In medical school, you are taught to listen to your patients, and if you listen carefully enough, they will tell you, their diagnosis.
The statistic that gets thrown around is that the average amount of time, a physician listens before interrupting a patient, is 18 seconds!
Many of you, learn to use motivational interviewing skills to help and communicate with your patients. These statistics and methods involve training with your ears and mouths. But what about your eyes?
Patients communicate immense amounts of information through body language.
The primary understood, universal body language is choking. Anywhere in the world you go, if someone is choking, they use both hands to grab their throats.
No matter what country you are in or what language is spoken, you can recognize someone choking and provide aid if trained.
Body language is also understood to convey various subconscious emotions – crossed arms can be used by someone who is angry, frustrated, or scared, or shutting down in a conversation; open arms and uncrossed legs can be used by individuals who are open to new ideas, and willing to communicate with those they are talking to.
There are many other physical movements that patients can use that will provide clues to their health and, more specifically, their pain.
Like what you have been taught in training (listening with our ears and how we ask questions), if you watch patients well enough, they can give you a diagnosis, and more importantly, they can give you information to help treat their pain.
The Fascial Distortion Model (FDM) is an osteopathic model that was developed from 1991 to 2006 by Dr. Steven Typaldos, DO.
The main distinguishing factor between FDM and other manual and osteopathic models, is that it is patient-driven. In this model, the patient is the expert.
This is a novel concept, particularly for you as physicians, who have been in training for many years to be considered experts in the human body.
This is a humbling model that allows you to step back and trust the patient to communicate information about their own bodies.
The foundation of this Fascial Distortion Model is learning and interpreting patient body language. Whether a patient sweeps their fingertips across a body part, or pushes multiple fingers into a spot, they are communicating information from their nervous system about how the fascia is behaving.
Proprioception is a driving factor in this model; what the patient feels in their movements is shown to you as physicians in a predictable way.
This body language can be transformed into a treatment, involving a variety of manual manipulation techniques.
The outcomes of these treatments are predictable and reproducible, though when they don’t work (is anything really 100 percent effective?), then further pathology can be expected, and additional workup can be utilized. It is possible to save money by starting with a simple treatment before jumping to expensive testing to determine the causes of pain.
Diagnosis and treatment in the FDM, can be a quick addition to any practice. This model can be useful for both acute and chronic pain.
Patients who have been through years of procedures, medication regimens, with little to no success, could benefit from being listened to in another way.
Whether or not you choose to incorporate the manual techniques, might be individually driven for your own practice.
Suppose you can learn to identify these body languages and movement patterns in the FDM.
In that case, you can either utilize techniques yourself (only an additional couple of minutes to a patient appointment) or send your patient to someone who practices these techniques, for what can be a life-changing (and practice-changing) treatment.
Incorporating this into your practice, is mainly learning how to observe your patients in a way that you have not looked at them before – with your eyes.
The body language is already there. You just need to know what to look for..