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6 erreurs de débutants de diététiciens à éviter quand on démarre en libéral ! — Transcript

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0:02When starting in private practice, you
0:04want to do well, even too well. You put
0:07all your heart and soul into it, and
0:09sometimes you exhaust yourself doing
0:11things that, in hindsight, are neither
0:13useful for our patients nor for us. So
0:16in this episode, we’ll share with you
0:18, in complete transparency, the little
0:20things we put in place at the beginning
0:22or that we regularly hear from
0:24colleagues. So, the idea of this
0:26episode is not at all to judge, to say
0:29what’s good or what’s not good, but
0:31rather to save you time, energy, and
0:34perhaps even a little bit of serenity
0:36in your practice, because often what we
0:39think is a plus is sometimes an
0:41unnecessary burden. So, we’ll take
0:44you with us to dissect all of this. You
0:47may recognize yourself in certain
0:49situations, and if it allows you to let
0:51go of one or two things, well, we’ve
0:53accomplished our mission. Let’s go.
0:56Welcome to the podcast between two
0:58patients. I'm Elise Brot
1:00and I'm Marion Baudin. We are both
1:02dieticians and we are going to talk to
1:03you about our experiences in private
1:05practice. Do you want to boost your
1:07business, be more creative and more
1:09efficient in your consultations? In
1:11this podcast, we will discuss topics
1:13that are important to us and we will
1:15answer your questions. Let's go.
1:19Hello Elise.
1:20Hi Marion. So, welcome everyone to this
1:24new episode of Entre. We launched this
1:28podcast channel in 2020 with the idea
1:30of sharing what we would have liked to
1:32hear when we started our consultations.
1:35So here, the idea is to open the doors
1:37of our activities to have an unfiltered
1:39discussion about the reality of the
1:41profession, our thoughts, our struggles
1:43, what we have learned and our small
1:45daily victories. So whether you're a
1:48dietetics student, a recent graduate,
1:50or have been working for years, this
1:52podcast is here to inspire you, to
1:54question you, and above all, we hope it
1:57will make you want to practice your own
1:59way with confidence and pleasure. My
2:02name is Marion, and I've been a
2:03dietician since 2007. I was an employee
2:06for 12 years, where I provided
2:08consultations and support online. Then,
2:106 years ago, I founded my dietician,
2:12which is a digital solution to support
2:14dieticians in monitoring their patients
2:17, with the idea this time of also
2:19setting up my own business while
2:21developing my dietician. My goal with
2:23this tool was first to simplify the
2:25daily life of dieticians and also to
2:27enable better monitoring of our
2:29patients. Uh, to strengthen our
2:31patients 'commitment to their
2:32monitoring because I am convinced that
2:35digital technology can really be a
2:37lever for offering more fluid and
2:39personalized support. If you want to
2:41learn more, I offer free demos. They
2:44take place directly on the Monsie
2:45website. It allows you to ask questions
2:48and then we can go through the
2:50interface and all our tools together.
2:52You can also try out my Chivivi Diet
2:54for free for 15 days. Also, go directly
2:56to the Monidiet website to find all the
2:58information. And to make sure you don't
3:01miss any new features, you can find us
3:03on LinkedIn or Instagram. My name is IE
3:06, I have been a freelance dietician for
3:0815 or 16 years now and I have been
3:10working with my husband Nico since
3:122009. Together, in 2009, we developed
3:15the Diet in Transition training courses
3:17. These are training courses to help
3:19freelance dieticians become confident,
3:21happy and truly fulfilled in their
3:24freelance profession. We are here to
3:26help you improve your consultations
3:28with top-notch consultation training,
3:31but also to help you develop and grow
3:33your business with top-notch results
3:36support. So these are really our two
3:37training courses that are really there
3:39to help you take action. So, if you
3:41want to revitalize your consultations
3:43today, and to create a bit of a link
3:45with the day's theme, then stop
3:46spending your time on things that are
3:48not worth the effort. We have created a
3:51free guide called the guide to
3:53ultra-effective dietetic consultations.
3:56It contains lots of practical tips,
3:58including tools to increase your
4:00patient engagement, tips to reduce
4:03dropouts and dropouts during follow-up,
4:06and tips to make your organization
4:08easier. And then, we have two tools
4:11called the 10 Keys thematic activity
4:13and the self-assessment framework. So,
4:15you will really have all these tools in
4:17this free training. You can download it
4:20from our website, dientransition.com.
4:25On the home page, you can register
4:27directly. Otherwise, type in
4:28dietentransition.com/réussir with an
4:31accent on the word réussir and you
4:33will have direct access to the guide.
4:36It's a guide that you will receive by
4:38email for a week, so you will receive
4:40an email every day and you will have
4:42lots of tips thanks to that. I will
4:43also put the link in the description.
