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Lessons from the recorder

(21 posts) (8 voices)

Started 7 months ago by danellaw
Latest reply from DrPerron

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danellaw
Member

Hi All!
So after last weeks call I went out and bought a recorder to start recording myself. I've never laughed so hard in all my life. It has definitely been a humbling experience. A couple things I've learned so far... I've got a really good opening and closing with each patient, but the in between is painful. I wasn't talking at all! I had no idea. I don't know if I was having a running conversation going on in my head or what. :) So I'm working on actually talking to the patient (novel idea I know). I'm actually finding it a difficult process, I'm struggling with figuring out what to talk about, so right now it feels a bit forced. I know in the past I did a running commentary of what I found in their spine that day and how it related with what they were experiencing, but I guess I must have gotten out of the habit of doing that (I probably got bored of saying the same things, and forgot about the fact that they aren't repetitive for the patient). So anyone got any tips out there?

Also, I was speaking to Dr. Sea today and he suggested getting a nanny cam to record myself visually. Sounds terrible, but I'm going to jump in with both feet and get one today over lunch. I'm sure it will be much more revealing and will require much more alcohol to actually watch. So much for the raw diet!

Posted 7 months ago #
DrPerron
Member

Aren't most liquors derived from vegetables of some sort? I think there may be a loop hole for the raw diet.

Thanks for inspiring me to get a camera also. I'm in! Sometimes you just need to hear it one more time.

Posted 7 months ago #
Ed
Member

I have been subjecting myself to recording myself in an almost S & M way for a few months now. It is an incredibly painful process, which is why I send them on to our coaches so they can share the pain but l do agree it is very enlightening. I suppose what I have learned from not only listening to myself but also after the past few POD calls on Smart versus flat versus small talk, is firstly to increase my energy levels – be genuinely pleased and excited to see them; secondly to have more fun, crack a few jokes and thirdly to listen so carefully for the first few seconds for their issue or question of the day and then addressing it by touch and tell or whatever means! It is still a work in process but occasionally these days I actually do find myself catching myself doing something right rather than being sent to sleep! What I also find is without the benefit of sight and tactile senses it actually helps my listening skills to play back the patient encounters! As to videoing myself I have not had the balls to do it but you have encouraged me! We obviously do not enough video nasty’s lying around at home!! They have institutions for people like us!

Posted 7 months ago #
Dr. Tad
Member

Comes back to that listening thing, bloody hate that. When you ask what can I check for you today? Listen, then talk about just that while adjusting, ask the patient questions and let them talk, especially if they are high I. How is it affecting their quality of life. I was going to open a new topic, but this fits here I believe. Last night on the "Biggest Loser" the MD gave each team an envelope with a task. Basically it showed or brought to the contestant what their quality of life is now, how it is affecting them, their families, their finances, their future/employment. It was powerful to watch, but more importantly reminded me of that is what I need to be doing with my patients. Find out how this problem, neuroarticular dysfuntion is impacting their lives, then TALK about that with them between the opening and closing.

Posted 7 months ago #
DrPerron
Member

Ed, it always seems to return to the dog collar.

Posted 7 months ago #
dorian swystun
Member

Dr. Danellaw,
I feel your pain. The first time I recorded myself I was amazed at how much I didn't talk. The silence was painful. What's worse is that while listenning to the recording you actually pick up on the cues from the patient that you totally missed live. The last pod got me to wipe the dust off the recorder and tape myself again, but I haven't worked up the courage to listen yet. The first experience was too traumatic. After reading your posting and seeing your's and Perron's courage to actually get a comera I think I will listen to this weeks recordings tonight. Let me know how the camera thing goes guys.

Posted 7 months ago #
Ed
Member

Well following your example I too have bought a spy cam! It should make for painful penance! Whilst we are on the theme of day to day communication I assume most people are closing strongly with Dr Seas line "is there anything else you want me to check? Ok see you wednesday" but what about the opening? What opening gambits do you all use? I know Dr Frank always tells us hands on talk, hands off shut up; I just need to pay more attention to it so for me the opening is a somewhat critical component! My tendency is asking too open a question and not starting my analysis immediately!

Posted 7 months ago #
dorian swystun
Member

Hi Ed, I have been focussing on opennings since the revised module came out and I have found 3 things that have been helping to get to the 'pressing issue' for that person on that day. If they are actively under a treatment schedule the 'Mrs. Smith how are those headaches? Same, better, or worse?' works well. If they are actively under a maintenance sched. and are in for their regular check, 'Hello Mr. Smith, good to see you, is there anything in particular you want me to check today?' works for me. If they haven't been in for a while and not under any particular sched. 'Hi Miss. Smith, how can I help you today?' gets to the point quickly. I know these 3 don't fit every patient coming in, but it has been what I have focussed on lately. The Mr.,Mrs., Ms., Miss. thing was tough at first, but now it just seems natural and I like it. Hope this helps.

Posted 7 months ago #
DrAnthonyDavis
Member

My openings are pretty much the same as Dr. Swystun's. I use the patient's first name rather than Mr., Mrs. or Ms. LastName.

Anybody have thoughts as to whether using the first name is too casual, or does it depend on behavioral style?

Posted 7 months ago #
Dr. Tad
Member

When your exam tech intoduces you to the patient, she'll say doctor davis this is mr. jones. I continue to use that unless Mr. Jones says, call me Tony. Then I'll use the first name, if I don't get that I continue to use their last name.

Posted 7 months ago #
danellaw
Member

Do you get a lot of patients who don't ask you to call them by their first name? I'd be interested to see if it is generational or cultural at all. I know I am much more likely to call a patient by their first name, but if they are in their senior years I definitely tend to call them by their last name.

