A Message:

From Dr. Shelley Simon

Happy new year . . . a couple of months late. This is the first issue of Practice Your Way for 2010. I had shoulder surgery in late December and, while I’ve been fortunate to be able to continue working with clients by phone, spending a lot of time at the computer has proven to be a bit of a challenge. But I’m getting closer to having full function of my shoulder with each passing day and anxious to get back to 100% and start enjoying these early days of spring.

For this issue of the newsletter, I’m sharing a slightly edited version of an article I wrote for Chiropractic Economics. A number of my clients in recent months have expressed an interest in developing the wellness side of their practice and in attracting patients who want to be active participants in their health. What some of these practitioners find, however, is that bringing these patients into the office is just the beginning. Helping them find and maintain the motivation to make changes toward a healthier lifestyle requires no small amount of motivation on the part of the doctor. I hope you’ll enjoy reading this article.

And after you’ve finished the feature article, be sure to keep reading to find out about a special offer. I only extend discounted rates once a year or so, and the offer you’ll find below is only for newsletter readers, prior and current clients, and individuals who have called me about coaching or working with their office team. If you’re ready to make positive changes in your practice and have been on the fence about engaging my services, now’s the time to hop off that fence and into action.

Feature Article:

Influencing Behavior Change in Patients

Research continues to confirm that lifestyle is one of the most important factors influencing health outcomes. Yet despite the facts, figures, and public health messages, many people continue behaviors that are associated with poor health. If you provide on-going care for patients, your office may be well suited to provide wellness education. Yet, as you may have already discovered, there is much more involved in guiding patients toward wellness care and positive choices than simply offering information or telling them what to do.

You no doubt know from personal experience that change is hard. Try to remember a time in your life when you vowed to exercise more consistently, lose weight, improve your eating habits, get more sleep, or break a bad habit — only to slip back into old patterns before you’d even gotten a good start on your goal. Perhaps you found your motivation, time management, or follow-through lacking. Think also, about a time when you were successful in making a significant lifestyle change. What resources were valuable to you? What worked well? What was different this time? Reflecting on your own successes and failures will help you better understand what your patients are going through and what might make a difference to them.

You have the advantage of understanding what constitutes a healthy lifestyle and odds are that you follow your own advice in this area. That said, it’s not uncommon for healthcare providers to have their own issues around wellness. This illustrates that knowledge alone is not necessarily motivating. Assuming you have a reasonably high level of commitment to your own health (even if you don’t happen to have the body fat level of a marathon runner), it’s easy to forget that patients who are overweight, sedentary, and on ten different pharmaceuticals can’t make the leap to adopting a wellness paradigm in a single bound, no matter how persuasive you may be.

Resist the urge to “win over” everyone to your way of thinking about wellness. Getting on a soapbox about something you’re passionate about will only influence individuals who already agree with you and who are highly motivated to change. Remember, patients are always asking themselves, “what’s in this for me?” They are only interested in your ideas, opinion, and advice to the degree that they believe you have something to offer that will benefit them. When we face resistance (or even ambivalence) to our ideas the tendency is to respond with a patterned, ineffective approach in an effort to bring someone around to seeing our point of view. Some of these tactics include using facts, fear, or force to influence behavior change and these approaches are rarely effective. Presenting facts assumes that patients always behave rationally (they don’t). Using fear may paralyze individuals or make them feel hopeless or helpless. And employing what may appear to be force or excessive control is a recipe for driving patients away from your practice.

Even when a patient has expressed an interest in exploring wellness and becoming healthier, it’s helpful to assess their genuine urgency, readiness, and motivation to change. Again, reflect on your personal experience. When you achieved a health or wellness goal of your own, were you truly ready for change? Most likely you were. Change efforts made in the face of ambivalence are not usually successful. Meet patients where they are by understanding what their desired outcomes are and tailoring your conversation to their degree of readiness for change. Open-ended, coaching-type questions such as “In what ways do you think you’d feel different if you achieved this particular wellness goal?” and “What impact would being more energetic have on your life?” are useful.

In his book Change or Die author Alan Deutschman discusses the “three keys to change” which are: relate (offer new hope), repeat (gain new skills), and reframe (adopt new thinking).

When you relate to a patient, you build trust and form an emotional bond that gives them hope and helps them believe (because you believe) in their ability to change. This step also involves demonstrating that you have the knowledge, skill, empathy, and methods or strategies to help patients change and achieve results, because belief must be coupled with action.

When you repeat something with a patient, you are helping them learn, practice, and master new habits and skills. For example, you might discuss a patient’s exercise regimen at each visit and encourage them to push a little more toward optimal fitness with each passing month (assuming that’s their goal, of course). In the role of teacher/coach/mentor, you can provide guidance, encouragement, and direction that will enable patients to be successful in adopting new behavior.

When you reframe with a patient, you are supporting them to see themselves differently as they make progress — as someone who is healthy and fit and who has the capacity to achieve their wellness goals. This step allows patients get a glimpse of what a positive, healthier future might hold for them and helps them maintain motivation to continue their efforts toward wellness.

Change (and influencing change) is both a process and a journey. As you work more closely with patients to help them achieve their health and wellness goals, you’ll naturally become more effective in assessing readiness for change and more skilled in influencing patients. If you are like most healthcare professionals, this is why you go to work everyday – to share your philosophy in a way that makes a difference in the lives of others and empower patients to make sustainable, positive changes in their health.

Special Offer:

Improve Your Bottom Line

Speaking of positive change, what’s your readiness level for improving the bottom line in your practice, building a more effective team, or working with greater ease? If you’re ready then the timing could not be better. I only rarely offer special rates (not more than once a year) and now is that time for 2010.

For readers of this newsletter, previous clients, and individuals who have been in touch with me within the last three years about coaching, I’m offering a 15% discount off individual coaching, and a 20% discount off on-site staff retreats, team coaching, and strategic planning. If you are current client, you can receive this same special rate if you renew your coaching contract before your current one expires. To take advantage of this offer, you must request a consultation before March 31.

Online Now:

Read Dr. Simon’s Latest Published Work Online

Chiropractic Economics: Connecting with Your Community

Dynamic Chiropractic: Success in an Age of Transition