Kelsey Marksteiner: And actually a follow-up is, “I’m also curious at what point you feel a patient is not a good fit for you.” Perfect addition here because if someone comes to me and they want to work with me but they’re a vegetarian and they’re not willing to give up vegetarianism … vegetarianism is kind of on the cusp of what I feel like I can work with or not. If they’re willing to eat dairy and eggs, for example, and if digestive concern isn’t huge, like if I don’t think they have anything going on digestively that’s going to impact what we’re working on, and so maybe they can probably tolerate beans, in that sort of situation I’d say we can probably work together, but I would put a huge caveat before this. Make sure you’re talking to this person and saying, “I think we can work together, but if, for example, I discover that there is some digestive concern and that we need to take out some of the foods that you are relying heavily upon for some of your nutrient intake, things are going to get really hard, and at that point, I’m not sure we’re the best fit to work together. But if you’re willing to try, then I’m more than happy to work with you.” But if she is very resistant to eating a Paleo type of diet, first of all, I wonder what she is seeing as a Paleo type of diet. Make sure you understand that. Maybe she only knows Paleo as, like, full-on … not meat-only, but meat-heavy diet, which it can be but also doesn’t have to be. You can certainly have someone who eats a higher-carb diet, just a moderate-protein diet. Maybe they’re having, like, 15 percent of their calories coming from protein. Maybe a chunk of that is coming from things like beans. You don’t have to eat a whole ton of meat if you don’t want to, especially if you tolerate dairy and beans. That’s why it can work to be vegetarian. Actually I should add fish to that too, so I guess pescatarian would be the proper term, but a lot of people who are pescatarian, they call themselves vegetarians too. So I would really suss out what that means to her, like what she’s willing to actually eat on a regular basis, and if it’s truly vegetarian in the sense that maybe she’s eating eggs and a little bit of dairy, but that’s it, it might be a little tough.
OK, she’s saying, “She’s eating a Standard American Diet and doesn’t want to try cutting out grains, dairy, or legumes, for example.” Yeah, at that point, I would say, “I’m not the right clinician for you.” You will definitely have people—which I don’t understand entirely—that come to you, knowing your position on nutrition and wanting to work with you, but then saying, “I’m not willing to do anything that you recommend,” basically, and it’s not worth fighting with those people. I know that can be really tough, especially when you’re starting out and you really want clients, but you are going to be so much happier as a clinician and you’re going to start to get people who really trust and like the way that you work that soon enough it’s not going to matter. Don’t be too picky. Definitely work with people that maybe don’t seem perfect in the beginning, because that’s going to teach you a lot, but at a certain point, if someone is not going to follow even just the beginning recommendations of what you are going to teach them, it really usually is not worth it for either party. You’re going to get frustrated. She’s going to get frustrated. She’s going to feel like, I spent all this money, and we didn’t do anything, and it’s not your fault at all, of course. It’s pretty much entirely on her because she said she wanted to work with you but then won’t do anything that you say. So definitely feel free to tell people they’re not the right fit.
I have gone through many ways of accepting clients over the years, and you start to learn how to tell if someone’s going to be a good client or not. At this point, I have people fill out a little form before I even talk to them or consider working with them. Basically I have an application process to be a client. It’s really simple. It just asks them, What are the main issues that you’re dealing with? What have you tried so far? And then the most important question: Why do you feel that we would make a good team? That’s where I will tend to see, “Oh, I read this article that you wrote, and I really liked it,” or, “I listen to your podcast all the time, and I get a good sense of you and I trust what you say.” That’s what you want to see. You want to see that someone sort of follows your work and at least knows something about the way that you work with people, and that’s another benefit of putting out content on a regular basis, whether that’s a podcast or a blog post or videos—anything you want to do—or even just being active on social media. You do want your clients to sort of know who you are and what your approach is because that’s going to make you get clients that actually work with you and understand what they’re getting into. That’s a really important question to ask if you have some sort of screening process: Why do you want to work with me specifically? What makes you feel like we’re going to be a good team to work together? You’ll learn a lot about a person with that question and whether or not they’ll be a good client.
OK, so this person is saying, “Totally makes sense. She wants the functional medicine tests without worrying about diet.” Oh, yeah. You’re going to get a lot of those people. You will get people that think that just getting the testing is going to, like, instantaneously heal them because now they know what’s going on, or you’ll get people that want to do the testing, and then they just feel like supplements will fix everything. Those are the people that are, of course, usually super-stressed out. Lifestyle is a huge, huge factor for them in what’s causing their symptoms. So you really just want to make sure that you explain to them that this is a very involved approach. It’s not a quick fix. It’s going to take effort on their part. It’s going to take habit change on their part. You’re there to walk them through it. You’re there to hold their hand through the whole process, but if they’re not willing to take those steps with you and work with you on these habit changes over time, they’re really not going to get anywhere. I usually just phrase it as, “I can’t force someone to do something, but I can give you the information and walk you through how this will fit into your lifestyle, and I’m here for you if you have any questions or if you feel like something isn’t working for you, we can work through it together, but I need you to be on this journey with me. If you feel like you’re not going to be or you’re not ready to make those changes, talk to me when you feel like you are. Take some time to just think about it and think about how you can maybe … For example, if you’re really, really stressed out with something going on in your life right now and you feel like this isn’t the time to start making a lot of lifestyle changes, why don’t you come back to me in a couple of months when things settle down a little bit and you have more time to focus on making these changes. You want to get these habit changes into your life before something crazy happens because then they’re already habits and they won’t totally fall to the wayside when some big thing happens in your life that disrupts a lot of other things. The best time to do that is when you have a little bit more time. Maybe don’t do it during your busy season at work. Don’t do it if you’re having some family issues at the moment. Wait until things settle down and come back to me.” That usually starts to make people think about, All right, I’m really viewing this as an investment in myself. When can I focus on myself for a couple of months so that this is part of my lifestyle at that point and that it’s really going to stay with me through my life?
I hope that helps. That’s one of the hardest things to learn, and you learn it over time. It can be really hard to turn people away at first, but trust me, you will be happier for doing so because you’re just going to spend a lot of the time feeling really stressed working with those kinds of clients because they’re really tough to work with, and they certainly don’t make things easy. So if you have a sense—I think of it as a sixth sense at this point, for me. Even just reading a written statement by someone in the form that I ask them to fill out, I can tell almost right away if they’re going to make a good client or not. And if I can tell that they’re not, I might have a phone conversation with them if I feel like they’re sort of on the borderline of being a good client, and that will help me to determine if they will or won’t be. But if I can tell that it’s not going to work out, I will just tell them, “I don’t think we’re a good fit. Here’s a recommendation for somebody else that you might try.” Or I point them towards PrimalDocs.com or Paleo Physicians Network to just have something else to give them. I don’t like to turn people down without giving them an alternative. If you can give them some sort of alternative, usually that makes letting them go a little bit easier.