January 26, 2025 • 19 mins
In this episode of The Provider’s Report, we’re diving deep into building meaningful provider-patient relationships. From that critical first impression to fostering trust over time, we explore proven strategies to connect with patients from all walks of life.
We’ll discuss social psychology principles like thin-slicing and the halo effect that shape patient perceptions, and share actionable tips for creating a safe, welcoming space for everyone who walks through your door. Plus, you’ll get conversational strategies to ensure you’re communicating effectively and authentically.
Whether you’re navigating tricky patient interactions or just looking to elevate your practice’s patient-centered care, this episode is packed with value for healthcare providers in any specialty.
What You’ll Learn in This Episode:
- How patients form impressions of providers in seconds—and what you can do about it.
- The role of thin-slicing and the halo effect in shaping trust.
- Open-ended and closed-ended questions to improve patient conversations.
- How to respond when a patient asks a question you don’t know the answer to.
Key Quotes from the Episode:
💬 “Trust is not built in one moment; it’s a series of small, intentional actions that make patients feel heard and valued.”
💬 “Your non-verbal cues speak louder than your words—maintain open posture, make eye contact, and be present in every interaction.”
Recommended Reading:
- The Empathy Effect by Helen Riess, MD
- Compassionomics by Stephen Trzeciak, MD, and Anthony Mazzarelli, MD
- When Empathy is not Enough by Joshua Satterlee, DC
Join the Conversation:
What’s your go-to strategy for building trust with patients? Share your thoughts on Instagram @TheProvidersReport or send us a DM!
Subscribe & Leave a Review:
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Follow us on social media!
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Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Scarlett Solo USB (00:00):
Hello.
(00:00):
So quick question before we getstarted here.
I want you guys to sit down andthink about your current
practice wherever you are.
Imagine your patient base.
New, established, old, doesn'tmatter.
Do you think you are buildingtrust with every single one of
them?
Like actual trust.
That's a hard question.
What is trust?
(00:21):
How do we get it with ourpatients?
Are we achieving that with someof them and maybe not others?
And why does it even matter,right?
Well, This episode is all aboutthe social psychology behind
trust and why it matters so, somuch when it comes to health
care.
So I want to talk about firstthat first impression.
When you are introducingyourself to a patient, what does
that look like?
(00:41):
And to be honest, it starts allthe way with how a patient makes
their first appointment.
You guys already know, I loveJNAP.
That's our current privatepractice software that we use
for our EMR.
And the number one reason Ipicked them is actually because
it starts at the at that onlinebooking.
And in my opinion, they're theonly ones that have the best top
(01:03):
notch online booking system thatI've ever seen.
It's incredibly user friendly.
It's modern.
A couple clicks, they're done.
it's almost too easy to behonest.
So what does yours look like?
Do you have a contact form onyour website where they have to
input their information and thenwait a couple days to be
contacted?
Do you have an online bookingsite at all?
Do they have to make a phonecall to make an appointment with
(01:25):
you?
What does that look like?
nowadays it can look like a lotof things.
There are even apps out therethat people can use.
People can make an appointmentquickly online.
and I recommend thinking aboutyour process and making sure it
is as easy as possible becauseyou're going to be losing
people.
if it is challenging.
They're not going to book anappointment if they have to
work.
times harder on your sitecompared to someone else's.
(01:47):
Do they have to spend 20 minutesdoing paperwork when they
arrive?
I cannot believe, like forexample at my OB office, The
amount of times I'm handed aclipboard with a printed out
piece of paper to fill out and 9times out of 10 it's the exact
same information I filled outlast time and typically minimal
changes.
It's a waste of my time everysingle time, and I understand
(02:07):
that they need updates, but Iwould much rather do it in an
email, at home, than sittingthere when I'm currently on time
for my appointment.
So what does yours look like?
When they show up, are theygreeted with a friendly face?
Are they not?
Are they greeted to a roomwithout any staff at all?
Next up, what happens when theyactually get to meet and see the
provider?
Are they greeted with a smile?
(02:29):
Are they, talk to first, notlike a patient.
Hey, how are you today?
How's your day going?
Oh, were the roads bad?
You know, something like that.
You can obviously tell I'm fromthe Midwest with that one.
are they actually talked to likea real person right away from
the get go before you dive intothe nitty gritty?
In a lot of cases, it's just nothappening.
(02:49):
The provider walks in andinstantly goes, Oh, so I see
you're sick.
There's like no, there's a majordisconnection there.
And we are forgetting that thepatients that we are seeing on a
daily basis are humans, justlike we are.
