3 Ways to Help People Get the Most Out of Their Appointments
By Jay Faber, MD
In traditional medicine, outpatient visits to a doctor’s office have become quick 15-minute appointments, during which the patient quickly describes their symptoms, communicates any side effects from medications, and discusses how they are functioning. Following this supersonic chatter, the healthcare provider rapidly analyzes the situation, reviews labs, and then writes a prescription. The patient leaves the office and is told to return anywhere from 1-12 months later.
If the purpose of healthcare is to deliver a service that promotes, encourages, and inspires others to live life at a greater quality of life, how well is this system doing? Reframing this quandary another way, how effective is that 15-minute appointment in leading patients to invest the ensuing 525,600 minutes (1 year until the next doctor visit) toward health, energy, and vitality? Wouldn’t it make more sense to have appointments that lead to impact, change, and transformation?
As forward-thinking clinicians, you likely devote more time to the people you serve. But even if you dedicate more time to appointments and you see people on a more frequent basis—quarterly, monthly, or even weekly—you still need to think about what happens in between those visits. How can you find ways to optimize the health experience for your clients or patients to help them get the biggest “bang for the buck?”
Here are 3 important steps you can take to help promote wellness, longevity, and a higher quality of life between appointments.
1. Provide a well thought out post-visit wellness plan.
At the end of each appointment, give your clients or patients a follow-up plan (preferably a typed hard copy they can take with them and a follow-up email with the same information) of health-enhancing activities they can do between appointments. In my own practice, I make sure that each of my patients has an individualized plan that goes well beyond which medications to take in which dosages. Technological advancements with dictation make this step quick, realistic, and cost-effective for any clinician.
Encourage the people you help to keep their personalized “to-do lists” in an easily accessible place—on their computer, online calendar, or note-pad for frequent review. This greatly improves the likelihood that optimal change will occur
What should be included in this wellness plan? According to Dr. Catherine Pipas’ book a Doctor’s Dozen: Twelve Strategies for Personal Health and a Culture of Wellness, the overall concept of wellness encompasses contentment, living life to its fullest, energy, vitality, and vigorSpecifically, your wellness plan should incorporate recommendations that will help them enhance the following eight areas of their life:
- Physical—nutrition, nutritional supplements, and physical activity
- Intellectual—new learning and personal development
- Emotional—relaxation and mindfulness
- Spiritual—finding their purpose in life and developing a “secure” attachment to their creator (or to something greater than themselves)
- Social—having “secure” attachments to family and friends
- Environmental—creating an external environment that is aesthetic and internally pleasing
- Financial—having a sound financial plan that promotes staying out of debt
- Occupational—having work or volunteering (if retired) that is meaningful
To create these post-appointment wellness plans, start with a boilerplate version that would apply to most people. Then simply personalize the sections applicable to each client or patient. This guiding tool should provide concrete steps they can take in the months before their next visit.
2. Help the people you serve learn to develop new habits.
Giving people recommendations is a powerful first step, but getting them to turn those suggestions into daily habits can be challenging. Etched deeply into our brain’s programming, behavioral patterns have been ingrained, reinforced, and tenaciously embedded. In order to get engaged, remain motivated, and not quit, it is important to learn systems that promote new habits, healthy behaviors, and resilient change.
Here are six strategies detailed in the book Crucial Conversations that you can share with your clients or patients to help them move forward in the habit-making process:
- Apply incentives. Reward yourself after doing new behaviors
- Apply disincentives. For example, commit to donating money to a charity that you don’t like if you don’t act on your new behavior.
- Go public and tell others about your new habit.
- Remember your goal. Ignore the temptations and visualize what you are trying to attain.
- Think about adding health “things.” Put healthy things in your life to help you stay on track. For example, eat an apple before you splurge on that tempting bowl of ice cream.
For those interested in a deeper dive into this subject matter, The Power of Habit by Charles Duhigg offers great guidance to change unwanted tempting behaviors. As Aristotle stated centuries ago, “We are what we repeatedly do. Excellence, then, is not an act, but a habit.”
3. Help people develop a secure attachment to themself.
A secure attachment brings relief, calmness, and safety in times of distress. Rather than becoming anxious, avoidant, or outraged in times of uncertainty, a secure individual will lean towards love, comfort, and soothing to solve a dilemma, resolve a conflict, or face an area or shortcoming.
The concept of secure attachment has become a hot topic in recent years. Statistically, about 60% of individuals grew up with secure attachments As for the other 40%, individuals tend to be anxious, avoidant, or emotionally confused when dealing with intimacy and conflicts. Those who practice techniques to foster a secure attachment (with oneself and others) will be more likely to be successful, fulfilled, and content. Putting it another way, those with an insecure attachment style will be more likely to avoid, dismiss, or become so emotionally anguished that progress towards improvement stops!
Recently, I took a self-care class at George Washington University. During the 8-week course, we were required to journal on 3 areas of wellness that we committed to working on that week. Following 7 days, we were required to honestly review how we were doing in these areas.
During this review process, it was amazing how much “life” put obstacles in the way of staying on a plan that focused on health, wellness, and longevity. Time commitments, other priorities, and lack of motivation often led to specific areas of wellness not being addressed. In addition, one’s attachment style strongly influenced the degree and willingness to change.
By helping the people you serve to develop a secure attachment with oneself, an individual becomes much more resilient, open, and enthusiastic to look at these opportunities of change. A secure attachment involves a sense of self-acceptance, self-understanding, and self-forgiveness towards oneself. By guiding your clients and patients to a secure attachment, you will help make it much easier for them to take the time and energy needed to compassionately assess areas of their lives that need to change and actually have some fun while innovating their lives to reach their goals.
Making the Most of the In-Between
When I talk to my patients about their post-appointment wellness plan, I like to say that it’s like buying a car. When we drive off the lot, we know there are necessary steps we must and will take to make sure our vehicle stays “healthy.” We go to JiffyLube for tune-ups; we stop by Midas to get our brakes fixed, and we visit AutoZone to replace burned-out headlights. Instinctively and by habit, we do what is necessary in order to keep our vehicle working, fit, and functional. If we don’t, something will inevitably break, and we’ll get hit with a huge repair bill that is far more than what we would have spent on routine maintenance.
I encourage them to think about our appointment as one of those cars. They’re making an investment in their brain and body health, and it makes sense for them to do some maintenance in between appointments. Practicing mindfulness, reading a great book on purpose, journaling, eating one extra healthy meal per week (as opposed to getting more junk food), and taking a hike out in nature are affordable, cost-effective, brain-enhancing activities that help us think more clearly, feel calmer, and function more effectively. Then at their next appointment, ask them worked, what didn’t work, and what they can do before their next visit to make life their life a journey of constant everlasting improvement.
About the Author: Jay Faber, MD, Amen Clinics Los Angeles
Dr. Faber is double board-certified in Child/Adolescent and Adult Psychiatry by the American Board of Psychiatry and Neurology. In addition, he is a board-certified physician in Anti-aging and Regenerative Medicine, after completing a fellowship in metabolic medicine. Dr. Faber received his Bachelor of Arts degree in Biology at the University of St. Thomas in St. Paul, MN and an MD from the University of Minnesota. Dr. Faber completed his Residency in Adult Psychiatry and went on to receive a Fellowship in Child and Adolescent Psychiatry at the Harbor UCLA Medical Center in 1991 as well as a Fellowship in Forensic Psychiatry at USC Institute of Psychiatry and Law in 1995.