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Why do you care?

People like to know about their healthcare professional. Do you have a brief story about how it all began? Consider the setting? The year, the circumstances in which you set off on the path. What was the challenge? What issues or circumstances made you feel less sure of the path you were on at the time? What was the turning point? What chance encounter or experience ultimately made the option you chose the right one?  How do you feel about what you do? It shouldn’t take more than two minutes, if that. Rehearse the story.

Picture by Björn Engqvist

What do you share about yourself that’s a safe topic?

Health warning:

As a doctor, the reality is you are never off duty and their status in the public eye demands a high standard of conduct at all times. Dr Naeem Nazem 

At some point someone will ask you where you went on holiday or why you have a model airplane on your shelf. You can choose to be very ‘private’ or have something you might find increases the connection with that person without befriending them on Facebook.

Physicians aged 40 to 59 years report that they most enjoy running or jogging (36%), bicycling (35%) and camping or hiking (24%). About 50% of physicians older than 60 years reported walking to stay healthy.  Other interests include golf, aerobics and cardio, skiing, tennis and fishing. Other leisure activities reported include reading, with many physicians describing themselves as avid readers; regular reading was reported by more than half of physicians under 40 years, 58% of those aged 40 to 59 years and more than 64% of those aged 60 years and older. Endocrinology advisor

The trick is not raising topics that should be off limits but it makes you more human if your client, customer or patient knows you are an avid reader, you play golf or sing in the choir. You can prompt the chat by having a prop for something that you are happy to share. My doctor has a picture of a civet cat in his room. I’d love to know why,  he tells me everyone asks him about the cat.

Picture by  Daniel Colovini  

Are you worried they’ll never stop talking?

It’s a busy day at work and the next customer, client or patient settles in to tell you something. Are you secretly asking yourself:

 How long will this take?

Will it pay off allowing them to take a couple of minutes to speak about whatever’s on their mind? Have you tried it and timed how long before they stop?

Studies have even shown that participants are willing to give up between 17% and 25% of the monetary reward offered for talking about others in order to feel the intrinsic rewards of talking about themselves. And outside of the lab, 40% of our everyday speech is devoted to telling other people how we feel or what we think. That’s almost half! Belle Beth Cooper

So if you want to do something special for your client, customer or patient give them a chance to say what they want- you might be surprised that it doesn’t take that long and pays enormous dividends.

Picture by Stiller Beobachter

How will your respond to the next ‘big idea’?

You can bet that just around the corner there will be another ‘break though’ in healthcare.

A new drug will be launched, a new procedure will be advertised, a new expert will pop up claiming to have found a cure. It won’t take much, just swallow the pill as often as they recommend and see the magic for yourself.

So if you are in healthcare you will find yourself subject to advertising, information, journal articles, patient enquiries and it seems Dr. Google’s recommendations.

The neatly packaged product will promise anything from increasing longevity, symptom relief and possibly enhanced function if only you would prescribe it for the next person with this condition that you see in your clinic.

It isn’t a case of might, its a case of when this happens.  How will your respond?

Although in the majority of critical incidents GPs considered initial information inadequate and used further evidence or colleague opinion before prescribing, in many incidents GPs relied heavily on the pharmaceutical industry as the major information source. This is disquieting since information from representatives may be misleading, biased, contain inaccuracies that doctors fail to recognize and encourage less rational prescribing. Prosser et al

Picture by  malik ml williams

Your fists stop swinging where my nose starts

You complain when people are rude, late, unreasonable, inconsiderate or selfish. However to what extent does this reflect your messages to them? Might you be suggesting:

It’s Okay. I’m easy. My feelings don’t matter. I can cope. I’ve got broad shoulders. I don’t really expect much. It’s okay to vent.

But could it be that you are actually saying:

Please like me. You can hurt me. I’m scared of you. I need you to be nice to me. I’m weak. I have no confidence. I am disposable.

What Amy Morin suggests writing in Forbes magazine makes sense:

Encourage employees to speak up when they’re frustrated, confused, or nervous. Invite them to share their opinions through the correct forums, however. Airing their grievances to any co-worker who is willing to lend an ear does more harm than good.

Address rude behavior when you see it. Ignoring sarcasm in an email or allowing disrespectful comments to be exchanged in an email chain sends the wrong message. Make it clear that you value direct communication.

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Are drugs always needed?

There is some evidence that housework helps anxiety and depression.

So if you are a healthcare professional would you suggest that doing simple chores at home might help more than drugs? How do you bring that up in the conversation?

