Differentiating Strategic vs Needy Humour

How to get better outcomes using humour. This is off the back of a conversation I had with an associate of mine, a relatively recent grad. She came down to observe a few days ago and I set her a little task. I said, right, while you're observing, I want you to note down anything you notice that I do that you don't do, and I want you to note down anything that I don't do that you are doing, and then we'll have a discussion afterwards. And she observed the day, she's making some notes, and at the end of the shift I said, right, what did you find? And she said, well, the main thing is like you joke around a lot with your patients. Like you're doing that all the time. She's like, I don't really do that. And I said, okay, well, that's interesting. Why not? She said, I just don't think that's me. She's like, that's not the kind of person I am. She's like, it is for you, but that's not really me. And I said, okay, but what about if you thought it would help your patients? And she went, well, I see how it could. I guess it's for like building rapport and things like that. But she's like, ah, it's not really me. I said to her, look, there are good and bad reasons for why I do this. I do it deliberately. And I do it because I found it actually does get better results and outcomes for people. Now, when I first started out in practice, I was doing it for the wrong reasons. In fact, I'll never forget, a floor tutor of mine called me out on it towards the end of my intern year at college. He said, 'Stop trying to make your patients like you. Stop trying to make them laugh. You're doing it because you don't have confidence in yourself and you think, well, the treatment's probably not going to work, but oh, if I can get them to like me and joke around, then maybe they won't be so mad when the treatment doesn't work and they'll still be happy.' He said, doesn't matter what you do, if they don't get better, they're not going to be that happy. But you having joked around isn't going to change it, so stop doing that. You're doing it because you're insecure. And that hit home because I was definitely doing it out of insecurity. And in all honesty, although I agreed with it, it took me some time to change that. And certainly when I started out in practice, I was trying to get patients to like me, and one of the ways I would do that would be to joke around and use humor. Now my approach is very, very different. I still set myself a little target is I want to get a patient laughing at least once before they leave the room. Every single patient, every single appointment, whether it's a maintenance patient or brand new patient, whatever it is, I want to at least get a chuckle out of them. But the reason for that is not because I need it. It's not because I happen to enjoy it and I like having fun with patients. I do, and that's nice for me, but that's not the reason. And it's not just because of building rapport. That's a nice benefit, but I don't need to use humor for that. The reason I'm doing it is because humor is a very, very big safety signal for the patient to their own nervous system. If the patient laughs, it tells me that their nervous system is feeling relaxed. And actually, it has a cyclic effect as well. So if they laugh, that's a signal from their body. It's an automatic thing telling their brain, we're in a safe place, we're relaxed, because you can't feel anxious and laugh. You can't laugh whilst also worrying about what's going to happen next. So if I can use humor, it helps to just defuse some of that tension. It helps the patient to relax a little bit more. They get an endorphin release that's going to help them feel more comfortable. And that means when they're laying on the bench, they're going to be a little bit more relaxed. They're going to be a little bit more open to letting me do my treatment. They're going to be a little bit less nervous. Treatment is going to go a little bit smoother. And also that endorphin release, we know these kind of things do have an impact on healing. So you can use humor to shift their physiology. Now, I explained all this to the associate. That doesn't mean that I can then go, so right, how are you going to make your patients laugh? It's like if you go to someone and go, oh, tell me a joke, make me laugh. That's not going to work. But I said to her, have a think about this, because to me it's a very, very underutilized skill in terms of helping people heal. And you need to think about some ways of doing it. You can't just go in and go start telling jokes. Like, that's not going to work. And I actually have a couple of rules for this. And the number one thing is that the humor at all times, wherever possible, should be self-deprecating. So I should be the butt of my own jokes. I don't make jokes about silly things other patients have said. Because if I'm laughing with this patient about another patient, well then what am I going to laugh about with another patient about them? You don't want patients to think you're laughing at them. And I use it because what it does when it's self-deprecating, it shows that I don't take myself too seriously. So yes, some patients will come in and they'll perceive a hierarchy in terms of power. They might see me as, oh, I'm the expert, I'm the doctor, this, that, the other. By using humor, I show them that I'm elevating up because I'm treating them like an equal. So. So this could be something simple, like a common joke I'll often use if a patient comes in apologizing for the fact that they're dressed a bit casually, or that, oh, they're a little bit scruffy, or I had to dash out the door. You know, I treat in scrubs, so I'll just say to a patient, like, wouldn't worry about it, I come to work in pajamas, I'm not one to judge. It's a silly little line like that, but it gets a little chuckle. It shows them that I'm relaxed, and it shows them that I don't take myself too seriously. They can't be offended at a joke when it's at my own expense. Because I'm not joking about something that's personal. Now, readers will know this who've been on my email list for a while. I'm not going to retell it now because it still makes me cringe. I've lost patients because I've made jokes about things that I didn't realize were dear to them. So as a rule, I won't make jokes at the expense of other things because I don't know how the patient feels about that. But I would encourage you to have a little think about it. Have a think about ways you could be a little bit self-deprecating. Like, it could be little things. It could be that scrubs thing. It could be, you know, when I'm using the drop table and I'm explaining that to patients, I'll say, You can feel it's not a big movement. The bang is just because I like to scare the patient who's waiting in reception. Something like that. The joke is that, oh, Chris is silly, he's pretending he's a sadist. That's an easy thing to do as a chiropractor. If they go, well, that does feel better, I'll go, oh, do me a favor, don't tell anyone in reception. They'll all want me to make them feel better. Little things like that. They don't have to be big laughs. It doesn't have to be a big punchline setup or anything like that. But these are all little signals to the patient to help them to relax. It also projects a lot of confidence because if I can make a joke at myself, if I can chip away at my own expertise and my own standing, it shows that I am comfortable and I am confident and I'm not insecure and I don't feel threatened and I can laugh at myself. And that is a really, really good way to build the trust as well, but also get the patient to actually relax. And that's gonna improve the healing as well. So if you are not somebody who does use humor in that way, I would encourage you to have a think about it. I would encourage you to think of little ways you can make little jokes at your own expense or something like that. If you do, I would encourage you to think about why are you doing that? Are you doing it deliberately? Are you thinking about what would be the best way of doing this for this particular patient? What are some of the benefits for them? Or are you doing it the way I used to do it, which is it was kind of more for my own benefit and it was kind of to reassure myself. And if that's the case, think about how approaching it differently might change the way you do it. Because like I said, I think humor is really, really underutilized there. I'm not saying you've got to be hilarious. I'm not saying you've got to be a comedian. Certainly my wife will tell you I'm not half as funny as I think I am sometimes. But using it like that can help get really good results for your patients, and it makes practice more fun for you as well. It's a win-win for everyone.