Hello. So quick question before we get started here. I want you guys to sit down and think about your current practice wherever you are. Imagine your patient base. New, established, old, doesn't matter. Do you think you are building trust with every single one of them? Like actual trust. That's a hard question. What is trust? How do we get it with our patients? Are we achieving that with some of them and maybe not others? And why does it even matter, right? Well, This episode is all about the social psychology behind trust and why it matters so, so much when it comes to health care. So I want to talk about first that first impression. When you are introducing yourself to a patient, what does that look like? And to be honest, it starts all the way with how a patient makes their first appointment. You guys already know, I love JNAP. That's our current private practice software that we use for our EMR. And the number one reason I picked them is actually because it starts at the at that online booking. And in my opinion, they're the only ones that have the best top notch online booking system that I've ever seen. It's incredibly user friendly. It's modern. A couple clicks, they're done. it's almost too easy to be honest. So what does yours look like? Do you have a contact form on your website where they have to input their information and then wait a couple days to be contacted? Do you have an online booking site at all? Do they have to make a phone call to make an appointment with you? What does that look like? nowadays it can look like a lot of things. There are even apps out there that people can use. People can make an appointment quickly online. and I recommend thinking about your process and making sure it is as easy as possible because you're going to be losing people. if it is challenging. They're not going to book an appointment if they have to work. times harder on your site compared to someone else's. Do they have to spend 20 minutes doing paperwork when they arrive? I cannot believe, like for example at my OB office, The amount of times I'm handed a clipboard with a printed out piece of paper to fill out and 9 times out of 10 it's the exact same information I filled out last time and typically minimal changes. It's a waste of my time every single time, and I understand that they need updates, but I would much rather do it in an email, at home, than sitting there when I'm currently on time for my appointment. So what does yours look like? When they show up, are they greeted with a friendly face? Are they not? Are they greeted to a room without any staff at all? Next up, what happens when they actually get to meet and see the provider? Are they greeted with a smile? Are they, talk to first, not like a patient. Hey, how are you today? How's your day going? Oh, were the roads bad? You know, something like that. You can obviously tell I'm from the Midwest with that one. are they actually talked to like a real person right away from the get go before you dive into the nitty gritty? In a lot of cases, it's just not happening. The provider walks in and instantly goes, Oh, so I see you're sick. There's like no, there's a major disconnection there. And we are forgetting that the patients that we are seeing on a daily basis are humans, just like we are. Patients are missing that. They want to know that the health care providers they're seeing are actual human beings as well. And so we're missing this personalization, this conversation piece, and there are really simple things in your practice that you can do to get that back. So in social psychology, there is this thing called thin slicing, which means patients can form judgments about providers literally in seconds, just by taking like thin teeny tiny little details, little splices, if you will, of their first interaction with you. And sometimes this works great. Maybe you're on top of your game and you end up giving them a first impression that It makes you seem like an even better clinician than you already are. That's wonderful. But most of the time it can be the opposite where, you know, they're going to just pick apart little things that you do, bad body language, minimal smiling or friendliness to the conversation, little things like that. And if a visit starts in that manner, they're less likely to be compliant with their care. They're less likely to follow your recommendations for whatever medication you're recommending or follow up appointments. and That trust aspect is just not there. And as we know, trust can really dictate and influence the way a medical condition goes. Patients who don't trust their healthcare providers are less likely to disclose information that is necessary to provide the right medication, the right treatment, to come to the appropriate diagnosis. So trust is more important than we realize. And then the obvious, if a patient trusts you, they're not going to leave you. They're going to feel comfortable going to you for the rest of their lives, which is also very important when it comes to getting the right diagnoses over time and really getting to know your patient base. The next thing I want to touch on in social psychology is called the halo effect. So this is all about how early impressions can dictate long term perceptions. Basically the halo effect is a cognitive bias where the patient will kind of look at the first impression of a healthcare provider or anyone for that matter, and they will literally make their full judgment of who that person is, why they do what they do, what they do on a general basis. This could be great if that first impression is solid. They might start thinking you're the greatest person in the world with minimal details. But on the flip side, what if it goes the wrong way? You could be the best doctor in the world, but if your first impression is terrible, that will run its course throughout the time that you are seeing this patient and it's really hard to come back from. So some really easy ways to help mitigate this is to remember to dress nice, be approachable, be hygienic, make sure that we are giving off happy body language. If we are all closed off and turned into our computer when the patient walks into our door and we don't immediately welcome them openly, that starts us off on a bad foot and sets the tone for that patient visit. We have to remember this thing called open mindedness. Posture. Are you turned toward the patient? Are you open to receiving them as a patient that day? Are you closed off? Are you making appropriate eye contact or not? Believe it or not, a lot of people still aren't doing this. In computers, yes, they play a role, but I promise you