A simple strategy for demonstrating real value to your patients

Hi everyone, it's Chris from Patient Centered Training and this is a quick video I wanted to go through something that was mentioned in an article a colleague shared with me recently. Thylining is a really powerful tool for building solid rapport and really getting long term trust between you and your patients makes a bigger difference to their results and their outcomes. But also they're more likely to be a raving fan of yours, much more likely to refer friends and family to you as well, and really helps you show how you're making a difference in their lives versus just treating their symptoms. And this is a paper, it was published about helping support patients with self management strategies. So helping Patients to Support Themselves published by Alice Kongstead, who you might be aware of. Jan Hartfigsen was a co author as well. And one of the strategies they mention in this, and they talk about it, but they don't go into a lot of detail is what's called values based care or values based goals. And what this means is not just setting a goal that is based on somebody's symptoms, but making it about something they really care about. And what that does is it really turbocharges their motivation. They're much more likely to follow your advice, to stick with the plan and to feel more enthusiastic and actually heal faster as well. So when we talk about setting goals, one of the problems that I find a lot of clinicians run into when they're first starting using the strategy is, is they just ask the patient, so what's your goal for care? And if you've ever tried this, you'll probably find most of the time they say, I want to feel better, I want to get rid of my back pain, I want my elbow not to hurt. Whatever it is, they want to get rid of the symptoms. And clinicians sometimes feel a bit frustrated because they go, well, you know, I'm looking for something deeper than that. But not necessarily being able to ask can be a bit of a problem. And not knowing how to do that can be a bit tricky as well. Now what I'm going to link to here as well as the paper is I've written a big article on this. I'm not going to go through all of it here. I'll send you guys the link in the article. There's a PDF I've included that has lots and lots of different questions you can ask ways of phrasing it to find out what it is they really want to get back to. And often you'll find that something like they want to get back to Gardening, they want to be playing with their grandkids, they want to be getting in the gym and losing some weight. Something that goes beyond the pain. And if we can get them to that, then that really allows us to make a bigger difference for their lives. But that in and of itself isn't the full story of values based care in my opinion. As great as this article is, I think they miss out some of the elements that really make it powerful. And this is about finding out why that goal is important to them, what matters to them and why. And the interesting thing is that you can have the same goal with two different people, but completely different motivations underneath. Now, I will say you don't necessarily get to this stage with every patient and I would not try and go at this full on and really try and force an answer out of them because you're going to end up messing up the rapport there. But be open to the idea and sometimes some gentle probing and it might be two, three, four sessions in. This isn't necessarily something you're going to get right at the start start, but trying to just look for what is it about this that matters to the person in front of me here? To give you a quick example, one person might want to get back in the gym because they want to lose weight and the underlying reasons they want to maintain their health. Maybe they have a family member who had cardiovascular disease, maybe they lost a parent or a grandparent quite young because of that. And it's really important to them that they maintain their health and that doesn't happen. Another person might want to go into the gym because they want to lose weight, because they want to look better, because they're worried that, you know, over the years they settle down, they've had kids, life's built on top, they've put on some weight and they're worried that their partner isn't as attracted to them. They're very, very different motivators for the same thing. And showing the patient you want the same thing as them, the same goal to get them in the gym is key. But if you can show you understand the underlying value behind that, that really shows you understand this person at a deeper level. Now, the exercise example. One thing I might ask somebody is what is it about exercise that's important to them or what is it they would like to achieve by going back to the gym? And you want to be a little bit careful with this because the first thing we want to ask is why? Now I'm not anti why as a question, but it can be a little bit confrontational. If you just said to a patient, you said they want to get back in the gym, why do you want to go to the gym? It can sound a little bit like you're disbelieving or you're challenging sometimes, even if you don't mean to. So you want to be aware that why can seem like a bit of a confrontational question. Now, there's a number of ways around it. Like I say, you could ask, what is it you're looking to achieve? Or what would getting back to the gym mean for you? What difference would that make for your life? Or sometimes I'll ask it, but I'll just make sure to frame it a little carefully. First of all, I might say to the patient, this might seem like a strange question for a health professional to ask you. I'm really just curious here, but why do you want to get back to the gym? Specifically? Why is that important to you? And by taking the care to just frame it a little bit, I'm letting them know. This might seem like an odd question, but I genuinely don't mean to seem confrontational here, but like I said, there's plenty of other ways of asking that. But you're really trying to look for what's the underlying value here? You know, it might be that they want to feel appreciated by others. You know, somebody wants to feel attractive to their partners. They want to feel loved. They want to feel like they're in a loving relationship where that other person, you know, is attracted to them physically as well as emotionally. For the other person who wants to protect their heart, it's about maintaining their health and taking good care of themselves and being independent. Maybe that family member ended up having a lot of care and feeling like a bit of a burden on their spouse or their family, and they want to maintain a sense of independence. That independence is a very different value there. So this is something I'd recommend not necessarily drilling into at the first visit, not necessarily doing this with everybody. You'll get the vibe with some people this is maybe territory they're not really willing to talk to a chiropractor about. Maybe this is something that they, you know, they might go, oh, it sounds a little bit like therapy. You're trying to get into my head. So be mindful of that. And if they, if you ask and they seem to rebut, maybe just step back and go, right now, I don't necessarily need to have this conversation with this patient, but if you can do it and then reflect it back to them, it really does show you understand that and you've built that really solid trust and empathy there. So give this a go with your patients. The article I mentioned, I'll link to it here. It's a blog post. It's all about goal setting. It talks about values based care, it talks about how to use the goal, how to find the goal. There's a free PDF download you can get there as well with lots and lots of different ways of asking the questions. There's so you don't ever feel like you're trying to find out what the goal is, but they're just coming back with symptom relief or that's a superficial goal there and give this a try. Any questions, you can always reply to me as well below for those of you who aren't aware. If you want more access to me as well. I've started a mentorship program with my colleague, Dr. Rob Pape. Rob's a colleague of mine, he's a friend of mine and a mentor of mine. And what we're doing is for members who sign up, it's only 10 pound a month. We're making it very, very cheap is we're doing a couple of calls a month where you can submit questions to us anonymously or you can join us live on the call and you can ask us questions about anything to do with practice, whether it's a tricky case, how to handle certain situations. Rob's an absolute master when it comes to mechanical diagnosis and treatment as well. He's forgotten more than I will probably ever learn. So if you just want a place where you can come and you can ask him, maybe you want it to be anonymous, maybe it's something you feel a bit embarrassed about not knowing and you don't want to turn to other colleagues. You're worried you might look silly or people might judge you. It's the complete opposite of that sort of thing. It's really just to be there to help others and to learn from each other as well. Members who sign up, you get access to the recordings of the previous calls as well. So if you can't ever make it live, that's no problem at all. There's no long contracts or anything like that. You can join for a month and leave if you want, but hopefully it's something that provides a bit of extra value if you want to work with us a little bit more closely. So if you're interested in that again, all the links will be in the email or below this post as well. But give this a go. Give it a try digging into those values a little bit more. It's something that I think we really often leave on the table, and we're missing a lot of the powerful results we can get from that. All right, so give that a go, as always. Any questions, you can get in touch. Otherwise, I'll be back for another video soon. Take care of.