3 Key Assumptions you SHOULD make with patients

So something a little different for you guys. This week I'm going to be sharing three videos for you and I'm using this in a three two one format. I've stolen this from James Clear. He wrote the book Atomic Habits. Very popular, very successful book. I know a number of you have read it. He has an email newsletter that goes out where he has a 3:2:1 format. I think it's three quotes from others, two quotes from him, one question to ask yourself. I like that format so I'm stealing it, but I'm tweaking it a little bit. So today we're going to talk about three assumptions that you should be making with your patients to get better results. Then in a couple of days time I'll share with you two key skills that you should be using to get better results taken from motivational interviewing. And then on Friday I'm going to share with you one reason why you shouldn't enroll in the Happy Patient project. Because I'm going to be opening enrollment next week. So that's coming up. On Monday, 3rd of April, we'll be reopening enrollment. I know a bunch of you have messaged me asking when this is going to happen. It's been closed for a while. Well, you'll get your chance because I'm going to reopen it just for a few days next week. But first on Friday, I want to share with you one reason why you shouldn't buy it. Because I don't want people getting it for the wrong reasons. Anyway, that all said, let's dive in. This first video is all about three key assumptions you should make, which we'll see right here. Clever, eh? So assumptions, are they really the mother of all screw ups? This is a phrase that's often thrown around and I think it's quite a smart phrase. Often when we assume things, we then get things wrong and that's where a lot of problems and miscommunication can occur. Having said that, these three assumptions I think are actually ones we should be making not because they're necessarily true, but because they're going to change the way that we actually approach our interactions with our patients. So I've got three things for you here. One is for new patients, one is for the report of findings, and one is for maintenance care. The three big topics I get asked on the most. So the first assumption, this is something I would assume for all of your new patients is what I do regularly and it really helps me get better rapport with them and that is that I assume they don't know how they feel or why they're even here. That's going to sound a little bit counterintuitive, but let me explain. I don't assume they know how they feel because what that does is it means when I'm talking to them, I'm aware that the first answer I get might not be the true one and it might not be the deepest one. They may say, oh, it's not that bad. It's kind of annoying. But then as we get into the conversation, I start to dig. I find out, actually, there's quite a bit of fear or frustration there. They just maybe aren't ready to show it to me in the first few minutes of an interaction because we don't have enough trust yet. And I'm going to start to look out for cues and clues that they may be feeling something a bit different. Maybe it's something they're not even aware of. And if you can point that out to them skillfully, you often then start to look like a mind reader. They'll be like, wow, Chris understands me better than I understand myself. He must really know what he's talking about here. And I also with them, I assume they don't know why they're here. Because if you ask a patient, why are you here? It's a bit like if you have been trying to use goal setting already, but you've asked the patient, what's your goal for care? You're going to get a superficial answer, which is basically, get rid of my pain. That's what they will always answer if you ask, what is your goal? So I assume they don't know what the goal is. And what that does is it makes me get curious. And I start getting much more skillful, much more investigative with my questions. And because I'm trying to find out, wait, what's the real reason they're here? They maybe don't know. I maybe have to dig a little bit. I have to look into different areas of their life and get them to unpack and explain how it's having an impact. And then I have to work out which of these seems the most important one to this patient. Because often what they give you at the start and what they think is the reason why they're here isn't actually true. And if you accept that on face value and you just assume they're telling the truth and you assume they know themselves really well, you're going to miss some really, really key information. So this is a safe assumption to make because it will make you get Curious and it will make you get investigative and you'll start to act like a detective. Not cross examining a witness in a court drama, but just starting to probe a little bit more, not being satisfied just because you've got an immediate answer on something. And trust me that patients will sense that. They really like that. They love to feel that they're with a practitioner who is curious. So that's an assumption to make with your new patients during the history. The next assumption is for the report of findings. This is going to sound a bit weird, so stay with me here for your report of findings. What I would recommend you assume is that the patient is not going to come back. Whether you do this on visit 1 or visit 2 doesn't matter. Assume that they're going to hear everything you have to say and they're going to understand it. They're going to get the big idea, they're going to get why you're doing all this stuff. Everything you could possibly want them that they would understand. They'll get that. But they're going to go, thanks, but I don't want that. And they're going to walk out there and cancel. Why on earth would you assume that? Well, the reason is when you assume that you're actually not going to try so hard. Now I'm not saying we shouldn't try. I'm not saying that you should just be like laid back, I don't care, whatever. But where most of us go wrong in the