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De-stress for Success
By Holly O'Dell
By recognizing the factors that cause stress, and dealing with them head on, chiropractors can reprogram and reinvigorate their practices—and their attitudes.
Stress manifests itself in many ways and, if not properly addressed, can have many negative effects. But by identifying common stressors, recognizing them and their effects and implementing methods in which you can better handle them, chiropractors can refresh their practices—and their lives.
What's Getting You Down?
The chiropractic profession is no stranger to stress. One major stressor is the nature of the profession itself, notes Shelley Simon, R.N., D.C., M.P.H., Ed.D, founder of Beyond Practice Management in Portland, Ore. "Chiropractors are in a high-demand environment and don't have control over as many aspects of their practices as perhaps they'd like," she says. "Health care is changing—reimbursement policies are constantly shifting, patients ultimately make their own decisions on whether or not they come in, laws get passed by state boards, the economy turns."
Another common stressor that chiropractors encounter is one that requires them to continuously defend their industry. "Because we're not considered ‘mainstream' in health care, chiropractors many times feel like second-class citizens," says Patrick Gentempo, D.C., cofounder and CEO of Chiropractic Leadership Alliance and CEO of Creating Wellness Alliance in Mahwah, N.J. "Although the bias has been improving over the years, it's still there and presents issues and challenges."
Chiropractors sometimes experience frustration with patients who don't implement their suggestions for better health. "There are chiropractors who personalize someone's decision to not get care," Simon says. "It's very stressful when a chiropractor doesn't realize that it's the patient's choice and that their decisions are related to readiness or perceived need. Chiropractors take it personally, and that's where they get into trouble."
Other stress factors that chiropractors commonly list include isolation in practice and lack of support. The physical aspects of a chiropractor's work can cause physiological stresses as well, particularly for those who are already in poor shape, Gentempo adds. "Performing adjustments is a stressor, especially in someone who's deconditioned. Obviously this will take its toll over a period of years if you run a high-volume practice."
Sometimes, though, stress factors can be so subtle that they are buried in the subconscious. But they'll eventually make their way to the forefront, says Kevin Pallis, D.C., cofounder of The New Renaissance in Norwood, Mass. "Stress acts like a pebble in your shoe," Pallis says. "It can start out as a vague fear that you can't put your finger on, and it can pile up to become anger, violence, aggression or lack of compassion for your spouse, children and practice members."
Additionally, stress can have a trickle-down effect, Gentempo says. "Stressors manifest themselves in five major ways: loss of passion for the profession, depression, loss of confidence, lack of success and then, as a result of all these things, a loss of one's own health."
Identify—and Manage—Your Stressors
Given the role that stress plays and its potentially devastating effects, it becomes imperative for chiropractors to meet these challenges head on. The first step, according to Simon, is to identify the actual source of the stress. "Is the event itself stressful, or is it the reaction to the event that's stressful?" she posits.
As such, self-awareness becomes a critical piece in addressing stress. "Chiropractors have to live consciously," Gentempo advises. "That means taking great strides to assess your life, as compared to coming home, turning on the TV and tuning out."
Part of the self-assessment process is recognizing your coping styles. "If you look at yourself when stress hits, you have a pattern of how you cope," Simon says. "We tend to think, feel, relate to others and behave or react automatically when we're under stress. If you don't pay attention to your behavior, you won't recognize there are patterns to your reactions. It's only when you've identified your own habitual reactions that you can begin to shift them, if needed."
Coping mechanisms can take the healthy track—getting a massage, going for a walk, meditating—but sometimes skew toward the unhealthy. "When you don't have healthy ways of dealing with stress and choose methods of coping such as withdrawing, eating or drinking too much or procrastinating, those behaviors become yet another source of stress," Simon says.
As the old G.I. Joe public service announcements stated, knowing is half the battle. "Noticing when you are stressed and how stress shows up allows you to start to understand the causes of stress in your own life, as well as which strategies are helpful and not helpful," Simon notes.
And knowing leads to action. Gentempo suggests a three-step process to address and handle stress, a topic that is regularly addressed in his four-day Total Solution boot camp: Step one is finding clarity on your values and priorities, as well as the order of those priorities. Step two is to create systems or habits that serve your values appropriately. Step three is having the discipline to live them regularly.
It's a system that has served Gentempo well in his life. "I run two companies, I'm married, I have three kids and I travel a lot. I've got every excuse in the world to not live [according to this philosophy]," he says. "But the reality is that I've looked at everything that's important to me, I've created a system and I follow it."
For Pallis, the key is to focus on reducing stress, rather than unrealistically thinking one can completely eradicate it. "We can't eliminate stress. It's all around us," he says. "We must focus on being centered. The real answer is heatlh, not avoidance."
To that end, Pallis has identified what he calls three pillars of success that keep stresses to a minimum. "First is having a great self-image," he explains. "Second is having a purpose—something in your life that's bigger than you, your practice and your worries. The third pillar is using communication skills that convey to people your self-image and purpose that puts their highest good ahead of self-gain."
Simon has found that self-management is one of the best tactics for reducing stress. "It's managing yourself according to your goals, values and objectives rather than defaulting to habitual behaviors. It's being aware of what's happening, seeing what's going on and recognizing the impact on yourself and other people. It's not exploding. It's not blaming other people or personalizing things," she says. "Whether you accomplish all this through a combination of self-reflection, taking time for yourself, being out in nature or doing things that actually slow your mind and allow more of an inward focus, you need to have effective strategies, practices or methods, plus some discipline, to cultivate self-awareness."
Staying in the moment also serves as an effective antidote to stress. "In the present, you have much more resilience and more capacity to see opportunities, to be flexible and empathetic, to enjoy the moment," Simon says.
Is Stress Affecting Your Practice?
Stress reveals itself to you in many ways: Tense muscles, short temper, anger, passive-aggressive behavior, boredom, depression, sarcasm, defensiveness and so on. Though you may believe that you're successfully masking these symptoms in your practice, think again.
"If a chiropractor is under a cloud of negative stress, it is affecting employees or patients, whether you know it or not," says Patrick Gentempo, D.C., cofounder and CEO of Chiropractic Leadership Alliance and CEO of Creating Wellness Alliance. "The only question is to what degree."
Chiropractors can gauge if their stress is bringing down their office by watching their employees, advises Kevin Pallis, D.C., cofounder of The New Renaissance in Norwood, Mass. "The employees mirror who the DC really is," he says. "If employees are unmotivated or depressed, you must take responsibility for it. If your office has everyday drama and gossip in it, you have created that environment."
If you don't manage your stress and anxiety, you are directly affecting your clients. "You have to be whole in your own life outside the office so you have the resources to meet the needs of the people coming to see you," Gentempo states. "If you're sucking energy off patients because you don't feel good about life, that's not right."
The same goes for how your stress affects your staff. "You are off center when you feel the need to talk to your teammates about everything in your life that isn't working," Pallis notes.
The unfortunate truth is that if you let your stress overtake your life, it may ultimately derail your practice. "You're not going to be able to keep employees because no one will want to work for you, and you won't keep patients because no one will want to see you," Gentempo says.
To keep your practice—and life—a success, make yourself aware of your stressors, identify how you react to them and find constructive ways to manage them. Your staff and clients will thank you. "When your teammates are happy and productive, there is a hum and a great feeling in your office," Pallis says. "People pick up on this vibration and respond in a positive manner."
©2006 Today's Chiropractic