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Working with neurodivergent patients and colleagues
19 Plays4 days ago
In the latest episode of our podcast In Conversation with the GOsC, our Head of Policy and Education, Steven Bettles speaks with osteopath Rosi Sexton about working with neurodivergent patients and colleagues within osteopathy. Rosi talks about her own journey into osteopathy and her autism and ADHD diagnosis, and how this has impacted and influenced her work with patients, including some of the small adjustments or accommodations practitioners can make when working with neurodivergent patients.
You can find out more about Rosi and Olton Health on their website as well as on their Instagram at @oltonhealthperformance. Rosi is also working on making musculoskeletal healthcare more accessible to neurodivergent people and helping MSK professionals to better understand the needs of neurodivergent people, and you can follow the journey at @neuroflect on Instagram.
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Transcript
Introduction to Podcast and Rosie Sexton
00:00:05
Speaker
Hello and welcome to another series of In Conversation with GEOSC, a podcast from the General Osteopathic Council. We regulate osteopaths in the UK and today I'm talking to an osteopath um as I'm joined by Rosie Sexton to talk about working with neurodivergent patients and colleagues ah in ah osteopathy and her own journey into ah osteopathy with a particularly diverse
Rosie's Career Transition and Background
00:00:36
Speaker
CV.
00:00:36
Speaker
hi Hi, Rosie. Hello, how are doing? How are you doing? I'm okay, thank you. I'm okay. um should Should we kick off by, perhaps you could tell us a bit about your your own kind of journey into osteopathy? Because I kind of, I sort of joked about a diverse CV, but I mean, it really is ah ah a sort of broad spectrum background. And an osteopathy is a career that does attract a lot of career changes.
00:01:06
Speaker
um And it's always ah interesting to hear you know the the routes that people have taken to end up as osteopaths. So, yeah, tell us tell us a bit about that. Absolutely.
00:01:18
Speaker
So i I started out in in maths. so So I was a very nerdy kid growing up. um i think, and and for reasons that will become clear later, people mostly terrified me.
00:01:35
Speaker
um and didn't make a lot of sense. So I found that but maths and science subjects were were reassuringly concrete. um but There was a ah one right answer, which as I say, as a and a child growing up, that was something that I um i felt really comfortable with. it um And for one reason or another, I got really interested in in maths and science.
00:02:04
Speaker
I ah followed that path, ended up doing a ah maths degree. sort of became institutionalised with the academia, um stayed on, did a master's and a PhD.
00:02:16
Speaker
um And at that point, for for various reasons, um i I'd been getting interested in martial arts for some time. i said That started off when I was a teenager.
00:02:30
Speaker
um I was never particularly sporty at school. and but But I discovered martial arts. I think it was something to do with that idea of wanting to feel more confident in myself and and sort of, again, something around that that fear of ah um of people, I guess.
00:02:53
Speaker
Yeah. Anyway, I um became really interested in that. That went from one thing to another. And around the time that I was doing my PhD, I discovered mixed martial arts, which was just starting to become a thing. It's obviously much more popular now than it used to be back then.
00:03:10
Speaker
um But that's something that that really fascinated me. So after I finished my PhD, I actually spent a bit of time competing professionally.
The Role of Osteopathy in Rosie's Life
00:03:20
Speaker
And that turned into a... um little bit, um, a career, if you like, um, professional mixed martial artist, um, but competed all around the world. i was the first British woman to fight in the UFC.
00:03:36
Speaker
Um, and again, along the way, i developed an interest in sports injuries. And some of that was from personal experience. Some of that was from the experience of people I trained with and, um,
00:03:51
Speaker
one of the things that I found was it was really hard to find um sports injury professionals who understood the sport because nobody really did at that time.
00:04:02
Speaker
So I spent a lot of time thinking about, well, how to rehabilitate injuries and um how to, what to do with injuries. and And and i i came across a very good osteopath um in my journey.
00:04:16
Speaker
I had a back injury at the time and ah this is where it's, I think quite a familiar story to a lot of people who get into osteopathy. um I had a really good experience. It sort of felt like magic at the time. It was like, how do you do that?
00:04:29
Speaker
and And then the next question was, how can I do that? um And that led me to investigate um osteopathy a bit further. I ended up going back to university. I studied at Oxford Brookes. I did the the part-time course um and qualified as an osteopath.
