Apply folk wisdom to your family practice patients (How to turn unsolicited advice into positive communication!)12

Great article on communication/relationship skills.
It shows how to show you value advice on your own terms.

This reminds me of a scene in Gone With the Wind. Rhett takes baby Bonnie for a walk in her baby carriage. He passes two older women and asks for their advice on breaking the child’s habit of thumb sucking. Although the advice does not seem good, Rhett smiles and thanks them profusely. After Rhett departs, the women talk amongst themselves what a wonderful father Rhett is.

From the 12 August 2012 article at KevinMD.com

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Late in my family practice residency – and very early in my parenting career – I had mentioned the persistent and sometimes uncomfortably intrusive suggestions offered by my mother and mother-in-law. One of our faculty, a seasoned pediatrician and parent, made the suggestion that I call both sets of grandparents regularly and ask for advice. He pointed out that their motivation (to be helpful and involved) was beyond reproach and that they probably had valuable insights to offer, if I could just reframe it to protect my own need to be autonomous and masterful. It worked like magic. The unsolicited advice nearly disappeared – and I learned a great deal from our conversations. The grandparents felt needed. I benefitted. And so did my kids.

Over the years, I have found it a valuable life strategy, and it comes up fairly frequently in practice:

• I tell all new parents at my first opportunity that they should each call their in-laws regularly to discuss parenting concerns and ask for suggestions, pointing out that the investment in making them feel like a valued contributor will pay huge dividends over time, and making sure that they realize that asking for advice will make it easier to ignore it.
• I suggest to parents that they play various versions of the “what if” game with their kids, getting the kids to help decide how best to set rules, reward success, and punish transgressions.
• I tell young adults starting a marriage (or other long term relationship – times have changed) that they should make a point of asking their partner’s opinion and advice often and sincerely, to build a comfortable platform of sharing.
• I suggest proactive questions and requests for feedback when I see people with job stresses.
• When patients are diagnosed with a serious illness for which others will be directing their care (cancer, degenerative neurologic disease), I tell them we are going to be proactive rather than reactive, and schedule regular appointments to discuss their progress and concerns. This makes sure that they understand I want to remain involved, and I avoid having to deal with crises and questions in a vacuum. (Since we often have a long term relationship, I also find that they need to have me tell them the same things the specialist has said to understand it and believe it.)
• When patients reach an age and health status where they are declining and vulnerable, I suggest that we schedule regular visits to talk about how things have gone and what problems we might expect, rather than waiting to things to go wrong.

Try it!

 

 

Validate Complaint Before Responding

From the 19 May 2011 Medical News Today article

…Listening, saying sorry, and validating the complaint by repeating the complaint word for word – or least paraphrasing – can solve the majority of the problems and diminish the need for fights. Sometimes people just want to be heard…hear their complaints and gripes about life validated. Doesn’t mean necessarily you’re wrong and they’re right….they just need to blow off steam. Also, for some people after hearing their complaint repeated back it makes them realize they’re making a mountain out of a mole hill….they’re being unfair, unreasonable, and even silly. ….

..Source: Sorry Works! (“advocacy organization for disclosure, apology (when appropriate), and upfront compensation (when necessary) after adverse medical events.”)

Click here to read the entire Medical News Today article

Related articles

• 10 steps to a successful complaint (telegraph.co.uk)

Psychologists identify influence of social interaction on sensitivity to physical pain

From a November 8, 2010 University of Toronto news release

TORONTO, ON – Psychologists at the University of Toronto have shown that the nature of a social interaction has the ability to influence an individual’s sensitivity to physical pain. The discovery could have significant clinical implications for doctor-patient relationships and the general well-being of an individual on a daily basis.

“Dozens of studies over the past several decades have demonstrated the impact of inadequate social connectedness on numerous health outcomes, including cardiovascular health, immune function, post-surgical recovery, and lifespan,” says Terry Borsook, a PhD student in the Department of Psychology at U of T and author of a new study published in PAIN. “Our study is among the first to show in humans that the perception of physical pain can be immediately impacted by the types of social experiences that people have in their everyday lives.”

In the study, healthy participants rated the intensity and unpleasantness of painful stimuli before and after engaging in a structured interaction with a trained actor who was instructed to be either warm and friendly or indifferent throughout the exchange. Participants who experienced the indifferent social exchange reported less sensitivity to pain after the interaction when compared to that measured before the exchange. Participants exposed to the positive social interaction, however, exhibited no change in pain sensitivity….

….

“If such everyday mildly unpleasant encounters are enough to provoke pain inhibition, then this suggests that many people may be exposed to chronic fight-or-flight responses, which can have many negative implications for health. This would be the case especially for people who are sensitive to social exclusion, such as those who feel lonely or fear rejection”

Borsook says that the results also have important clinical implications when it comes to seeing your doctor. “Health practitioners who are aloof, lack understanding, or are generally unresponsive to patients may provoke an analgesic response resulting in underestimated reports of pain, with insufficient pain control measures being a possible consequence.”

The findings are presented in a paper titled “Mildly negative social encounters reduce physical pain sensitivity“, published in the November issue of PAIN, the official publication of the International Association for the Study of Pain.

Editor Flahiff’s note: Click here to for ways to get this article for free or low cost