Patients are missing that.
They want to know that thehealth care providers they're
seeing are actual human beingsas well.
(03:10):
And so we're missing thispersonalization, this
conversation piece, and thereare really simple things in your
practice that you can do to getthat back.
So in social psychology, thereis this thing called thin
slicing, which means patientscan form judgments about
providers literally in seconds,just by taking like thin teeny
tiny little details, littlesplices, if you will, of their
(03:32):
first interaction with you.
And sometimes this works great.
Maybe you're on top of your gameand you end up giving them a
first impression that It makesyou seem like an even better
clinician than you already are.
That's wonderful.
But most of the time it can bethe opposite where, you know,
they're going to just pick apartlittle things that you do, bad
body language, minimal smilingor friendliness to the
(03:52):
conversation, little things likethat.
And if a visit starts in thatmanner, they're less likely to
be compliant with their care.
They're less likely to followyour recommendations for
whatever medication you'rerecommending or follow up
appointments.
and That trust aspect is justnot there.
And as we know, trust can reallydictate and influence the way a
medical condition goes.
(04:12):
Patients who don't trust theirhealthcare providers are less
likely to disclose informationthat is necessary to provide the
right medication, the righttreatment, to come to the
appropriate diagnosis.
So trust is more important thanwe realize.
And then the obvious, if apatient trusts you, they're not
going to leave you.
They're going to feelcomfortable going to you for the
(04:34):
rest of their lives, which isalso very important when it
comes to getting the rightdiagnoses over time and really
getting to know your patientbase.
The next thing I want to touchon in social psychology is
called the halo effect.
So this is all about how earlyimpressions can dictate long
term perceptions.
Basically the halo effect is acognitive bias where the patient
(04:55):
will kind of look at the firstimpression of a healthcare
provider or anyone for thatmatter, and they will literally
make their full judgment of whothat person is, why they do what
they do, what they do on ageneral basis.
This could be great if thatfirst impression is solid.
They might start thinking you'rethe greatest person in the world
with minimal details.
(05:15):
But on the flip side, what if itgoes the wrong way?
You could be the best doctor inthe world, but if your first
impression is terrible, thatwill run its course throughout
the time that you are seeingthis patient and it's really
hard to come back from.
So some really easy ways to helpmitigate this is to remember to
dress nice, be approachable, behygienic, make sure that we are
(05:37):
giving off happy body language.
If we are all closed off andturned into our computer when
the patient walks into our doorand we don't immediately welcome
them openly, that starts us offon a bad foot and sets the tone
for that patient visit.
We have to remember this thingcalled open mindedness.
Posture.
Are you turned toward thepatient?
(05:58):
Are you open to receiving themas a patient that day?
Are you closed off?
Are you making appropriate eyecontact or not?
Believe it or not, a lot ofpeople still aren't doing this.
In computers, yes, they play arole, but I promise you this is
even a thing outside of theworld of technology.
Are we responding to activelistening cues?
Are we making sure to let thepatient speak and showing them
(06:19):
that we're listening?
Are you letting them know, yeah,I hear you?
Are you repeating things back tothem that they're telling you?
A lot of people aren't.
They're just kind of checkingoff that box, yeah, I'll let the
person talk.
No, no, no, no.
This has to be a back and forthdialogue.
It has to be a back and forthtop notch communication
experience if you want to besuccessful in this area.
So I want to present a story toyou.
(06:40):
I actually had a patient who Ihad been taking care of for many
years.
She had followed me to multiplepractices over the course of
like a seven year period oftime.
I had seen her for obviouslymusculoskeletal things in the
past, and I didn't see herfrequently by any means, but
every few months or every sixmonths when she had a new issue
pop up, she always came to me.
And then this was probably Mayof last year, she came in with a
(07:02):
new complaint, which hashappened before, nothing new.
I sat down, listened to theentire story of what was going
on.
I didn't examine that area.
And I quickly realized this wasoutside of my scope.
She was having a complaint inher lower leg.
It was very obvious with myexamination, this wasn't a calf
issue, this wasn't an kneeissue, this wasn't an ankle
issue, I'm a chiropractor, Ispecialize in musculoskeletal
(07:23):
conditions.
Nothing on my exam was screamingthat it was something that I
could help with.
In that moment I told thepatient, hey, I know you're not
going to like this answer, butthis isn't looking like
something I can help you withright now.
What is the relationship youhave with your primary care doc?
Can we contact them as soon aspossible to have this evaluated?
Can we get this looked at?
