Patient plan adherence is dramatically influenced by that moment and how that handoff happens. And if we can understand the patient better, we can say, again, to be lazy, this is the kind of patient you have to bribe and motivate. This is the kind of patient you have to scare. This is the kind of patient you need to say: “here’s the charts and facts and figures.” And you say to this one: “hey, if you want to be able to run with your kids when they’re 14, you got to do PT now.“ Whatever the lever is that we can pull. If we can tell a physician, hey, here’s the lever. Here’s the right answer and the protocol for this person. It’s just like imaging, but for their personality. And we’ll give you that information so you, the doctor, can be good with it.

Bill B

In addition, you can then talk to the patient about what they’re projecting onto the doctor. What are their expectations about the doctor based on the projections onto them?

Scott

And what are their needs for a doctor based on their makeup?

Bill B

And not just what are their needs, but how do they project that need onto the doctor? Either angry because the doctor didn’t meet that need or projecting onto the doctor a whole lot of stuff about meeting the need even when the doctor didn’t intend to fulfill this need. It’s powerful to go both ways. I think, once again, the higher the power differential, the greater is the amount of projection.

Scott

Which is why we started with husband and wife because we wanted to make sure that power differential was as close to even as we could find.

Perry

Scott, I’m really glad you brought this up because I think this is something that’s going to be an evolving and increasingly aggravating problem as technology continues to advance and tries to take out of our hands the very human need for human interaction. I worry about that, but this is very personal. And since we’ve been talking about things like Myers-Briggs I’ll just share an insight with you. My wife and I have been married for 54 years. I’m an ENTJ. She is an ISFP. It didn’t take us long to figure out that we see the world very differently. And both viewpoints are equally valid.

Our children seek our advice because they know that we provide very high-quality analysis, support and recommendations because we’ve together as a team. We can look at issues in very complex ways and kind of cover all the basis—we offer complementary ways. We learned a survival key early on. We realize we’re looking at something very differently. We have to go back and start from common ground. We’re very different people. We see the world differently–but we have very similar values. And starting from common ground, we can build toward a resolution of very different viewpoints. We start from the points we agree on and we work from there. And I think that your program—in helping people manage those kinds of perspective dichotomies—might include a search for common ground as the starting point.

With regard to Clinical encounters, I truly regret the way clinical medicine has gone. The amount of time that we can spend with our patients is severely limited. I mean, our clinical encounters are down to six minutes of face-to-face time. It’s hard to build a relationship . . .