Updated: Oct 29
Check out Part 1 first!
#3: Honest, Direct Communication
Express your fears, concerns, and doubts freely so we can address them together, rather than just pushing through a care plan that you don’t believe in.
I can't help you if you don't tell me what's holding you back.
You also can't communicate freely with me if you don't communicate honestly with yourself.
If you don't think you can realistically get up every morning at 5am and do an hour-long yoga routine -- don't make that commitment to yourself!
(Besides, it already goes against Principle #1 to start that big.)
Likewise, you'd be surprised how often I'll discuss a treatment plan with a patient and they pretend it's fine when it's really not.
Whenever I present a treatment plan to a patient, usually my last question is, "Do you see anything getting in between you and 100% sticking to this plan?"
Oftentimes, the default answer involves the following (in this exact order):
Patient looks down at the floor
Patient releases a long sigh
Patient states, "I don't know, I guess I just need to suck it up and do it."
No! If you're going to have that little faith in yourself, how much do you think I'm going to trust you to go through with it?
It's easy for us to paint ourselves as lazy, unmotivated people. Our nervous wiring primes us to save stress and energy whenever possible. If we encounter a small barrier on the way to completing our goals, it's completely normal for our nervous system to step in and move us away from that barrier.
That's why it's so important to discuss these barriers up-front and clear them out.
I know they can be embarrassing to admit sometimes, but if you can't admit your barriers to yourself (at a minimum), you're going to pretend they don't exist and keep letting them hold power over you.
"I really don't like swallowing pills" -> Let's find a chewable/liquid form!
"I'm afraid I'll have to get up in the middle of the night to pee if I have to drink that much water" -> Sounds like another symptom, let's look into that!
"I can't eat more of <insert food here> because I know I have a negative reaction to it" -> Well, I certainly don't want to make you feel worse! Let's find an alternative!
Give me the petty excuses holding you back so we can troubleshoot them together.
#4: Respect for Patient Autonomy
Never feel obligated to follow your doctor’s advice if you fundamentally disagree with it.
This is one that seems straightforward, but is surprisingly uncommon in our current medical system climate.
You're not required to follow my orders just because I'm the one running the visit.
Consent is important!
One of the fundamental tenets of consent is that your "yes" is only as strong as your "no". If you find yourself unable to say "no" in a situation, then your "yes" is weak and meaningless.
How many times have you found yourself agreeing to a social engagement that you didn't want to attend, or taking on a leadership position when you'd rather just stay in the background?
I used to offer extensive memberships and program options, but I found it just resulted in patients showing up half-heartedly out of a sense of obligation that they had to use their appointment time because they'd already paid for it.
I have a lot more trust in my patients' autonomy when they are actively consenting and choosing to show up for every single visit.
Don't waste your time and money on me if you'd rather be somewhere else.