Clinical Communication

During the recording of “Clinical Communication” episodes, before guests are asked the deep hard questions, they’re given some easier warm up questions to start with to help them feel comfortable. These are also recorded though not released at the time, until now. Some of this content from earlier episodes has been released on social media, but others from recent episodes have been held onto for this special episode, where you will hear: (00:00) – Introduction (01:26) Jo Gibson: Which Rotator Cuff Muscle Is The Heaviest? How To Build Rapport With Scousers? (04:18) Nick Lividas: Weirdest Body Parts People Have Had Steroid Injections Weirdest Substances Being Injected Where Are We Currently With Stem Cells? (14:29) Ian Reilly: What Is The Future Of Podiatry? Orthotics in Podiatry Original Podiatric Theories Do In-Soles Have To Be Specially Made?   For more, find @BWhybrowPhysio across social media.   Got questions, dilemmas or stories? Send them in to clinicalcommunication@outlook.com

Many healthcare clinicians can probably identify a bunion or toe deformity, but asked anything more than this by patients and most would get stuck. So how do we explain what they are, why they’ve occurred and what the management options are in a way the patient can understand? How do foot surgeons have conversations around surgical options & expectations and explaining risks? In this episode Ben is joined by Ian Reilly, Consultant Podiatric Surgeon & International Lecturer, where they discuss: (00:00:00) – Introduction (00:00:46) – Dad Jokes (00:02:05) – How Romanian Christmas’s Compare To British (00:03:50) – What Made Ian Choose Podiatry & Podiatric Surgery? (00:07:08) – How To Explain What A Bunion Is To A Patient & Why They Have It (00:13:00) – When Surgery Doesn’t Always Go Well (00:17:38) – How To Discuss The Risks Of Foot Surgery (00:21:28) – Shared Decision Making & Informed Consent In Foot Surgery (00:25:20) – What To Say If They Ask “Will My Bunion Come Back After Surgery?” (00:28:07) – How To Manage Different Surgical Opinions (00:30:50) – What To Say If They Ask “How Can I Prevent This Bunion Coming Back?” (00:33:53) – How To Explain What A Hammer Toe Is To A Patient & Why They Have It (00:35:58) – What To Say If A Toe Deformity Is Asymptomatic? (00:39:12) – How To Discuss The Risks Of Toe Deformity Surgery (00:41:05) – How To Discuss Toe Amputations (00:51:28) – How Surgeon Communication Skills Have Changed Over The Years (00:56:10) – Does Better Surgeon-Patient Rapport Lead To Better Outcomes? (00:58:24) – How To Tell A Patient Surgery Isn’t Appropriate (01:02:31) – Always Find Out What Your Patient Wants (01:03:37) – Ian’s Hardest Conversation (01:12:01) – Ian’s Most Rewarding Surgical Outcomes (01:16:00) – Outro Discussion & Ian’s Courses You can find Ian on Social Media here: X/Twitter: @podsurgery Instagram: @podsurgeon YouTube: @IanReillyPodsurgeon As well as on LinkedIn. His website is: https://podsurgeon.co.uk/ You can find Ben across Social Media @BWhybrowPhysio   More information on Podiatric Surgery Training: https://rcpod.org.uk/podiatric-surgery/become-a-podiatric-surgeon#:~:text=Qualified%20podiatrists%20undertake%20postgraduate%20training,Podiatric%20Surgery%20(MOPS)%20programme “Trick or Treatment” Book Mentioned by Simon Singh & Ezard Ernst. https://www.amazon.co.uk/Trick-Treatment-Alternative-Medicine-Trial/dp/0552157627 Have questions/situations you want help with or stories you would like to share? Send them into clinicalcommunication@outlook.com and it may well get read out and answered.