4:45Don't hesitate to follow us on
4:47Instagram. So it's Elise Bricot on
4:50Instagram or on LinkedIn. So there you
4:53have it, that way you will also have
4:55all the information about the new
4:57products and so on that we create at
4:59Diallez-vous comfortably. Here we go
5:03for a new episode of the podcast
5:05between two patients. The six things
5:07that are not worth it. So the first
5:10thing we noticed, and it's not
5:12something we've done but something
5:13we've observed among dietitians, is
5:15taking paper notes during the
5:17consultation and then writing
5:19everything down on the computer. I
5:21realized that this is actually very
5:23common. I realized this because I now
5:26offer demos to discuss my diet tracking
5:28system with the dieticians who are
5:30interested in learning more about it.
5:32And often during these discussions, we
5:34talk about what dietitians do today,
5:36how they work, how they take their
5:38notes. And I realize that often, there
5:40is note-taking that is done first on
5:43paper and then they write everything
5:45down on the computer. So it's obviously
5:47a double task that is extremely
5:49time-consuming. It's mentally tiring. I
5:52believe that it is genuinely quite
5:54exhausting to do things in this manner.
5:56and it also requires time after the
5:58consultation. What I have observed is
6:01that when we proceed like this, we
6:03often want to be present during the
6:06consultation, so paper notes do not
6:09allow us to have a better connection
6:11with our patients. Often, we are afraid
6:14of forgetting elements that would be
6:16important for the future, and then we
6:18want to do well overall and have as
6:20much information about our patients as
6:22possible. Obviously, this is very
6:24time-consuming. Finally, it really is a
6:26very time-consuming thing. So the first
6:28piece of advice is to take digital
6:30notes directly during the consultation,
6:33using software like my Cidette, but
6:35really to digitize them from the start.
6:38I think that to successfully switch
6:40from paper to computer directly, what
6:42is important is to have a consultation
6:44framework that is truly adapted to our
6:46consultation, that we can perhaps spend
6:48a little time at the beginning to
6:50create a consultation framework, to
6:51collect data that truly corresponds to
6:54our way of consulting and that will
6:55allow for effective data collection. I
6:58see that I have changed the way I
7:00gather information during the first
7:02appointment. I used to gather a lot of
7:05information during my first
7:06consultations. I think I had a doctor
7:08who was at least five pages long with
7:09questions. I gathered a lot of
7:11information. Today, my framework is
7:13much simpler. I think it is more
7:15effective. I have put, uh, on my diet
7:17monitoring, we can put evaluation
7:18scales, we can put little boxes to
7:20check to save time. But above all, the
7:22idea is to really target, in fact, the,
7:24the content of what we want to gather
7:26during the consultation, because not
7:28everything is useful, because it is not
7:30, uh, important to gather all the
7:32details of your patient's daily life.
7:34And so I think that it requires taking
7:37the time to build this framework in the
7:40best possible way and really having the
7:42most effective and useful information
7:45possible and also accepting the idea
7:48that note-taking may not be perfect but
7:50it must be useful. I really think we
7:53should keep this idea in mind: our
7:54note-taking must be useful. So there's
7:57no need to collect everything, but have
7:59things that make sense. It is also a
8:01topic we often discuss in masterminds.
8:04So mastermind sessions are short video
8:05sessions that we have every week with
8:07members of the top consultation
8:09training. And so we often discuss this
8:11question of, Yeah, no, I don't dare
8:13take my notes on the computer in front
8:15of my patient, so I write them down and
8:18then I copy them when the patient has
8:20gone to the computer. There you have it
8:22, so my file is well-organized. Uh yes,
8:25but no, in fact, what we have, the
8:27little tips...Because the goal is to
8:28exchange ideas in these masterminds,
8:30and everyone goes: "Oh yes, at the
8:32beginning, I think, I did it like this
8:34and I found a tip." And there you have
8:36it, it is a collective brain that is at
8:38work during these masterminds. And in
8:40fact, the little tips, in any case,
8:41that come out and that I also wanted to
8:44share during this episode of the
8:45podcast, were...there are ways, really
8:47practical tips, really practical,
8:49really for taking notes during the
8:51consultation, that's really it. And to
8:53not be afraid to take notes in front of
8:55the patient, it's already simply to put
8:56the computer on the side, so not to
8:58stand in front of it, so that the
8:59computer doesn't block the visual, in
9:01any case, that you have towards your
9:03patient, but to be able to write at an
9:05angle, on the...on the side. I have a
9:06laptop, and I also have two chairs;
9:08therefore, depending on where my
9:10patient chooses to sit, I place my
9:11computer either to my left or to my
9:13right side. That way, I can always see
9:15my patient clearly. Another tip that
9:16works well, if you're not comfortable
9:18taking notes in front of the patient,
9:20is to ask for permission and simply say
9:22, "Well, I need to take notes of what
9:24you're explaining to me on my computer
9:26because I can't remember everything."