And I believe at the time shehad already seen ED a couple
(07:44):
times and she just wasn'tgetting the care that she was
looking for, but they had ruledout some scarier things like
obviously a blood clot andthings like that.
But no one had really fullyexamined the area and I said,
This is just not the place forthis.
this is what I would recommend.
Gave her my recommendations, wegot a hold of her primary care.
I actually ended up going onmaternity leave shortly
afterward, and I never got tofollow up with her until three,
(08:06):
eh, two or three months later.
Turns out, she, Ended up goingto primary care and they ended
up going down that trajectory.
They started with blood work,imaging, the whole nine yards.
She actually had a severe mass,an actual form of cancer in her
leg.
And I know this is an extremeexample, but this is something
(08:27):
that really just encourages andreinforces why I want all of us
to practice this way and createtrust with our patients.
When I saw her for her followupwith me, when I came back from
maternity leave, she told methat the.
Only reason she went was becauseshe trusted me.
She didn't believe that therewas anything major going on.
She thought it was literally acalf cramp.
(08:48):
She only went because shetrusted me and she told me that
to my face.
And even to this day, it givesme chills just thinking about
that.
This is why it's so, soimportant.
Do I wish she would have gone inand it would have been nothing?
Yes.
Would it still have been awesomethat she did that because she
trusted her healthcare provider?
Yeah, that would have beenamazing.
(09:09):
But in that moment, that couldhave been a life or death
situation and I am so, sograteful that I was able to give
that patient that kind ofreassurance and care for her as
a patient instead of, justtreating whatever was in my
scope or, only caring aboutthings that pertained to me
directly.
She knew that I would always puther needs above anything else
(09:29):
and my recommendations would bebecause I truly cared.
The next thing I want to talkabout is open ended questions.
All the way back to ourtraining, we are taught to
basically ask people differentquestions, almost like a
multiple choice situation.
You know, is your pain sharp ordull on a scale of one to 10?
What pain levels do you have?
And yeah, that really comes intothe picture.
I think when we're filling outan intake form, but when a
(09:51):
patient is right in front ofyour face, instead of maybe
asking, is your pain sharp ordull?
Hey, can you describe the painand discomfort that you're
experiencing right now?
That is a great example of anopen ended question.
Instead of something like, Hey,how many surgeries have you had
in the last five years?
Have you had any?
Again, that's something that'smore meant for an intake form.
Instead of saying somethinglike, Do you exercise regularly?
(10:13):
Just to check off that box andput a yes or no.
Why not ask them, Hey, Sharon,What does a typical day look
like for you in the world ofdiet and exercise?
That is an open ended question,and you will probably get more
information out of that thanjust that little tidbit in
regard to exercise that you werelooking for, and that alone is
super, super valuable.
The last example I want to giveis about follow up and
(10:34):
monitoring.
Instead of saying somethinglike, hey, have your symptoms
improved since starting thismedication?
Why don't you let that patientcome in and say, Hey, how's the
treatment plan that we, that wedecided on and agreed upon
together working for you so far?
Hey, what changes have younoticed with your health since
starting to come to our clinic?
Again, these open endedquestions provide you with so
(10:55):
much more value and so much moredetail and information, and
there is a time and a place forthem.
Obviously in healthcare, it'simportant to have those very
specific questions for diagnosesand all of that, but I implore
you to make sure that that ismore of an intake form question.
And when we are in a clinic,person with these patients that
we are having that really openended dialogue.
It's very powerful.
(11:16):
One of the biggest things thathelps me when I'm one on one
with a patient when it comes tocommunication is I do this thing
called mirroring energy.
it's a really incrediblecommunication skill to develop
over time.
my background was inneuropsychology when I did my
pre med, and that alone taughtme so many valuable tools that I
still use today in clinicalpractice.
(11:36):
So when you have someone come inwith nervous energy.
They're anxious about theappointment.
How do you match that?
You don't want to overwhelm themby almost being too aggressive
or too energetic.
You want to be a calming figureand you want to make sure that
you're matching that energyappropriately.
On the flip side, We all havepatients who are incredibly
energetic.
If you were a more standoffishor quiet or reserved provider,
(12:01):
you are not matching theirenergy either and they're not
going to want that as well.
So it's important to really getto know your patients,
especially on that first visit,so that you know exactly the
type of energy to give back tothem in those day to day
behaviors.
as you guys know from previousepisodes, I'm obsessed with the
Enneagram.
