Limitations

One of the things I constantly review in my mind is the limit of my patients. Patients, not patience. What I mean by this is: how many is too many? I know for many doctors, if not most doctors, "the more, the better" serves as the general rule.

For example, in one chiropractic professional journal there is a practice management group that would run large ads and as part of the advertisement they would list the names of some of their clients from around the world with the average number of patients they would see a week (or PVA in chiro lingo). Some chiropractors named on the ad would adjust over 800, a few of them would acually have a weekly PVA of over 1000 patients a week. And this would be just one doc, not an office of several chiropractors, just one doc.

The first reaction for a struggling chiropractor after looking at these types of stats is one of awe. Maybe even envy. Then the math kicks in,"1000 patients a week times $40 a visit... holy smokes! That dude is making some bank!" But then the guilt kicks in, "But I'm sure that chiropractor is not in it for the money. He sees all those people because he cares about each and every one of them and wants them all to achieve optimal health through an optimal spine. So I shouldn't judge him or be jealous of his practice. That chiropractor is just better than me and I suck."

Then awe and wonder kicks in again, "How in the world can a single chiropractor keep up with a 1000 patients a week?"

I know I can't.

My limit right now is about 300. The most patients I've seen in a week is 311 and I struggled mightily with it. I struggled with focusing my heart into each and every adjustment. It was difficult keeping the stress low and the inner peace high when the waiting room is full and the time to spend with each patient got shorter and shorter. I began to feel like I was losing the ability to care and see the patient as an individual instead of some widgit on an assembly line. I started to fear how much my care, my personal touch, would suffer if started to see 400 or even 500 patients a week by myself.

Now I know what the "experts" say:

Get organized! Implement systems in your practice that facilitate great capacity! Train your staff so they take the burden off you! Use a technique that allows for quick treatments-- but communicate effectively so that the patient feels loved and educated in that short period of time!

I know a chiropractor in Hawaii who chased the 1000 patient visit benchmark like Ahab chased that white whale.

And you know what? He did actually eventually harpoon that number!

But do the math...

1000 patients over a week of 25 adjusting hours

equals 90 seconds per patient.

90 seconds to greet, assess, adjust, educate, encourage, and thank each one of those thousand who had entrusted themselves to those hands.

It can be done. Obviously. Limits are set to be broken.

But how much is too much? And what am I willing to sacrifice to break those impossible limits?

For me, at least for now, surpassing 300 patient visits a week requires too much compromise, too much departure from the core of who I am as Dr. Shiraki, chiropractor.

But again, this is not to say that the limitations should be set in stone and remain unchallenged. It's a tricky feat: balancing what is too much against what is not enough. That's why I'm always thinking on this thing.