16 The Only True Way to Avoid Practice Burnout
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Dynamic Chiropractic – March 1, 2020, Vol. 38, Issue 03

The Only True Way to Avoid Practice Burnout

By Steven Visentin

Forty-two percent of doctors are burnt out, according to a recent article on the American Medical Association website,1 but you don't have to be. Take this quick test to see if you need a real vacation:

  • Are you even a slight bit resentful toward your patients, practice, or staff?
  • Has it been more than four months since you've enjoyed a real vacation?
  • Do you feel under-rewarded, overworked ... or both?
  • Are you unable to sleep well?

If you answered "yes" to any of the above questions, read this article and discover an "escape plan" Find out how to take consistent, short breaks over the course of a long, fruitful career.

Are You Fried?

You should feel grateful for your opportunity to serve and not at all resentful. Resentment is the measure of burnout. If you're at all resentful about insurance reimbursement, greedy lawyers, your staff, or God forbid, your patients, you've waited too long to take a real break.

You're Not Fooling Anyone

Patients may not understand much of what you say and do, but they have an incredible knack for reading your soul. They can look into your eyes, see how you feel, and determine whether they should trust you with their health.

Your patients deserve a doctor who is fresh, focused and ready to give their professional best. They know if you're at all off or resentful. Patients will never tell you this; they'll just silently leave your practice and never come back. Wouldn't you do the same?

Seminars Aren't Vacations

By the way, a seminar isn't a vacation, it's work. When you go to a seminar, you may recommit yourself to your life's work, and feel a transient boost in your level of energy and self-esteem, but this is not a break. You must reward yourself and feel a little pampered if you're going to have a long, successful career.

B.J. Palmer, the developer of chiropractic, knew this. While he was running a school, radio and TV station, and his own clinics, as well as writing books, he took time out to travel the world. He also rested regularly in his winter home in Sarasota, Fla.

Plan breaks during holidays when patients may be distracted and fail to keep their appointments. Leave when the weather in your town is lousy and no one wants to go out, because the media is telling them it's too cold or dangerous to drive.

Don't Close the Office

What kind of message are you giving patients if you close your office? Didn't you tell them to keep their appointments and stay on track? Worse yet, what message are you giving when you imply it's OK to visit a colleague down the street while you're gone?

If you close, imagine how difficult it will be to recover the momentum your business will lose while you were off playing. How will you get it going again? Why should you have to get it going again?

With new patients worth an average of $1,000 or more, you can't afford to close. A well-run, established clinic is still profitable with a fill-in doctor. Just hire a doctor to work your usual hours and come back refreshed to a busy clinic.

How to Find and Use a Fill-in Doctor

Your state association may have a list of licensed doctors who do fill-in work. If it doesn't, post an announcement on Facebook's many chiropractic sites saying, "Wanted: Fill-In Doctor, Licensed In (state) for (dates)."  Call the doctors who respond and ask:

  • Can you commit to working the dates?
  • Do you know (my techniques)?
  • Are you willing to meet with me and study how my office works?
  • How much do you charge? (The going rate in my state is $300 for a full day and $250 for each half-day.)

Do your due diligence. Make sure they're licensed and have a good reputation. Get them to sign a waiver from your malpractice company at no additional charge. (NCMIC does this.) Train them thoroughly. If you do a technique that's unique, have the fill-in doctor study educational videos or other training resources, so they can do it well enough to help your patients.

Have then sign an agreement that states what they are being hired to do, when, and how they'll be compensated. Of course, you'll want your attorney to look at it.

Have them adjust you, so you can tell your patients, "Dr. (Fill-in) will be working for me. You're going to love him/her. He/she does the same technique I do. He's/She's my doctor and I only go to the best."

Tell your staff, "Dr. (Fill-in) will be here to do everything I do; accept new patients and care for regular ones." Tell them the doctor is very qualified, but is new to your office and needs their help to make the office run smoothly and on time.

As a solo practitioner, I've used this system for decades and take from a week to 12 days of vacation every 3-4 months. When I find a doctor I really like, I ask them to commit to a year in advance of fill-in work and give them approximate dates. After your break, ask your patients, staff and the fill-in doctor how things went. Look for ways to improve the process.

For the Arrow to Move Forward, First We Must Draw It Back

It's time to start living. Bringing in more patients or more money is not going to make you happy or fulfilled. Being well-rested and rewarded are feelings you can give yourself any time. Patients will find your rejuvenation extremely attractive. Plan to leave town, see the national parks, or even leave the country. Enjoy regular, well-deserved vacations and watch your practice flourish.


  1. Berg S. "Physician Burnout: Which Medical Specialties Feel the Most Stress. "American Medical Association, Jan. 21, 2020.

Dr. Steven Visentin, a 1982 graduate of National College of Chiropractic, is a solo practitioner and clinic director at Care Chiropractic in Denver. He is also the author of an e-book, Blow Your Head Off Practice Building Secrets. For additional information, contact Dr. Visentin via his Web site, www.carechiropractic.com.

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