00:04:47
Speaker
So I qualified in 2010.
Early Awareness and Autism Diagnosis
00:04:50
Speaker
So, um I suppose you say I've, uh, um, uh, I came to it via the, uh, a ah slightly longer route and people who, uh, maybe know exactly what they want to do straight out of university.
00:05:05
Speaker
Um, but I think I've, I i joke sometimes that I managed to stumble across so something that just happened to fit the way that my brain works really well.
00:05:19
Speaker
And, um, it's been a, it's been, it's been the perfect career almost for, um for for me personally. So I'm, I'm grateful to have found that.
00:05:32
Speaker
So you, you, um you, you said that you, you knew you were aware that your brain worked in ways that were different to perhaps, you know, your, your fellow students or, or, or when you were at school, those kinds of things that you, you kind of, you knew that you,
00:05:48
Speaker
you thought about things differently, but you didn't have a diagnosis of of autism at that stage. So, I mean, I've been very aware since since being very small, actually, that I struggle to fit in with other people. And I think that was that was my first awareness of of being different, is that um
00:06:10
Speaker
i I suppose just that sense of finding it hard to relate to other people. And I'd find that um certain things which I suppose seemed obvious to other people weren't obvious to me and vice versa.
00:06:26
Speaker
um ah but Maths was a good example of that. there was it There was something about it that just sort of clicked with the way my brain worked. And I found that that maths problems Not that it was straightforward, because obviously, ah you know, I had to work at it and about it, but they made sense um in a way that other people didn't or a lot of the people around me didn't seem to find that.
00:06:49
Speaker
um And equally, you know, there there there are things that that my brain struggled to make sense of, like, ah for example, you know, social interactions and group dynamics and things like that.
00:07:01
Speaker
I couldn't quite figure out what was going on. um The other people just seem to pick up instinctively. So I suppose there was always a sense of why can't I fit in? Why can't i just be like everyone else?
00:07:13
Speaker
Um, and I think for a long time, you know, it's certainly growing up, um, I felt like I was really quite broken in the sense that, you know, my brain doesn't, doesn't work like other people's.
00:07:27
Speaker
Um, and there's often a real sense of, of rejection of, uh, um, Again, you know why can't I just be more like everyone else? um I think I sort of carried that with me. you know There were there are things that I could do particularly well, I think, that other people struggle with. that And I think because of that, um I sort of used those as cover for the things that I found more difficult, if you like.
00:07:55
Speaker
um And this has always sort of been a ah a running theme. um It was only in the last few years, actually, since COVID that um I suppose I started thinking a little bit more about ah diagnosis for that.
00:08:11
Speaker
And um I think part of that was driven by hearing accounts of other people who'd been, um who'd had a ah diagnosis of of autism or ADHD as an adult um and sort of their experiences and being able to really relate to a lot of those experiences.
00:08:29
Speaker
Um, I think that was perhaps something that, um, that influenced my thinking. Um, I also had a friend who, who is also autistic and, um, I think there was one point at which she said to me, do you have an autism diagnosis?
00:08:46
Speaker
Um, ah actually, I mean, again, I wouldn't necessarily recommend framing it that way with people, but as it happened, that was a really good, good question. Um, and again, that sort of got me thinking about, um,
00:08:58
Speaker
ah looking into things a bit further. And, um and that's where I discovered that actually there's a whole community of people out there who have a similar set of experiences around finding it difficult to fit in, um finding it difficult with communication, um having challenges with sensory sensitivities, which again is something that I struggled with all through my teenage
Impact of Neurodivergence on Rosie's Approach
00:09:21
Speaker
years. And, you know, I remember going through a whole period at school where I'd, um,
00:09:27
Speaker
and sort of feel really unwell and need to go and sit somewhere quietly um and I can recognise that and in hindsight as as sensory overstimulation but I just didn't have any words for it at the time, I didn't have the language to explain that um and I think that led to a lot of ah i mean worry and concern from my parents because obviously I had this sort of mysterious illness that no one could quite pin down um and also I think my own part of not understanding why I was experiencing these things that people other people didn't seem to.