I don't know the Enneagram ofall of my patients, but that is
(12:22):
a tool that I've really usedover time to learn all of those
nine different types, so thatwhen someone does come in my
door, I can pretty much guesswhat they're going to be.
B right off the bat just byhaving that first visit with
them and that information I useto decide how I'm going to
manage that patient and how I'mgoing to communicate with them.
That's helpful when you'regiving diagnoses.
(12:42):
It's helpful when you're givingthem bad news.
It's helpful to know how tocelebrate their wins with them.
So overall, it's just soimportant to allow you to
deliver the best care possible.
Another major tip I have forcommunication is knowing when
you do not know the answer andwhat to say.
It happens.
We are human.
As we mentioned before,sometimes a patient asks you a
(13:02):
question, you're not going toknow the answer.
Google is great and all, but alot of times I don't like to do
my research with the patientright in front of me.
To be honest, in the world ofinsurance, we don't even have
the time to do that.
So what I will do, I willliterally say, That is an
awesome question.
I actually don't have the answerto it right now though and I
want to make sure I get you thebest answer possible.
(13:23):
I'm going to take a look at itand I'll get back to you as soon
as I can.
Do you mind if I send you anemail?
And everyone is like, oh yeah,thank you so much.
I'll look into that.
And I think it's a greatreminder to them that we are
also not pretending to knowthings.
And it shocks me how many timesI see this on a regular basis.
We don't need to stumble overour words.
We don't need to pretend to knowthings that we do not know.
(13:44):
It's another great example toprovide information and to also
loop in other providers.
We should be managing patientsin a cohesive manner with a wide
variety of health careprofessionals and this is a
great way to do that too.
The next tip is obviously to bevery well versed in the world of
cultural competency andinclusivity and here's the
reason why.
Number one, it makes people feelmore welcomed, supported,
(14:07):
included, and it makes them feellike people actually care.
That in return improves patientoutcomes, satisfaction, and
they're more likely to getbetter.
That is all that matters in whatwe do, and there is literally no
other answer.
And so why not be trained andwell versed in these things so
you can make sure that everysingle patient that walks
(14:28):
through your door is feelingbetter?
That same positivity from you asa healthcare provider.
thank goodness, there are, mostlicensures now require like X
number of continuing educationcredit on this every single year
or, licensure period.
So I encourage you guys to find,the right one.
Find an in person one if youcan, something that's going to
be a little bit more engaging,some kind of seminar that's
(14:51):
going to go into more scenariosin depth instead of just the
same old click, click, click,PowerPoint type of structure.
I think because it's still sofairly new, it's easy to look at
it as like something you justwrite off that you've done, but
I want you to take it and use itto better yourself.
Like, Oh, great.
I have to take a continuing edcourse on this every three
(15:12):
years.
What can I learn this time?
What population demographic ismy weakness right now, for
example, and how can I make thatbetter?
So I want you to kind of spinand rewire how we look at those
things because they should bebenefiting you.
in communication situations withyour patients.
And the last thing I want to sayis, it's important to remember
that trust is not builtovernight.
(15:33):
Yes, you can have a amazingfirst impression at that first
visit with a patient or client,but to be honest, that big time
respect, that big time trust isreally the result of consistent
meaningful interactions with aperson.
This can happen over a period oftime.
Let's say you're in primary careand you meet somebody for the
first time.
Visit goes well, you feel likeyou did an excellent job,
(15:56):
patient comes back to you in sixmonths.
It might take three visits forthem to realize How you are as a
provider for them to developthat lifelong trust.
But when they do, you are nowtheir primary care doc,
hopefully for the rest of yourlife and theirs.
The number one challenge I havefor you after listening to
today's episode is to look backat your first impression, start
(16:18):
from square one, all the wayback to that booking that I
mentioned, do you need toimprove your technology and
system?
Do you have an online intakeform?
Do you have an online bookingsystem?
What does that patient see whenthey walk through your door?
Put yourself in their shoes.
About once a year I pretend thatI'm a patient in my own
structure and I complete thatintake form.
I book an appointment online.
(16:40):
I walk through my front doorpretending like I'm a patient.
Look around when you walk in.
Is it inviting?
Is it welcoming?
Does it feel clunky andcluttered?
Honestly, is it not evenaesthetically pleasing?
All those little things matterfor that first impression.
When they walk into the room tomeet the provider, how are you
greeting them?
(17:00):
Are you sitting down?
Do you stand up and shake theirhand?
Do you even introduce yourself?
I know these seem like reallysmall things, but these are
things that people often forgetabout, especially if you've 10
years, right?
