Personal Clinic Policies (Hold Fast to the Centre)
It’s often in times of discomfort that we grow.
There is no question that we are closely tied to our clinics - physically, mentally, spiritually, and financially. When patients are getting better, we feel great. When patient’s aren’t getting better, we don’t feel great. When our roster is full, we feel like we’re a success. When our roster is sparse, it hurts a little.
You = Your Practice
If we compare our practice to the flow of the Yin-Yang symbol ☯️, or even a roundabout (merry-go-round) not found at children’s parks any longer, it would make the most sense to stay far away from the edges because this is where the most spin is. Riding the outside of the Yin-Yang is akin to riding a rollercoaster (of emotion). In fact, chapter five of the Tao Te Ching says:
Heaven and earth are ruthless;
They see the ten thousand things as dummies.
The wise are ruthless;
They see the people as dummies.
The space between heaven and earth is like a bellows.
The shape changes but not the form;
The more it moves, the more it yields.
More words count less.
Hold fast to the center.*
Holding fast to the centre is a method of not riding the rollercoaster of running a clinic - and one practical way of doing this is to have personal clinic policies in place. I’d like to share three of mine.
Time
Time is a precious thing, so I teach my patients to value theirs and mine. I do this by taking my patients in exactly at their appointment time. I also don’t allow patients who are more than 10 minutes late to take their appointment. I have turned patients away at the 15 minute mark because it’s not fair for anyone - them, me, and the rest of my patients that day.
Yes, it may seem difficult to turn away a patient who is physically in front of you, but they do learn their lesson: don’t show up late for an appointment. Like all matters to do with health and healing, communication is key. Let them know why you are sending them home and why they have to rebook: it’s because you just cannot physically take care of them in the reduced amount of time.
Missed New Appointments
The first missed appointment of a new patient is often a mistake. However, the second missed appointment is often a cause for alarm: I truly believe the patient doesn’t value my time, or their health.
It’s hard to charge a missed appointment fee for a missed initial appointment because there’s no rapport build yet. That being said, a second missed initial appointment is an opportunity to teach the potential new patient about clinic policies and personal boundaries.
In this case, patients are told they have to fulfill three steps in order to rebook with me again:
1. Send me my initial consultation fee in full via email transfer.
2. I will then unlock their account and they can rebook on the app.
3. If the appointment is missed, the fee is forfeited in full.
After the potential patient has received their three steps to getting back in my good graces, I let the chips fall where they may. This process says to all newcomers, “Serious patient’s only.”
Missed Follow-Up Appointments
At the bottom of the last page of my intake form, I have patients initial the fact that I will charge them a $30 missed appointment fee. Initialing this box is important because they can never dispute that they never knew about the policy.
Why $30? I found charging the full fee was too harsh. Patients didn’t come back. Use your discretion how small or large your fee is. Change it up and make a mental note of how people react.
Some patients will ask if I can bundle the fee in with their third-party insurance. My response is always, “No. That’s called insurance fraud,” which immediately stops them from any other requests of that nature.
Once a patient realizes that they have to pay $30 above and beyond their insurance payment (out of pocket), they start keeping their appointments. I must say that I am very compassionate about patients who call in sick, have a family emergency, or get told they must stay late for work. Missed appointment fees are for patients who do not respect my time. All patients get one warning prior to me starting to charge - where I remind them that they initialled about the $30 fee when they filled out the intake form.
Breaking Your Own Policies
In my career, there have been times I have broken my own clinic policies. I’ve let someone have their appointment after being 30 minutes late. I’ve come to work on a Saturday morning. Guess what happened? I got burned. Was it because the patients who act this way are used to taking advantage of people? Was it because I needed kick in the pants from the Universe telling me to uphold my policies? Maybe both.
Regardless of the reasons, there have been many times I’ve had to become more strict with the way I run my clinic. I will be the first to admit that it has been very hard. I rate high in agreeableness, so being a hard-ass is difficult. However, it’s often in times of discomfort that we grow.
Creating and upholding clinic policies is more than just being a hard-ass: it’s about boundaries. If I can stick up for myself in the clinic, and I get good at being impartial about it, this then filters into my friendships, romantic relationships, and other business dealings. It becomes a new way of life where I love and respect myself more than before.
May your boundaries be crossed, so that your personal policies are strengthened and gradually never broken.
*Translation by Gia-Fu Feng and Jane English