Picture by Bev Sykes

Is there such a thing as simple administrative task?

Jane was invited back to have a repeat colonoscopy ( examination of the bowel). Her specialist wasn’t happy that he had a clear view through her bowel last year and he couldn’t be completely reassuring. Meantime Jane had noticed a change in her bowel habit and was now worried.

So she made an appointment with her doctor who practiced several suburbs away. It is a vagary of the system that although the specialist invited her back she had to get a letter from her family doctor to accept the invitation. Her doctor didn’t ask whether she was worried about it or why she had made an appointment that particular day given that the specialists note to her was a month ago. He simply wrote:

This lady needs a repeat colonoscopy as per your previous records. Thank you for seeing her again.

Two minutes later she was handing her credit card to the receptionist and walking out of the building.

Lost opportunity. Is there such a thing as a simple administrative chore or what we choose to make of an opportunity presented to practice our art?

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What was the journey like?

Do you know what your customer, client or patient’s journey to your office, clinic or shop was like? How did they get there? How long did it take? Who travelled with them? What did it cost? If they drove where did they park? Did you take any of that into account in your dealings with them today? Does it matter?

If you’re lying on a table waiting for radiation, you can’t just jump up and plug your meter,” she wrote to the city. “As someone who has gone through and survived cancer, I can’t tell you the anxiety experienced at finding a parking ticket on my vehicle. Nancy Piling

That patient’s experience was impacted by factors that had nothing to do with the professional care she was receiving. But…..

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What would happen if you didn’t show up at work today?

What would happen if you didn’t show up to work unexpectedly today? Would the show go on? Who would provide continuity for the what you have been working on? Is there a contingency plan for that possibility?

Data from the Office for National Statistics (ONS) for 2016 recorded an absence rate across all workers in the health sector of 3.5%. This compares with an average rate of 2.9% across the public sector and 1.7% in the private sector. In its analysis of these data, the ONS says, “It is possible that the exposure of health workers to infections and diseases contributes to their higher sickness absence rate.” BMJ May 2018

….any policy that mandates strict back-to-work rules must also ensure adequate staffing and coverage of health care personnel to limit feelings of personal responsibility that encourage presenteeism. Despite the best efforts of education and mandatory exclusion rules, health care providers will likely continue to come to work if they feel that their absence would burden their colleagues or affect delivery of patient care. Policies that maximize efficiency at work can therefore be detrimental to public health. Furthermore, a policy that ensures adequate coverage may be cost-effective for health care institutions by mitigating the negative financial impact associated with large nosocomial outbreaks. Widera et al

Meanwhile what do you do to ensure someone at work knows where to find that crucial document? Who knows what you are working on? Who is  on standby if something unexpected happens? What is the risk to the team if you can’t be there tomorrow?

Picture by  Ben Seidelman 

Do you use stories?

Outcomes in healthcare can be assessed using measures, meters and monitors. The art of healthcare is to ‘sell’ health because most of what promotes health are the choices of autonomous individuals. Healthcare can choose to present facts and figures:

Your BMI is 27, your blood pressure is 150/95mmHg, your lipids are in the higher range, your K score ( measure of depression) is 26

So if this is you you’ll be advised to lose weight, exercise more, eat less and relax. Even as you hear these numbers you will glaze over. In other industries they use stories to avoid ‘push-back’. The typical story has a setting, a hero, a complication a turning point and a resolution. Story teller’s say:

He must enter the hearts of his listeners, where their emotions live, even as the information he seeks to convey rents space in their brains. Our minds are relatively open, but we guard our hearts with zeal, knowing their power to move us. So although the mind may be part of your target, the heart is the bull’s-eye. To reach it, the visionary manager crafting his story must first display his own open heart. Peter Guber

The story might be:

You know you remind me of another 45 year old chap I knew. He was a very successful and worked long hours. While he loved his job he also wanted to retire early so he didn’t pay much attention to his lifestyle. Then one night he went to the Emergency department because he had terrible chest pain. He was due to go to an important meeting in the morning but that evening he was sweating, vomiting and clutching his chest. He was lucky because it turned out he didn’t have any serious illness but he needed to change his habits. Two years later people didn’t recognize him, he put all of his skills to reinvent himself, lost weight, started exercising and having regular breaks. So although he, or should I say I, won’t retire soon I plan to live long enough to enjoy it when it does happen.

Bernadette Jiwa’s new book the Right Story might help.

Picture by MorkiRo