The PT Project » AdamBanks

Influence – how do you get compliance?

AdamBanks — Wed, 14 Sep 2011 22:43:30 +0000

Seems like patient compliance should be easier than it is; After all, patients seek you out for your advice, but why don’t they follow it?

Robert Cialdini, Regents’ Professor of Psychology and Marketing at Arizona State University and author of Influence: The Psychology of Persuasion and The Science of Compliance has studied the science of how to influence people. Medical providers can apply his principles to their practices, as this is what you’re actually trying to do in your practice, influence people to take your advice. Below are some of Cialdini’s suggestions applied to the practice of medicine.

Display Your Expertise on the Wall

Cialdini believes the principle of “authority” is the least-employed area of influence when it comes to medical practitioners. In a study performed on the physical therapy ward of a hospital, Cialdini found a surprising number of post-discharge stroke patients were not following through on their rehabilitation. The patients cited not knowing the expertise of the physical therapy staff as the number one reason they did not commit to therapy. After posting the therapist’s diplomas on their walls, Cialdini notes compliance jumped by more than 30%. Two simple things you can do to improve patient compliance is to hang your diploma on the wall and to wear a lab coat. This will make you appear more knowledgeable and professional, both of which will contribute to cultivating patient trust in your skills and abilities.

Tout Your Credentials

Cialdini states that touting your credentials is essential to establishing authority in the eyes of patients. One way to accomplish this is by writing a letter of introduction to patients that establishes your academic and professional experience. If this feels too forward, another good idea is to have a mutual contact praise your record for you.

Make Comparisons to Similar Patients

“Social proof” is the principle underscoring people’s tendency to follow the example set by others who are similar to them. For example, someone is more likely to commit to treatment when they understand that patients with the same condition have experienced a great deal of success on a certain regimen. This helps relieve the patient’s unease by letting them know they are safe in adhering to the prescribed care. As a result, compliance will most often increase.

Highlight Potential Downsides

Having trouble with patients not taking their rehab seriously? Then lay out what they stand to lose. Cialdini calls this the principle of “scarcity,” or the value people place on that which is rare. By highlighting the potential downsides to ignoring proper medical procedure, patients are more prone to recognizing the value behind what they have and respond by taking the necessary steps to keep it.

Be Likable

Do what you can to make the patient like you by pointing out shared similarities. This may be difficult given the amount of information you have about the patient. Termed “liking” by Cialdini, it means people are more apt to follow those who they like. By mentioning similarities between your lives and giving the patient genuine compliments, you can influence them to work with you on their treatment rather than against you.

Give Generously

A generous provider will invoke feelings of “reciprocity” in patients, says Cialdini. Reciprocity is the persuasive technique of gifting to others in order to instill a sense of repayment. In your practice, this means giving above and beyond the call of duty in the form of plentiful advice, dispensation of information, and undivided attention, among others. Cialdini warns not to reward behavior, however, but rather to initiate the giving ahead of client performance.

The Pen Is Mightier

Getting a client’s commitment in their own writing is one of the most powerful motivators a therapist can employ. Cialdini calls this “consistency,” and by drafting letters of intent and obtaining the patient’s signature for every phase of treatment, you stand a better chance of achieving higher levels of compliance. When the client puts into words their willingness to undergo care, the odds are better they will listen to themselves as a complement to the provider’s counsel.

Honing your skills of influencing can improve patient compliance, leading the patient to achieve the outcome that they sought you out for.

*The author, Adam Banks, studied effective leadership and Robert Caldini’s work while attending the University of Chicago Booth School of Business.

Contributor Paul Ochua in Men’s Journal

AdamBanks — Fri, 08 Jul 2011 03:44:36 +0000

Congrats to NY SportsMed PT Paul Ochoa for his mention in Men’s Journal.

NY SportsMed Helps Runners Avoid Injury With New Book

AdamBanks — Fri, 08 Jul 2011 03:15:44 +0000

Running. For some it is the means to a healthier body. For others, it is much more than that. Some runners hit the pavement to stay in shape, improve their heart health, relieve stress or lose weight. Others look at running as something they “should” do, but they just can’t quite figure out how to get started. Still others can’t imagine life without running – the act of running is a driving force in their life that provides euphoric happiness.

No matter what type of runner you are or may hope to be, however, one thing is clear – it is important for runners to know how to avoid injury.

