What did that feel like when you did it?

Jack Holroyde joins me to talk about bringing your whole self to your practice of healthcare.

Jack and I talk about

- The concept of professionalism constraining our ability to help someone

- Communicating effectively instead of clinically

- Appreciating the gravity of our patient's experience in what we might find a mundane interaction

- The identity we are assuming, and whether that serves us

- Recognising that we are full of shit a lot of the time, and how to become more comfortable with that.

- Challenging long held biases

Connect with Jack on Twitter https://twitter.com/jack_holroyde

We can “fix” their problem AND not actually improve their lives or their health. BUT if we understand what matters to them then we are better able to fix their problem in a way that not only improves their health, but also improves their lives.

I’m joined by Eva Villalba for a conversation all about values based healthcare. We chat through

What is values based Healthcare?

The traditional ways we have been measuring healthcare and why they are outdated now

Providing healthcare through a broad lens

When and where the best place is to have a values led conversation

What it’s like as a patient not having your values taken into account

Giving information so people know what to expect and can plan for it

Giving people the tools to make informed decisions

Predicting and preventing future challenges from occurring

Why patients often don’t realise that they can talk about things other than their problem

Why Values based care is great for healthcare providers as well as patients

Why Values based conversations are important to continue over the whole course of treatment

How we can measure values based care

Why you shouldn’t measure what you are not going to change

How we develop patient partnerships at a micro, macro and meso level

I’m joined by Grant Downie OBE, medical and performance specialist consultant. He is also a physiotherapist and mentor for people wanting to improve their leadership and communication skills.

Today we talk through

• Every day is a school day
• Broadening our experiences through learning about others
• Learning for curiosity NOT perfection
• Advancing our learning past the fear of getting thring wrong
• Pushing the boundaries and waiting for the science to catch up
• Using scientific principles AND remember you are an artist
• Why Grant has never treated an injury in his life
• The art of changing the metaphor
• Not using belittling language
• Broadening our vision of the person past the pathology
• Developing our emotional intelligence
• Seeking help ourselves
• Trying to solve problems we need to learn how to manage instead
• Showing your own vulnerabilities
• Not telling people how to see the world, but trying to understand how they see it
• Understanding your strengths and working on them
• Creating personal development plans as well as professional development plans
• Figuring out how to treat the person opposite you the way they want to be treated

What’s shaped that evolution?

How do you try to consciously evolve your beliefs?

Do you spend too much attention on the doing side of health that you miss the being side of health?

Mark Stolow, CJO of Huddol had a deep conversation with me about these questions and many more. And don’t worry, it wasn’t just questions, he offered up some great practical ways that we can answer them in our own practice.

In this episode we talk through

Healthcare is the art of honouring our state of being in the world

Our evolving understanding of health at our individual level

Our evolving understanding of health at a collective level

Improving health through improving ability to make sense of the world

How health providers fit into the being side of health and the doing side of health

Moving out of an either or mindset in regards to health

Incorporating science into our broader understanding of the human experience

There is no singular healthcare truth

How to operate from an integral perspective in healthcare

Baking a healthcare cake

Letting go of old beliefs that are no longer helpful

Why we shouldn’t just try and build a better mousetrap

What is informing who I believe I am?

If you enjoyed this episode and want to dive deeper into learning these skills with likeminded health professionals then you’ll want to consider joining the Art of Healthcare Team

This episode’s guest is Danielle Blanch Hartigan, PhD, MPH who is social scientist with interdisciplinary research and teaching interests in psychology and public health. Her research, broadly defined, aims to understand how psychological constructs influence the powerful relationship between healthcare providers and patients to foster patient-centered care and to improve patient perceptions of their care.

Today we talk through

• What empathy is in clinical interactions
• How empathy shows up for different participants of the healthcare interaction
• How we define empathy
• Why we shouldn’t use the term “soft skills”
• Empathy and non-verbal communication are “hard skills”
• How the use of empathy is valuable for pain relief
• The behaviors we should be training to bring more empathy to our practice
• How non-verbal information is perceived
• How we use verbal and non-verbal information to make judgements about each other
• Why we should discuss non-verbal behavior with our patients, and why it doesn’t always matter if we get it wrong
• How we can get better at our non-verbal behaviors
• Why you should make a list of questions you can use to dig deeper
• Some of the communication challenges and opportunities that come with telemedicine

If you enjoyed this episode and want to dive deeper into learning these skills with likeminded health professionals then you’ll want to consider joining the Art of Healthcare Team

As healthcare providers we’re trained to solve problems. When it comes to person-centred care we typically focus on the wrong problems. We’re good at finding and addressing bio-medical and bio-mechanical problems. We’re even reasonable at identifying and addressing patient-centred problems. We haven’t been trained to look for problems at a person-centred level.

