From: Alan Moran

Good start. Remembering the details now is the issue …

I'd like to see more about the yes-butters. I feel the commonest problems for GPs are the 'mind readers', the 'fortune tellers' (always pessimistic) and the 'amateur doctors'. I am getting a Google University certificate for my wall and will ask patients what kind of qualification they think I should have. Looking forward to trying this at work.

Thank you, and be reassured that remembering the details comes with practice. A Medical NLP Workbook, designed to facilitate this process, will be available soon. Meanwhile,

practising just one skill set at a time reduces pressure and speeds up the learning process.

As for the ‘amateur doctors’ you refer to, we often hear complaints about patients who turn up with masses of notes gleaned from the Internet (together with some pretty fixed opinions about their condition). They are generally perceived as heartsinks. But, perhaps it would be better to reframe them as collaborators in the clinical process, rather than passive recipients of the doctor’s wisdom. This is at the heart of the Ko Mei principle underlying Medical NLP – cooperating to bring about change - which has been found to facilitate, rather than impede, the consultation process.

Until the advent of the Internet, doctors functioned as a kind of guild, applying knowledge so arcane that the patient was discouraged from knowing about the functions of even his own body, hence the use of Latin and coded commentaries. Now, however, that information is available to anyone who has the patience to look for it.

Our belief is that health practitioners who wish to integrate smoothly into the new world of 'information democracy' may need to act as filters for their patients, encouraging the mutual search for knowledge, but guiding the patient through the maze of information to select the most useful and appropriate data.

We would need some examples of mind-reading in order to suggest an approach, but, as a rule, aim to restore deleted information from the exchange. “How do you know that?” is an excellent question, but should only be used where strong rapport has been established.This approach can sometimes also be used with pessimists.

Remember that when people answer that they 'just know' something is the case, they are at the edge of their conscious model of their experience. They may argue to stay at this point simply because it seems safer than to acknowledge the yawning chasm of not-knowing. However, Rule One of Medical NLP is for the practitioner to help reduce the patient's allostatic load. How? By pacing the patient's concerns, then gradually becoming very calm and measured himself. This is essential to the process. If the patient is in limbic hang-up (the 'rational' forebrain shutting down and the reactive hindbrain taking charge), he will simply not be able to process anything you are saying, however wise and knowledgeable that may be.

We will return to the subject of yes-butters in Part 2 of the Helping the Heartsink thread.

Let us know how the Google Certificate works out for you.  We are told Google is now the most used reference tool of doctors in both the UK and the USA, so maybe you’re on to something.

GT/KK