00:10:01
Speaker
So i think when I started looking into it, it it all started to to make a lot more sense of some of these things. And I think the biggest thing that I found was actually um by engaging with some of this online community in some of those neurodivergent spaces, people who were talking yeah openly about their own experiences of autism,
00:10:24
Speaker
and It sort of helped me, one, to realise that I wasn't alone, but also um to pick up some of the yeah the tips and ideas people had for how to how they managed these things. um And I found a lot of that really useful.
00:10:41
Speaker
um i think that that sort of put me put me on that on that journey, if you like. And it's taken me a few years to to really start to process some of that.
00:10:55
Speaker
um and to it to and implement some of those changes in my own life. But I think it's got me to a place where I understand myself a lot better and I'm a lot more comfortable with myself than than I was. um And I think that's also fed into a lot of the work that I do with other people as well.
00:11:13
Speaker
um And it's it's made me better able to both utilize the strengths that I have um and the skills the ways that my brain works that actually make it really good at doing some of the things it does, um but also to compensate for some of the things it does less well um and to find ways around that and to um to make adjustments for it. So ah I think that that's been been a really helpful thing for me.
00:11:44
Speaker
Yeah, that that sort of self-acceptance of this is who you are, this is how you manage. I mean, in that respect, they're out respect in terms of osteopathy as a career,
00:11:56
Speaker
um you know the the the description you gave of your kind of you you your younger years and and that the the sort of social challenges of just interacting, communication with with people...
00:12:09
Speaker
Would you have predicted then that you would end up in a career where there is kind of intense communication with and on a sort of one-to-one basis? Is that easier to manage than than a group so sort of scenario?
00:12:22
Speaker
So I think if you'd asked me um when when I was so growing up um about what I'd see myself doing, this absolutely would not have been it. and I think the whole idea of working with people on quite such a...
00:12:39
Speaker
intense basis, that would have that would have scared the life out of me back then. um And I think that's something that I very much learned how to do. um and i mean, that whole journey that I've been on sort of through maths and science to and quite an intense sporting environment and then going from there to the healthcare side of things.
00:13:04
Speaker
I think it's something that ah that I've learned along the way Um, and actually I think the way that I interact with people is perhaps different from the way that some of my neurotypical colleagues might do.
00:13:17
Speaker
And I think that comes with both pros and cons. Um, I think, uh, I mean, for example, one of the the strengths that I think I have is that i don't make as many assumptions as I think some people do, because I know that I struggled to read people. I struggled to read body language.
00:13:35
Speaker
I struggled to read facial expressions. So I ask a lot of questions because I don't make the assumption that I know what's going on in that person's head. um And I think sometimes perhaps people wonder why I'm asking quite so many questions, but I think it also allows people to to explore much more about what is going on for them.
00:13:57
Speaker
And and it saves me from maybe assuming things that, i mean, one of the the common complaints that neurodivergent people patients have a lot of the time, and I'm sure we'll come to more of this later on.
Understanding Neurodivergence in Osteopathy
00:14:10
Speaker
um One of the common complaints I have is that um healthcare professionals make assumptions about how much pain they're in from their body language and their facial expressions. And they'll say things like, it doesn't look like you're in that much pain.
00:14:23
Speaker
So they won't treat that pain seriously. and And again, I think that's something that I am perhaps a little bit less inclined to do both because I know how it feels to be treated in that way but also because again I don't ah um I rely less on my ability to read that person um and if if in doubt ill I'll just ask the question um and I will take people's um uh
00:14:54
Speaker
i will I will take somebody's word for it. You know, if somebody tells me they're in pain, I'm going to believe them. um I'm not going to second guess that based on on how they look. and And how would you um you, know, what would you, what would your and you've written some some interesting articles in the ah Institute of Osteopathy magazine I've i've read recently. and And you talk in there about how you, the sort of steps that osteopaths can take to support patients with different, you know,
00:15:24
Speaker
ah whether they whether they are neurodivergent or aware of that or not, you know how how you operate a sort of inclusive practice in that respect. And that that kind of you just described there that comes from your own way of thinking in your own diagnosis and and just being, you know, not not making assumptions and being doubly short by asking questions to to really get the information you need. is that Is that the sort of thing that you would advise others? how would you How would you suggest that we can all start to think about this a bit more?