9:27Is it okay for you if I take notes
9:29while you're explaining to me, so that
9:31the patient doesn't stop until you take
9:33notes and they continue explaining what
9:34they need to explain? And then, there
9:36are some diets that prefer to first
9:38listen to the patient who explains, and
9:40then say: "Well, here it is, I'm going
9:42to write it down, I'll give you a
9:43summary", and explain out loud, in fact
9:45, what they are writing at the same
9:47time to their patients. And above all,
9:48well, as you were saying, uh, well, it
9:50shouldn't be very long, it shouldn't be
9:51great literature that we have to write
9:53down. And that's what's useful about
9:55the templates that are available on My
9:57Diet Tracker: it's, well, we're just
9:58going to put keywords, short sentences
10:00to remember the important things that
10:02the patient said, but we're not writing
10:04great literature. For me, if you
10:06remember Marion at the very beginning,
10:08I was also really reluctant to take
10:09notes on the computer. I was, I still
10:12have a few in hand sitting next to me,
10:14to also put them on paper. I was really
10:18afraid of feeling distant from the
10:20patient and in the end, well, I don't
10:22remember how long ago, I switched to
10:24the digital version, but it's been like
10:264 years? 4 years, 5 years, I think I
10:28switched to the digital version and
10:30it's clearly much more practical. I
10:31always have my files with me. So if I
10:33have to go and do some work on another
10:35file during a gap in my consultations,
10:37well, I know how to do it. If I have a
10:39patient who arrives unexpectedly,
10:40because I've had problems with my agent
10:42before, I have a patient who arrives
10:43unexpectedly. And so my kids with me
10:46and clearly, I have to print a lot less
10:48paper too because it used to take up...
10:50I still have four big drawers with some
10:53of my files and 50 million binders in
10:55my office. So clearly, it's a lot less
10:58paper. There you have it. And then
10:59there's something else I had, I'm a bit
11:01of a chatterbox here, I apologize
11:03Marion. Another thing, sometimes, is
11:07when you talk to dieticians who do this
11:09, and it's really without any judgment.
11:11Sometimes when you only have one or two
11:13patients a day, you think, "Oh, I have
11:15time after my consultation to put
11:16everything in order." It's also
11:18reassuring to do that. That time, that
11:21half hour or hour that you take to copy
11:24, that time—especially if you're
11:26starting out as a freelancer—spend it
11:29developing your freelance business,
11:31taking steps that will help you get
11:33more patients. And don't spend that
11:35time trying to be a good student and
11:37trying to do everything perfectly,
11:38because that won't change much in terms
11:40of follow-up or your patient's
11:41engagement. So that time, that half
11:43hour or that hour, if you're just
11:45starting out, you're working to develop
11:47your private practice. We recommend at
11:49least 10 hours per week. So if you're
11:51starting out in private practice, at
11:53least 10 hours per week should be spent
11:54on making yourself known and developing
11:56yourself. So that's it, that time
11:58should be spent on that.
12:00Yes, you're right to point that out
12:02because the discussions I've had are
12:05with people who are starting out in
12:07private practice and who also have that
12:10time to copy notes onto the computer.
12:12Except that we also quickly fall into
12:15consultation habits that are rather
12:17difficult to break later on. And when
12:19we start to have more patients, it can
12:22really become a problem to have gotten
12:24into the habit of taking out paper and
12:26copying, and that's time that we're
12:28inevitably spending on other tasks.
12:30Sometimes I do put it in anyway, that's
12:32it, it can be painful, maybe for some
12:35people, I really apologize. Sometimes
12:37it's a bit of disguised procrastination
12:39, the fact that I don't know how to
12:42make myself known, I don't know how to
12:44develop my freelance business, I don't
12:46dare contact a doctor or whatever. And
12:49so we spend this work time on a job
12:52that should be used for something else.
12:55So that's what I call disguised
12:58procrastination. So we should be doing
13:00certain things, but instead we choose
13:02tasks that are less difficult, giving
13:04ourselves a clear conscience by telling
13:07ourselves that I am working anyway.
13:09It's perhaps not the task that should
13:11be the most useful to do at that time.
13:14Okay, I may be a bit confrontational, I
13:16admit, but here's the thing: trying to
13:17do the right things at the right time,
13:19the most effective things. That's also
13:22why we wanted to do this episode today,
13:24so that your time is used as best as
13:26possible. Absolutely. And then the
13:28second point, I think it's the mistake
13:31that we've all made as dieticians, that
13:34we still make sometimes, is not daring
13:37to reframe our patients and make
13:40appointments that last 2 or 3 hours.
13:43I've heard that before. Really, that's
13:45the mistake that happens all the time,
13:47which can be really challenging,
13:48because I really remember doing very,
13:50very long consultations at the
13:51beginning and thinking to myself, but
13:53not seeing any way out of it, thinking
13:55to myself, but how am I going to make
13:57shorter consultations because now,
13:59overall, I'm going to take on three
14:00patients a day and I can't do more. So
14:02it's really, really difficult at the
14:04start. These are things that you can
14:07continue to do later on. You always end
14:09up with a patient. There you go, we
14:11didn't get there. But in any case, you
14:14have to know that it's a really common
14:16mistake, very challenging, but really
14:18keep in mind that I think all diets go
14:20through this very long consultation
14:22that makes us feel a bit overwhelmed.
14:25There you go, it happens to everyone.
