pursuing this fulfillment, successful people usually acquire a fair amount of wealth. Beginners seek ways to earn cash quickly.
Beginners feel material wealth brings eternal happiness. Professionals focus on whatever brings a sense of satisfaction. They devote the necessary time and resources to discover their passion and zeal.
On the other hand, the average person focuses on the effects, and often ignores the cause. Even if he or she does earn more money, fulfillment does not automatically knock on their door. Material wealth is an effect, which does not create the cause.
Professionals enjoy what they do for a living and gain fulfillment. Successful people don’t work for money.
-Terry Rondberg
Neurologically Based Chiropractic
Here’s the first clip of a webinar presented by Richard Barwell, DC, founder and president of Chiropractic Equity Offices Inc. Dr. Barwell has more than 30 years of experience in chiropractic practice and he has some great slides to illustrate his points, like penguins and “black” camels. He talks about how the public perceives chiropractic — including misconceptions and limitations — and how neurologically based chiropractic can expand the profession and benefit patients. Enjoy!