00:15:58
Speaker
Yeah, absolutely. i mean, I think the first thing with neurodivergence is realising that we all, I mean, I think there's an underlying assumption um when we interact with other people a lot of the time that other people see the world in basically the same way that we do, that their brain is processing that sensory input in a similar way to the way that ours does.
00:16:24
Speaker
And the thing that we're starting to realise with the the neurodiversity movement in general more widely is that actually individual brains can differ quite significantly in how they process the world, um, in the, the waiting they give to different sort of input channels, um, to, to how they so construct a sense of reality.
00:16:50
Speaker
Um, you know, and we, uh, we all have slightly different operating systems. Now when somebody differs from, I suppose the norm sufficiently, that's where we start to think of people as being neurodivergent.
00:17:07
Speaker
Um, and um Just a quick word on terminology. Neurodiversity is the sense that neurodiversity basically means that ah people have a range of different ways in which they their brains operate and which they process the world.
00:17:24
Speaker
um So a neurodiverse population is ah a group of people, all of whom have different ways of engaging with with reality, if you like. So that might include autistic people, it might include people with ADHD, it might include people with learning differences, um, uh, that there's a whole range of these conditions that could be included in that.
00:17:47
Speaker
So a neurodiverse group is just a group of people, all of whom process the world in different ways. Um, to say that somebody is neurodivergent, um, is to say that their brain differs from what we might regard as, as normal sufficiently that, um,
00:18:09
Speaker
they experience certain challenges because of those differences. um ah So typical conditions that would be neurodivergent, autism, ADHD,
00:18:22
Speaker
um OCD, dyspraxia, dyslexia, certain mental health conditions, Tourette's syndrome. And again, you know we can take quite a broad definition of this.
00:18:36
Speaker
So when I say neurodivergent, it can refer to any of that or even to people who don't have a diagnosis at all and perhaps wouldn't even qualify for a diagnosis, but who find that their way of of interacting with the world differs from the people around them and that that causes them difficulties.
00:18:57
Speaker
um And I think this actually fits quite nicely with an osteopathic way of thinking, because we don't necessarily need to pin a label on something in order to make allowances for it.
00:19:09
Speaker
um And what I'll always say to people is that it's much more important to look at um what that person's experience is and what that person's needs are and to to make accommodations for those rather than to worry about exactly which label we should put on it.
00:19:26
Speaker
So if somebody is, um i mean, one of the challenges that many neurodivergent people have is that they process sensory information in a different way. um And ah for example, if somebody's hypersensitive to to lights, for example, they might find that the bright lights or even lights that um other people would experience is perfectly um ordinary, no problem at all.
00:19:53
Speaker
They might find that that's too intense for them. So they may prefer to have a ah dimmer environment. um And those are the sorts of things that we can make accommodations for, again, without needing to worry about what that person's diagnosis is or isn't.
00:20:11
Speaker
um So being aware that there are people who who have some of these differences just opens us up to maybe asking some of those questions.
00:20:23
Speaker
Or if we start to see signs that somebody ah potentially has some traits that may fit into one of these categories, um we can be alert for for other things that might be going on. And it's worth saying as well, isn't it, that you know as osteopaths, we're not going to be diagnosing these... these No, no, no, no, absolutely. And I will always... Yeah, absolutely.
00:20:49
Speaker
and go When I talk to people so people about this, and I mean, it's interesting because um the more you you look into these things, the more you start to see some of these traits in the in the general population. And again, some of those will be people who have a diagnosis.
00:21:04
Speaker
Some of those will be people who probably would be diagnosed if if they were to to seek an assessment, but maybe haven't done so at least yet.
00:21:16
Speaker
um And then there are other people who who may um not fit into that category at all, but may just have certain traits in common. um And when I talk to people about it, and I don't always, you know, if if ah ah I might see somebody who has certain traits who are I start to wonder, well, you know, perhaps that person might be autistic.
00:21:37
Speaker
um I won't necessarily have a conversation about that. That would always depend on the context. There may be contexts in which it would be appropriate to have a conversation around neurodivergent divergence um but there may also be context in which that's unnecessary or inappropriate or it it wouldn't fit with the reason that that person has come to see me um but whether i do or whether i don't talk to them about it i can still ask some of the questions around for example you know how are the lights in here you know is it or um if i'm going to use some some massage wax for example you know i might want to check with them whether the smell bothers them
00:22:19
Speaker
Again, that's something that um people with certain sensory sensitivities might find. Or if I find that somebody is struggling with coordination, for example, when I'm giving them instructions either during the treatment or um when but we're going through exercises, I might find that that person has certain difficulties either copying movements or following my verbal instructions.