So everybody with someexperience it's easy to forget
how important the little thingsare.
I know for me, a handshake iseverything.
everything.
(17:20):
When I meet a health careprovider for the first time, if
they don't shake my hand, I'mlike, Oh, weird.
Okay.
Obviously outside of COVIDtimes, but it usually throws me
off guard.
Or if they don't tell me whattheir name is, I can't believe
how much that happens on a firstvisit.
They just expect you to know,because you booked an
appointment with them.
And that is just It's not agreat way to create a long
lasting impression.
(17:41):
So like I said, audit yourpractice, pretend that you are a
brand new patient for the veryfirst time, and see if there's
one or two things that you canalready tweak in your current
approach.
I guarantee you it will pay offin dividends and you will be
enhancing your patientcommunication immediately.
Thanks for listening.
I hope this was helpful.
Hello.
(00:00):
So quick question before we getstarted here.
I want you guys to sit down andthink about your current
practice wherever you are.
Imagine your patient base.
New, established, old, doesn'tmatter.
Do you think you are buildingtrust with every single one of
them?
Like actual trust.
That's a hard question.
What is trust?
(00:21):
How do we get it with ourpatients?
Are we achieving that with someof them and maybe not others?
And why does it even matter,right?
Well, This episode is all aboutthe social psychology behind
trust and why it matters so, somuch when it comes to health
care.
So I want to talk about firstthat first impression.
When you are introducingyourself to a patient, what does
that look like?
(00:41):
And to be honest, it starts allthe way with how a patient makes
their first appointment.
You guys already know, I loveJNAP.
That's our current privatepractice software that we use
for our EMR.
And the number one reason Ipicked them is actually because
it starts at the at that onlinebooking.
And in my opinion, they're theonly ones that have the best top
(01:03):
notch online booking system thatI've ever seen.
It's incredibly user friendly.
It's modern.
A couple clicks, they're done.
it's almost too easy to behonest.
So what does yours look like?
Do you have a contact form onyour website where they have to
input their information and thenwait a couple days to be
contacted?
Do you have an online bookingsite at all?
Do they have to make a phonecall to make an appointment with
(01:25):
you?
What does that look like?
nowadays it can look like a lotof things.
There are even apps out therethat people can use.
People can make an appointmentquickly online.
and I recommend thinking aboutyour process and making sure it
is as easy as possible becauseyou're going to be losing
people.
if it is challenging.
They're not going to book anappointment if they have to
work.
times harder on your sitecompared to someone else's.
(01:47):
Do they have to spend 20 minutesdoing paperwork when they
arrive?
I cannot believe, like forexample at my OB office, The
amount of times I'm handed aclipboard with a printed out
piece of paper to fill out and 9times out of 10 it's the exact
same information I filled outlast time and typically minimal
changes.
It's a waste of my time everysingle time, and I understand
(02:07):
that they need updates, but Iwould much rather do it in an
email, at home, than sittingthere when I'm currently on time
for my appointment.
So what does yours look like?
When they show up, are theygreeted with a friendly face?
Are they not?
Are they greeted to a roomwithout any staff at all?
Next up, what happens when theyactually get to meet and see the
provider?
Are they greeted with a smile?
(02:29):
Are they, talk to first, notlike a patient.
Hey, how are you today?
How's your day going?
Oh, were the roads bad?
You know, something like that.
You can obviously tell I'm fromthe Midwest with that one.
are they actually talked to likea real person right away from
the get go before you dive intothe nitty gritty?
In a lot of cases, it's just nothappening.
(02:49):
The provider walks in andinstantly goes, Oh, so I see
you're sick.
There's like no, there's a majordisconnection there.
And we are forgetting that thepatients that we are seeing on a
daily basis are humans, justlike we are.
Patients are missing that.
They want to know that thehealth care providers they're
seeing are actual human beingsas well.
(03:10):
And so we're missing thispersonalization, this
conversation piece, and thereare really simple things in your
practice that you can do to getthat back.
So in social psychology, thereis this thing called thin
slicing, which means patientscan form judgments about
providers literally in seconds,just by taking like thin teeny
tiny little details, littlesplices, if you will, of their
(03:32):
first interaction with you.
And sometimes this works great.
Maybe you're on top of your gameand you end up giving them a
first impression that It makesyou seem like an even better
clinician than you already are.
That's wonderful.
But most of the time it can bethe opposite where, you know,
they're going to just pick apartlittle things that you do, bad
body language, minimal smilingor friendliness to the
(03:52):
conversation, little things likethat.
