“Focus on the real problem, not the first problem.” – Michael Bungay Stanier, ‘The Coaching Habit’
This interesting statement from Stanier’s work encapsulates a crucial concept for clinicians in their daily practice.
It challenges you to look beyond surface-level issues and delve deeper into the root causes of your clients’ health concerns.
The Significance of Identifying the Real Problem
In healthcare, clinicians often face pressure to provide quick solutions. However effective this approach often is when managing acute injuries, when it comes to managing chronic injuries and illness, it may lead to addressing only the most apparent issues, potentially overlooking underlying causes that could be more significant.
Consider a scenario where a client presents with chronic lower back pain. The first problem might appear to be a musculoskeletal issue. However, upon deeper investigation, the clinician might discover that the real problem stems from the client’s sedentary lifestyle due to a high-stress job, poor sleep habits, or even undiagnosed depression.
By focusing on the real problem, clinicians can:
- Provide more effective, long-term solutions
- Improve client outcomes and satisfaction
- Reduce the likelihood of recurring issues
- Enhance overall quality of care
Implementing This Approach in Clinical Practice
To effectively focus on the real problem, clinicians can adopt several strategies:
1. Comprehensive Assessment
Conduct thorough initial assessments that go beyond the presenting symptoms. This might include:
- Detailed history-taking, including lifestyle factors
- Take into account what medications have been prescribed. Clients taking anti-depressants may process information differently to what you expect
- Assessment of daily habits and routines
2. Attentive Listening
Employ attentive listening techniques to pick up on subtle cues that might indicate underlying issues. This involves:
- Paying attention to non-verbal communication
- Asking clarifying questions
- Reflecting back what you’ve heard to ensure understanding
3. Utilise Open-Ended Questions
Open-ended questions encourage clients to provide more detailed responses, potentially revealing information crucial to identifying the real problem. For example:
“How do you feel this issue is affecting your daily life?”
“What changes have you noticed in your overall wellbeing since this problem began?”
The Impact on Treatment Adherence
Identifying and addressing the real problem can significantly improve treatment adherence. When clients feel that their core issues are being addressed, they are more likely to:
- Engage fully in their treatment plan
- Follow through with home exercises and lifestyle modifications
- Attend follow-up appointments
- Take an active role in their recovery process
Case Study: Physiotherapy Application
A 45-year-old client, Sarah, sought physiotherapy for chronic neck pain. The first problem appeared to be poor posture and muscle tension. However, by employing the strategies outlined above, the physiotherapist uncovered that Sarah’s real problem was work-related stress leading to teeth grinding at night.
By being aware of the impact of stress and collaborating with a dentist for assessment, Sarah’s neck pain significantly improved. This holistic approach not only resolved her immediate concern but also enhanced her overall quality of life.
Innovative Concepts for Clinicians
- Health Mapping: Develop a visual representation of the client’s health ecosystem, illustrating connections between various symptoms, behaviours, and environmental factors.
- Temporal Assessment: Evaluate the client’s health trajectory over time, identifying key events or changes that may have contributed to their current condition.
- Collaborative Problem Identification: Engage clients in the process of identifying their real problem, fostering a sense of ownership and improving their health literacy.
Conclusion
Focusing on the real problem rather than the obvious problem is a paradigm shift in clinical practice.
It requires clinicians to look beyond immediate symptoms and consider the broader context of a client’s health. By adopting this approach, clinicians can provide more effective, personalised care that addresses the root causes of health issues.
This method not only improves client outcomes but also enhances professional satisfaction for clinicians. It transforms the clinical encounter from a simple problem-solving exercise into a comprehensive, client-centred approach to health and wellbeing.
As you continue to evolve your practice, consider embracing this concept, always striving to uncover and address the real problems your clients face. In doing so, you will elevate the standard of care and contribute to the long-term health and wellbeing of those you serve.
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