00:22:43
Speaker
And again, I can just make allowances for that. I don't need to to make a thing of it. I don't need to... um ah you know have a um either you know start talking about diagnoses or something like that, I can just notice that that person is having a particular issue with that.
00:23:01
Speaker
um do do do you set you ah Do you ask all patients, do you have any preferences in terms of, you know do you have any sensitivities or um you know preferences from that perspective that you you might need to take into account?
00:23:17
Speaker
That's a good question. I think it it depends on context. I, there's an interesting question as to whether I should actually just ask that as standard as part of my, um, uh, my introductory session.
00:23:30
Speaker
Um, I don't, and I think it's because there's so many things that you could ask about if you were to ask about all of them, you'd be there all day. Um, so there is an element of judgment there. and,
00:23:42
Speaker
and
00:23:45
Speaker
I will ask about things like, you know, diagnosed medical conditions and um that and that gives people an opportunity to bring some of these things up.
00:23:57
Speaker
Again, if they think it's appropriate and if it's something that they want to talk about. Now, not everyone does. And it's true that not everyone will necessarily think of that as a medical condition.
00:24:07
Speaker
mean, there's a ah really interesting debate actually as to whether, you know, should we regard... autism as a medical condition. I think there's, there's two sides to that. Um, but, uh, um, but some people, some people will mention it. I mean, i've had people who've come in with wearing a, one of the Sun flight lanyards and, uh, saying that I'm autistic.
00:24:28
Speaker
Um, and actually that was a ah really good conversation opener. And, uh, um, you know, we got into a ah a chat about that and I asked her about how you find it lights in here. And she laughed and said, yeah, they're a bit bright. so we can adjust that.
00:24:44
Speaker
um And ah as that, that made things really easy, but there's other times when somebody won't necessarily say something. um And again, you know, sometimes you can pick up if somebody is uncomfortable, but sometimes you won't.
00:24:58
Speaker
um So I think giving, um giving people enough space that they can, that they can give feedback on, on things like,
00:25:11
Speaker
the environment and letting them know that it's okay to to do that. I think there's ways to signal that so that those are things that you're open to. And again, you know, i very often i I will, if I'm going to make put the lights on or turn the lights down or before I um ah do something, I will ask people, how do you feel about this?
00:25:36
Speaker
You know, is is that something you're comfortable with? um And if there's any hesitation or anything like that, then I might follow that up and pursue it a little bit further. um But I think it's it's being aware that these things can be an issue for some people um and sort of leaving space to have those sorts of conversations.
Building Relationships in Osteopathy
00:25:56
Speaker
what What about sort of... um you familiarising a patient who's expressed a particular, maybe an anxiety about coming to see you and, you know, having a conversation then with them in advance about what to expect. And, you know, maybe even they come in and see you, meet you first. So it's not the first time they meet you when when they first come in. I mean, do do you ever have situations like that?
00:26:23
Speaker
and So again, another really common thing, obviously, if somebody... Certain kinds of neurodivergence often are associated with social anxiety, with anxiety around change and different situations, unfamiliar environments.
00:26:38
Speaker
um And one thing that I try to do is to allow people to, if they um if they want to, and not everyone does, um to get in touch in advance of a session, to to drop me ah an email or to request a conversation.
00:26:56
Speaker
um And I'm always happy to, to arrange a phone call in advance of the conversation so that that person can um can ask any questions they've got, can get to know me, um and hopefully will feel a bit more comfortable about coming in.
00:27:10
Speaker
um I think, ah again, the more we can do that, and the more we can, again, offer those opportunities to people, um the easier it makes things, um or it can make some ah things for for somebody who who may be struggling with that.
00:27:28
Speaker
It's the opposite, like a lot of professions. It's so it's essentially about relationship building, building isn't it? At its heart. And I suppose anything that supports that process successfully. Absolutely. Yes.