The good news is that runners no longer need to search for information related to various aspects of running from a variety of sources, nor do they need to worry about whether the information they find is accurate and reliable. NYSM now has the info runners need, and has packaged it all in one convenient place. Their new book, titled Running Without Injury, is a collaboration between sports medicine specialist, Dr. Michael Neely, and physical therapist, Krista Simon, with added contributions from a number of physical therapists and staff members of NYSM. The book is geared to runners at every level, from those just looking to begin a running program to experienced competitive runners, and it provides loads of information that runners can use before, during and after they run.

Running Without Injury is intended to teach runners how to avoid injury, as well as how to improve performance. It includes a step-by-step guide geared to easing into a running routine, from getting ready to run by first obtaining a proper medical and biomechanical assessment and choosing the right running shoes to proper warm-ups and stretching, cross-training techniques, nutrition and hydration, clothing and other tips that can help runners remain healthy and injury-free. There is information for experienced runners interested in training for distance events and the book also addresses what to do for minor aches and discomfort that may occur when running so that full-blown injuries are less likely to occur. In the event that an injury does arise, there is even a section that helps runners deal with the emotional process of dealing with an injury.

Dr. Neely, Krista Simon and the various other contributors from NYSM were able to provide information related to the sport of running from varying perspectives. For one, they are experienced in the treatment of running injuries and have shared their medical expertise within the book. NYSM treats a wide variety of running injuries and we understand what causes injuries and how they can best be prevented. As an added bonus, both Dr. Neely and Krista are avid runners themselves, as are many of the other staff members of NYSM. They have competed in marathons and other distance events, and they understand the sport of running from a runner’s perspective, enhancing the level of information that they were able to provide to others engaged in the sport. Through this connection, the book better addresses the psychological aspects of running and the effect running injuries can have on an athlete.

Runners of all levels, as well as anyone interested in considering the sport of running, can obtain a copy of the Running Without Injury book absolutely free! Simply stop into any of NYSM’s three Manhattan locations to obtain your copy today. After reading the book, you should be able to lace up your sneakers with more confidence the next time you are ready to hit the ground running!

(If you would like to book shipped to you, please help us out and pay $10.00 for printing, shipping and handling, make a credit card payment here. In the comments section be sure to include your shipping address, the address associated with your card is NOT saved).

Jon Jezequel’s Follow up to CPM in “PT Products On-line”

AdamBanks — Sun, 19 Jun 2011 00:05:45 +0000

Jon’s follow up article on CPM has just been published on PT Products Online.

A little excerpt:

The indications for CPM are not so very different in the present as they were in 1970. They include total joint arthroplasties, articular cartilage defects, ligamentous reconstructions, osteoarthritis, release of contractures, intra-articular fractures, and reflex sympathetic dystrophy.^26,35 Since these indications were claimed, basic science and clinical research have built overlapping layers of ever-elucidating information to better focus and explain how, why, and when CPM is efficacious.

CPM can therefore be theoretically applied to and ameliorate any component of the human body that moves about. Motion is the operative term and common thread. For a basic science review, the reader is directed to the synthesis provided by O’Driscoll and Giori concerning the pathophysiology of joint stiffness, organized into four stages.²⁶ Paucity of supporting data and/or dubious clinical significance precludes some indications from further consideration at this time. General alterations in healing time frame, costs and convenience of physical therapy, use of pain medication, and physiological healing effect will be appraised.

Read the entire article here.

Tendinopathy Seminar: Forget the Recipes – Understand How to Rehabilitate Tendons

AdamBanks — Wed, 01 Jun 2011 22:38:47 +0000

This seminar covers tendon physiology and pathology, the response to load of normal and pathological tendon and will provide a clear understanding of the conceptual framework and key progression criteria from initial to end stage tendon rehabilitation. Dr. Malliaras will de-mystify eccentric training – you will clearly understand current evidence, it’s potential effects, when indicated, when it is not, and when it can be harmful.

The seminar will enable you to prescribe the right rehab program and other effective modalities, considering your patient’s irritability, pathology and functional ability.

Dr Malliaras manages approximately 300 Achilles and 200 patellar tendons every year, including premier league football and rugby players, elite tennis players, elite dancers.

