This topic contains 2 replies, has 2 voices, and was last updated by 
Seth Schultz, DC June 13, 2018 at 11:23 am.
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Russell Jensen
Hey guys,
A major challenge and roadblock I have in practice is accidentally, through poor communication, focusing my patients on symptoms and not function.
After asking, “how has your X body part been since last visit?” more often than not i get a response about how it feels symptomatically and not how it functions, which is typical and not unexpected
My question is how do you, in the early stages of care, recondition patients to focus on function over symptoms? If I think of any specific instances or questions later I’ll post them in this thread also.
Cheers!
Adam Holen D.C.
Sounds like you’ve already identified the problem: communication. Which is great because that’s the first step. You have to connect the dots for them by tying in symptoms and function/diagnosis. Patients come in because of symptoms (predominantly) so naturally, that will be their focus. In order to get them to appreciate function, you have to very clearly explain how their function is related to their symptoms.
If they report it feels better (symptomatically), that’s your cue to point out any improvements in function and reduction in adhesion. “That’s awesome you’re feeling better, you can see how important it is to reduce your adhesion.” “When we fix your adhesion and you move/function better, you feel better. Great progress!” Doing this will allow you to keep them focused on function throughout care, especially if/when they’re pain-free, but still have more work to be done. This will reduce dropout rate toward the end of care.
If they report that it’s sore or flared up, most of the time that’s on them for doing too much outside of the office. Also, another pivotal time to connect those dots, so they don’t blame you or keep flaring it up. “I’m sorry to hear it’s still painful, but with X diagnosis, you really can’t handle Y load.” “Going forward, I need you to hold off on XYZ so your tissues can heal between visits.”
Seth Schultz, DC
More times than not a patient has had their problem for years. It is going to take more than a few visits for them to notice real, sustainable improvements. That should be addressed from the start. Let them know “I understand you’ve had X symptoms for # of years/months, over time our treatment will help reduce those symptoms dramatically. How we will do that is by getting you to move better. I know you will be focused on how you feel each day, that is normal. What I want you to do is note anything that is easier or less noticeable than before. That is progress and a sign that your body is healing. My treatment is going to improve your function so those things become easier over time.”
It’s good when symptoms change even if it’s a small change. It’s still a step in the right direction and communicate with them that continued treatment will further decrease their symptoms. They want to make sure they have made the right decision.
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