Talking Research with Dr. Shawn Thistle
Tell us a bit more about your areas of work and what you're most passionate about.
My passion shifts from week to week. I used to be strictly passionate about patient care and being a rock star in practice. I still really enjoy this but with the evolution of my company, RSS Education, my passion has shifted to knowledge transfer. I think that the term 'knowledge transfer' has been geek-a-fied in the research world to the point where no one will care about it. So I try to make knowledge transfer practical and reasonable for my colleagues.
A side passion is business development. As practitioners, we don't have MBA degrees so we need to work hard if we are interested in developing a business. I am fortunate because I have a lot of patients who are involved in business and entrepreneurship so I always receive great advice from them. I have also built my network so I know that I can reach out to people when I need them.
My other passion is cooking - I know more than 3 things to do with an egg and I have my own set of knives.
What's something you've recently learned that you're really excited to implement into your practice?
Competence of current practitioners in any discipline and how knowledge is developing is so important to our practice. The more that I read, the more that I realize that we don't really know much.
I think what will affect us all the most in the next 10-15 years is pain research. A lot will be discovered that will teach us how to manage our patients regardless of what their condition is.
The research community, the medical community, and the allied disciplines are trying to figure out the human experience of pain. Central sensitization is key and affects us all, but so many of our colleagues have minimal knowledge about this concept. We don't know how to deal with people who have chronic pain and many practitioners don't understand that people with chronic pain need to be treated differently. If we can wrap our heads around this and get good at it, we will be able to have a much bigger positive impact on our patients.
I've applied current pain research into my practice by becoming more of a generalist rather than drilling into specific areas of practice.
Movement is also a really interesting area of research and a topic that I think will evolve in the coming years. Moving more tomorrow than you moved today is a common piece of education that I give to my patients.
What does the next year of your professional life look like?
First and foremost, I'll be taking care of my wife and our firstborn who's due in the next month.
In my professional life, I want to decentralize the seminar experience and create one-hour webinars at a reasonable price. I'm also always trying to grow the business and make our offerings as useful and practical for our colleagues as possible.
I started doing medicolegal consulting last year for chiropractic malpractice cases. I find that work interesting - it's like detective work. My job is to give my professional opinion on whether the standard of care was met. It has been eye-opening to see how a clinical relationship can devolve and result in legal action between clinician and patient. It has changed the way I deal with my patients and I would like to continue doing more consulting of this nature.
What's one course or event that you're planning to attend in the next year that you're really looking forward to?
I really enjoy teaching my own seminars and I really enjoy speaking so I'm looking forward to my upcoming seminars. I think one of my strengths is speaking and I particularly love running my own seminars since I have complete control over the structure and flow of the course.
This Fall I attended our National Convention hosted by the Canadian Chiropractic Association (I spoke there as well), and I'll be at a research symposium at CMCC in February on disc herniations - looking forward to that one.
Apart from that, I don't have a lot of time at the moment to attend courses, but in the future as my scheduled shifts, I would like to go to more courses and even re-do some that I've done in the past.
What's one book that you think other practitioners should read?
- Blue Ocean Strategy - This book is about demonstrating your unique value to make your own mark and not worry about competition. The book is older now but the concepts are still relevant.
- If you're uncomfortable with promoting yourself, Selling the Invisible is a great read. It has a lot of interesting psychological communication advice that can help boost your confidence.
- Outliers - this is interesting to read about how other people master things
- Let me off the top by Ron Burgundy is a great vacation book.
What's been one big 'Aha' moment for you in your professional life?
"Don't lie. Say I don't know if you don't know."
3 words we need to be more comfortable saying is "I don't know". We're often terrified of saying this but over the years of my practice, I've realized that patients appreciate honesty. An outright, frank "I don't know" can go a long way and helps patients understand that we're not Hoodini, but rather well-trained healthcare practitioners who don't have all the answers.
It's ok if you don't know. Don't lie to your patients. You're still going to work with them to help them get better and it's better to build an open and honest relationship rather than trying to deceive your patients that you know everything.
What's something that you learned the hard way that you would like to share with others?
"You're far less likely to get into legal conflict with a patient if you communicate well and they like you."