14:28We can feel the memory, Marian. Okay,
14:31we're going to try to see some tips for
14:33this. And while preparing the episode,
14:35we laughed because I said to Marion, uh
14:36, I had another 15 days ago, I had
14:38another consultation that lasted an
14:39hour and 45 minutes. I felt bad. Then,
14:42I said to myself, what the hell did you
14:44do there? It was the end of the day, so
14:46that's it. So it happens even with the
14:49best tools and the best will, we still
14:51manage. We have the patient there, and
14:54given the context, well, it was really
14:56quite comical. So to help you avoid
14:58having this kind of situation too often
15:01, I realize that it's at the end of the
15:03day when I'm tired, these are my last
15:06patients, that's when I really have no
15:08energy. That's when it really goes
15:11wrong most of the time. And often, we
15:14also end up in situations where we are
15:16unable to refocus the conversation,
15:18because we simply do not dare to
15:20interrupt the patient while they speak.
15:23And that's what creates a bit of chaos
15:25in this type of consultation. And then
15:28we just have to have a patient who
15:29talks a lot, who wants to tell them
15:31their whole life story, and well, it
15:32all goes to pot. And what happens is
15:34that the patient, as a result, ends up
15:35exhausted, and we ourselves do not feel
15:36particularly proud of the way that our
15:38consultation went. Because often things
15:43go off in all directions and you don't
15:45get the results you wanted at the end
15:47of the appointment, and secondly,
15:48you're completely exhausted afterwards.
15:50So, as you said, if you only have three
15:53appointments like that a day, well,
15:55financially, you have to charge a lot
15:58for the consultation.
16:01A few tips, that's also the goal of
16:03this episode, to share advice with you
16:05to achieve that. The first thing was to
16:08set a clear framework when you start
16:11your consultation. So, in fact, I
16:13always explain it at the first
16:15appointment, but in the past, I hadn't
16:17done it, I hadn't done it, I remember,
16:19I hadn't set my framework. When she
16:20arrived, she left, she started right
16:22away, I didn't have time to put my
16:23stuff down and it really went to.
16:24So it's really important to set the
16:26framework when you start the
16:28consultation, how this first
16:29appointment is going to go. And also,
16:31during the first appointment, I explain
16:33how the follow-ups will go, so they can
16:34already see how long it's going to take
16:36, what we're going to do, the work
16:37they're going to have to do at home
16:39beforehand, etc. So everything is
16:40already very clear, in fact, for them.
16:42It's also important to work on your
16:44posture as a professional. So you can
16:47say no, you can reframe with kindness.
16:49That doesn't mean you're a bad
16:51dietician, that you're a bad dietician.
16:53It's not at all authoritarian or
16:56pejorative to reframe a patient, really
16:59. But we do it by reframing and saying,
17:00"Okay, here we go, we're going to do
17:02this now, it's time, we have to move on
17:03. It's important that I ask you this
17:05and that question now." That also shows
17:07them that you have mastered your
17:09subject, that you are used to doing
17:11consultations, that you can be trusted,
17:13that you are a good guide for your
17:15patient. And so it's actually quite
17:17positive to reframe and actually give
17:19your patient the right direction when
17:21you see that they are getting a little
17:23lost. Also, at the end of a
17:27consultation, we shouldn't, in any case
17:29, at the first appointment because it's
17:31often the first appointment that starts
17:34. There you go. We're not here to
17:38answer everything, to solve everything,
17:39to answer all the questions. We'll come
17:41back to that later. But we needn't
17:43cover, understand, and know everything
17:45about our patient at the first
17:46appointment. So we need to know the
17:48general idea, but also a little bit
17:50about his background. And we are mainly
17:54there to help him see things more
17:56clearly, to give him tips, to give him
17:58goals to achieve for the next time and
18:01to make him happy and want to come back
18:04to his next appointment. So that is
18:06also the goal of the first appointment
18:07and not to know everything and give him
18:09everything. Otherwise, it is not
18:11expensive in any case for the first
18:12consultation if he already has
18:28everything for € 60. And also, uh, uh
18:33, finally, uh...Uh, and there are
18:36others, well, there you go, they are
18:39more effective over half-days, either
18:41in the morning or in the evening, and
18:43so on. So it's important to also know
18:46at what time of day you are most
18:47effective, most attentive, most focused
18:49, and to be able to plan your
18:51consultation schedules accordingly.
18:53There you go. And I think it's
18:55important to also keep in mind that the
18:57patient, because it's true that we all
18:59have these patients who embark on their
19:01personal story, you know, who will
19:02develop it, and that's often where we
19:04can't cut them off, because we think: "
19:06Well, the patient needs this space to
19:08express what they've experienced," and
19:09so on. Except that it's not always
19:12constructive and effective for the
19:14patient, because we're not there to...
