This is a YouTube video titled "ππππ€ π¨π ππ₯π₯ ππ«ππππ¬, π¦ππ¬πππ« π¨π π§π¨π§πβ¦" created in January 2024. The content is a monologue or talk by a single speaker discussing the balance clinicians should strike in patient care, particularly around diet, exercise, and lifestyle advice. The speaker shares a personal approach using an 80/20 rule to determine when to provide basic advice and when to refer patients to specialists, emphasizing multidisciplinary care and practical patient management. The video is educational and reflective in nature, aimed at healthcare professionals or those interested in patient-centered care.
Are you doing too much with your patients? That can seem a little bit of an unfair thing to ask given that we always try to do everything we can for our patients. I always want to help them. But recently I had a discussion with some of my members in the Patient Centered tribe and it was talking about, you know, how far do we go, what's our job and what isn't, you know, and we were talking about this in the context of diet and dietary advice. Now, you know, many of you all know Simon Billings, friend of mine. He's got put out a great course. I thoroughly recommend it on nutrition, the Academy of Chiropractic Nutrition. And, and I knew that diet was important, but I learned a lot from this myself about a specific role. Certain vitamins and nutrients take certain foods, how you might want to experiment with them. It's a really cool, patient centered way of doing it and there's so much content in there. The thing is, is that some people look at that and go, yeah, that's interesting. And many of Simon's members have taken a real dive into it and go through really, really detailed, really useful dietary stuff with their patients. However, other people I know will go like, well, that's not my job. I'm a chiropractor. It's not my role to mess with diet. If I can get them better with my hands, I might maybe say, look at a dietitian. And I think both sides have a point here. So I want to talk about my personal approach, which is kind of like the middle ground. And I'm going to apply this to diet because it's in this context. However, you can apply this to strength training, rehabilitation, you can apply this to mental health, you can apply this to lifestyle change, sleep, stress, whatever it might be. I like to basically think of it as like an 80, 20 rule. And this is what I did with Simon's approach. So I got the course early on. There was tons of detailed stuff in there about the microbiome, but Simon actually split this up relatively similarly as well. That, you know, when it comes to other stuff outside of chiropractic, there will be like 20% of stuff that will help 80% of patients. So the same kind of standard dietary advice I will give most my patients, if diet is playing a role in their condition, that'll be enough to help them. Similarly, in terms of exercise, if they just need to get a bit stronger, I've got my routines, I've got my similar kinds of advice and exercise that I can give them. And for 80% of people, they just need that 20% and that's it. However, 20% of people, the more complex ones, the more challenging ones, the ones that need more, they might need that other 80%. And when it comes to that, that's where I draw the line. I will happily signpost people, I will happily give them exercises, I will happily give them some dietary advice, recommend a couple of supplements, and you can do this in a tailored way. You know, I how to spot when somebody likely needs B12 or doesn't. I'm not going to recommend that to everybody, but it's about looking at, okay, where's the standard stuff going to be helpful? Or do you need something more? Now, you could go the route of becoming an expert in everything. You could spend your entire career gradually learning bit by bit and being able to give that 80% to everybody. And there's potentially some value in being the kind of practitioner that can look at their mechanics, that can look at their detailed movement patterns, that can look at their diet in a detail, where they can look at their microbiome, that can look at their overall lifestyle that could be useful. But let's be honest, if you're going to do that well and actually do that 80%, your appointments are going to be an hour long every single time. Now, that's you. And you're happy with the fee that you charge for that, and you're happy doing that. Okay? I don't think there's anything wrong with that, but most of us don't really want to do that. And I will be honest with you, I've said this to Simon. I don't like looking at meal plans. I don't look at looking at food diaries. That doesn't interest me. You know, if they just need a bit of advice, great. But if they need that kind of detail, that's where I will refer out. But that doesn't mean I go, okay, diet's not my job. That doesn't mean I go, okay, I'm not interested in this. You know, they need to go find somebody else. I think as clinicians, we have a responsibility to spot when somebody else can be brought in to spot when something that isn't our job would be useful. We do that with medical conditions, right? We do that with blood pressure. You can't just go, well, I'm not a cardiologist and I'm not a gp, so it's not my job to ever check blood pressure. We need to find out if there's something else going that could be quite urgent. But the stakes may be lower. I think we should be doing this for other lifestyle things as well. So I thought I'd share that. That kind of 8020 approach there. If you know enough to know when it's time to bring in an expert, bring in somebody else. Patients generally really like that because the experience I've had is most patients who've been to a multidisciplinary clinic, there wasn't really much triage going on. There's a couple down the road with like 20 different professions, but the patient has to decide who they see. There's no triage, there's no referring going on. It's really just okay. Do you want to see the podiatrist or do you want to see the physio? Would you want to see the strength and condition coach? That's kind of it. I think as clinicians we have a responsibility to learn when it's time to do that so we can signpost our patients. Because I can tell you my most loyal patients and the patients I've had the most fun working with are ones where I have co managed them with different people. That doesn't mean that I go, I don't know anything about this and it doesn't mean I go, oh yeah, I know what you need to do. So I thought I'd share that as that came up recently. Hopefully that kind of 8020 principle will be helpful for you. And yeah, if you ever do want some brilliant chiropractic nutrition stuff, I check out Simon's stuff. It's really great course and there's lots of good detail there, so hope that's helpful. I'll see you soon for another video.