I haven't learned this the hard way myself, but I've seen others learn this the hard way through my experience as a medicolegal consultant - you're far less likely to get into legal conflict with a patient if you communicate well and they like you. One of the most important things that young practitioners have to realize, which took me a long time to figure this out, is that not every patient is a good match for me and that's ok. When a patient doesn't return for their scheduled follow-up care, it can be really stressful, especially when we start out as practitioners. However, we all have our core group of ideal patients who mesh well with us and value our practice.
I now only take a few new patients but I always tell them that we have to figure each other out a little bit. During the next couple of visits, we'll determine if this is the right fit for both of us. I'll be able to give you a better prognosis on treatment 3 because I'll have a better sense if we're on the right track or if we need to change gears if you're picking up what I'm putting down and how your tissue responds.
This has helped me help my patients manage their expectations - my assessments and treatments are much smoother now. I think that as a whole, we could all improve how we manage the expectations of our patients.
"We can't fix anything. We can help you feel better and prived tools to help yourself"
We don't often ask our patients if they understand what we're telling them. Does my diagnosis and my explanation of what is going on make sense to you? If the answer is no, then our treatment and future sessions will not go well.
I frequently see patients who have seen many other practitioners and it always amazes me that they're seeing me (yet another chiropractor, or clinician). My question to them is always what kind of treatment did the other practitioners provide and what did they understand about the treatment plan and prognosis. Communication is what we build your practice and improve your confidence as a practitioner. Patients frequently have no idea what kind of treatment they had and why. Communication is so important for effective treatment
I also think that prognosticating on the first visit is really challenging and shouldn't be done. We don't know a patient on the first visit and how they will respond to treatment, or even more importantly how they'll respond to our treatment.
I believe that personality traits lead to successful practitioners - not hands-on skills. Manual therapy skills facilitate effective treatment but they don't determine it.
There's medical data that shows that patients care most about feeling heard and feeling cared for. Medical proficiency is way down on the list.
Part of being a good practitioner is understanding how to communicate with different patients and having a Frequently Asked Question section in your mind that you can refer to. Many patients have similar questions and needs. So if you're prepared for this and know what to say and when you'll be very successful in practice. The key to any good clinician is that they're good with their ears, not their hands.
What's the most valuable piece of advice you've ever received
- If you're in the manipulation world - Only manipulate a patient when they're ready, not when you're ready. This is something I learned from the late Dr. Oryst Swyszcz.
- Always ask a patient what they think is going on with their pain/symptom/condition. Patients are often right. Most people use the internet to self-diagnosis and this often clouds the water a bit but when patients are honest with themselves, they often have the answer. This is also a great way to figure out if you're on the same page as the patient and whether they'll pick up what you're going to put down.
This question also helps bring patients into their own care and part of our job is to empower our patients to be involved.
I'm not sure if the internet has helped or hindered patient education and empowerment since there is a lot of misinformation available.
My joke to my patients is that you're only ever 3 clicks away from cancer.
What role do you believe technology can play in rehabilitation for both practitioners and patients?
I think as technology advances, there will be many ways patients and practitioners can use and share technology to advance patient care and rehab. As you know, I think we're all still trying to figure that out in the most efficient manner. However, like in many other areas in life, I think we shouldn't seek technological answers at the expense of personalized, one-to-one care - which still has a huge role to play.
Dr. Shawn Thistle B. Kin. (Hons.), D.C., Medical Acupuncture, ART®, C.S.C.S
Dr. Shawn Thistle is a chiropractor, entrepreneur, educator, speaker, knowledge transfer leader and medicolegal consultant. He has been in practice since 2004 as a Clinic Director at SHAPE Health & Wellness Centre, Toronto where he leads a multidisciplinary team of health professionals including chiropractors, physiotherapists, registered massage therapists, nutritionists and strength and conditioning specialists.
Shawn is Founder & CEO of RRS Education. As a practicing clinician himself, Shawn ensures that RRS Education provides practical insight into the rational application of current scientific research to clinical practice. Practitioners are faced with a daunting task of staying abreast of emerging information as the volume of evidence-based information grows. RRS Education content is designed to help bridge this gap by providing weekly reviews of current scientific articles to subscribers in 15+ countries, as well as online courses and seminars!
As a speaker, Shawn blends contemporary research with his entrepreneurial business acumen and experience in clinical practice to provide passionate, high-energy presentations on topics relating to Chiropractic and Manual Medicine to Chiropractic, Physiotherapy and Sport Therapy organizations and colleges as well as groups interested in learning about health and fitness.
Shawn can be reached at email@example.com.