SESSION #3 COMMUNICATING RESULTS & SEQUENCING PROTOCOLS Dr. Daniel Kalish
SESSION 3: COMMUNICATING RESULTS & SEQUENCING PROTOCOLS Patient education and patient communication are the main drivers of every successful practice and while some of us are natural great communicators many of us need to learn these skills. Today will cover communicating effectively with patients and how you can hone these skills yourself. How to interpret labs and explain test results to patients Sequencing treatment plans based on clinical findings and patient goals How to improve compliance by developing patient communication skills
COMMUNICATION SKILLS DEVELOPMENT Some people naturally have excellent communication skills For the rest of us we need to practice and learn how to do this intentionally, it s a skill you can learn! Patient communication skills are the main driver of income and sales Patient education leads to better compliance, better clinical results and ultimately drives referrals Patient communication is the key skill set in mastering the fundamentals of functional medicine
CONDUCTING PATIENT INTERVIEWS STEP 1 STEP 2 STEP 3 STEP 4 STEP 5 STEP 6 Get Situated Establish Rapport Determine Top 3 Complaints Explain Lab Testing & Logistics How to Sell Labs Communicate Results & Administer Protocols
STEP ONE: GET SITUATED Five minutes or less: 1-2 minute chit-chat, how are you, here s a little about my background Ask who referred them make comment about the person who referred them - Did X tell you about my program/what I do? Categorize and track each new patient by who referred them end of each week send thank you cards to patients for referrals Describe what functional medicine is to your patients Differentiating from typical medical system of symptom oriented treatment vs. determining underlying cause
10-15 minutes: STEP TWO: ESTABLISH RAPPORT Ask when did all these problems start? Childhood? Teens? 20 s? college? Find the one that goes back farthest keep digging You may need to ask this question in slightly different ways five or six times until you get accurate answer giving them time to process and think back on their lives Next, ask what else was going on in your life at that time? Ask social readjustment questions back when you first developed this problem, was there a divorce, new job, death, birth, move you ll find significant period of emotional stress coupled with health event By the end of this process, you should have discovered something new that no other practitioner knows and that the patient probably never thought of themselves It is important to remember you are building rapport to access accurate and often suppressed information, not to build up a friendship network #1 rule of sales is people will make the decision to purchase the lab kits based on emotion and will use logic later to rationalize the decision
STEP 3: DETERMINE TOP 3 COMPLAINTS 10-15 minutes: Look at chief complaints and make comments about top 3 complaints Ask probing, detailed questions, let the patient do most of the talking Figure out when their chief complaints first started, even if this was in childhood Figure out what else was going on in their life around the time their chief complaints started, i.e., " my sister died when I was 17 and when I was 18 my hormone problems started" or "ever since I was in college I..." you are looking for the "ever since I was in Mexico..." or any "ever since I was..." life event If you can't figure out the origin of the problem easily, start making guesses using your intuition, if that fails you don t worry, just go on to the next step and try again with your next patient
STEP FOUR: EXPLAIN LAB TESTING AND LOGISTICS 10 minutes: Relate health conditions to the lab tests using the 3 Body Systems model
10 minutes: STEP FIVE: HOW TO SELL LABS Here s an example of how I sell labs for an overweight patient using the Condition-Description Technique: Hormonal Balancing your hormones that control blood sugar is absolutely essential to lose weight and keep weight off in a healthy manner. Most weight loss programs that ignore blood sugar control have only temporary benefits. Digestive The inability to digest and absorb nutrients leads to food cravings and overeating. Pancreatic enzyme deficiencies, hydrochloric acid deficiencies and gall bladder dysfunction are all common causes of poor digestion and absorption of nutrients. With poor absorption you will overeat until your basic nutrient requirements for protein, fats, vitamins and minerals are met. Untreated yeast overgrowth, often referred to as candidiasis, is a common root cause of weight gain. Any significant disruption in mucosal immune function will trigger yeast overgrowth. This leads to the excessive consumption of carbohydrates and sweets and undesired weight gain. Detoxification People who have chemical toxicity will hold excessive fluid in the body in an attempt to buffer the harmful effects of the harmful substances. This results in weight gain due to bloating and fluid retention that is often mistaken for fat.
SPEAK THE PATIENT S LANGUAGE Translate their language of symptoms and complaints, using the Kalish Method Treatment Model: Underlying causes of Health Issues Physiological Damage Problems with the three body systems Ultimately resulting in their symptoms The key to patient compliance is creating scripts that link the symptoms your patients are experiencing - their language, the language of symptoms - with the underlying causes
KALISH METHOD TREATMENT MODEL Underlying Cause Physiological Damage Body Systems Symptoms Emotional/spiritual (trauma/abuse/chronic stress/addiction) Dietary (blood sugar, poor diet, nutrient deficiencies, dairy, food allergies) Gluten Inflammation Catabolic Physiology Insulin Resistance Oxidative Stress Neuroendocrine GI Liver Weight gain Fatigue Depression Anxiety GI problems (gas, bloating, constipation, diarrhea, heartburn) GI infections Toxins (heavy metals, chemicals) Genetics/Epigenetics Structural (physical trauma, chronic injury, pain, posture) Sleep Exercise Medications/surgery Dental Lyme, mold, viral or bacterial (SIBO, environmental exposure) Sex hormone imbalance (low sex drive, infertility, hot flashes, nightsweats, PMS, PCOS) Pain Allergies ADHD Insomnia Brain fog Sugar cravings Skin problems Autoimmune
HEALTH PROGRAM DESIGN UNDERLYING CAUSE PHYSIOLOGICAL DAMAGE BODY SYSTEMS SYMPTOMS
STEP 6: COMMUNICATE RESULTS AND ADMINISTER PROTOCOLS Relate the need for a 3 to 6 month protocol to the symptoms and that a 1 month program won t change anything Tell the patient. What each supplement is for How it will help them Why the specific lab values indicate they need this specific protocol Explain the need for diet and lifestyle changes This is the real core of what we re doing
GI SYSTEM
STANDARD TREATMENT SEQUENCE NEUROENDOCRINE GI DETOX
PUTTING IT ALL TOGETHER- COMMUNICATE THE NEED FOR AN ADRENAL TEST Three sources of stress that cause adrenal fatigue: Emotional Dietary Inflammatory Three common symptoms of adrenal exhaustion: Weight gain Fatigue Depression The key to patient compliance is creating scripts that link the symptoms your patients are experiencing - their language, the language of symptoms - with adrenal exhaustion
PRESENTING ADRENAL LAB FINDINGS TO PATIENTS 1. Verify their top 3 complaints and orient your conversation to address the Big Five: fat, fatigued, depressed, female hormone problems and GI issues 2. Explain the 3 types of stress: emotional stress, dietary stress, pain and inflammatory stress 3. Explain the essential four-lifestyle factors: diet, exercise, stress reduction and sleep 4. Explain the place of supplement programs as essential to healing. 5. Let patients know it is a six to twelve month program and how important it is to follow through with the entire protocol and not just stop when they initially begin to feel better 6. Talk to patients about their main sources of stress
THE IMPORTANCE OF EDUCATION When you offer high quality patient education information you are in fact selling at the same time The Actual Clinical Process We specialize in patient education processes to teach patients about why protocols are important, but also how things work which leads ultimately to sales If you can t educate, you can t sell, and vice-versa