And if a visit starts in thatmanner, they're less likely to
be compliant with their care.
They're less likely to followyour recommendations for
whatever medication you'rerecommending or follow up
appointments.
and That trust aspect is justnot there.
And as we know, trust can reallydictate and influence the way a
medical condition goes.
(04:12):
Patients who don't trust theirhealthcare providers are less
likely to disclose informationthat is necessary to provide the
right medication, the righttreatment, to come to the
appropriate diagnosis.
So trust is more important thanwe realize.
And then the obvious, if apatient trusts you, they're not
going to leave you.
They're going to feelcomfortable going to you for the
(04:34):
rest of their lives, which isalso very important when it
comes to getting the rightdiagnoses over time and really
getting to know your patientbase.
The next thing I want to touchon in social psychology is
called the halo effect.
So this is all about how earlyimpressions can dictate long
term perceptions.
Basically the halo effect is acognitive bias where the patient
(04:55):
will kind of look at the firstimpression of a healthcare
provider or anyone for thatmatter, and they will literally
make their full judgment of whothat person is, why they do what
they do, what they do on ageneral basis.
This could be great if thatfirst impression is solid.
They might start thinking you'rethe greatest person in the world
with minimal details.
(05:15):
But on the flip side, what if itgoes the wrong way?
You could be the best doctor inthe world, but if your first
impression is terrible, thatwill run its course throughout
the time that you are seeingthis patient and it's really
hard to come back from.
So some really easy ways to helpmitigate this is to remember to
dress nice, be approachable, behygienic, make sure that we are
(05:37):
giving off happy body language.
If we are all closed off andturned into our computer when
the patient walks into our doorand we don't immediately welcome
them openly, that starts us offon a bad foot and sets the tone
for that patient visit.
We have to remember this thingcalled open mindedness.
Posture.
Are you turned toward thepatient?
(05:58):
Are you open to receiving themas a patient that day?
Are you closed off?
Are you making appropriate eyecontact or not?
Believe it or not, a lot ofpeople still aren't doing this.
In computers, yes, they play arole, but I promise you this is
even a thing outside of theworld of technology.
Are we responding to activelistening cues?
Are we making sure to let thepatient speak and showing them
(06:19):
that we're listening?
Are you letting them know, yeah,I hear you?
Are you repeating things back tothem that they're telling you?
A lot of people aren't.
They're just kind of checkingoff that box, yeah, I'll let the
person talk.
No, no, no, no.
This has to be a back and forthdialogue.
It has to be a back and forthtop notch communication
experience if you want to besuccessful in this area.
So I want to present a story toyou.
(06:40):
I actually had a patient who Ihad been taking care of for many
years.
She had followed me to multiplepractices over the course of
like a seven year period oftime.
I had seen her for obviouslymusculoskeletal things in the
past, and I didn't see herfrequently by any means, but
every few months or every sixmonths when she had a new issue
pop up, she always came to me.
And then this was probably Mayof last year, she came in with a
(07:02):
new complaint, which hashappened before, nothing new.
I sat down, listened to theentire story of what was going
on.
I didn't examine that area.
And I quickly realized this wasoutside of my scope.
She was having a complaint inher lower leg.
It was very obvious with myexamination, this wasn't a calf
issue, this wasn't an kneeissue, this wasn't an ankle
issue, I'm a chiropractor, Ispecialize in musculoskeletal
(07:23):
conditions.
Nothing on my exam was screamingthat it was something that I
could help with.
In that moment I told thepatient, hey, I know you're not
going to like this answer, butthis isn't looking like
something I can help you withright now.
What is the relationship youhave with your primary care doc?
Can we contact them as soon aspossible to have this evaluated?
Can we get this looked at?
And I believe at the time shehad already seen ED a couple
(07:44):
times and she just wasn'tgetting the care that she was
looking for, but they had ruledout some scarier things like
obviously a blood clot andthings like that.
But no one had really fullyexamined the area and I said,
This is just not the place forthis.
this is what I would recommend.
Gave her my recommendations, wegot a hold of her primary care.
I actually ended up going onmaternity leave shortly
afterward, and I never got tofollow up with her until three,
(08:06):
eh, two or three months later.
Turns out, she, Ended up goingto primary care and they ended
up going down that trajectory.
They started with blood work,imaging, the whole nine yards.
She actually had a severe mass,an actual form of cancer in her
leg.
And I know this is an extremeexample, but this is something
(08:27):
that really just encourages andreinforces why I want all of us
to practice this way and createtrust with our patients.
