Trust in Motion

In our last blog we focused on how trust, particularly self trust, can greatly impact patient's progress with rehab and adherence to a home exercise program.  In today's segment we will focus on how to build trust with your patients as adapted by the book "The Speed of Trust" by Stephen M.R. Covey.

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An alarming survey suggests that over 60% of medical school students admitted to cheating at one point or another during their time in college/residency to pass a test, complete an assignment or hand a project in on time.  Don't worry we still did better then business students (75%), however this number is still a bit alarming.  How can we expect patients to trust us when more then half of us have likely cheated at one point or another to get where we are?  How do we establish a mutual feeling of trust not only in the clinic but in our personal lives?  First we have to admit what we cannot do and be honest with ourselves.

I cannot fix anyone.  I cannot cure anyone.  I cannot eliminate your pain in one visit.  I cannot make patients come to PT.  I cannot make anyone do their HEP.  At the end of every first session with a patient or client I always say "We will get you better".  Notice WE.  I never say "I" because it is just not something I believe I can do.  It needs to be a team approach, and the only way to succeed as a team is to trust each other.  Here are 4 simple steps to follow:

  1. TALK STRAIGHT:  Do not be afraid to admit to the above statements.  Be upfront with patients regarding expectation and treatment duration.  It is OK to see someone over the course of 6-8 weeks - especially if your goal is to make permanent change and modify behaviors.  There is just no short cut around this and scientific evidence will support you.  Let patients know what their role is, and be straight-foward when they are not meeting their end of the deal.  If you have children and you tell them they cannot go out unless they clean their room the same applies for patients with "home work" and lifestyle changes.  Here I always find the wise words of Yoda helpful, "Do or do not, there is no try."
  2. DEMONSTRATE RESPECT:  Thank your patients for every visit.  Realize that it is they who have to alter their schedules and lifestyles to come see you.  We are just doing our jobs - we wait for our clients to arrive in our offices.  We do not alter commutes, get babysitters, etc.  Follow up with e-mails.  Be it after the first session to see how they felt, or after a "hard" day to remind them that they are doing great.  Take notes of your patients.  It is easy to put a reminder about the names of kids, activities they did over the weekend/vacation or even birthdays.  Most importantly seek feedback - yes both positive and negative and be willing to accept both in stride since it is usually the negative feedback that will require you to change something or take action.
  3. RIGHT WRONGS:  I can recall one instance in the last two years where a patient was not satisfied with her treatment and experience at the clinic.  The only way I was able to establish that was by following up.  In response we refunded her for her entire visit in cash.  On other occasions where I have had to call out of work due to personal or health reasons I made sure it was myself the patients heard from.  I let them know what I would take into consideration if they had issues arise in the future and I would do my best to extend hours that week or next to accommodate the visit and ensure their rehab does not fall behind.  
  4. GET BETTER:  Do not be afraid to make mistakes but learn from them.  Take courses and work with people who challenge your way of thinking, not solidify it.  I always say you "know what you already know."  A key ingredient to patient care may be connecting a new thought or treatment you had not yet tried.  People see when you are going above and beyond for them and they can quickly identify when they are being forced to continue treatment that is not working.  

In conclusion while thinking about the above steps I invite you to try this simple exercise:  Send yourself a Start/Stop/Continue Report.  Think about what you need to start doing, stop doing and continue doing to build trust - this also makes for a great team exercise!  

Until next time, Happy Rehabbing!