19:16we're there to listen to the patient's
19:19experience, of course, but sometimes it
19:21can go beyond the scope of the dietetic
19:24consultation, and that's where you need
19:26to know what's interesting and useful
19:29for their follow-up, and what's not the
19:31place for all that. So I think that
19:34reframing the patient on the objectives
19:36of our follow-up in the dietetic
19:38consultation, and perhaps referring
19:40them to follow-up with a psychologist,
19:43a psychiatrist, or whatever, if there
19:45are things to complete what needs to be
19:47addressed and having the space to do so
19:50fully, is important. And not saying to
19:52yourself: "I'm cutting my patient off,
19:54it's not caring or it's not..." Well,
19:56actually, no. You also need to know
19:58what will be useful to your patient,
19:59what will be effective for their
20:01follow-up, for their consultation. And
20:03sometimes, reframe things by saying: "
20:05OK, uh, we've seen this, what are we
20:07going to do together?", and again as
20:09you said, reframe the framework of our
20:12consultations and our support. What are
20:14we going to work on together and what
20:16can perhaps be worked on elsewhere,
20:18because during this first consultation,
20:20there are lots of things that will come
20:21up and we, the dietician, won't be able
20:23to discuss everything and work on
20:25everything with the patient. So, uh,
20:27well, the difficulties I've had are
20:28really with patients where, uh, well,
20:30there are, uh, traumas, there are
20:32things that come up and, all of a
20:34sudden, we find ourselves quite quickly
20:35overwhelmed. And that is when it is
20:37hard to cut the patient off. And there
20:39you have it, so it's important,
20:40obviously, to listen to them and not
20:41tell them, "No, I don't want to hear
20:43that at all." But there are also ways
20:45to refocus the consultation and help
20:48the patient find other places, perhaps,
20:52where they'll have more space and time
20:55to discuss all of this. The third point
20:58we wanted to address was regarding the
21:00use of tracking apps like our diet
21:02tracker, which involved looking at what
21:04our patients have written down on the
21:06app every day. So, for those who aren't
21:08familiar with my diet tracker, the idea
21:10is to offer patients a logbook on an
21:12app where they can enter their meals as
21:15well as everything that happens during
21:17their day so that they can see what
21:19works and what doesn't work as well,
21:21take pictures of their meals, track
21:23their goals, and so on. The mistake we
21:25can make when starting out is to check
21:27when we have few patients, it's still
21:29possible, and check every day what our
21:31patients enter into the app because
21:33it's really interesting. I remember
21:35when I first started doing this, I
21:36checked every day that my patients came
21:38in. In fact, we really learn a lot
21:40about the patient. It's also reassuring
21:42to say to ourselves, "Ah, OK, I
21:43understand their portions better, what
21:45they eat, and how they organize their
21:46days, I'm going to be able to help them
21:48better." So it's really, really
21:50reassuring for us and gives us this
21:52feeling of really knowing our patient
21:54better. Except that really doing this
21:57every day suddenly becomes a huge
21:59mental burden on our side. We also make
22:02ourselves available to the patient
22:04non-stop and that can be very, very
22:06time-consuming. So there is both this
22:09desire to be super present and to
22:11pamper our first patients, to want to
22:13do better with them as well, but the
22:15difficulty of setting limits. So I
22:18think it is super important before even
22:19starting with my CD. This is a piece of
22:21advice that I always give when I do my
22:23demos with diets: to say how you want
22:25to use the tool with your patients. Do
22:27you already want to make it a service
22:29other than your consultations? And
22:30therefore provide too much support
22:32outside of sessions? Do you just want
22:33it to remain a tool for your patients
22:35and not see it at all? But in any case,
22:37think about it first and then set the
22:39framework with the patients, set your
22:41limits. How am I going to use it as a
22:43dietitian? Am I going to watch your
22:44meals? And then in concrete terms, in
22:47my schedule, how am I going to organize
22:49this service? So, for example, set
22:51aside a time slot once a week that will
22:54be just for follow-up via the app
22:56dedicated to consultations, but that
22:58will be organized into our schedule to
23:00clearly set our own limits. And then,
23:03talk to the patients about it, say: "
23:05Here, once a week I'm going to look at
23:07the content of what you've put in the
23:09diary. You may or may not see a little
23:11bit of feedback, a little message of
23:13encouragement." It can be done like
23:14that, but in any case, the first thing
23:16is to frame it on our side, in terms of
23:18diet, so that we can then set limits
23:19with the patient and clearly explain to
23:21them how it's used. And then, there's
23:23also the possibility on Mon Subsidy to
23:25automate certain tasks. So we can also
23:28encourage exchanges between
23:29consultations without it being feedback
23:32on what they've specifically noted in
23:34the app. That is to say, we can also
23:36program a message, uh, notifications at
23:38the end of a session so that the
23:40patient automatically receives little
23:43words from us of motivation,
23:44encouragement, or in the messaging
23:46system, a week later, to offer them to
23:48take stock of how the first week went,
23:51uh, what they managed to put in place,
23:53what their difficulties were. So these
23:55are things that we can program in
23:57advance so that we don't have to think
23:59about them later between two
24:00consultations. So this can also help to
24:03create a concrete link between
24:04consultations without necessarily
24:07requiring time for us to go and see
24:09what the patient noted in the app. So
24:11frame this well because it is a real
24:13service, it is a real quality of
24:15chemistry that we can offer to patients
24:17via apps like this, but it is something
24:19that must be organized and thought of
24:20as an additional service in terms of
24:22cost. Uh, it's true that we haven't
24:24talked about it, but we've mentioned it
24:25in several episodes on Between Two
24:26Patients. But it's important if it's a
24:28service that we offer in addition to
24:30the consultation to think about it in
24:31terms of the cost it could have for the
24:33patient and especially the organization
24:35on our side. I really like the
24:36reassuring aspect. It's true that, when
24:38you're starting out, especially when
24:39it's your first patient, you need to be
24:41reassured. And so, it's a very
24:42reassuring aspect, the fact that we can
24:44see, before the patient comes to the
24:46office, a little bit about what they
24:48ate and what was easy, what was
24:49difficult for them, and maybe even
24:51start with some little tips. That's
24:52true. Uh, it's true that sometimes if I
24:55have 5 minutes before the consultation
24:57I still take a quick look at their food
25:00diary, but it's really something that I
25:02don't do at all outside of
25:03consultations. If my patient doesn't
25:05specifically ask, we'll look at that
25:06day because I had a bit more difficulty
25:08and they didn't come to ask me a
25:09specific question. I'm not going to
25:11check everything my patients noted.
