John V. Guiliana, DPM, MS. What Makes a GREAT Doctor?

John V. Guiliana, DPM, MS

What Makes a GREAT What Makes a GREAT Doctor?Doctor?

PersuasionPersuasion(Credibility + Trustworthiness(Credibility + Trustworthiness) )

credible personcredible person = = expert experienced, qualified, intelligent, skilled)

trustworthy trustworthy = = honest, fair, unselfish, caring).

It’s all in your presentation!It’s all in your presentation!

What the heck is he

talking about?

VerbalVerbal VocalVocal VisualVisual

The Elements of Communication

The non-verbal basicsThe non-verbal basics

Eye ContactEye Contact Body LanguageBody Language Listen!Listen!

THE “CONNECTION” THE “CONNECTION” BEGINS WITH BEGINS WITH

LISTENING SKILLSLISTENING SKILLS

ACTIVE VERSUS PASSIVE

GAINING EMPATHY GAINING EMPATHY THROUGH THE THROUGH THE

EFFECTIVE USE OF EFFECTIVE USE OF QUESTIONSQUESTIONS

OPEN ENDED VS CLOSED OPEN ENDED VS CLOSED ENDED QUESTIONSENDED QUESTIONS

“ “I HEAR YOU” FEEDBACKI HEAR YOU” FEEDBACK

I UNDERSTANDI UNDERSTAND I SEEI SEE UH-HUHUH-HUH HEAD NODSHEAD NODS PARAPHRASEPARAPHRASE

The VERBALThe VERBALCanned SpeechCanned Speech

Present from a “want” perspectivePresent from a “want” perspective

Not from a “need” perspective!Not from a “need” perspective!

Needs vsNeeds vsPossible WantsPossible Wants

Bunion surgery?Bunion surgery?

Orthotics?Orthotics?

P&A?P&A?

Shoe variety/comfort

Preclude the need for surgery

Eliminating the need for “bathroom surgery”

Say what it is…Say what it is…Not what it isn’t… Not what it isn’t…

DO NOT think of a white carnation!DO NOT think of a white carnation!

Speaking InfluentiallySpeaking Influentially

ToneTone PacePace VolumeVolume MirroringMirroring Law of DecisivenessLaw of Decisiveness Law of ContrastLaw of Contrast Law of AssociationLaw of Association

Be sure to answer:Be sure to answer:

What is it?What is it? Where did it come from?Where did it come from? What do we need to do about itWhat do we need to do about it

- Be verbally efficient- Be verbally efficient- Layperson’s term only!- Layperson’s term only!

The stories your are about to The stories your are about to hear are true…hear are true…

Disclaimer…

Maybe you need an orthoticMaybe you need an orthotic

It’s essential that we get you into a functional foot orthotic

MaybeMaybe you need an orthotic you need an orthotic

It’s essential that we get you into a functional foot orthotic

The orthotic will help support your The orthotic will help support your archarch

Your orthotic will control the mechanical weakness of your

foot

The orthotic will help The orthotic will help supportsupport your your archarch

Your orthotic will control the mechanical weakness of your

foot

I’m going to give you a DME I’m going to give you a DME product that will help product that will help

I’m going to prescribe a helpful device for you to wear

I’m going to I’m going to givegive you a you a DME DME product that will help product that will help

I’m going to prescribe a helpful device for you to wear

So this ligament is tight. A night So this ligament is tight. A night splint will be important here. Sue will splint will be important here. Sue will

be right in to dispense it.be right in to dispense it.

…in order to stretch the ligament during your sleep when it wants

to tighten up

…in order to stretch the ligament during your sleep when it wants

to tighten up

We need to use a device to We need to use a device to offload this ulceroffload this ulcer

In order to keep (get) this wound closed, we need to redistribute pressure

away from the area

We need to use a device to We need to use a device to offload offload this this ulcerulcer

In order to keep (get) this wound closed, we need to redistribute pressure

away from the area

Some examples of “canned speech”Some examples of “canned speech”

The orthotic is essential for your The orthotic is essential for your condition. It is designed to control condition. It is designed to control the mechanical instability of your the mechanical instability of your feet, much like eye glasses control feet, much like eye glasses control the instability or weakness in our the instability or weakness in our eyes. They often help prevent the eyes. They often help prevent the need for surgery…need for surgery…

The orthotic is The orthotic is essentialessential for your for your condition. It is designed to control condition. It is designed to control the mechanical instability of your the mechanical instability of your feet, much like eye glasses control feet, much like eye glasses control the instability or weakness in our the instability or weakness in our eyes. They often help prevent the eyes. They often help prevent the need for surgery…need for surgery…

The orthotic is essential for your The orthotic is essential for your condition. It is designed to control condition. It is designed to control the mechanical instability of your the mechanical instability of your feet, feet, much like eye glasses control much like eye glasses control the instability or weakness in our the instability or weakness in our eyes.eyes. They often help prevent the They often help prevent the need for surgery…need for surgery…

The orthotic is essential for your The orthotic is essential for your condition. It is designed to control condition. It is designed to control the mechanical instability of your the mechanical instability of your feet, much like eye glasses control feet, much like eye glasses control the instability or weakness in our the instability or weakness in our eyes. eyes. They often help prevent the They often help prevent the need for surgeryneed for surgery……

The ankle/ foot orthosis is crucial for The ankle/ foot orthosis is crucial for your healing. It is designed to your healing. It is designed to stabilize and rest the tendon when stabilize and rest the tendon when you walk. It will hopefully help you walk. It will hopefully help prevent the need for surgery prevent the need for surgery

When you sleep, your foot relaxes When you sleep, your foot relaxes and the ligament that we talked and the ligament that we talked about contracts. That’s why your first about contracts. That’s why your first few steps in the morning are the few steps in the morning are the most painful. A night splint is used to most painful. A night splint is used to stretch the ligament during your stretch the ligament during your sleep. sleep.

It’s crucial that you wear extra-depth It’s crucial that you wear extra-depth shoes that are designed to help shoes that are designed to help prevent diabetic foot complications. prevent diabetic foot complications. These are covered under Medicare These are covered under Medicare and you are entitled to one pair per and you are entitled to one pair per year. year.

Power WordsPower Words

ImportantImportant EssentialEssential CrucialCrucial CriticalCritical ImperativeImperative VitalVital

Be your patient’s physicianBe your patient’s physician

Thank You!Thank You!

Jguiliana@aappm.orgJguiliana@aappm.org