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Are you sure they can help?

One of the key roles in healthcare is to refer people to other sources of help. The list of therapists, specialists and clinics is as long as any phone directory. However off loading someone elsewhere is hardly worthwhile if it’s a waste of time and money.

The goal should always be the initiation of a discussion about a patient’s needs and the beginning of a triaging process to address these, rather than problem identification being an end‐goal itself. Gemma Skaczkowski

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Did this person need those pills?

No matter what business you are in you might ask yourself if whatever you just sold to your customer is what they really needed. If you are a doctor that question cuts deeper- did you really identify  that person’s problem or did your prescription just get them out the door?

Inappropriate prescriptions are known to pose health risks for older adults, leading to unnecessary hospitalisations and undue cost. Budnitz et al

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What do they know about you?

Whenever someone new visits your shop, cafe or clinic for the first time they make a decision to give you a chance. It’s worth asking what persuaded them to do that. What’s their perspective on your business? Which of your previous patrons do they know? What do they expect? Can you deliver? They are telling you something merely by their presence on site.

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What do you do that you could stop?

We often do things out of habit rather than for a good reason. As healthcare professionals that might be poor. Ordering tests because it’s something we always do ‘ in these circumstances’ might lead to  problems- specifically false positive and false negative results. When that happens it doesn’t just buy time while we think of a diagnosis it also potentially creates a false diagnosis. What if you were a doctor and were held to account for every false diagnosis you made?

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Are you credible as a lifestyle coach?

The commonest conditions doctors encounter are illnesses directly related to poor life style choices. Diseases that arise because we eat too much and don’t take enough exercise.

People who seek healthcare advice will be told more often than not that they must make different choices. How credible is your advice as a doctor? How persuasive are you as the messenger? How could you do this better?

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Do you prepare to disappoint?

In any business there will be time when you don’t see eye to eye with your customer.  In fact there will be times when you disagree with them because what they want is either impossible, illegal, unavailable or otherwise difficult for you to deliver.

You might encounter that situation more than once in the course of your day. You expect it right? So if you are a doctor how do you prepare to deliver that news to a patient?

Once you’ve dumped your baggage and assumptions, approached patients with humanity and compassion, and discovered the real problem, what’s your next step? That depends upon what the real problem you discovered is. Is the problem something that is your fault or one you can solve? Did the patient have expectations that weren’t correct? Have an honest and forthright discussion with them. If you can do that, you’ll be getting thank you cards from your patients for a very long time. David J. Norris, MD

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Do you use aids to help you explain?

If your job involves explaining complicated ideas- and let’s face it nothing is simple in medicine- do you use models or aids of any kind?

if not, why not? If you do what do you use and how do you know they work? How do you explain sciatica, heart disease, asthma, cancer?

Physicians cannot control all the reasons for patients pursuing legal atonement but they are able to determine the quality of their connection with them, by improving their communication skills and techniques. Law-suits for medical negligence can be lowered or prevented by taking steps to keep patients content, thus making them more compliant to the treatment, adhering to the medical policies and procedures. Tevanov et al 

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Who talks most in your office?

Who’s voice is heard the most in your office? How do you know? Does it matter? How long before you interrupt the other person? What are you thinking while the other person speaks?

The most striking finding of these studies, however, is not the type, the goal, or even the ultimate effect of the interruptions. It is the fact that after asking patients to express their concerns, physicians were able to listen to patients’ stories for a median of only 18 to 23 seconds before interrupting in some fashion. JAMA

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Are you sure you will focus on the right problem?

In any business where you are paid to solve problems you need to be clear that you are indeed solving the right problem. Doctors can frame the problem in many ways- if their patient has been brought in after a car accident then ‘the problem’ is  clearly the broken leg or the bleeding wound. What’s much less obvious is the problem that needs to be solved in all other circumstances.

In the moment you are sitting in front of the doctor the problem isn’t the runny nose, the headache, the sore throat or the anxiety. Being told it’s just a virus won’t help. You need that  doctor to give you their undivided attention and to see the context in which you are experiencing that discomfort. To acknowledge your distress. There is ‘no cure’ for a viral upper respiratory tract infection and you knew that before you walked into that office. Right?

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Are you persuasive?

If your job involves advising- are you a credible source of advice? How do you know?  What can you do to make yourself a more influential? Apart from giving credible advice is there something you can do to make your advice more likely to persuade?

There’s a critical insight in all this for those of us who want to learn to be more influential. The best persuaders become the best through pre-suasion – the process of arranging for recipients to be receptive to a message before they encounter it. To persuade optimally, then, it’s necessary to pre-suade optimally. But how?

In part, the answer involves an essential but poorly appreciated tenet of all communication: what we present first changes the way people experience what we present to them next.
Robert B. Cialdini, Pre-Suasion: A Revolutionary Way to Influence and Persuade

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