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The green laces may not be a daft idea

Researchers from Harvard University have just published a study entitled The Red Sneakers Effect. They conclude that:

A series of studies demonstrates that people confer higher status and competence to non- conforming rather than conforming individuals. These positive inferences derived from signals of nonconformity are mediated by perceived autonomy and moderated by individual differences in need for uniqueness in the observers. An investigation of boundary conditions demonstrates that the positive inferences disappear when the observer is unfamiliar with the environment, when the nonconforming behavior is depicted as unintentional, and in the absence of expected norms and shared standards of formal conduct.

It is unlikely that sneakers and torn jeans will impress people when consulting a healthcare professional. However if that practitioner wears green shoe laces or eye catching socks it might not do his or her credibility any harm.

Picture by Kaleb Fulgham

What is your approach to the biggest health risk of our time?

Sixty to eighty percent of people are now overweight or obese. This is associated with considerable morbidity. Yet it is a very complex issue and the causes of the condition are many and varied.

…..the dramatic rise in the incidence of obesity in many countries appears to be due to the complex interaction of a variety of factors including genetic, physiologic, environmental, psychological, social, economic, and political. Wright and Aronne

The experience of overweight people with healthcare professionals is not universally good.

Seventy‐six individuals (aged 16–72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Thomas et al

Over my whole 40 year dieting history I found two doctors who have said ‘well, come back once a week or once a fortnight and I will weigh you’. I found that very helpful and useful, because you feel like somebody is on your side. (65 year old female)

 They have helped because they guided me and pointed things out and they were there for me. If I’ve got questions they are helpful. (28 year old female)

 Oh well, I have spoken to my doctor about it and he just says get more exercise. I did mention it to one other doctor and he said there is only one way to lose weight and that’s meal replacement drinks or tablets. So I never went back to him because I don’t agree with that. (49 year old male)

 My doctor keeps saying, you need to lose weight. And I say, yes, I know that and I want to and I try to watch what I am eating, but it is just getting harder and harder. (59 year old female)

If you are a healthcare professional it is very likely that you will see several people today who are overweight or obese. How will you raise the topic with them? How will you know they want to address the issue? What help will your offer? How do you know you have been helpful to others in these circumstances?

Picture by Paola Kizette Cimenti

The doctor is a busy lady

My friend Alex is a good daughter. She would accompany her mother to the clinic for injections every two weeks. They would wait patiently in the waiting room before they were called in to have the treatment. Alex’s mother was a diabetic. Because of her treatment she needed regular meals. At one visit Alex went up to the reception desk and asked how long before it was her mother’s turn.

You see she is a diabetic and needs some food.

The response was jarring:

The doctor is a professor.  She is a very busy lady. She will see you when she is free.

Alex tells me that professor was a wonderful doctor and would have been horrified to hear that the receptionist had been so rude. Do you know what the person who saw you customer, client or patient just before you said to that person? Isn’t it your business to know?

Picture by Ronnie Scotch Finger

Are you catering to those who need you?

40 years ago people older than 65 years of age were a minority in the population. In the very near future they will be a significant minority and for some service providers they will be the majority. Healthcare is a good example. However the population may be ageing but it is also changing.

This aging population has many options from which to choose and they are looking for more than just a particular retailer, restaurant, product or service. They want their purchase to count: to satisfy mental, emotional and even spiritual needs as well. Older consumers: Redefining Health and Wellness as they age.

How has this been factored into your plans for how you will respond?

Picture by Nicolas Alejandro

Do your words strike a discordant chord?

Most upper respiratory tract infections are caused by viruses. However saying that to a parent with a sick child doesn’t always help:

Parent 2: They think they make you feel better saying it’s a virus…but they make you feel worse

Parent 7: When they say it’s a virus, I mean what kind of virus? Just where does it come from? Parent 1: You’re none the wiser how they got it, what you can do, how long it will go on…

Parent 5: You feel you’re no further forward…you just have to accept it if they don’t explain further, I would like to know…

Parent 2: It’s an unknown thing to a doctor, they can’t pinpoint it, they don’t know really…

Parent 1: I feel a bit annoyed really because you think they’ve studied for years to learn that and I haven’t studied at all, you feel dissatisfied as if you wanted to hear something more…you just wish that everything was clean cut

Parent 4: At least if you really knew what it was then it’s easier to cope with (Group 3) Joe Kai BMJ 1996

What do you say in these circumstances?

Picture by Massimo Variolo

Does your performance at work depend on coffee?

Does the time of day determine how you respond at work? Are you tired by mid afternoon? Are you slow to get going in the morning? How does that impact on the decisions you make at that time?

Decision fatigue is the concept that as we make more decisions during the day, they become less and less good quality… I know that I would much rather be one of my first five patient contacts of the day than my last five. Rachel Ali

Remedies for decision fatigue might include time-dependent decision support, modified schedules, shorter sessions, mandatory breaks, or snacks. Further studies could clarify the sources of the problem and test corresponding solutions. Linder et al

Does this resonate with you? What are you doing about it?

Picture by Albert Drobin

What small thing could add value?

I didn’t think about it at the time. He left my consulting room with a letter to a specialist. I advised him to le me know if the appointment he is offered doesn’t suit and that I would find another specialist who might be able to see him sooner. He had returned to the waiting room because he’d forgotten he was overseas the following week and the appointment he was able to get wasn’t going to work out. It would have been a matter of minutes to change the name of the specialist on the letter and get him on his way. An hour later someone in reception told me he was waiting for the change of name on his letter, I hadn’t been alerted. He had wasted an hour, patiently sitting, assuming I was too busy to deal with the matter and the shine was coming off his experience at the clinic. There was no major policy change required just a bit of foresight and team work to make sure that people aren’t unnecessarily inconvenienced by a system that potentially serves them very well.

Picture by Daniel Pink

Steep hill but nice view

On this beautiful earth it is not long before you have to climb a hill to enjoy the view. Where in your job is extra effort required to get to the end of the day? What makes it harder? Could it be the voice in your head telling you that this particular ‘hill’ was specifically designed to make life harder for you? Is it because you were not anticipating any ‘hills’. Are you on the wrong road? Do you need to get fitter? Is hill climbing not for you? Could it be that the view is not worth the effort?

Here’s a perspective from Jonathan Mead

Picture by  Tejvan Pettinger

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