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Request for Advice: Communication and Time Management Tips/Tricks

Exit forum ID Forum Discussion Request for Advice: Communication and Time Management Tips/Tricks

This topic contains 6 replies, has 2 voices, and was last updated by   Russell Jensen October 27, 2017 at 8:08 pm.

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    Russell Jensen

      Hey guys,

      First time forum poster here so I am sorry if this has been covered before. Lately I have had a real issue with time management. I feel like within a session I am biting off more than I can chew or getting locked into unnecessary conversation which results in me running late.

      Do you have any advice/tips/tricks for redirecting patients conversation or to keep yourself focussed down?

      And my second question, how do you ask your patients (visit to visit) about their pain or symptoms to keep track of it, while still keeping their focus on movement and tests for a gauge for improvement?



      Carl Nottoli, DC

        Hi Russell,

        Great to have you on board with ID! Very good question and extremely important topic. Staying on task with patient symptoms between visit is best followed with the “2 minutes to test.” This video can be found in the communication sections tab. This keeps you and your patient focused on why they are there.

        As far as the rest of the visit goes, follow the ID tests as laid out in the Level material. What’s the patient diagnosis, what’s the worst test, what’s the most relevant tissue to fix that test (if it is a reducible pathology). Stay with that until the test is full or plateaued, then move on. Seems simple when written out but as we all know it’s tough to maintain laser focus.

        Last tip/trick is to get to as many hands-on seminars as possible. Here you will hone your testing and treatment skills. The more focused you are here, the less likely patients can distract you and you get better results. This results in happier and healthier patients! Win all around. Look forward to seeing you soon!


        Danielle Hommer, DC

          I second the 2 minutes to test video but also the case study videos. Case study videos put you in the room with Dr. Brady and see how he handles redirecting patients when they trail off and keeping things concise. As Carl said all of the above is simpler in theory than nailing all facets upon implementation but all you can do is get better each visit.

          The thing that helped me the most was qualifying the complaint. Instead of ‘How have you been doing since last visit?’ you lead them with ‘How has your low back been doing since last visit?’ The former will give you more information than you need/want about their dog, the weather and/or new complaints. The latter focuses the patient in on their symptoms. So try implementing that on every visit next week and it’ll soon become a habit.


          Russell Jensen

            Thanks for your responses guys.

            I like that idea with the case study vids. I didn’t particular attention to the communication aspects of those videos on my most recent viewings, too busy learning the diagnostic aspects. I’ll go back and check them out now.

            Side question: When it comes to asking “How is your X-body part going?” visit to visit, how do you handle the way the question focuses them on symptoms without focusing too hard on pain as a gauge for improvement?



            Adam Holen D.C.

              The case study videos are a great reference, but Dr. Brady is continuously refining the material so a lot of the protocols used in the case studies are out-dated. For example, the knee case study: treating the medial insertion points of the adductors (sartorius, gracilis, etc) are not utilized. I’d recommend watching the case study videos as more of a communication and case management aspect. Not that there isn’t value in the treatment, but it’s best to focus on the most up to date version of the ID protocols when it comes to treatment.

              As for asking the patient “how has x body part been since last visit?” This is done to keep them focused on the task at hand and give you a chronological idea of what happened between visits. For example, if they say it’s really bad or flared up, that gives you an indication to ask about their load factors since the last visit (they likely did something to flare it up). Then you can use this information to educate them that what they did was too much load for their body part to handle and to dial it back (healing environment).

              Patient’s are focused on their pain/symptoms, so sometimes (especially starting out), it takes several visits to make a significant change in both function and symptoms. You can relay this to the patient in terms of unlayering their problem: “You’ve had this problem for years and we’re making great progress chipping away at the adhesion. As we improve your function, your symptoms should reduce more.”

              We also need to reality match the response to treatment with the diagnosis. Usually visit 2-3 and on I’ll ask “what % better would you say your problem is?” to gauge response to treatment. If you’re making big changes to their function (say 60-70% improvement), but their symptoms are only 10-20% better, this keys you into something more. Think about damage/degeneration playing a bigger role in their problem than you initially diagnosed or that their symptom threshold has been altered (more load, metabolic issues, red flags, etc). Hope this helps and welcome to the ID community!


              Seth Schultz, DC

                I always review their chart, specifically any provocative movements/positions. Then I’ll ask if those have changed since last treatment. For example, if sitting causes tingling symptoms after 15 minutes. I’ll ask “how has the tingling been doing while your sitting?” Sometimes they won’t really know the answer, which is a good sign as it hasn’t been at the top of their mind. I ask about their most provocative test and then dive deeper if I want to collect more data.


                Russell Jensen

                  Thanks guys,

                  I really like what you said, Adam, about reality matching. and directly asking what % improved they think they are. It is something I don’t do enough of.

                  I also like what you said Seth about checking and asking about their provocative movements. Such simple advice but potentially game changing. Much appreciated.

                  I have had trouble keeping succinct notes in the past and I think that has held me back from asking those specific and direct questions because my notes weren’t prompting me.

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