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My Practice Part IV The Process

The most important part of the work I do comes from the history. I need to know (1) the person and (2) the diagnosis and how it came to manifest in the person and (3) How the person perceives of his or her condition and what beliefs they have about their situation.

Getting to know the person and the ways that they interact with the world is paramount. I want to know the basics -- their personal history, what they do for work and play, their career, their habits, their family(both family of origin and current family). I want to know their medical history and family medical history. I really value hearing about their support system -- friends, family and who they feel they can turn to in times of stress.

As a doctor, I need to know about their diagnoses both past and present. I review their medicines and experiences with medicines in the past. I really value hearing about how their interactions with the medical world have gone in their past. I review tests and the evaluation leading to their current situation as necessary.

Next(and this is the part that I believe separates me from other doctors) I want to understand how the individual perceives their diagnosis and situation. What do they know and understand about their challenge? What are their beliefs about their diagnosis and situation? What are their beliefs about the treatments that they have experienced or are being offered to them? Why do they think that this situation is in their life? How does this fit in with their life philosophies and values? What do they feel are the things that are blocking them from getting better/well? This dialogue is the true "pulp" of the interview. This conversation lays the groundwork for the future healing plan.

With all this information and the "data" that is available(lab tests, xrays, prior consultations from medical experts and other providers(psychologists, healers, etc), we then make an individualized
healing, care plan. This plan takes into account all of the above and my "gut feelings" regarding (1) the type(s) of people they will most positively interact with (2) the types of activities/behaviors they are most likely to adopt and practice and (3) their beliefs and perceptions that need re-evaluating and changing in order for healing to evolve. I then outline and give them my healing plan that is specific to them. This is always multifaceted but always includes: (1) a new way to look at their situation (2) referrals to people who can support this new perspective(physical therapists, counselors, complementary practitioners, or new specialty doctors with approaches more in line with their values) (3) resources to expand their knowledge or open their eyes to new possibilities and (4) ways to expand their support system that will reinforce their new beliefs and approach to their challenge.

From here, I make sure they are clear about the plan and make it easy for them to follow-up with me for future tailoring and incorporation of the new way(s) of being into their lives.

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