25:12It's really time that I devote to it
25:14during the appointment and it's also
25:16what I recommend in the top
25:17consultation training, because we work
25:19a lot with the top consultation
25:20training with the my diet monitoring
25:22tool. It's not a tool that is mandatory
25:24to follow the top consultation training
25:27but we still strongly recommend it in
25:29the training. But what we really
25:31recommend is that during your
25:33consultation, you dedicate yourself to
25:36checking what has been entered on the
25:38application, whether it's photos,
25:40trackers or whatever, but to be able to
25:42take that time during the appointment.
25:45So there you have it. So, tip 4, not
25:47tip 4, trap 4, what did we call it? Tip
25:524 that is not worth it in any case.
25:54There you have it, that's it. It's
25:56about creating personalized documents
25:58for all these patients and therefore
26:00working on the text, the design and all
26:02that adapted for all patients. That's
26:04also something we notice a lot among
26:06young dieters, is wanting to create
26:08beautiful things on Canva, nice design,
26:10well adapted for the patient, almost
26:12with the patient's name on it and so on
26:15. Uh, we are not at all into this
26:17philosophy of creating personalized
26:19documents because it is also work that
26:21is done outside of consultations, that
26:24is not paid for and that is not
26:26particularly useful, or even not useful
26:28at all. We are more into telling you, "
26:31Make a template document for all your
26:34patients." So you work on a thematic
26:36activity on a topic. So here you are,
26:38you want to discuss, I don't know,
26:40omega-3 with your patients, but you
26:42create a template document on omega-3
26:44and distribute it to all the patients
26:47you discuss this topic with, and you
26:49can adapt the advice on it if necessary
26:51. I cross things out or add things by
26:53hand. It's a document that I often
26:55print out and give to the patient
26:56personally since I work in an office.
26:58But for those of you who are working
27:00via video, you can also share all of
27:02your documents directly by using the
27:04tool provided here. And so, uh, the
27:06patient can also, uh, uh, receive and
27:08consult the documents, at least on it,
27:10but it will be the same for everyone
27:12and that way you do it once and that's
27:14it, we don't talk about it anymore and
27:16you have the same. And for me, I'm 80,
27:18so for me it's, uh, 20%work, 80%results
27:21, that's kind of my philosophy. So I'm
27:23not at all into fancy, super-designed
27:25stuff. Look at my Instagram account.
27:27It's not the most effective, but it's
27:31effective and the messages get across.