We need to be able to identify these person-centred problems in order to help deliver person-centred care. This podcast will help you do that.

It’s not the only way to improve your person-centred healthcare, it’s probably not the best way, but it is a way we can wrap our heads around so we can improve our ability to help people.

Just like athletic performance doesn’t just come down to how well the person catches, throws, or passes. Healthcare performance isn’t just the technical skills that we’ve learned, it goes so far beyond that. It’s the way that we prepare and show up to deliver our care.

I’m joined by David Clancy, a father and husband, and also physiotherapist to multiple high performance athletes and host of the fantastic “Sleep, Eat, Perform, Repeat” podcast, to talk through the traits we should be looking to develop to be high performers in the healthcare world.

We talk through

• The three traits high performers share
• How to develop these traits
• Trainable practices for developing curiosity, presence, and a learning mindset
• Where ego serves us and where it impedes us
• How we can range out from our profession

Two questions that this week’s guest Ben Darlow has been pondering for quite some time. How do we as health professionals help people make sense of their health, all the health information that is out there, and hopefully nudge them towards healthier behaviours in the long run.

Today we talk through

• The spectrum of beliefs
• When rules around healthcare are helpful, and when (most of the time) they’re not
• Going from population based health information to applying it at an individual level
• Exploring health beliefs – our patient’s and our own
• Some of the beliefs that get in the way of recovery
• Equipping someone to make their own @rules@ about health
• “Some of it’ll be in your body. Some of it will be in your head. Some of it will be in your world. Some of it will be in your past. Some, it will be a future”
• Creating a safe container for sharing healthcare information
• Co-creating frameworks for patients to experience their recovery through
• How a biomedical orientation and fear avoidance go hand in hand
• How we can go about challenging our own biases
• Why it’s vital we adopt a scientific mindset towards our practice
• How we can get better at dealing with uncertain healthcare situations

As health professionals we learn the “health” side of healthcare from textbooks, and lectures, and reviewed practice. BUT has anyone ever taught you the Care side? Or has it just been assumed that you have it, or worse, not considered at all?

I’m joined by Ben Lynch of Clinic Mastery to talk about how we can practically work on the Care component of our practice. It’s not easy, but it pays dividends, for the people we serve, ourselves, and for the businesses we work in.

Today we talk through

• The ACT of caring
• frameworks for caring
• Helping our patients feel safe
• Empathy mapping
• Learning how to care
• Understanding how we want our patients to feel, then creating the conditions to achieve that
• Mapping out a journey of care
• How healthcare leaders can develop their people
• Why it’s important you care for your team as well as caring for your patients

There are a variety of reasons these beliefs exist. AND part of our role as health providers is to challenge these without destroying the therapeutic relationship we have with this person, because if we do that then we lose the change to help and may have created another nocebo belief in the process.

Find out how to nudge that belief gently.

For more information on the Art of Healthcare team and to jump on board head to https://team.artofhealthcare.nz/

I’m joined by Sarah Morse to understand what Modern Slavery is, and how we as healthcare providers might come across it. And it’s not just your boss being a dick and asking you to stay late repeatedly.

Today we talk through;

What modern slavery is

Where we see it in healthcare

The symptoms to look for

How to respond appropriately

That the human side of healthcare is where we all start from

Empowering people to take action when they feel ready to

Understanding context but not forcing your support onto your patient

Should Healthcare be high performance?…… Most of the time

What do you think about when you think about high performance healthcare?

If you’re anything like the me who started out their healthcare career the first thing that pops to mind is probably a really high level of clinical skills. If I’m being honest it’s still often the thing that pops into my mind first because of the way the health system conditions us.

Clinical skills are important but Liam Caswell joins us to discuss why you’ll never attain high performance if that’s all you focus on, and where true high performance comes from. The answers might surprise you (but after you’ve heard them you’ll probably say “Oh yeah, that makes sense”).

This conversation covers a range of topics including

• Why we need support to achieve high performance
• How great healthcare teamwork is an art
• Where social programming in healthcare holds us back
• Searching for our clinical identity
• The importance of doing the inner work
• Looking after our mental health
• The power of hugs
• Creating psychologically safe workspaces
• Stepping into leadership positions
• What hold us back from seeking out leadership positions
• Why we shouldn’t focus on the How
• Collecting all the certificates
• Why it’s dangerous to stay in our comfort zones

Less often than we should I’d wager. Both at the individual interaction level and across the wider health system. We’re the experts right? What we think is best, is probably best isn’t it?

But health outcomes are getting worse, and the number of people suffering persistent health challenges seems to be exponentially increasing.

Pete Moore, creator and coach of the Pain toolkit joins us to talk about supported self-management, and where we can bring the most value to the lives of our patients.

