2 Key skills you need to empower patients whilst IMPROVING compliance

Advice for how to better empower your patients, but also how to get them to actually take the steps you'd like them to take. This is one of the reasons why I started coaching and why I started the Happy Patient Project, is that we have so much skill and so much knowledge. But one of the biggest challenges that all practitioners face, especially chiropractors, is getting patients to actually understand the knowledge that we're trying to teach them. Because if you're like me, you've probably tried a bunch of different ways trying to get patients to take in information and, and found a lot of them don't work. Seems really good. They leave all fired up. And the next time they come in asking the same question or clearly saying something, that means they didn't get that whole explanation you gave them before. And that's one of the things I'm going to share with you today, is how to avoid that. So the way we avoid this is using a skill from motivational interviewing called epe. That stands for illicit, provide, elicit. And this is a really powerful framework for giving advice without triggering what's called psychological reactance, or which is when you get a yeah, but so the patients is they're saying how they're struggling with something, you identify the problem, go, I heal from motivational interviewing called epe. That stands for illicit, provide, elicit. And this is a really powerful framework for giving advice without triggering what's called psychological reactance, which is when you get a yeah, but so the patients is they're saying how they're struggling with something, you identify the problem, go, ah, here's what you need to do if you did this, that or the other, or why don't you try doing it this way? Really sensible advice, you know, it will work. And they go, yeah, but here's my reason not to try, or here's why I can't do that. When you hear that, yes, but it means you've had a roadblock in communication and they're not taking it on board. EPE helps you avoid that. So what does it stand for? E, the first elicit. That means you elicit the patient's thoughts about the problem. So. So before you go in and give advice, you find out what have you tried, you know what, have you had any thoughts about what might work for you? Find out what's in their head. Because if what's in their head is really going to clash with what you're going to say, you want to know that in advance so you can better prepare it. Equally, you may find out they have no idea. And either way, once you found out what's going on, you've explored it and shown you understand what they've tried or what thoughts they have about this problem. Problem. You can then move on to step two, which is provide. This is where you provide the advice, but do it with permission. Don't just go in and say, here's what to do. Say, well, I have some thoughts about something that could really help with that. Would you like to hear them? Would you be interested in that? Would you like me to share that with you? However you want to phrase it, but you basically say, I've got some ideas about that. Would you like them? And then what's going to happen is the patient's going to say yes, because they're going to go, oh, new solution, I'd like that. And when they've said yes, they've given you permission to speak, which means they will sit back and listen. Rarely. You might get a no. It's very rare. It's always never happened to me. But that does happen occasionally. If you get a no, fine, move on. Pick your battles. Don't try to talk them out of it. You know, it's sometimes it's better to recognize this might not be the best time or place to provide some information or give some advice, but it almost never happens. You can then provide that information, provide whatever advice you would give, and then once you've done that, step three is elicit again. This time we want to elicit the patient's thoughts about the advice you've given. So I would then ask the patient, what do you make of that? How does that sound to you? What are your thoughts there? And I really want to do this because hopefully it's gone in and I then get confirmation. They're like, yeah, that's a really good idea. I think that could really help. Great. Now I know that I can trust it. However, if they have any barriers, any obstacles, anything in their head that's going, yeah, but that wouldn't work for me. I want to know that because that's going to help me. Then get them over that barrier. Or maybe there's a misunderstanding, they haven't understood what I've said. So by using that framework, elicit, provide, elicit, you will find the advice you give goes in much better, it's much more effective and you can avoid a lot of frustration. So that's part one. Part two is what I like to call the progress ruler. This is something I do in every case review. I'll occasionally do it at other points during their care, but certainly when I'm reviewing their care. And this is where I would ask the patient out of 10 how they feel they're doing. So if we say 10 out of 10 is you feel great, you've achieved all your goals, no problem at all, and zero is no change whatsoever since we met. What would you give yourself so far out of 10? Notice I'm saying give yourself, not me. So I'm making it clear to the patient, how do you feel you're doing? I'm giving them ownership of it and then they'll give you a number. I was. I'll joke with them. It's a bit arbitrary. Don't worry if you can't be too specific on it. But they might say, let's say they pick a six. Yeah, I guess I'm six out of ten. I'll then say something to the effect of, ah, that's interesting. What makes it a six instead of, say, a four, I'll pick a number one or two levels below. The reason I'm doing this is because they are then going to start to give me reasons why it's a six and not a four. They're going to come up with reasons why they're doing better. And when they say it, it's much more powerful than me saying it, because as soon as it comes out of their mouth, they have to believe it, because it just came from their mouth. You could say the exact same words. They wouldn't necessarily believe it as well. So it gets them to come up with the changes they've noticed, the things that are different in their life. And it's done in a way that that doesn't sound like I'm trying to lead them. They're like an nlp. So what are all the improvements you've noticed so far? So I'd use that progress ruler anytime you want to have a conversation about their progress so far. 10 is great, 0 is no change. Where do you feel you are? If you're worried it's going to be a low number, still use it because it is far, far better to have that conversation now than keep avoiding it. Those of you who've known me for a while might remember I did a video called Don't Hide Things in the Fog a while ago. This is that concept. Have the conversation now because it will get you much, much better results. It's always better to find that out and show the patient you can have a discussion that involves them being a bit frustrated and not making progress without shutting it down. Or judging it. So there's your two skills for this. One, elicit. Provide elicit. When you want to give advice, use that EPE framework. Ask what the patient thinks about it so far. Offer some advice, but get permission and then ask what they make of your advice. And then the other one there in terms of getting that review, getting that discussion about where they're going, the progress rule, ask out of 10 and then go, okay, why this and not something a little bit lower so you can give those a try right away to start getting better results to your patients. I will be sharing another video this week in a couple of days. We've done three assumptions, we've done two key skills. Now we're going to do one thing. This is going to sound a little bit odd, a little bit counterintuitive. I'm going to give you one very, very good reason why why you shouldn't enroll in the Happy Patient Project. Why you should look at what I'm going to share with you next week and go, thanks, Chris, but that's not for me because it's really important to me that if somebody does enroll, it's the right fit. I don't want to just take on loads of people and take everybody's money and go, great, thanks for that. Here's the thing. Hope you do well. I'm only really looking to work with people who I know are going to succeed, so I'm going to share that with you on Friday. Keep an eye out for that. And if you are looking to enroll and I don't put you off on a Friday with that reason, then keep an eye on your email inbox. Monday morning, the links will be going out, you'll be able to enroll and you can start getting better results with your patients, getting more reviews and referrals and just having a much more fulfilling practice. I've seen that with many, many practitioners. Everyone who's gone through the Happy Patient project, who's completed the course has told me that's the difference they've made. I know it's possible for you too, so if you'd like that, keep an eye out and I'll see you soon on Friday for another video take.