27:34And that's also my philosophy for my
27:37patient documents. So the goal is for
27:40the patient to leave with tools, tips,
27:42and advice to help them take action and
27:45change their habits. So if there's a
27:48nice document, a nice design on it, or
27:50if the writing is a little less nice,
27:52well the goal is for them to take
27:54action, and in general that's not
27:55what's going to make them change. In
27:57any case, the 5th trap, the mistake
27:59that can waste time, is wanting to
28:01answer all the patients' questions and
28:03give them all the information during
28:05the first appointment. So, we touched
28:09on this a little earlier about
28:10consultations that last a very long
28:12time, but what we wanted to talk about
28:14here was really the fact of saying that
28:15sometimes during a consultation, and
28:17this is what we were taught for a long
28:19time, is that our role is to provide
28:21information to the patient, to tell
28:22them what to do, to give them as much
28:24nutritional information as possible, to
28:26give them as much knowledge as possible
28:28during the consultation. So that's
28:30something we were taught a lot. I think
28:34it's changing a little bit, but that's
28:36sometimes the idea we have of a
28:38consultation. And when we start, we're
28:40still kind of thinking: "I'm going to
28:42have to give my patient the keys, to
28:44give them all the information they need
28:46to know from the very first appointment
28:48.""So I think we shouldn't forget that
28:50patients aren't just coming to get
28:53nutritional information, but that
28:55they're actually there to help them
28:57take action and to support them in
28:59their daily lives to establish new
29:01habits. So I think it's important that
29:03they feel that from the very first
29:05consultation. The problem with sticking
29:08to the idea of" we give patients
29:10information "and just knowledge is that
29:12this approach doesn't leave much room
29:15for patients, it puts them in...in fact
29:17, they remain spectators of their
29:20follow-up and, overall, it doesn't
29:22promote long-term change. They'll just
29:24listen to what they're told during the
29:26consultation and when they get home,
29:27they'll have to go back to what the
29:28dietitian said. Oh yes, she told me to
29:30eat this. She told me that the best
29:32foods were this. There you have it. And
29:34it's not necessarily adapted to their
29:35daily life and it's not necessarily in
29:36line with their own motivations. So
29:38it's complicated in the long term. The
29:40idea is rather than giving him a ton of
29:42information and knowledge, it's to
29:45explore with him what he's going
29:47through, what he already knows, what
29:49he's tried, and what hasn't worked in
29:51his daily life. So it's already really
29:54important during this first
29:56consultation to explore his daily life
29:59with him and then to build his own
30:02goals with him. So don't also tell him
30:04during the consultation," Well, we're
30:06going to do this and that based on our
30:08own opinions and according to an ideal
30:10patient who should set such and such
30:12goals at the end of a consultation. "So
30:15really rebuild his goals with him based
30:16on what he's told us, based on what
30:18we've explored with him. Uh, also to
30:21validate his own resources, uh, to
30:22validate his small victories, even if
30:24it's not directly related to his diet,
30:26but to also know how to observe what
30:28he's already doing well in his daily
30:30life. That's what we can rely on, and
30:33that he's aware of it, that's important
30:35. And then, give him tools during this
30:37first consultation. That's when I talk
30:39about the application, for example, and
30:41show him that it's going to be a
30:43working tool for him once he gets home.
30:45It'll allow us to observe what's going
30:48on with him even better. What's working
30:51well, what's not working so well. It's
30:53really going to be an exploratory tool
30:55that will also put him back at the
30:56center of his follow-up and will allow
30:58him to be an active participant in his
31:00care between consultations. It could be
31:02the application, but it could also be
31:04questionnaires that we'll give him
31:06between consultations. Again, to get
31:07more feedback, to find out what's
31:09working, what's not working so well, to
31:11encourage him to think about his
31:13resources, his difficulties, and that
31:15too can be a way for him to remain an
31:17active participant between
31:18consultations. In any case, in this
31:21first meeting, we need to get out of
31:23this position of" I know and I'm going
31:25to pass this knowledge on to the
31:27patient "and instead work in
31:28collaboration with the patient. What
31:31will work for my patient? What can we
31:34put in place together? What will be
31:37effective for him or her? I completely
31:39agree with you, Marion, and this is
31:42somewhat of a link to the last point we
31:45wanted to discuss with you, which was
31:47to stop wanting your patients to also
31:52become dieticians. It's not at all
31:54their goal, and it's not at all your
31:56goal, to make each of your patients get
31:59a BTS in dietetics. I have a small
32:01anecdote, and my colleague will
32:02recognize herself if listening. It made
32:06me laugh and it really made me think of
32:09this colleague who...We were together
32:12at a trade show and a little lady came
32:15up to her and asked her a question. The
32:17little lady said:" Tell me, is it just
32:19as good to eat a dish of compote as it
32:21is to eat a piece of fruit? "That was
32:23the little question from the lady who
32:25asked that. Well, I think, yeah, that's
32:27it, because she had a little question
32:29to ask a dietician. And so my colleague
32:30, in all her goodness, in all her
32:32kindness, and with all the devotion she
32:34holds for her passions, began
32:36explaining some truly great things to
32:38her; it was really quite something! It
32:40was wonderful how she explained it to
32:42that lady, but she began discussing the
32:47glycemic index and the impact of fruit,
32:49fructose, and glucose on the body,
32:50which was all quite fascinating and
32:52informative to hear. She knows a lot of
32:54things, but I think the little lady
32:56felt completely overwhelmed by the
32:59information and that she didn't expect
33:01an answer like that from my colleague.