this is even a thing outside of the world of technology. Are we responding to active listening cues? Are we making sure to let the patient speak and showing them that we're listening? Are you letting them know, yeah, I hear you? Are you repeating things back to them that they're telling you? A lot of people aren't. They're just kind of checking off that box, yeah, I'll let the person talk. No, no, no, no. This has to be a back and forth dialogue. It has to be a back and forth top notch communication experience if you want to be successful in this area. So I want to present a story to you. I actually had a patient who I had been taking care of for many years. She had followed me to multiple practices over the course of like a seven year period of time. I had seen her for obviously musculoskeletal things in the past, and I didn't see her frequently by any means, but every few months or every six months when she had a new issue pop up, she always came to me. And then this was probably May of last year, she came in with a new complaint, which has happened before, nothing new. I sat down, listened to the entire story of what was going on. I didn't examine that area. And I quickly realized this was outside of my scope. She was having a complaint in her lower leg. It was very obvious with my examination, this wasn't a calf issue, this wasn't an knee issue, this wasn't an ankle issue, I'm a chiropractor, I specialize in musculoskeletal conditions. Nothing on my exam was screaming that it was something that I could help with. In that moment I told the patient, hey, I know you're not going to like this answer, but this isn't looking like something I can help you with right now. What is the relationship you have with your primary care doc? Can we contact them as soon as possible to have this evaluated? Can we get this looked at? And I believe at the time she had already seen ED a couple times and she just wasn't getting the care that she was looking for, but they had ruled out some scarier things like obviously a blood clot and things like that. But no one had really fully examined the area and I said, This is just not the place for this. this is what I would recommend. Gave her my recommendations, we got a hold of her primary care. I actually ended up going on maternity leave shortly afterward, and I never got to follow up with her until three, eh, two or three months later. Turns out, she, Ended up going to primary care and they ended up going down that trajectory. They started with blood work, imaging, the whole nine yards. She actually had a severe mass, an actual form of cancer in her leg. And I know this is an extreme example, but this is something that really just encourages and reinforces why I want all of us to practice this way and create trust with our patients. When I saw her for her followup with me, when I came back from maternity leave, she told me that the. Only reason she went was because she trusted me. She didn't believe that there was anything major going on. She thought it was literally a calf cramp. She only went because she trusted me and she told me that to my face. And even to this day, it gives me chills just thinking about that. This is why it's so, so important. Do I wish she would have gone in and it would have been nothing? Yes. Would it still have been awesome that she did that because she trusted her healthcare provider? Yeah, that would have been amazing. But in that moment, that could have been a life or death situation and I am so, so grateful that I was able to give that patient that kind of reassurance and care for her as a patient instead of, just treating whatever was in my scope or, only caring about things that pertained to me directly. She knew that I would always put her needs above anything else and my recommendations would be because I truly cared. The next thing I want to talk about is open ended questions. All the way back to our training, we are taught to basically ask people different questions, almost like a multiple choice situation. You know, is your pain sharp or dull on a scale of one to 10? What pain levels do you have? And yeah, that really comes into the picture. I think when we're filling out an intake form, but when a patient is right in front of your face, instead of maybe asking, is your pain sharp or dull? Hey, can you describe the pain and discomfort that you're experiencing right now? That is a great example of an open ended question. Instead of something like, Hey, how many surgeries have you had in the last five years? Have you had any? Again, that's something that's more meant for an intake form. Instead of saying something like, Do you exercise regularly? Just to check off that box and put a yes or no. Why not ask them, Hey, Sharon, What does a typical day look like for you in the world of diet and exercise? That is an open ended question, and you will probably get more information out of that than just that little tidbit in regard to exercise that you were looking for, and that alone is super, super valuable. The last example I want to give is about follow up and monitoring. Instead of saying something like, hey, have your symptoms improved since starting this medication? Why don't you let that patient come in and say, Hey, how's the treatment plan that we, that we decided on and agreed upon together working for you so far? Hey, what changes have you noticed with your health since starting to come to our clinic? Again, these open ended questions provide you with so much more value and so much more detail and information, and there is a time and a place for them. Obviously in healthcare, it's important to have those very specific questions for diagnoses and all of that, but I implore you to make sure that that is more of an intake form question. And when we are in a clinic, person with these patients that we are having that really open ended dialogue. It's very powerful. One of the biggest things that helps me when I'm one on one with a patient when it comes to communication is I do this thing called mirroring energy. it's a really incredible communication skill to develop over time. my background was in neuropsychology when I did my pre med, and that alone taught me so many valuable tools that I still use today in clinical practice. So when you have someone come in with nervous energy. They're anxious about the appointment. How do you match that? You don't want to overwhelm them by almost being too aggressive or too energetic. You want to be a calming figure and you want to make sure that you're matching that energy appropriately. On the flip side, We all have patients who are incredibly energetic. If you were a more