Group programmes can be a part of the management of many long-term conditions, combining various different activities which combined can have greater outcomes than individual components. Whilst suggestions may exist for what kind of content to cover in the specific group, the practicalities of how to run a group and ensure it is effective, have not been discussed in much depth, until now. In this first discussion episode, Ben is joined by Conor Creedon who is a Back Pain Specialist Physiotherapist & First Contact Practitioner. Both Ben & Conor run group programmes for people with persistent pain, in this episode they cover: (00:00:00) – Introduction (00:02:11) – Connors Group Programme (00:06:25) – How Should We Assess If Someone Is Ready For A Group Programme? (00:12:00) – Is It Possible To Individualise Elements Of A Group Programme? (00:17:00) – What Is The Impact Of The “Mechanisation Paradigm” On The Thinking Of Clinicians & Patients? (00:28:44) – How Do We Help Patients Understand The Context Nature Of Long Term Conditions? (00:30:30) – How Using Stories Could Be The Future (00:38:00) – How To Help Patients Understand The Multi-Factoral Nature Of Their Condition, Without Devalidating Their Existing Beliefs. (00:42:43) – How Do We Help Patients Understand These Factors, Without Feeling That It’s Their Fault? (00:48:27) – How To Use An “Accusation Audit” In A Programme (00:53:43) – What To Do When Participants Don’t Get On (00:57:06) – When To Remove Someone From A Programme (00:58:12) – Conor’s Hardest Conversation (01:02:08 – Success Story From Conor’s Programme   You can find Connor on LinkedIn or at www.conorcreedonphysio.co.uk    You can find Ben across social media @BWhybrowPhysio   Got questions/situations you need help with or interesting stories to share? Send it to clinicalcommunication@outlook.com and we’ll read it out.   Books Mentioned: Ian McGilchrist – The Matter With Things Chris Voss- Never Split The Difference Donald Miller – Building A Story Brand Alan Gordon – The Way Out Liam Mannix – Back Up   Baaahhh

Over the past year I've been asked to deliver some talks or webinars to various organisations and departments around clinical communication skills and difficult conversations. One of which I was given permission to record the audio for, and so am releasing now to you. There are interactive elements which you are welcome to play along with at home, work, in the car or wherever you listen. It covers the topics of: What is empathy and how to demonstrate it? How to show you are attentively listening to the person in front of you? How manage difficult conversations around patient expectations? (in this case of imaging) Plus some audience questions at the end. Want to know more? I am @BWhybrowPhysio on X/Twitter, Instagram, TikTok, LinkedIn & YouTube. Please follow & subscribe. Thank you for listening and watching this year.

Shoulder pain is a common reason for people to seek healthcare support. Whilst many will respond well to time and rehabilitation, certain situations and beliefs make it harder to treat and manage. This may be in relation to certain tissues being “torn”, the joint being “out of place” and “unstable” or having to break bad news when there is no easy solution. Jo Gibson is an Upper Limb Specialist Physiotherapist & International Lecturer for shoulder conditions. In this episode Ben & Jo discuss; (00:00:00) – Introduction (00:01:37) - What Influence Did Jo’s Father Have On Her Practice? (00:06:07) - Where Did “Communication Is Your SuperPower” Come From? (00:09:00) - Which Communication Skill Did Jo Find The Hardest To Master? (00:16:05) - Are We Done With The Term “Shoulder Impingement”? (00:21:00) - How To Help Someone With A Rotator Cuff Tear Buy Into Rehab (00:26:42) - How To Support Those Who Are Worried Their Shoulder Will Regularly Dislocate (00:33:03) - How To Discuss Frozen Shoulder With A Patient (00:37:47) - Jo’s Hardest Conversations (00:45:48) - What Did The Upper Limb Unit Team Mean To Jo? (00:47:57) - Jo’s Courses & Further Info   Jo is on X/Twitter: @ShoulderGeek1 & LinkedIn Her course is “Shoulder Steps To Success” available either in person or online.   Ben is available across social media @BWhybrowPhysio – follow & subscribe to stay up to date.