When I saw her for her followupwith me, when I came back from
maternity leave, she told methat the.
Only reason she went was becauseshe trusted me.
She didn't believe that therewas anything major going on.
She thought it was literally acalf cramp.
(08:48):
She only went because shetrusted me and she told me that
to my face.
And even to this day, it givesme chills just thinking about
that.
This is why it's so, soimportant.
Do I wish she would have gone inand it would have been nothing?
Yes.
Would it still have been awesomethat she did that because she
trusted her healthcare provider?
Yeah, that would have beenamazing.
(09:09):
But in that moment, that couldhave been a life or death
situation and I am so, sograteful that I was able to give
that patient that kind ofreassurance and care for her as
a patient instead of, justtreating whatever was in my
scope or, only caring aboutthings that pertained to me
directly.
She knew that I would always puther needs above anything else
(09:29):
and my recommendations would bebecause I truly cared.
The next thing I want to talkabout is open ended questions.
All the way back to ourtraining, we are taught to
basically ask people differentquestions, almost like a
multiple choice situation.
You know, is your pain sharp ordull on a scale of one to 10?
What pain levels do you have?
And yeah, that really comes intothe picture.
I think when we're filling outan intake form, but when a
(09:51):
patient is right in front ofyour face, instead of maybe
asking, is your pain sharp ordull?
Hey, can you describe the painand discomfort that you're
experiencing right now?
That is a great example of anopen ended question.
Instead of something like, Hey,how many surgeries have you had
in the last five years?
Have you had any?
Again, that's something that'smore meant for an intake form.
Instead of saying somethinglike, Do you exercise regularly?
(10:13):
Just to check off that box andput a yes or no.
Why not ask them, Hey, Sharon,What does a typical day look
like for you in the world ofdiet and exercise?
That is an open ended question,and you will probably get more
information out of that thanjust that little tidbit in
regard to exercise that you werelooking for, and that alone is
super, super valuable.
The last example I want to giveis about follow up and
(10:34):
monitoring.
Instead of saying somethinglike, hey, have your symptoms
improved since starting thismedication?
Why don't you let that patientcome in and say, Hey, how's the
treatment plan that we, that wedecided on and agreed upon
together working for you so far?
Hey, what changes have younoticed with your health since
starting to come to our clinic?
Again, these open endedquestions provide you with so
(10:55):
much more value and so much moredetail and information, and
there is a time and a place forthem.
Obviously in healthcare, it'simportant to have those very
specific questions for diagnosesand all of that, but I implore
you to make sure that that ismore of an intake form question.
And when we are in a clinic,person with these patients that
we are having that really openended dialogue.
It's very powerful.
(11:16):
One of the biggest things thathelps me when I'm one on one
with a patient when it comes tocommunication is I do this thing
called mirroring energy.
it's a really incrediblecommunication skill to develop
over time.
my background was inneuropsychology when I did my
pre med, and that alone taughtme so many valuable tools that I
still use today in clinicalpractice.
(11:36):
So when you have someone come inwith nervous energy.
They're anxious about theappointment.
How do you match that?
You don't want to overwhelm themby almost being too aggressive
or too energetic.
You want to be a calming figureand you want to make sure that
you're matching that energyappropriately.
On the flip side, We all havepatients who are incredibly
energetic.
If you were a more standoffishor quiet or reserved provider,
(12:01):
you are not matching theirenergy either and they're not
going to want that as well.
So it's important to really getto know your patients,
especially on that first visit,so that you know exactly the
type of energy to give back tothem in those day to day
behaviors.
as you guys know from previousepisodes, I'm obsessed with the
Enneagram.
I don't know the Enneagram ofall of my patients, but that is
(12:22):
a tool that I've really usedover time to learn all of those
nine different types, so thatwhen someone does come in my
door, I can pretty much guesswhat they're going to be.
B right off the bat just byhaving that first visit with
them and that information I useto decide how I'm going to
manage that patient and how I'mgoing to communicate with them.
That's helpful when you'regiving diagnoses.
(12:42):
It's helpful when you're givingthem bad news.
It's helpful to know how tocelebrate their wins with them.
So overall, it's just soimportant to allow you to
deliver the best care possible.
Another major tip I have forcommunication is knowing when
you do not know the answer andwhat to say.
It happens.
We are human.
As we mentioned before,sometimes a patient asks you a
(13:02):
question, you're not going toknow the answer.
Google is great and all, but alot of times I don't like to do
my research with the patientright in front of me.