reporter findings is we try too hard. We really try to convey something to the patient. We try to convince them of something. We try to get them to do something that we think is right. And I'll be honest here, I know this is going to upset some of you. Essentially it becomes a sales pitch. Now I don't mean you're trying to sell them loads of treatment or be unethical, but I did this for years. My report of findings was an ethical, altruistic, well meaning sales pitch because I was trying to convince the patient to do what I thought they wanted. And that worked some of the time, but some patients sensed it and they didn't like that. Since then I started assuming that the patient isn't going to come back. So I'm going to give them the plan and my recommendations. But internally I'm going to think if they don't want that, that's fine. And my energy is going to really change there. My energy is going to convey a lot more natural confidence because I'm no longer seeming a little bit needy or A little bit desperate or a little bit insecure. That's why I'm trying to convince them. That may not be true for you, but it is often what patients pick up. So by saying, look, here's the plan, here's the options, here's what you can do in a calm way where I'm not attached to the outcome, I don't mind when they take me up on it or not. Patients will pick up on that and actually have more trust in you because you will see much more relaxed in your authority as an expert. It also means if they don't follow my advice, I don't mind. I'm not attached to that. I don't start trying to convince them or subtly kind of neg them or guilt them if they haven't done it. Try to make them feel bad so they come around to my point of view. Because I promise you that never works. And even when it does, they're looking for a way to get out. So assume the patient won't come back. Make your peace with that, and I promise you, you will deliver a more effective report of findings and patients are more likely to come back. It's quite a counterintuitive thing. So make that assumption for your reporter findings. The third one, the big one, maintenance care. This is probably the most common thing I get asked about after how do you deliver reporter findings? Is how do you talk about maintenance care? And again, the way many of us go wrong about this is that we make the wrong assumptions about patients. This assumption will help you flip that into something that's going to be much more empowering for you and your patients. And again, it's a bit counterintuitive. Assume the patient already wants maintenance. Because what all of us do when we approach this discussion with patients is we assume the patient doesn't want maintenance care, thinks they're done and is going, oh, that's great, thanks, I'm going to go now. And then we try to go, look, there's this other thing called maintenance care. It's another option. It's a bit different. You haven't heard of it, maybe you're not sure about it, but it's something I'd recommend for you. Oh, and by the way, it means coming back to see me and still paying me more money. You know, you're not putting it to patients like that, but when they're hearing it, they are hearing, oh, there's this other option that's a little bit different. Very simple, switch. Just switch it around, assume that they want maintenance care. So when you're talking to a patient and it's time to discuss maintenance care, which, by the way, is not the final visit and is usually not a big discussion at the very start of care, you have to be skillful with when you choose. But if you assume they already want maintenance care, you go, okay, so one option that we can do is what's called maintenance care. This is probably something that you've thought about already. This is the idea that when you're feeling better, we can start to still see you for occasional checkups, what a lot of patients choose to do. So that's the option. If you wanted, you could also leave it for now as well and come back if you want, you know, later on if something flares up. So what I've done there is I flipped it around. I haven't gone, look, you can leave it, or there's something else, I can go, look, you can have the thing most people want, or you can leave it if you want to. And there's no guilt attached to that. There's no blame, there's no judgment if they choose not to. But I'm assuming, right, there's a single mate scare. You'd want that, right? You want to make sure this doesn't come back. So, yeah, this is the thing you'd naturally want. And you'd be surprised, the number of patients who, when you say that to, you go, yeah, that is what I want. They're already on board with the idea since I stopped doing such a big sell at the start of Cairn. Such a big pressure on the reporter findings, trying to ethically convince them to. To do what I wanted. I found more and more patients have started asking me about maintenance care without me even bringing it up, saying, can I come back when I'm feeling good, just for a checkup? So there's three assumptions there. Number one, assume your new patient doesn't know how they feel or why they're there. Number two, assume the reporter findings won't be successful and they won't come back because that will help your confidence. And number three, assume they already want maintenance because it will shift the way you recommend it and it will make it seem easier for patients to go, oh, yeah, that makes sense. So give those a try. Let me know how you're getting on as well. I want to know from you, do you make these assumptions already? Are there other things that you found? Oh, and I assume this, it goes better. Are you finding this idea of making these assumptions really challenging? Is it something you think you can't do, let me know. Drop me a reply. Drop a comment below. I want to hear from you. And then I'll be back in two days. The next video, we've gone from three to two. This is two key motivational interviewing skills that you should be using with your patients to help empower them better. And I'll see you there for that video. All right, Take care.