To script or not to script?

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Good evening, 66.1ers.

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To script or not to script?

Was working with a fellow coach this week. Talking through a challenging patient case, how they might do better next time. They’re already good at what they do, but want to do better. And when you’re working with folks navigating cancer treatment, there can be a lot to balance. In this particular case, the patient was mourning the loss of a loved one in addition to their own treatment. Coach said they didn’t like how it went, asked me to listen to the call, could I provide feedback? Sure. 

Listened to the first 2 minutes of the 23 minute call. When the coach initiated the call, they sounded timid. Like they were approaching a dog that wanted to bite them. Not without reason (previous conversations with this patient had been challenging), but let’s think about this for a minute. If you’ve dropped your car off at the mechanic and they call a few hours later sounding nervous, how will you respond? Full confidence? Swipe my card, do whatever you think needs to be done? Or might you wonder if they’re hiding something? If there’s something they’re not telling you? Are you going to let them help you?

Now, what if, when your mechanic calls, they’re confident and clear, and they even say something non-scripted and make you laugh in their opening line? Are you more or less likely to trust them, to ask them to help you with brakes in addition to the oil change you initially took your car in for?

Parallel to health coaching? When this patient answered the phone, the coach did the typical (HIPAA mandated) intro: shared their name, confirmed patient’s identity. No sweat, that’s the law. After that, though, there’s room to roam. Coach asked patient, “How are you?”, patient said “fine” but their tone said, “dreadful”. If this was your best friend, would you continue with the script, ask how their pain is today? Or would you say, “Jim! Know this is a phone call, so I can’t see your facial expression or your body language, but your voice is telling me something else is going on. Or am I imagining that?” Jim’s going to tell you what’s going on, and then you can begin to help Jim. 

In the first 2 minutes of this call, there were 3 opportunities to take a detour and ask the patient what was really going on. Discussed these with the coach. They understood, but shared hesitation in deviating from the script. It’s a difficult thing to figure out in clinical research. We’re conducting the same intervention for 650 patients over 3 years. Yes, we have a script. Not meant to be followed word for word, but you’ve got to hit the major bullet points. Do everything the study says you need to do, so we can publish it, replicate it, and change the world. But…

Do it how your patient needs it done. Ask them what’s really going on, meet them where they’re at today, and problem solve from there. Or maybe this spin, from a mentor, might make more sense: “don’t start a conversation they know the script to.” 

Not a health coach or medical provider? No sweat. Maybe what you want to do is apply the above advice next time you call a friend. Or next time you start chatting with the checker at the grocery store. Maybe you’ll learn something about someone by starting a conversation they don’t know the script to?

Have fun out there.

Marcus