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Yes, Where Do I Start?

Important Advice for Functional Health Patients

There is one key strategy you can use, as a functional health patient, to make visits with your clinician more efficient and effective.  Let’s discuss.

Dr. R’s Fast Facts
  • The goal should not be to use every single minute of the visit asking questions.
    • The goal SHOULD be to use a little time asking the MOST important questions and then leaving time for your doctor or clinician to have a discussion with you. This will optimize your visit.
  • Do an 80/20 analysis – Consolidate your questions to the top 20%.
  • This helps the clinician have time to ruminate on the information and ask follow up questions that will help you.

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Dr. Michael Ruscio: Hey, everyone. This is Dr. Ruscio, DC, with some advice for functional health patients. So if you’re a patient working with a functional health practitioner, there’s one piece of advice I’d like to give you that I think will be very helpful. And that is regarding questions. And here’s a little bit of context. And bear with me as I try to explain this.

I think on the patient end it’s maybe a good feeling to say, “I walked into that visit, I asked every question that I had, and I used every minute that was available with a doctor or with a clinician.” I can understand how that would, from the patient perspective, seem like the way to go.

However, that actually may not be an optimum strategy. And what I’d recommend you do instead—and I’ll explain why in a moment—is take a deep breath before your visit. Look at the questions that you have and do a Pareto analysis. The Pareto principle is essentially the 80/20 principle that 80% of the value usually lies in 20% of X.

And I would focus on the 20% of your questions that are the most important. So consolidate your question list down to 20% of the most important and ask those. And the reason for this is because it’s very important on the clinician end that there’s a little bit of free time before the next visit to be able to look through their chart notes, reflect, and think on your case.

So while it may seem helpful or it may seem like the best strategy to use every minute you can with your clinician, it’s important not to be too demanding in terms of how much time you use and try to be efficient. Really, this comes down to efficiency. Trying to be efficient in asking the most important questions and then leaving your clinician some time at the end of your visit while the information is fresh to ruminate on what you’ve said, the responses that have been given, look at the chart notes, look at the different hypotheses he or she is trying to develop, organize everything, and keep good notes.

And if you’re trying to use every minute of the time that you have allocated or squeeze in every question, what you actually do is you force the provider to take that time to ruminate, think on your case, update their notes—you force them to do that in a more condensed time window which is not the best position to be in.

And while no clinician ever wants to rush, the more time you use, the more you push a clinician to not having as much time as they may feel to be ideal. And here’s another way of thinking about this. In case it’s counterintuitive for you to consolidate to the 20% of the most important questions, think about it in reverse. If you went to see your provider and they had you fill out a 20-page questionnaire, but another provider was really able to consolidate that down to the most important and effective questions—the quality of the care was still the same, but they were able to consolidate that down to a six-page questionnaire that really focused on the most important items. Wouldn’t you prefer that?

Or another way of thinking about this is if a provider was going to have you do thousands of dollars’ worth of lab tests or another provider was going to say, “What are really the most important and most critical tests to get this patient feeling better?” And focused on that 20%. Wouldn’t you be grateful?

So something that I think a lot of—I don’t think. I hear this in conversation with other providers. They wish they had more time at the end of their visits to sit with the information for a patient’s case. So one of the things you can do to help give your provider a little bit of extra time to really think on your case and sit with that information and figure things out is not to try to use up every single minute in your visit. Try to consolidate to the questions that are the most important to allow he or she a little bit of extra time to really sit with the information and try to be as effective for you as they can. Because a little bit of time to think can go a long, long way.

So while it may seem counterintuitive, again, what I would recommend you do is before a visit, if you have lots of questions, look at your list and consolidate to the 20% that you feel to be the most important. And I think that will actually end up being a method that gets you to feeling optimal more quickly.

So just a thought there, and I’m certainly open to thoughts or comments if people have them. And this is Dr. Ruscio, DC, and hopefully this information helps you get healthy and get back to your life. Thanks.

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