00:27:41
Speaker
If you go on some of these neurodivergence awareness courses and things like that, something that people will often say is that... um good practice for neurodivergent people is just good practice for everyone.
00:27:53
Speaker
Because again, a lot of these things that you're putting in place can help everyone to feel more comfortable, whether they're neurodivergent or not. And I think that's the the advantage to this. um I do think that as osteopaths, um quite a hot ah a significant proportion of people who end up coming to see us do have some form of neurodivergence or at least some traits in that space.
00:28:20
Speaker
And I think there was some really well-established reasons why neurodivergent people often struggle with healthcare. um And I think the the more difficult it has become to access um some of the NHS healthcare um and things like continuity of care have become harder to um to establish.
00:28:44
Speaker
um access to appointments. um
00:28:49
Speaker
Again, the more pressed people are for time, the less they're able to give consideration to some of those individual needs. So I think a lot of neurodivergent people do struggle with um ah with healthcare in general, and very often they will look for other alternatives, and one of those alternatives may be osteopathy.
00:29:10
Speaker
So I think it's um it's not a coincidence that A lot of people who do come to see me are neurodivergent, you know, and I have patients who are autistic, who have ADHD, who have a whole range of different conditions.
00:29:24
Speaker
um Both people who know that they do and people who may suspect that they do, um but haven't had a diagnosis. ah And like as I say, we can, um one of the nice things about the way that we work is that we we can engage with some of those um differences in sensory perception um without ah get without that need for to to to put a label on it.
00:29:55
Speaker
yeah that's Yeah, that's a really good point. I think that's that's it, isn't it? it's about Because if you don't know, if so if if you if you have a patient and the patient doesn't even know that they haven't got a diagnosis, they're not they haven't even thought about it practitioner, if you don't treat everyone,
00:30:19
Speaker
with a degree ah of, of, uh, sort of, if not to say a equality, but just treat people the same, find out what their preferences are, what's important to them, what their needs are and, and do your absolute best to meet those, uh, in a way that works for them.
00:30:35
Speaker
Um, that seems to be the way forward. I mean, we, we spoke earlier about, um, yes about, um, ah ah about osteopaths themselves, practitioners, and, uh, you know, a background in osteopathic education and a lot of students have a neurodivergence, maybe more latterly than previously, but, um, there are a large number of, uh, osteopaths with this dyslexia, you know, that we know. Yes. Yeah. Yeah. I mean, I think we are a profession attracts neurodivergent people.
00:31:10
Speaker
Um, and again, I think there are some, there are some good reasons for that. ah going back to the same reason that I think a lot of patients are attracted to osteopathy. I think and a lot of practitioners come to osteopathy because they've had an experience with an osteopath.
00:31:29
Speaker
um And sometimes that can come out of some of our own challenges with the healthcare care system. And I know that I have really struggled in my life um with, um with seeing doctors for various conditions um and, and,
00:31:44
Speaker
again, I find that there are real challenges around communication when it comes to things like pain and and and perception of illness and and things like that. And those those have led to some really quite negative interactions with with doctors in the past.
00:32:01
Speaker
And I think that's perhaps one of the things which made me look at osteopathy as an alternative um way of looking at the body and ah of of treating some of these conditions.
00:32:15
Speaker
So I think, um, for the same reason that many of our patients may have, um, some neurodivergent traits, I think a lot of osteopaths do as well.
00:32:27
Speaker
Um, and I think um some of us and more people now, there's a lot more public awareness of it. A lot more people are seeking diagnoses as adults. And I think actually that's a really positive thing because that allows us to, um,
00:32:43
Speaker
to understand ourselves better. um And again, to make the most of our strengths and to to compensate for some of the our weaker areas.
Adaptations in Practice Due to Autism and ADHD
00:32:53
Speaker
yeah um and would How would you support colleagues if you in in that in those circumstances? how how would What would you do to sort of... So, I mean, I can maybe start by talking about some of the things that I've put in place in my own practice.
00:33:08
Speaker
um Now, I have a diagnosis of autism and ADHD. um Again, that's come as not particularly surprising to a lot of people who know me, um and particularly if you look at my background.
00:33:24
Speaker
um
00:33:27
Speaker
I think what that means for me personally is that um in the context of treatment, I struggle to work in in in busy environments with lots of other people.