Cost: $250

Date: Saturday, June 25, 9am – 5pm

Venue: NY Sports Med, New York, New York

Info and booking: contact Dustin on 212-750-1110 or dustin@nysportsmed.com

More Info about Peter:

Dr Peter Malliaras is a Senior Clinical Lecturer and leads the masters programme in Sport and Exercise Medicine at Barts and the London School of Medicine and Dentistry, Queen Mary University London. An experienced physiotherapist, Peter has worked with elite athletes at the Victorian Institute of Sport (Australia) as well as National and International level football, volleyball and basketball players and Olympic track and field athletes. He has toured with sports teams in Australia, Asia and Europe, including the Commonwealth Games (Melbourne, 2006) and World Weightlifting Championships (Thailand, 2007). A great clinical interest is the management of difficult tendinopathies in the upper and lower limb. Peter works in two multidisciplinary tendinopathy clinics alongside sports physicians and surgeons who all specialise in tendinopathy. In this capacity he often consults to elite athletes, including premier league and championship football players, elite rugby and tennis players, and any others who succumb to tendinopathy.

Tendinopathy is also Peter’s primary research focus. His PhD identified novel factors that may increase the risk of patellar tendinopathy. Recent research has included reviews and original research into the pathogenesis and management of Achilles, rotator cuff tendinopathy, and tennis elbow. His work has been published in peer reviewed international sports medicine journals, including the British and American Journal of Sports Medicine. Peter enjoys post-graduate lecturing and is a regular invited speaker at conferences.

Explain Pain: A two-day interactive seminar with Dr. David Butler

AdamBanks — Wed, 01 Jun 2011 19:28:39 +0000

The Explain Pain course is based on David Butler and Lorimer Moseley’s book of the same

name. Dr. David Butler will help you understand how the pain system works when there are

injured tissues and nerves, and what happens in the brain in relation to pain experiences.

You will also hear about the impact of stress in relation to pain. The seminar is delivered

in a way in which any professional working with patients or clients in pain can utilise.

Neuroscience can be fun. You’ll be introduced to the newest knowledge about pain

‘neurotags’, ‘brain ignition nodes’, zinging and zapping nerves, smudging in the brain

and backfiring nerves. You will learn about how the immune, sympathetic and cortisol

systems can be critical in pain experiences.

The provision of pain knowledge to patients is an effective evidence based treatment tool.

Patients can understand far more than most health professionals realise. The therapeutic

tools taught on this course are educating patients about how they can use their pain in an

effective way, even if it is ‘in their head’, graded exposure to stimuli which evoke pain and

also included are virtual body exercises – exercise your synapses not just your muscles.

Course aims

1. To expand the clinical framework of rehabilitation via the paradigms of neuromatrix

and pain mechanisms.

2. To teach biologically based pain management skills under a framework of the

sciences of clinical reasoning and evidence from clinical trials, neurobiology and

education research.

3. To reconceptualise pain in terms of modern neuroscience and philosophy.

4. To stimulate an urgent reappraisal of current thinking in rehabilitation, with benefits

for all stakeholders in clinical outcomes – the patient, the therapist, the referrer and

the payer.

5. To teach the core pain management skills of neuroscience education.

This course is open to: All professionals working with patients or clients in acute and

chronic pain and stress states, for example, physiotherapists, occupational therapists,

doctors, psychologists, rehabilitation counsellors.

Enhancing your course outcomes: A strength of the Explain Pain course is that

participants come from many professions, so come with an open mind.

Pre-reading the “Explain Pain” book would also be ideal.

New York, USA | 11-12 June 2011

Venue KIMA Center for Physiotherapy and Wellness

7 W 22nd Street, 8th floor, New York

Cost $600 per person

Cost includes light breakfast

and afternoon tea.

Host: Steven Lavender

stevenlavender1@yahoo.com.au

Fax 212.686.3107

Register your interest by contacting the

course host or by lodging an ‘Enquiry’ via

www.noigroup.com/courses

Dr David Butler (NOI) has an international reputation for innovative

clinical thinking, translation of basic science findings into real world

applications, and being able to communicate both like no-one else. He

is author of several books, including Mobilisation of the Nervous System,

The Sensitive Nervous System and Explain Pain. He has developed and

implemented pain science curricula for undergraduate and post-graduate

programmes, has taught over five thousand clinicians in 25 countries and

is also a regular keynote speaker at international clinical conferences.

David is also the driving force behind the innovative NOI 2012

Neurodynamics & the Neuromatrix Conference which is coming to

Adelaide in April 2012. Find all the information and register your interest

at www.noi2012.com