Today we talk through

• What is supported self management?
• Why healthcare systems and teams need to include people with lived experience
• Where healthcare professionals can bring the most value
• Where healthcare professionals think they bring value – but actually don’t
• What we get wrong
• Why operating as a team is so important
• Why healthcare systems need to focus on the upstream causes
• How some healthcare providers make everyone else’s’ job harder
• Why the self-management conversation needs to start on day 1

https://www.paintoolkit.org/

What does that mean? And how do we do it?

It involves having some clinical bravery.

Bravery to understand the philosophy of how we practice and stay true to it.

Bravery relinquish clinical control to others

Bravery to continually reflect on how we could do better

Bravery to consider that we aren't the expert in this situation

Claire Killingback (amazing physio name) joins us to discuss how she is shaping the physios of the future to practice this way, and how we can do it too.

In this chat we talk through;

• Setting up university physiotherapy program for physios of the future
• The philosophy of person centered care
• How person centered care is different from patient centered care
• Clinical bravery
• The role of systems and environments in shaping care
• The continuum of person centered practice
• Learning when to stop people
• Assessing as a narrative as opposed to a list
• The philisophical underpinnings of how you want to practice
• Using your philosophy to shape your career path
• Reconceptualising physiotherapy identities
• Letting go of control
• Understanding who the expert is
• Physiosplaining
• Reflecting on our practice

BUT

How do we actually do that?

Dr Laura Rock joins the podcast to have a conversation about empathy in real clinical practice.

We talk through

• The power of stories for teaching
• The importance of listening to patient stories
• Why we should pay attention to the "small" stuff
• Reflective writing
• Training to look at problems from more than one perspective
• Why we shouldn't be afraid of people crying
• The reasons emotions are scary for health professionals
• The problem with suppressing emotions
• Understanding how we add emotional load to patients
• The GIVE framework for empathy
• The Ask - tell -ask framework for an empathetic response
• Expert parenting strategies
• How we can perform better as healthcare teams
• How we can communicate better as healthcare teams

We'd like to think that we're doing a good job of conveying information to everyone else who hasn't had the depth of learning we have. I'm sure a lot of the time we do a really good job, BUT can we actually be sure?

Jasmine Marcus is a journalist turned physical therapist who still remembers living life as an adult without knowing this stuff. She couples this with her communication expertise as a journalist and joins me on the podcast this week.

We talk through

• Understanding what it's like to be an adult not working in the health industry
• The challenges of not having something tangible to show for your work
• The value of recording and acknowledging your wins
• That it's normal to question our abilities
• Glorifying our ego by oversharing what we notice is "abnormal"
• Why we should normalize "abnormal" findings
• How to shift the direction of dominant narratives
• Why you should question what you take for granted
• Trying to make yourself more skeptical
• How to challenge nocebo effects
• The power of celery water
• Why you should consume professional education on social media

Tyson Franklin joins me to discuss why we need both (and how they can fit together) in order to be practicing at the top of our game.

Today we talk through

• How everyone has a creative streak
• How to cultivate your creativity 
• The role creativity plays in communication 
• Why you should seek out new experiences outside your profession 
• Brain books
• Creating a disaster folder
• Bringing a buffer zone into your day
• Using the concept your future self effectively 
• Preparing to be your best, in the worst situation
• The real reason Tyson has that ear ring 
• Bobcats fighting rattlesnakes 
• Everyone has a favourite super hero

One reason that healthcare doesn't adequately address many of the health challenges facing our societies at the moment is reductionist thinking (to not be reductionist here, there are also a lot of others).

Human beings are complex systems, living within complex systems and environments. Our symptoms are (sometimes) caused by a biological response, but the drivers for that biological response are often complex and varied. Reductionist thinking hits the biological response (which is helpful) but not the drivers of the response (which is not).

Alex Murray joins me for a conversation on Complex systems theory, non specific effects, practical stuff we can do with our patients in the face of these, and the bastardisation of the concept of the Art of Healthcare.

If we want to support healthier communities, then us as the health professional need to empower our patients to take control of their health, make the healthy choices, and live their healthy lives.

Jennifer George joins me to talk about how we can do that by entering into empowering patient partnerships.

We talk through;

Therapeutic relationships

How to create partnership

Engaging patients that are seeking for us to "fix" them

What happens when patients aren't empowered 

Flexing our empathy muscles

Why compassion, empathy, and communication are harder than a clinical skill, plus what to do about it

Why we need to believe in our patients

Yeah it is

AND

It's only harder in when you get started, once you get used to it, it's no harder than not personalizing the care you give. Plus you get better outcomes for your patients, and enjoy yourself more. 

Dr Nick Kimber joins me for a conversation about personalizing Healthcare. For our patients and clients.