00:33:41
Speaker
so I think I would particularly struggle to work in an NHS environment, for example. And again, i have ah brilliant autistic colleagues who do who who are employed by the NHS um and ah they manage to make that work for them. But the the way that I think my brain works in particular, I would find that really stressful and difficult.
00:34:05
Speaker
um Having my own clinic allows me to set things up so that I can work in a way that works for me. um some of the things that I do, um i always allow a bit of extra time for initial appointments um because I find that my brain likes to process a lot of detail.
00:34:24
Speaker
um And having that bit of extra time means that I'm not having to rapidly switch from and from one patient to another, which again, I think is a better fit for my brain. It allows me to ah to feel less stress and actually to, to do a better job.
00:34:43
Speaker
So that's something that I've always done. I think the patients that I tend to attract, um, appreciate that because it means that they don't feel rushed as well. We can have a much more relaxed conversation, um which can sometimes enable them to, um, to say things which they might not feel comfortable saying, um, in a faster paced, um, appointment, for example.
00:35:06
Speaker
So I think, um, yeah, it's, it, that's worked out as win-win um some of the things that I do particularly well I i love working with um with complicated cases where there are several different things going on again because I like working with lots of um lots of detail um it's the kind of thing where I will you know I will take some of these cases and I'll puzzle over them and um i think I think we can all think of cases that but keep us awake at night, that yeah we go away and we're like, oh, what could I do differently?
00:35:44
Speaker
um And again, i that's one of the things that I really love about this job is having that so fairly sort of in-depth relationship with that patient. It's not just a passing in-out, quick bit of treatment, here's a sheet of exercises.
00:36:04
Speaker
you have a much more, a much richer sort of interaction. um And again, I get to talk about something that I am really interested in with somebody who is also really interested in it because obviously it's ah affecting their life. um So I get to, to, to focus really deeply on this area of particular interest for me, which is, is something that my, my brain just loves to do.
00:36:29
Speaker
um On the flip side, some of the things that I do less well, um i I have challenges around um some kinds of executive function, for example.
00:36:41
Speaker
I struggle with with routine tasks that things like um managing so ah finances and taxes and you know replying to business again, generally not patient emails, but sort of the, the standard admin type things. Um, yeah, yeah, yeah. The, the, the things that go with running a business.
00:37:10
Speaker
Um, and again, I'm, I'm really fortunate. Um, is my husband helps me out a lot with some of those things. He, um, he's our clinic manager, so he takes care of a lot of the, um, and the, uh, the admin and, uh, and that side of things.
00:37:25
Speaker
Um, And again, i've I've been able to to outsource a lot of that. So we've got the system set up so that um I don't have to worry so much about that, um you know, the the booking and that side of stuff.
00:37:42
Speaker
Yeah, you've that that side of of of stuff um yeah you So someone else to do the boring bit. and that seems Basically, yeah. yeah Hire someone to do the things that ah yeah that you're not so good at. Yeah, I mean, again, is is it's fairly simple advice, right? But again, i mean for years, i was thinking that if I was just somehow more diligent or, you know, maybe I'm being lazy, maybe I'm just not...
00:38:15
Speaker
this I just need to try harder and I'll be suddenly be able to do this and I think it's something you see and in in in this profession as well it's a where there is lot of osteopaths in soul practice that they they have to do everything for themselves and obviously that's everyone but there are there are plenty who you know they're their own receptionist and cleaner and painter and decorator and kind of everything that around that practice kind of centers around them and sometimes yeah you you need to step back and think actually no this is not this is not my area of expertise yeah and again this is this is one of those times where I think this advice applies to everyone um but I think particularly for neurodivergent people sometimes we grow up thinking that um you know some of those things that we find really difficult um it's a personal failing um and we feel bad about it and because of that I think that makes it harder to to then say you know what
00:39:10
Speaker
I'm just not good at this. I'm going to pay someone else to do it. um And I think ah it's almost one of those things where having a diagnosis has sort of freed me to go, there's some things I just don't do very well.
00:39:22
Speaker
And that's okay. you You know, I don't have to be able to do everything. um What I need to do is to concentrate is to to free myself up to concentrate on the things that my brain does well.
