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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?

Pcture by Luis Sarabia

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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How do you frame your solutions?

How do you frame a suggested solution to someone’s problem? Do you mention the possibility that your suggestion won’t help? If you are a doctor do you speak of the number need to treat? We know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. One of the commonest reasons that patients consult doctors are for sore throat. How many people with a sore throat should be treated for one person to be free of the sore throat at day 3 of their illness? At day 7 of the illness?

Protecting individuals with sore throat against suppurative and non-suppurative complications in modern Western society can only be achieved by treating many with antibiotics, most of whom will derive no benefit. Cochrane Primary care

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What do people see on your desk?

Okay so you might not have chosen the wall paper, the carpet or the size of your office but what’s on display on your desk? What impression is created at a glance? Do you look organised? Do you look like you’ve got the time to give your visitors some attention?

There are six reasons to clean off your desk and as Catherine Conlan suggests:

Remember, your workspace speaks for you even when you’re not there.

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What’s your vibe?

Do the people who seek your help sense that you are distinctive in some way? How? Is there anything remarkable about you? Your blue shirts? Your leather boots? Something that they immediately recognize as your ‘trademark’. According to Dana Lynch image consultant, your style matters for three reasons:

  1. People for impressions of you within a mere 3 seconds!

2. Your style makes you memorable.

3. Your style allows you to express who you are, which ultimately leads to an improved self-image and confidence.

If you are a doctor your patients will likely decide within seconds if they are going to take your advice.

Picture by Ronald Menti

How many senses do you engage?

How many of the five senses are engaged in your office? Sure people see things, hear things and touch things but are their other senses stimulated?  Do they associate your office with a smell or a taste? What is it? If you are  a doctor it’s not likely to be something pleasant. But if you are and have done something about it then Elizabeth Ely sounds like she would approve:

Just what is it about medical disinfectant? It just smells so, well, medical. So like it’s covering up sick, and bringing you along with it, pulling you under its odourous spell.

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How do you explain?

In any meeting where you are the expert how do you explain technical details? As a doctor how do you explain viral illness? Warts? Heart disease? Cancer? How do you know the other person ‘gets it’? Do you say the same thing every time? Do you use pictures? Sounds? Have you practiced the script as much as you practice other aspects of your art? Why or why not?

Andrew McDonald wrote in the BMJ:

The development of such a language, securely founded in shared meanings, would be a good first step towards better communication between professionals and patients. It would not, of course, deliver the goal of full participation in decision making, but that goal will remain elusive unless we begin by understanding one another.

Picture by Marco Verch

How do you end your meetings?

We know how to start a meeting- we stand up, shake hands, say hello, smile. But what’s the best way to end a meeting? It matters for one reason:

The peak–end rule is a psychological heuristic in which people judge an experience largely based on how they felt at its peak (i.e., its most intense point) and at its end, rather than based on the total sum or average of every moment of the experience. The effect occurs regardless of whether the experience is pleasant or unpleasant. Wikipedia

If you are a doctor this is all the more important because people generally don’t seek a meeting with you because all is well. They may be experiencing all sorts of unpleasant feelings. So how do you end that meeting? How do you know it’s working?

Picture by Peter Lee