33:03And so, that made me think a little bit
33:06about this last point. So, in fact, in
33:08any case, what we wanted to convey to
33:10you in relation to this is that, uh, we
33:13should still talk to each other as
33:15little as possible during consultations
33:18because otherwise our patients really
33:20lose interest and, uh, if possible,
33:22also use visual tools to simplify the
33:24information as much as possible for
33:27your patient. So, I use Ludiconsulté
33:29games a lot, which are available on the
33:31website ludiconsult.com, which are
33:33really simple tools, visual tools that
33:36allow us to explain concepts that are
33:38sometimes more complicated, more
33:40abstract to our patients, which seem so
33:42simple and obvious to us, but for the
33:44majority of the population, these are
33:47still very complex and abstract
33:48subjects. And so these tools really
33:51simplify the messages and make them
33:54much clearer for all our patients. So
33:57another question that I like to ask
33:58when a patient asks me, what do you
34:00think about applesauce? What else do
34:02you think about? It's asking her to
34:05formulate a question again and asking
34:08her," What is your question? "What are
34:11you thinking about? What do you expect
34:14from me in relation to this? Do you
34:15have a situation? Is it already for you
34:17? Is it for your children? That's it,
34:20so you can ask more questions than just
34:22starting out with something very
34:24abstract, very theoretical. So you can
34:27simply ask patients questions and in
34:30fact the answer often comes much more
34:33easily that way. So really simplify
34:37your messages. That's really the big
34:40message that we wanted to get across to
34:42you regarding this point. I think we've
34:44covered it all, Marion. That's good for
34:45you with this episode. We've been a bit
34:47chatty as always. We apologize for that
34:49. We're preparing our podcast for you.
34:51We're preparing, we have our, we still
34:53have a little outline, we're trying to
34:54follow it but we can't. At the
34:56beginning, in the very first episodes,
34:59we were able to do it, but over the
35:00years, we've been less and less able to
35:03follow our outline of our episode plan
35:05and we deviate a little each time. We
35:07apologize, so we make extra long
35:09episodes. You say," Oh, come on,
35:10another hour-long episode to listen to,
35:12I'll never have time. "Okay, tell us,
35:13you can tell us if you prefer shorter
35:16episodes or longer episodes and then
35:18we'll try to adapt. There you go. In
35:22conclusion, that's it
35:23for the conclusion. So if you try to
35:28follow our advice as best you can, and
35:33to avoid the dietician fads that we
35:36said, I'll give you a quick summary. So
35:40you'll still be able to save time, and
35:42I think we've talked a lot about this
35:44time saving, this time saving during
35:46the consultation but also outside of
35:48the consultations to really do useful
35:50things, particularly to develop your
35:52business. We've also talked about
35:55serenity, relaxation, and confidence
35:58thanks to that. So also, we have...this
36:01is really our goal and the goal of our
36:03training, the goal of our tools too, is
36:05that you are more serene in any case
36:07during consultations, that it is not a
36:09rush, it is not stressful every day
36:11either, that it is pleasant for you to
36:13consult, that it is great for you to
36:15consult, that it is not a chore, also
36:17to have a better relationship with your
36:19patients. If they feel well guided,
36:21well listened to, there you go, you
36:23know where you are going to lead them,
36:26but it will clearly contribute to the
36:28relationship that you will have with
36:30them. And also, well we want you to be
36:33able to practice for many years in joy,
36:36happiness and serenity. And so, we
36:39talked in particular in an episode
36:40there not too long ago about burnout in
36:43January, we released an episode on
36:45burnout. So, uh, there you have it,
36:47these are also all the traps that we
36:49talked about here, these are also
36:51things that can accentuate this burnout
36:53during consultations, at least for
36:55dieticians, and so, uh, that we want
36:57you to avoid, and so this is also
36:59something that will help you in this
37:01regard so that you don't get exhausted.
37:03And then, uh, to summarize all that,
37:05the idea of this episode was also to
37:08tell you that to optimize your time and
37:10stay focused on what's essential, well
37:13for us, there are three important
37:15things to put in place. They are to set
37:18a clear framework from the start of the
37:20consultation, to use semi-automated
37:23frameworks and supports, let's say, and
37:25then to prioritize action rather than
37:27information overload. uh, always think
37:30in terms of efficiency, what will be
37:32effective for my patient. Thank you in
37:35any case for listening, for your
37:37faithful presence on the podcast, your
37:40support, your feedback, and all the
37:42discussions we have during these
37:44episodes. Each time, it's super
37:46interesting and enriching for us to
37:48have your feedback on each episode. So
37:51don't hesitate to continue. If you
37:53enjoyed the episode, consider
37:55subscribing to the YouTube channel or
37:57your favorite podcast so you don't miss
38:00anything that comes next. And don't
38:02hesitate to share and comment on each
38:04episode to tell us what you thought or
38:07simply to continue the discussion. If
38:10you see other things you may have made,
38:12uh, other mistakes you may have made
38:13that were wasting a lot of your time,
38:15well, don't hesitate to tell us and, uh
38:17, share them with us. Or if you see
38:19other solutions that we didn't mention
38:21in this episode, well, don't hesitate
38:22to post them directly in the comments
38:24so that everyone can benefit from them.
38:27If you want to go further, as usual,
38:30we'll leave you with some free
38:32resources in the video description. You
38:35can download the guide for
38:37ultra-effective dietetic consultations
38:39from Diète en Transition or discover
38:41the Mon Suivi Diet app. So, to optimize
38:44your nutritional monitoring. There you
38:46have it, you'll also find a link to
38:48download our free ebook on digital
38:51monitoring. Thank you Marion, see you
38:54soon for the next episode. See you soon
38:57between two patients. Take care of
38:58yourself. Ciao Marion. Co?

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