Cultivating Rapport

We will ask questions from general to more intimate. We will need to save more embarrassing or emotional questions for later if we want to maintain good rapport. We want to balance tact and interpersonal flow with medical accuracy. By using a simple and streamlined methodology we can focus on the patient in front of us, timing our breathing to theirs and then slowing ours down and watching their breathing automatically calm down as well. Make sure they are seated and relaxed in their new atmosphere. You want them to feel more at home in your office than they do in their actual home. Some herbal tea is a good place to begin. If your clinic is busy having them wait with a Shangrila Tibetan footsoak is a lovely way to get them settled in. The more relaxed they are, the more they will trust you and give you better information.

Pre-framing Rapport:

To see Jin Zhao, you pay a lot more than to see ordinary doctors. The lines are long and the wait time can be hours. Once you see him he is calm and focused, but doesn’t chit chat. Because his body language is so at peace he can be very direct about getting people to the point so they don’t take up everyone’s time. Because he comes so strongly referred he needs to spend very little time developing rapport. In fact, it’s enough that he is there. His social proof is already strong, that lets people know that he’s powerful, after this looking at them with focus and kindness and laser targeted questions is enough for him to develop strong rapport. After this he asks a handful of very targeted questions.

Anchor questions to chief complaint:

Remember to relate your diagnostic questions back to the chief complaint otherwise you may cause your patient to feel that you are off topic and lack professionalism.

Ask Permission to Ask:

First of all it’s professional to ask permission to ask them questions followed by briefly explaining why you are asking is a great way to get better intel.

It may be obvious to you why you are asking, but they are still trying to determine if they trust you.

Before we begin to use this approach, look for general evidence of dampness.

General signs of damp:

It’s difficult to wake up and get moving even after 6-8 hrs. (Wait thats everybody right?!? No, it is not. That is how prolific dampness is among our target demographic.

Cloudy urination

Chronic pain

Chronic fatigue

Yeast infections (candida)

Brain fog

Dizziness

Weight gain

Heavy limbs

Oily skin

Loose or watery stools

Athletes foot

Toenail fungus

PCOS

Vaginal discharge

Dizziness

Palpitations

Light edema (ankle swelling)

Pulmonary edema,

Hypochordria pain from water accumulation (typically from an enlarged liver),

Sputum and mucus

Tongue:

Puffy possibly with with toothmarks, likely coated.

Tongue biofilm distribution:

Tongue biofilm which covers the base of the tongue may be reflecting dysbiosis in the urogenital microbiome. As the tongue’s biofilm grows to cover the middle of the tongue the more likely it is that the patient has gut dysbiosis in the GI microbiome. When it reaches the tip of the tongue it’s more likely that the respiratory microbiome is experiencing dysbiosis and latent pathogens.

Tongue biofilm color: Yellow tongues are associated with heat. This is not always the case. 72% of yellow tongue biofilms contain bacillus. This has a thermogenic effect on people to warm them up so that the bacillus bacteria can spread out.

Pulse and palpation: Soft, weak, or slippery. Slower pulses tend to indicate “cold” while faster pulses indicate “heat”.

Forearm Palpation: Shi Re: Damp heat. You touch the body/forearm. Feels cool, hold for a bit and it gets very hot. The yang is not spreading.

Movement

As the patient sits down we are going to be watching their movement and face. Is their fluidity as they walk or are they stiff? As they sit down is it easy or is it like they are moving slowly on some type of hydraulic pump? This can give us an idea as to how hindered their muscles and fascia may be due to water retention and resulting muscle fatigue.

The shape of their face and neck.

This gives you insight into water retention and mucus accumulation such as plaque which may add pressure to the heart and create an enlarged neck. You will also want to look for signs of swollen cervical lymph nodes.