Q:

Dr. M.  I have been reading your e-mails for several years now, and 
thought I'd ask you a question, since I value your experience.

My background - I have been in private practice for 4 1/2 years now, 
and we do very well (in my opinion).  I graduated in Spring '97, 
bought an existing office in Aug '97, and have elevated the practice.  
We are busy (could always see more), doing about 50-75 a day for my 
full days of M-W-F.  I work on Tues and Sat morns also, and often 
have to come in on Sundays or other evenings to finish x-rays, 
dictation, etc etc.  I enjoy what I do, and don't mind coming in.

My question to you is this.  I am finding myself becoming 
disillusioned (for want of a better word).  For every 10-15 people 
that are getting better, I have that 1 or 2 that aren't.  I know that we 
cannot help all the people.  But it's that 1 or 2 that really eat at me.   
Sometimes they seem like they could be 'easy' cases, and I would 
expect their bodies to respond quickly.  Of course we review outside 
activities, to see if there is something beyond our control that is 
affecting it.  We try home use of exercises, ice, nutrition, etc etc.  
But that 1 or 2 eat away at me, and they destroy my entire day.  I do 
look forward to coming in to the office, since every day is different, 
but I still have those 1 or 2 that eat at me. Or, it may be that patient 
who responds slower than expected, then goes to his or her medical 
doctor who tells them that Chiro care cannot help them, that they 
have "X" or "Y" which we a) already know, and b) which are EXACTLY 
the things we treat, like sciatica, but of course will not heal 
overnight.  So they quit, despite you explaining to them.  In fact they 
already made up their mind, so educating them is a lost cause; it 
falls on deaf ears. Now this doesn't happen often, and I've been told 
that I'm building a good reputation in town for helping people, and 
we have many success stories of those harder cases.  But why do I 
let the others get to me, and how can I get over this?
Hopefully I've explained myself, and sorry for the babbling.

A:

After 4 1/2 years .. like the seven year itch .. you may be mildly 
burning out. Not to say that the symptoms are the same .. but self 
doubt .. even mild .. is a clear sign that changes are needed sooner 
than later. 

MD's working in ER or onology have patients that don't make it. They 
get hardened to the fact. We chiropractors give great worth to the 
adjustment and our application of it. Patients should respond but 
some don't usually the ones we care about the most. After 25 years 
of practice I've come to the conclusion that I didn't create the 
problem .. just ready to help fix it. 

So .. what would I recommend. I always have found based on my and 
friends experiences that taking another technique course .. 
especially in a weak area .. works best. You feel more excitement and 
patients pick up on it ..  but a vacation also won't hurt.

Don't despair .. be glad you feel for results and your patients .. just 
don't let it dictate your life. Your other patients need your energy .. 
the few that drain it .. will do so if you let it

Have a Great Day

Dr. M