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Treating the Patient, Not Just The Foot Condition

by | October 12, 2020

In today’s modern language,  beaten-beyond-death buzzwords such as authenticity, self care, mindfulness, wellbeing, wellness, and holistic (that seem soon to be linked to honest John’s “pre-loved” car sales) proliferate across brands, products and services. In healthcare one of these terms is “holistic,” but what truly does that word mean?

I enjoyed reading Jeff Bezos’s U.S. Senate testimony whereby he discussed the importance of always attempting to go beyond just customer service. Although a far cry from the domination of the global Amazon forest we are not, since Circuit Breaker seedlings started to unearth in my mind to unearth about extending the consultation beyond the clinic and into people’s homes. And, for this, I revisited my own past experiences as a patient, client and consumer.

Consistency seems to be a key essential element for effective treatment; stimulated by the first interaction and engaged through ongoing buy-in from the patient. Consitency to some may come in the form of a script – a monologued process to ensure that every patient hears the same thing and receives the same exact treatment information. Although, this approach may work for larger medical practices or hospital systems where one practitioner is substituted for another on shifts to manage quality standards of patient care and efficiency, as a private practice clinic I prefer to bypass the automated conveyor belt for a more intimate dialogued approach with each person that walks through our doors at The Foot Practice.

Recently, I’ve seen quite a few new patients who have parried from one clinic to the next, and then into The Foot Practice with the devout belief that I will be the expert podiatrist who will finally “fix” them. Occasionally, patients arrive in the clinic who have had an awful experience elsewhere. It’s difficult to accept all these situations are borne from malice or intent by the former podiatrist to create an awful experience, but it may well be in fact communication and learning styles are the culprit. Whilst the focus is undoubtedly on sending a patient home from the clinic in a better condition than when they entered, I first take a step back to understand the patient’s expectations in order to clearly and positively affect the journey forward towards painless mobility or treatment of foot conditions.

The whole experience of health care is changing from the traditional model of seeking treatment for specific symptoms to that of preventive services. This new paradigm is a tall task for any practitioner; most research fails to predict injury based upon anatomical shapes, race, gender, much less the types of injury.

“The focus on learning styles and their role in the classroom came from Howard Gardner’s Multiple Intelligence research,” states Edward Steinhauser, an educator at the Long Beach Unified School District. He argued (and I agree), “Individuals excel at different things, and to define intelligence as simply literacy and math skills is to inaccurately understand the strengths of the learner.”

If we shift from a symptom-treatment approach to involving the patient through a learning approach, we care more aptly create far-reaching benefits versus short-term fixes. I was reading an interesting book about the effect of focusing on the drama of the day, which leads us to ignore or forget about other conditions that could be present. So, how do we help patients understand that a machine can provide the treatment of a symptom and modification of the action will reduce one aspect of the stress on a condition; but, without strengthening the other areas involved the chance the symptoms may resurface (and sometimes in a different place) with the origin of the catalyst being the same?

It’s convenient to focus on treating a symptom, which in all honesty is more than acceptable practice and what most health care practitioners are trained to do. However, these days I find it much more rewarding when I see patients pain-free or in high comfort for a longer periods.  This is why initial consultations are so important and typically take longer than subsequent follow-ups. Possibly it is better to spend longer trying to understand the patient before we can understand the condition.

So what type of learner are you? This is a question that I had been told to ask my childrens’ teachers to establish how I can assist with their learning. Each of us experience the world in different ways and perceive things differently. And this wholeheartedly applies to my professional everyday interactions. Understanding the differences in the way patients interpret the world gives me a better understanding of how to adjust my own approach to help educate them during our clinical sessions.

The trouble with medicine and healthcare is that it is not always predictable and in an age of fast-moving noise, sometimes our desire to prove worth to the patient or worse our entitlement that the patient will listen to everything we say and fully understand will stand in the way of more effective consultations for both parties.

Without recognizing that disparities in learning styles and comprehension exist, healthcare practitioners might end up with a group of patients who never seem to improve, possibly in part because their unique questions or learning styles have not been addressed in a way that makes sense to them to parlay the treatment plan into their daily life.

Reflecting back again on my own past experiences as a patient or customer (and not a practitioner), I asked myself whether recieivng dead trees full of information in the form of brochures, collateral, etc. better or are there other learning styles that patients that might resonate with patients. So it got me thinking is there a way we can apply learning styles with each patient that comes into the clinic so we can ensure that they leave fully understanding the plan of action for them.

Thoughts from Tim Maiden, Lead Podiatrist at The Foot Practice

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