standoffish or quiet or reserved provider, you are not matching their energy either and they're not going to want that as well. So it's important to really get to know your patients, especially on that first visit, so that you know exactly the type of energy to give back to them in those day to day behaviors. as you guys know from previous episodes, I'm obsessed with the Enneagram. I don't know the Enneagram of all of my patients, but that is a tool that I've really used over time to learn all of those nine different types, so that when someone does come in my door, I can pretty much guess what they're going to be. B right off the bat just by having that first visit with them and that information I use to decide how I'm going to manage that patient and how I'm going to communicate with them. That's helpful when you're giving diagnoses. It's helpful when you're giving them bad news. It's helpful to know how to celebrate their wins with them. So overall, it's just so important to allow you to deliver the best care possible. Another major tip I have for communication is knowing when you do not know the answer and what to say. It happens. We are human. As we mentioned before, sometimes a patient asks you a question, you're not going to know the answer. Google is great and all, but a lot of times I don't like to do my research with the patient right in front of me. To be honest, in the world of insurance, we don't even have the time to do that. So what I will do, I will literally say, That is an awesome question. I actually don't have the answer to it right now though and I want to make sure I get you the best answer possible. I'm going to take a look at it and I'll get back to you as soon as I can. Do you mind if I send you an email? And everyone is like, oh yeah, thank you so much. I'll look into that. And I think it's a great reminder to them that we are also not pretending to know things. And it shocks me how many times I see this on a regular basis. We don't need to stumble over our words. We don't need to pretend to know things that we do not know. It's another great example to provide information and to also loop in other providers. We should be managing patients in a cohesive manner with a wide variety of health care professionals and this is a great way to do that too. The next tip is obviously to be very well versed in the world of cultural competency and inclusivity and here's the reason why. Number one, it makes people feel more welcomed, supported, included, and it makes them feel like people actually care. That in return improves patient outcomes, satisfaction, and they're more likely to get better. That is all that matters in what we do, and there is literally no other answer. And so why not be trained and well versed in these things so you can make sure that every single patient that walks through your door is feeling better? That same positivity from you as a healthcare provider. thank goodness, there are, most licensures now require like X number of continuing education credit on this every single year or, licensure period. So I encourage you guys to find, the right one. Find an in person one if you can, something that's going to be a little bit more engaging, some kind of seminar that's going to go into more scenarios in depth instead of just the same old click, click, click, PowerPoint type of structure. I think because it's still so fairly new, it's easy to look at it as like something you just write off that you've done, but I want you to take it and use it to better yourself. Like, Oh, great. I have to take a continuing ed course on this every three years. What can I learn this time? What population demographic is my weakness right now, for example, and how can I make that better? So I want you to kind of spin and rewire how we look at those things because they should be benefiting you. in communication situations with your patients. And the last thing I want to say is, it's important to remember that trust is not built overnight. Yes, you can have a amazing first impression at that first visit with a patient or client, but to be honest, that big time respect, that big time trust is really the result of consistent meaningful interactions with a person. This can happen over a period of time. Let's say you're in primary care and you meet somebody for the first time. Visit goes well, you feel like you did an excellent job, patient comes back to you in six months. It might take three visits for them to realize How you are as a provider for them to develop that lifelong trust. But when they do, you are now their primary care doc, hopefully for the rest of your life and theirs. The number one challenge I have for you after listening to today's episode is to look back at your first impression, start from square one, all the way back to that booking that I mentioned, do you need to improve your technology and system? Do you have an online intake form? Do you have an online booking system? What does that patient see when they walk through your door? Put yourself in their shoes. About once a year I pretend that I'm a patient in my own structure and I complete that intake form. I book an appointment online. I walk through my front door pretending like I'm a patient. Look around when you walk in. Is it inviting? Is it welcoming? Does it feel clunky and cluttered? Honestly, is it not even aesthetically pleasing? All those little things matter for that first impression. When they walk into the room to meet the provider, how are you greeting them? Are you sitting down? Do you stand up and shake their hand? Do you even introduce yourself? I know these seem like really small things, but these are things that people often forget about, especially if you've 10 years, right? So everybody with some experience it's easy to forget how important the little things are. I know for me, a handshake is everything. everything. When I meet a health care provider for the first time, if they don't shake my hand, I'm like, Oh, weird. Okay. Obviously outside of COVID times, but it usually throws me off guard. Or if they don't tell me what their name is, I can't believe how much that happens on a first visit. They just expect you to know, because you booked an appointment with them. And that is just It's not a great way to create a long lasting impression. So like I said, audit your practice, pretend that you are a brand new patient for the very first time, and see if there's one or two things that you can already tweak in your current approach. I guarantee you it will pay off in dividends and you will be enhancing your patient communication immediately. Thanks for listening. I hope this was helpful.