We talk;

• Barriers to progress when care is not personalized
• Benefits of a personalized approach
• Some tips to begin to personalize your approach
• Becoming a key person in someone's life
• Why science is never 100% conclusive
• The problem with scientific theory when we don't extrapolate it out into practice

We can just keep giving. Giving to our patients, giving to our colleagues, giving to systems that haven't been fully set up to support us. Giving can feel good, we feel like we're doing something worthwhile.

BUT if we just keep giving without question where does that lead us? We follow a career progression not of our own choosing. We give to a system that isn't designed to value us. When one patient goes another comes in to take their place and we start over. We stop giving to ourselves.

Nurse Jacqui O'Connor joins me on the podcast to talk about how we can do healthcare more authentically.

We talk through

- Burnout

- Setting our values

- Learning the tools of boundaries

 - Rubbing off on others

- Moral injury in  healthcare

- Enabling the system not to change

- Shame and guilt in healthcare

- Shaping a career path that aligns with who you are

Often the pathology is straightforward but we just can't seem to be able to communicate with the person in a way that elicits a positive change.

My mate Heather Watson reckons that to improve that connection we need to be more vulnerable. She joins us today to talk about how to build vulnerability into our practice, and our lives.

We talk through

• What vulnerability is in a Healthcare interaction 
• What can happen when we practice with vulnerability 
• The barriers that pop up if we aren't vulnerable
• Fear of being wrong
• Fear of blame
• Iterative process in health improvement 
• Being creative and curious in practice
• Starting to understand yourself better
• Actually SEEING your patients and their challenges, not just their diagnosis

AND

A challenge for a lot of Healthcare professionals is that we don't understand the value that we deliver to our patients and clients. We undervalue ourselves, and in turn are undervalued by others - which makes us grumpy.

We all need to start to understand the value that we can provide to patients. This value isn't just in a monetary sense, although it's often easiest to think about it that way.

Victor Ahipene joins us to help us understand and articulate our value whether patients pay you, or you get funded by insurers or through the public system. It's great for us, and plays a huge role in how we connect with our patients and how we can assist them to get better.

We talk through

• Why being a "people person" isn't enough to really connect with a patient
• What primary rapport is, and what secondary rapport is
• Why you don't need to ask someone about their cat
• Different ways you can think about your value
• Why you're doing your patients a disservice if you don't value your skillset
• Why you are an "expert"
• How to set and meet expectations 
• Why practice doesn't actually make perfect

BUT can they be cured?

Travis Christofferson is a health researcher and author of "Tripping over the truth" "Ketones, the fourth fuel" and "Curable"

With that last title, Travis investigates some of the areas that are broken, and some of the ways we can "cure" the healthcare system.

Strap in as we chat through

- Why we get into trouble if we soley rely on intuition

- That we're not as rational as we think we are

- How bias shows up in our decision making

- The incentives we respond to, even when we think we aren't

- How we can apply checks and balances to our intuition going awry

- Capping the downside of health problems

- What best practice is and how we can find it

- Moneyballing Medicine

- Advanced healthcare for the future

- Solving Zebra problems

- DIY fecal transplants 

- And how to think differently for the greater good

In this conversation we talk about;

- trying to understand the health problem in the context of the patient's life

- making positive health impacts through opening up new health possibilities

- the conscious and unconscious limitations placed on us

- questioning what we were taught

- some of the barriers we face to doing great work

- learning from indigenous health practices

- the danger of people and systems who think the same way we do

Hope you enjoy

This week we're joined by Golnaz Tabibnia, an affective neuroscientist at UC Irvine studying self-regulation in adults and author of the fantastic paper "An affective neuroscience model of building resilience in adults" 

We'll chat through

- The simple three route model of building resilience in adulthood

- The neuroscience behind each of the pathways

- Examples of strategies that activate each of the pathways

- Why we should be attempting to cope, and the multiple benefits that has

- One of the ways that stress makes it harder to recover your health

- Why just doing one positive thing can have many benefits

- How to switch off your default mode network

- How to watch for hidden opportunities to build resilience

The full paper can be found here

https://www.sciencedirect.com/science/article/abs/pii/S0149763420304085

This is a problem for us Health professionals because we've been trained to only speak medicine. This can unwittingly lead to a disconnect between us and our patients making healthy progress so much more difficult.

We're joined by Rachel Callander to help us bridge this divide - and #hottip it's up to us to do it, NOT our patients.

Rachel is a sought after healthcare communication trainer and speaker who comes from a place of lived experience 

We cover off

- Why it's difficult for us to explain health concepts simply

- Untraining our learnings

- Identifying our fear in communication

- Communicating for understanding (our own and our patients)

- Communicating for progress

- How to shift from jargon to empowering communication

Here is what it's all about

Cheers

Chris