A cranial nerve examination can be part of a general neurological examination for some clinicians, but often not considered by others. Whilst resources and guides now exist online on how to perform a cranial nerve examination, less guidance is available on what to say to patients before, during and after performing one. Until now. Alan Taylor is a Specialist Physiotherapist in Vascular Flow Limitations, especially related to Cervical Spine Risk, as well as being an Associate Professor at The University of Nottingham. In this episode Ben & Alan Cover: (00:00:00) – Introduction (00:00:50) – What led to Alan Being Interested In Cranial Nerve Testing? (00:03:50) – Why Are Cranial Nerve Examinations Not Taught As Much At Undergraduate Level? (00:07:18) – How Accurate Are The Cranial Nerve Tests? (00:08:50) – How To Prepare Patients For A Cranial Nerve Examination? (00:10:54) – What To Say During Each Part Of A Cranial Nerve Examination? (00:20:49) – Can The Torch On A Mobile Phone Replace A Pen Torch? (00:22:57) – What Should We Say To Patients After The Cranial Nerve Examination? (00:29:40) – What Is It Like To Be An Expert Witness & Who Should Consider Doing It? (00:34:10) – Alan’s Hardest Clinical Conversation (00:39:20) – What Is The Story Of Alan & Rogers Not Country Music Band?   You can find Ben across Social Media: @BWhybrowPhysio   Alan’s Social Media: X/Twitter: @TaylorAlanJ Instagram: @alan_taylor_physio YouTube: @alantaylor1068   Alan’s Cranial Nerve Examination Paper Discussed: A Guide To Cranial Nerve Testing For Musculoskeletal Clinicians https://pmc.ncbi.nlm.nih.gov/articles/PMC8725776/ Lawrence County Band: https://www.youtube.com/@Skiffleshow https://linktr.ee/lawrence_county?fbclid=PAZXh0bgNhZW0CMTEAAaYxduB4Kcna3j5NI8XIulc8pDwQqlZMuXOZIOK-WIG5gz0gJ2D89APPTG0_aem_84E4Qu8lQKBU2EoDXM5AJA

Trying to influence individual patient beliefs is tricky, but can be made even harder when someone else in their life is giving opposite information to you and having a greater influence. This episode talks through who else could influence a patients belief and how you could try to manage it. If you find this useful then do share & subscribe. For more follow @BWhybrowPhysio on X, Instagram, TikTok, YouTube or LinkedIn.

One of the hardest conversations in clinical practice is when the person in front of you holds the opposite belief to you as to how their problem should be managed, and they are not open to changing their mind. Engrained beliefs don't change suddenly, but how these conversations play out can be made more productive and collaborative for everyone involved. This episode discusses how to achieve this and important aspects to consider. Find this useful? Then please subscribe and share it with anyone you think would find it useful. You can find Ben on X, Instagram, YouTube, TikTok & LinkedIn - @BWhybrowPhysio Thank you for listening.

Steroid injections have been available in healthcare for seventy years for various uses. But how should we discuss the risks and benefits of them for musculoskeletal pain with patients? How should we support someone who is really keen for one, but it’s not in their best interests? On this episode Ben is joined by Nick Livadas, Advanced Physiotherapy Practitioner & Lecturer at Teeside University for which he leads the Musculoskeletal Injection Therapy module.  They discuss; (00:00:00) – Introduction (00:01:25) – What Made Nick Interested In Steroid Injections? (00:04:30) – What Do Patients Usually Ask About Steroid Injections? (00:08:50) – Shared Decision Making With Steroid Injections (00:13:15) – How Have Patient Questions & Knowledge About Steroid Injections Changed Over Time? (00:13:40) – Should We Still Describe Steroid Injections As A “Window Of Opportunity”? (00:18:00) – How Should We Tell A Patient A Steroid Injection May Not Help Them? (00:19:40) – What Should We Say To Someone When The Benefit Of The Steroid Injection Lasts Longer Than Expected? (00:23:07) – How To Discuss The Risks Of Steroid Injections To Patients? (00:29:55) – How To Tell The Patient When A Steroid Injection Isn’t In Their Best Interests (00:36:10) – Are These Conversations Really The “Advanced” Part Of Being An APP? (00:38:50) – How To Support Those Who Are Afraid Of An Injection (00:41:48) – Nicks Hardest Conversations (And Helpful Strategies) (00:48:50) – The Time Limit Downside To Being An Advance Practitioner (00:54:04) – What Would Nick Change About Persistent Pain Management In Society? (00:56:23) – How NEMS was formed & What It Is (01:01:10) – How To Contact Nick & Further Courses   You Can Find Nick On; X & LinkedIn – @nicklivadas   His Musculoskeletal Injection Therapy Course at Teeside University is here: https://www.tees.ac.uk/parttime_courses/sport_&_exercise/ucpce_musculoskeletal_injection_therapy.cfm   You Can Find North-East Musculoskeletal Society (NEMS) at: X – @nemsoc16 Instagram – @nemsociety   You Can Find Ben on X, Instagram, TikTok, YouTube & LinkedIn - @BWhybrowPhysio

The tone of voice we use to communicate is as important as the words we say, and yet much less attention is made towards it. Until Now. This episode covers essentials points on using different tones of voice with the patients we see, as well as giving some examples and when to use them. For more, subscribe and follow @BWhybrowPhysio on your social media of choice.