Enhancing Patient Care through Collaboration
00:39:33
Speaker
um And I don't need to try and try and be all things to all people and it's the same way that actually there are some patients that I I engage with much better than others um I think again it's sort of been realizing that it's not that I mean ah I will treat anyone who comes to my practice that's you know um but I also know that there are some people who
00:40:00
Speaker
I will really work well with. And, you know it's so you know, when somebody walks in and i think you're in exactly the right place, i know what to do with this, I am the person to help you.
00:40:13
Speaker
um And then there's other times when somebody comes in and I might um even gently suggest that actually, you know, who's really good with this. I wonder whether, um and I've got some some um great associates now, so I will sometimes say,
00:40:29
Speaker
why don't we get you in with our physiotherapist? um And again, sometimes it's just that sense of, actually, I think there may be a better fit for what you're looking for. um And once it's that sort of realization, and again, I think that some of this is just growing as an osteopath as much as anything else.
00:40:46
Speaker
It's realizing that I don't have to be all things to all people. You know, there will there will be some people who ah I am exactly the right person for, and there will be some people who might have a better result or a better experience from a slightly different way of working.
00:41:03
Speaker
Um, and, and that's fine. Actually, we're, we're a very diverse profession. And what that means is that, um, you know, if there's, there's somebody who we think maybe we aren't able to help as well as one of our colleagues could, um, it's fine to suggest that.
00:41:25
Speaker
yeah Um, and, Actually, I think the more experienced I've got, the more willing I've been to do that. and So, you know what, I think this person would be a really good fit for you.
00:41:35
Speaker
Yeah,
00:41:38
Speaker
yeah excellent. Well, the look, Rosie, thank thank you so much for sharing so much of your experience. And... you know, yourre youre your own autistic diagnosis and the impact of that on your practice and how you manage all of that.
00:41:55
Speaker
and And yeah, it's really interesting also to think about that, how you support patients and and colleagues as well. So we've covered we've covered quite a lot in a relatively short space of time.
00:42:08
Speaker
But um yeah, no it's been it's been that's been really useful. um We'll post links to you and how people can contact you ah in the notes and links to our own um ah resources as well but that we've published.
00:42:26
Speaker
ah it hit I wonder if I could just sort of add one more thing to close with. I think um something that I always encourage people my colleagues to do is if a patient feels like a difficult patient for whatever reason and we all have that experience of somebody just being that we feel that they're difficult to work with the natural tendency you know and I think um certainly this is something that I've done in my less experienced days is to to
00:43:04
Speaker
push that onto the patient and to say oh well they're just not engaging or um you know they're not being helpful or then they're not committed to doing the work that they need to do or you know um and see it as as some um i suppose the patient's failing um rather than that i think to it's good to look a bit deeper and see is there something else going on that means that this person is seeing this differently and is there a way that I can i can help them with that?
00:43:39
Speaker
Because what we find is that a lot of the time with neurodivergent patients, they will come across as being difficult. um And historically, what you'll often see is um practitioners labeling them as um sort of inconsistent or argumentative or non-compliant or that we have all these horrible labels that we like to, or that the practitioners sometimes ah apply to patients.
00:44:08
Speaker
And I think sort of trying to see it from and what that patient's point of view might be, um ah particularly true with ADHD patients, for example, is sometimes they can present as being unreliable and inconsistent and um yeah not committed or whatever.
00:44:29
Speaker
um And actually, I think when we when we start to engage with what some of those barriers might be, um it makes it much more rewarding for both us as practitioners, but it enables the patient to get more out of it.
00:44:43
Speaker
So I think sort of looking behind some of those of surface perceptions, I think can really help. and Yeah, so I suppose that's what I'd say is that if you're going to look out for anything, the thing to look out for is um sort of that sense that this,
00:45:01
Speaker
person is is not connecting somehow, is in some respect a difficult patient. and And I think then sort of trying trying to turn that around and um wonder if there might be something else going on there that's that's creating that that difference.
00:45:20
Speaker
um And quite often, for example, those differences in communication can it can be be highlighted as well. So so That's, I suppose, my my takeaway.
00:45:32
Speaker
That's a great point to end on. So thank you again, Rosie. That's been really, really insightful and helpful. Thank you very much. Brilliant.
00:45:43
Speaker
Thank you.