Posted 7 months ago #
DrJohn
Member

I'm in the same boat as you Danella, I tend to call them by first name unless they are much older than I. Of course, I know that it's one of the recommendations here to address patients as 'Mr/Mrs...', and I'm also missing another step (among many) of having my tech introduce me. I've always just been more accustomed/comfortable with the first name opening, but then maybe that's part of the issue of being Dr-centred?

Posted 7 months ago #
Ed
Member

The more formal Mr/Mrs is something I have struggled with. These days we generally always use first names pretty much across the board! Except occasionally for the elderly. Whether or not it is a cultural or generational thing I am not sure but personally I have never been comfortable with any title including "Dr". When a patient how I like to be addressed it is Ed, whereas my staff do refer to me as Dr! But I do like your approach Tad where you start off more formally and change as directed! I will try it!

Posted 7 months ago #
DrPerron
Member

I am definitely a first name guy except with the very rare and VERY old patient maybe. I think like many things in the office it depends on your natural style and what comes off as genuine to the patient. In the avoidance of taking on a personna different than your own using Mr. or Mrs. "just because" will probably not be comfortable and can send a vibe of awkwardness. Just like calling a 90 yo grandma by her first name may do the same. For me it is 99.9% first names. I would imagine that that is what their friends and people closest to them refer to them as so that is what I am going for. With that said I am very comfortable with that and in other parts of world the Mr. or Mrs. may be more natural. My point is that I don't think that this is a one size fits all. I was just going through a pile of re-exam "report cards" and other than the efficiency comment the even more common is the friendliness. So take a look at those things and let the patients decide what is best. I think in our aging society that now a days a 60 yo or a 70 yo does not think of themselves as old relative to past generations so when you call them by their first name they are on an even plain with you, where we are typically the younger in those cases where as calling them with title, although not bad, might make them feel older. If they are at the chiro office they are the healthier minded end of the spectrum usually, in my experience. The ones that just pop pills for the final years and therefore see themselves as "old" won't be the ones at our office anyway. I think they want to feel young. If we look young and healthy then we are often the target. I think they often want to be like us so letting them into our world by talking to them as a friend/next door neighbor rather than in doctor speak may be a plus. To each their own and I say do what is natural to you as long as it comes across with respect and feels genuine then there is no wrong.

My two cents.

Posted 7 months ago #
DrPerron
Member

My pen cam just arrived Fed Ex! My staff wants me to speak in a Sean Connery accent for the day to commemorate the occasion. Break open the Pinot, it will be a long night.

Posted 7 months ago #
DrPerron
Member

Watched my adjusting "prowess" for the first time last night on video. I highly recommend it (not me). It was so obvious to see time consistently wasted. What were passing thoughts and ideas on how to improve were blatantly revealed. Really cool. Can't fix what you don't know. It has definitely added to the "to do" list. Thanks Dr. Danella for sparking the idea and Ed for finding the pen. I do like my pen, color and audio. Modern technology!

Posted 7 months ago #
DrPerron
Member

Along the lines of my revelations with my new toy. It got me thinking about how I have always viewed my "adjusting" as something that I was solid with and all this new management stuff was where I could spend my focus and energy. Following along the tennis analogy with the intrinsic and extrinsic learning work what I noticed is that because my Activator had become that racquet in my hand that I barely noticed and I was just focused on the patient I had developed some bad habits. Not bad as in harmful, but bad as in wasteful. Because my adjusting style had become so ingrained, so had the seemingly "meaningless" little habits to the tune of 15 seconds to 2 minutes per adjustment and that was just the most obvious one. So my point of sharing this is two fold. This would not have stood out to me remotely as much if I was not watching myself on screen with the video timer in the corner ticking away and getting the realty of what impact my habit was having. The other is not to get too comfortable with any aspect of your practice. Things left unattended can take on a life of their own, so beware of what you think you know, it can be deceptive.

Posted 7 months ago #
drdanella
Member

I finally got me recorder!!! :) OK. some questions... where are you putting this thing? I know I read somewhere that someone put it in a plant. How close did you have that plant? I put mine in a pen cup with a bunch of other pens and it's not all that far away but I can't hear it very well on the playback (thank goodness for that right?). So are you guys wearing it? I need some practical suggestions guys...
And by the way... this thing totally makes me feel like James Bond. :)

Posted 7 months ago #
Ed
Member

Like you I put the pen in a jar with lots of other pens on a shelf just near the head of the adjusting table! Patients use the shelf to put their belongings on it. It is about waist height! And then it is simply a case of pointing it towards the foot of the table! I tried wearing it but there was too much bouncing around! Also if you wear it you dont see yourself which is the main point! Just play around with the location of it! As regards to the sound the quality is generally ok! If the sound is so bad use the voice recorder simultaneously!

Posted 7 months ago #
Ed
Member

By the way where did the postings on "I can with a spy cam" go to? Since the new website was started that whole thread has gone?

Posted 7 months ago #
DrPerron
Member

I placed it on a shelf at one corner of my adjusting suite and could get two of my three tables in the shot. Obviously the physical set up of each of our offices will dictate somewhat where you can place it. I will admit that reading Ed's post about it being waist height was going to go in a different direction. :) I was happy to get as wide a shot as I could and as far as audio, I just looked at that as bonus. I could tell my tone and enthusiasm level and many of the words but I would leave that for a recorder on you if that is a focus at this time. I got enough off my physical actions to work on for a week or two then I will record again and see how I did and see what else. I only recorded a couple of clusters the first day I got it last week and I have my assignment. Hope that helps and thanks to you both for getting me to do this too.

Posted 7 months ago #

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