by John V. Guiliana, DPM, MS
Hackettstown, New Jersey

Well, you made it. You have successfully completed both medical school and residency. The time that you have been longing for is finally here. You are now practicing medicine.

Have you ever wondered why we call it "practicing" medicine? If so, I'm going to let you in on a little secret - it's because none of us ever get it 100% right. That's right…it's an imperfect art and science.

Now that you are a doctor, in order to get it as close to 100% right as you can, you must transform from a doctor to a "caregiver". Caregivers get it almost right. What's the difference between a doctor and a caregiver? Caregivers have the fundamental capability of getting their patients to do what's best for them. In a single word…they get them to "comply". Caregivers are often hugely successful physicians, both professionally and financially.

Having years of accumulated knowledge stored up inside of your head is worthless unless you can persuade patients to do what's best. The art of persuasion is a critical component to the art of medicine, yet many doctors fail at it.

As physicians, we often become very frustrated with non compliant patients. Noncompliance is estimated to cost our nation's healthcare system over 100 billion dollars annually! Yet the blame for most noncompliance can be placed squarely on the shoulders of doctors. That's why I want to see you become caregivers.

As you read about the 7 rules to the art of persuasion that I will be teaching you in the next 6 editions of New Docs on the Block, be careful not to confuse them with "manipulation". The two are polar opposites. Only persuasion involves getting someone to do what's best for THEM while manipulation often involves self serving purposes.

As I look back 20 years to when I was a new practitioner, I would have better understood what care giving is all about if someone broke it down into easy to understand rules that I could follow. After all, rules make things so much easier.

Well here they are…my rules (borrowed and modified from popular techniques of selling):

1. The Rule of Listening

2. The Rule of Decisiveness

3. The Rule of Association

4. The Rule of Contrast

5. The Rule of Objectiveness

6. The Two-by-Four Rule

7. U.P.O.D.

Each of these rules will be highlighted separately in upcoming editions of New Docs on the Block. For now, let's start with the first one…listening.

The Rule of Listening

Listen to your patients carefully. You should not only hear their words, but you should try to hear the emotions that their words carry. Capturing this is the essence of "empathy". Being able to reflect the patient's emotion back to them in the form of paraphrases is the building blocks of a powerful bridge of credibility and trustworthiness needed for persuasion.

As humans, particularly educated ones, we have a strong desire to impart information. This desire often conflicts with this first very important rule. Speaking (imparting information) is easy. Listening is not.

Active listening begins with good body language. Position yourself in front of the patient at, or just slightly above eye level. If you are sitting, your hands should be in front of the plane of your body and your feet flat on the floor and not crossed. Lean slightly forward.

Eye contact is critical. Lack of it immediately sends a subliminal message of doubt to the patient. If you have difficulty maintaining eye contact, as some people do, practice on your friends and loved ones. It will soon become natural. Eye contact does not have to be continuous, just meaningful.

Ask patients "open ended" questions. This type of question cannot be answered with a simple "yes" or "no". As your patient verbalizes the answer, it becomes your job to LISTEN and try to craft a paraphrase that accurately interprets and reflects the patient's concerns. As you are actively LISTENING, give the patient periodic verbal and nonverbal acknowledgements such as affirmative head nods, "I see", etc.

Finally, deliver your paraphrase. Begin the paraphrase with "so that I can be sure that I understand this"…

You have just laid down the first building block of the strong bridge to trust and credibility!

Dr. Guiliana is a nationally recognized speaker and author on topics pertaining to medical practice management. He holds a Master's in Health Care Management and is a Fellow and Trustee of the American Academy of Podiatric Practice Management. He practices in Hackettstown, New Jersey and can be reached at John@soshms.com