To be honest, in the world ofinsurance, we don't even have
the time to do that.
So what I will do, I willliterally say, That is an
awesome question.
I actually don't have the answerto it right now though and I
want to make sure I get you thebest answer possible.
(13:23):
I'm going to take a look at itand I'll get back to you as soon
as I can.
Do you mind if I send you anemail?
And everyone is like, oh yeah,thank you so much.
I'll look into that.
And I think it's a greatreminder to them that we are
also not pretending to knowthings.
And it shocks me how many timesI see this on a regular basis.
We don't need to stumble overour words.
We don't need to pretend to knowthings that we do not know.
(13:44):
It's another great example toprovide information and to also
loop in other providers.
We should be managing patientsin a cohesive manner with a wide
variety of health careprofessionals and this is a
great way to do that too.
The next tip is obviously to bevery well versed in the world of
cultural competency andinclusivity and here's the
reason why.
Number one, it makes people feelmore welcomed, supported,
(14:07):
included, and it makes them feellike people actually care.
That in return improves patientoutcomes, satisfaction, and
they're more likely to getbetter.
That is all that matters in whatwe do, and there is literally no
other answer.
And so why not be trained andwell versed in these things so
you can make sure that everysingle patient that walks
(14:28):
through your door is feelingbetter?
That same positivity from you asa healthcare provider.
thank goodness, there are, mostlicensures now require like X
number of continuing educationcredit on this every single year
or, licensure period.
So I encourage you guys to find,the right one.
Find an in person one if youcan, something that's going to
be a little bit more engaging,some kind of seminar that's
(14:51):
going to go into more scenariosin depth instead of just the
same old click, click, click,PowerPoint type of structure.
I think because it's still sofairly new, it's easy to look at
it as like something you justwrite off that you've done, but
I want you to take it and use itto better yourself.
Like, Oh, great.
I have to take a continuing edcourse on this every three
(15:12):
years.
What can I learn this time?
What population demographic ismy weakness right now, for
example, and how can I make thatbetter?
So I want you to kind of spinand rewire how we look at those
things because they should bebenefiting you.
in communication situations withyour patients.
And the last thing I want to sayis, it's important to remember
that trust is not builtovernight.
(15:33):
Yes, you can have a amazingfirst impression at that first
visit with a patient or client,but to be honest, that big time
respect, that big time trust isreally the result of consistent
meaningful interactions with aperson.
This can happen over a period oftime.
Let's say you're in primary careand you meet somebody for the
first time.
Visit goes well, you feel likeyou did an excellent job,
(15:56):
patient comes back to you in sixmonths.
It might take three visits forthem to realize How you are as a
provider for them to developthat lifelong trust.
But when they do, you are nowtheir primary care doc,
hopefully for the rest of yourlife and theirs.
The number one challenge I havefor you after listening to
today's episode is to look backat your first impression, start
(16:18):
from square one, all the wayback to that booking that I
mentioned, do you need toimprove your technology and
system?
Do you have an online intakeform?
Do you have an online bookingsystem?
What does that patient see whenthey walk through your door?
Put yourself in their shoes.
About once a year I pretend thatI'm a patient in my own
structure and I complete thatintake form.
I book an appointment online.
(16:40):
I walk through my front doorpretending like I'm a patient.
Look around when you walk in.
Is it inviting?
Is it welcoming?
Does it feel clunky andcluttered?
Honestly, is it not evenaesthetically pleasing?
All those little things matterfor that first impression.
When they walk into the room tomeet the provider, how are you
greeting them?
(17:00):
Are you sitting down?
Do you stand up and shake theirhand?
Do you even introduce yourself?
I know these seem like reallysmall things, but these are
things that people often forgetabout, especially if you've 10
years, right?
So everybody with someexperience it's easy to forget
how important the little thingsare.
I know for me, a handshake iseverything.
everything.
(17:20):
When I meet a health careprovider for the first time, if
they don't shake my hand, I'mlike, Oh, weird.
Okay.
Obviously outside of COVIDtimes, but it usually throws me
off guard.
Or if they don't tell me whattheir name is, I can't believe
how much that happens on a firstvisit.
They just expect you to know,because you booked an
appointment with them.
And that is just It's not agreat way to create a long
lasting impression.
(17:41):
So like I said, audit yourpractice, pretend that you are a
brand new patient for the veryfirst time, and see if there's
one or two things that you canalready tweak in your current
approach.
I guarantee you it will pay offin dividends and you will be
enhancing your patientcommunication immediately.
Thanks for listening.
I hope this was helpful.
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