As much fun as it is to start fiddling with a new gadget right out of the box without looking at the manual, it’s nice to know there is a manual if I just can’t get the thing to do what I want.
Kids, though. Eesh. My wife and I are blessed with boys we can take just about anywhere, but there are still times they won’t do what we want. They draw on the wisdom of “Star Wars” to explain what’s wrong when the other one isn’t minding: “He has a bad motivator.” Indeed. And unlike an R2 unit, the boys didn’t come with manuals that say how we might get them moving.
Your doctor, it turns out, wishes you came with the same manual I want for my boys. She can tell you what’s dragging you down and how to fix it, but her success ultimately depends on what you do with that information. Doctors don’t have a manual to fix your bad motivator, but researchers might have recently worked out the table of contents. Reading it over, I think it’s the beginning of a universal manual to get anyone moving in the direction you need them to — as long as everyone involved shares values and agrees on the goal. Until they hit their teens (please, Lord, let it last past their tweens), that ought to apply to the boys my wife and I are raising.
Peer-reviewed journals being what they are, the study in the March/April edition of the Annals of Family Medicine carries the unwieldy title “Supporting Patient Behavior Change: Approaches Used by Primary Care Clinicians Whose Patients Have an Increase in Activation Levels.” But you and I can call it the motivator manual.
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The researchers discovered that the clinicians who were best at getting their patients to do what they should frequently used the same strategies.
And — surprise! — the ones who came up last had something in common, too. Let’s hear what one of those unmotivating doctors told the researchers and then move on to what works: “Sometimes you just keep reminding people, ‘You’re going to kill yourself this way. You gotta do something.’ ” Got it. Harping on consequences doesn’t work. The boys back up the study on that one, for what it’s worth.
So what works? The researchers say the keys are emphasizing patient ownership, partnering with patients, identifying small steps, scheduling frequent follow-ups and showing care. Drop a couple of “patients” and I’m pretty sure they’re talking to all of us.
One doctor told the researchers she emphasizes ownership by telling her patients, “I’m here to coach you, not to make you better. You make yourself better. I can’t do that for you.” Me, I’ve been letting my boys know that my wife and I, our church, Cub Scouts, all their aunts and uncles and grandparents, we’re all working hard to be their coaches who show them the best path to the best lives we know how. Whether they actually become the good men we’re coaching them to be, though, is up to them.
The successful doctors got patients to join them as partners by asking their opinions on the best way to work together. As one pointed out, they don’t know much about their patients outside the clinic — just like I know less and less about my boys’ interactions at school the older they get. I need to ask them more about how they resist temptations to stray off the path.
The good doctors also cheer their patients’ small steps toward success. You cut down on smoking, Mr. Rodriguez? Hooray! You stepped over that heap of Lego bricks to put away your clothes, little guy? That’s a pretty good start on cleaning your room!
Scheduling frequent follow-ups, that’s easy. The boys are constantly around (please let that last past the tweens, too), and I bet they’ll be happy to hear those cheers.
Which bring us to showing that we care. That’s easy with the boys. They’re some of my favorite people.
I think that last step is the key to getting this motivator manual to work everywhere in the communities that we want so badly to improve. If our neighbors, the folks at the office and people we hope to influence all over the country believe that we care enough to want them to share the fruits of change with us, they’re much more likely to listen with open minds.
One of the successful doctors said his female patients tell him that because they know he really cares about their health, he’s the only man who can tell them they’re fat and still see them again.
An instruction manual that nails that is worth reading.
Richard Espinoza is a former editor of the Johnson County Neighborhood News. You can reach him at firstname.lastname@example.org.