Finally Starting to Make a Connection

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By Stephanie LeGare

Consider this scenario: A mom comes in with a sparkling white cranial remolding helmet. There's no food mashed in the cheek extensions, no smell, no smudges. Not a particle of foam is disturbed within. The helmet is immaculate. Suspecting non-compliance, you probe with questioning:

"How many hours a day would you say your baby has been wearing the helmet?"

The answer: "Oh, full time of course, at least 22 or 23 hours a day."

You know from inspecting the helmet that it has barely been worn. You verify your suspicions once you place the helmet on the baby's head, take measurements, and see that the child's head has grown in all the directions you hoped it wouldn't.

You fix up the helmet, return it, and remind the mom that full-time wear is important for cranial remolding success. The mom agrees heartily and departs. Yet somehow, you feel like you failed to make a connection.

I have had the privilege of having many of the "firsts" in my residency during my first pregnancy. Unexpectedly, I have discovered that my little belly bump has become a way for me to connect on a more personal level with some of my patients and their parents. Parents will offer tips and tricks for managing a baby and encouragement about the joys and trials of raising children. Parents even seem more willing to share their troubles at home with orthotic devices, such as children undoing straps, babies fussing over helmets, and teenagers refusing to wear their braces.

So what is the difference between patients who stretch the truth and fail to reveal difficulties they have with their bracing and patients who openly share their trials? I think part of it is the "personal touch," or convincing your patients that in many ways you are just like them and won't judge them for their failings or difficulties when using the device you provided for them.

I've seen practitioners connect with patients through common interests such as a love of motorcycles or sports. Those simple openers appear to put the patient immediately at ease. This tactic seems to work especially well for inpatients, giving them an opportunity to take their mind off their pain and current situation, if only for a moment while you evaluate, measure, or fit a device.

Rather than starting appointments like an interrogation session, instead start by offering up information about yourself or an anecdote from your own life to make yourself appear more approachable. By doing this, you set up a reciprocal relationship, where, ideally, the patient will feel like he or she should offer a glimpse into his or her life as well. Our goal is to guide the conversation to yield an honest assessment of how the patient is coping in his orthosis or prosthesis. Many of the devices we provide rely on good compliance for optimal function, and it is our job to determine whether our patients are compliant. Furthermore, our ability to improve their experience often relies on how the patient responds.

Granted, learning how to open this dialogue is not always easy. I learned the value of more personal interaction through an unstated look into my life—through my pregnancy. It made it easy for my patients to ask questions about me. After I told them a little about my life, it was always easier to start a dialogue about how my patient was doing as well.

Surprisingly, this personal interaction could also help improve patient care. A patient may remember the connection and will lead the next appointment with the same topic. In return, it jogs your memory, helping you to recall what you evaluated and details about the patient's particular situation. Remembering will help guide you to check on any previous adjustments you made, ensuring that the adjustments continue to be sufficient.

It's easy to ask formulaic questions and deliver information robotically. Next time, share a point from your life—something your son, niece, or friend's kid did that reminded you of that exact moment. Make it a challenge to yourself to add a personal touch to your appointments. Maybe then you will find that both of you are enjoying the interaction, rather than feeling like you've failed to make a connection.

Stephanie LeGare is a graduate of the master of science in prosthetics and orthotics program at the Georgia Institute of Technology (Georgia Tech), Atlanta. She is a resident at the National Orthotics and Prosthetics Company (NOPCO), Boston, Massachusetts, and will be sharing her experiences as she completes her first year as an orthotics resident.