Section: CME Category: Life Skills

Improving Your Speaking Skills

Lee Rogers, DPM

Lee C Rogers, DPM provides practical advice for preparing and giving presentations in a public forum. Dr Rogers provides tips to keep the audience entertained, as well as helpful hints for troubleshooting problems that may arise.

CPME (Credits: 1)

  • CME Progress
  • Pre-Test

  • View Lecture ( CPME Credits: )

    Lecture Transcript

  • Post-Test

    Requires: Pre-Test, View Lecture
  • Survey

    Requires: Pre-Test, View Lecture, PostTest
  • Certificate

    Requires: All Content Above
Method of Participation

Complete the 4 steps to earn your CE/CME credit:

  1. Complete the Pre-Test
  2. View the Lecture
  3. Complete the Quiz (Min. 70% Passing Score)
  4. Complete the program Survey
Goals and Objectives
  1. Know the situations in which a doctor is required to engage in public speaking
  2. Identify the components of creating a speaking presence and body language
  3. Understand the use of props in public speaking
  • Accreditation and Designation of Credits
  • CPME (Credits: 1)

    PRESENT eLearning Systems, LLC is approved by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine.

    PRESENT eLearning Systems, LLC has approved this activity for a maximum of 1 continuing education contact hours.

    Release Date: 03/16/2018 Expiration Date: 12/31/2020

  • Author
  • Lee Rogers, DPM

    Medical Director
    Amputation Prevention Centers of America
    White Plains, NY

  • System Requirements
  • To view Lectures online, the following specs are required:

    • PC Pentium-III class or better processor
    • 256MB minimum of RAM
    • Cable or DSL broadband Internet
    • Browsers must have javascript enabled. Most browsers have this feature enabled by default.
    • Adobe Acrobat Reader (Free) to print certificates
    • Supported Browsers:
      • Chrome
      • Firefox
      • IE 10+
      • Safari
      Supported Mobile OS:
      • Apple iOS 4.3+
      • Android 2.3+
      • Honeycomb 3.1+
      • Blackberry Playbook
  • Disclosure Information
  • It is the policy of PRESENT e-Learning Systems and it's accreditors to insure balance, independence, objectivity and scientific rigor in all its individually sponsored or jointly sponsored educational programs. All faculty participating in any PRESENT e-Learning Systems sponsored programs are expected to disclose to the program audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education program. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts.

    ---

    Lee Rogers has disclosed that he is a consultant for and receives financial or material support from KCI

  • Lecture Transcript
  • TAPE STARTS – [00:00]


    Male Speaker: Continuing along our life skills component of lectures for the residency meetings, we've invited Lee Rogers and he's going to be talking to us on oral speaking skills. Now, Lee has a few of those. He's a politician. He is a well-recognized wound management specialist with Restorix. He has been involved in many programs on television, magazines and he is a very good public speaker. So, please welcome Dr. Lee Rogers.

    Dr. Lee Rogers: All right, so what you guys didn’t know as I was sitting there and I was evaluating your presentations and your public speaking ability and will, I'm going to give you a little constructive criticism as we go through this. So I was asked to do this by Alan and we were initially thinking about doing it before you guys gave your talks and so that way you might be able to improve on that. But I thought it might be too confusing or make it too nervous if you thought I was going to be watching you speak. So these are the objectives of the talk today, is to make sure that we understand the situations in which a doctor would have to engage in public speaking, identify the components of creating the speaking presence which includes your body language. And then when to use props in public speaking. And I don't have any disclosures for this.

    So why is it important to speak better? And well, you get more respect, establishes your authority in the community. You might get more money if you're a better speaker because people would pay you to speak at industry or give conference lectures. You could speak out in the community to get referrals in for your practice. You can also get some publicity because it helps you to - if you're doing interviews for the newspaper or also for the TV, you'll be able to bring in more patients that way. And then everybody really has to do it. So throughout your training you're always going to have to present something, you have to present cases and even just in a doctor's lounge, talking to your peers, it's a form of public speaking.

    So what are the different situations in which you would speak? There's obviously the podium presentations. Those are like grand rounds, abstracts at conferences. You could do dinner lectures and these might be sponsored by industry or being out in the community. And then there’s a media interview with TV or newspapers and we're going to talk about all of these kind of individually and just the techniques in general. So the first thing is that it's important to be prepared for whatever presentation you're about to give. So you want to practice your enunciation. One of the things I noticed with you, Rogers, is that you mumbled a little bit. I think you were speaking very fast and mumbled. You want to practice the flow so that you know what you're going to say next already.

    And then you could even record yourself or watch yourself in a mirror. It's very - when you watch yourself speak on or recording, everybody's always hypercritical so, and that's important it'll help you improve yourself. But watch yourself in a mirror, look at your facial expressions, look at your body language and practice enunciating certain important points. Get constructive advice from a friend or a family member. And then time yourself because time management is very important. Nobody gets angrier than a moderator when you're running over on your time. So make sure that you're always timing yourself.

    There's an app on your phone you can get called speaker clock. And you can just put it up here on the on the podium and you set it for whatever time and just hit the button and it'll go and it'll keep the clock for you. This particular lectures have a clock down there with a green, yellow and red when you're supposed to stop. And then when you're really supposed to stop, Alan starts waving his arms like this in the back and cutting you off, then he cuts your mic off. So notes are okay but don't do word for word. Don't write anything down word for word because it doesn't flow as well. You look too prepared in those cases. You want to seem genuine and natural.

    So the other thing is to really know your audience. That's really important. You got to ask the planners in advance, who’s going to be out in the audience. If you don't know who's going to be in the audience and it's kind of like an impromptu situation, you can always poll people. You can say well, how many of you here see wounds in your practice and people raise their hand. How many of you use the wound vac, you know, people might raise their hand, so you get an idea of who's in the audience. And keeping the audience, keeping interaction with the audience is also a good way to prevent people from sleeping…

    [05:00]

    …and to be involved and interest in what you're saying. So, and then read the audience. It's sometimes hard like in these situations when you have lights in your eyes, you can't always see people in the back. But it is important to read the audience's body language in addition to paying attention to your own body language. You want to see whether people seem like they're interested and if and if they're not, maybe do something a little bit different, speak a little louder. If people can't hear in the back, you can kind of tell that they can't hear. They lean inward a little bit and even people might even go like this in the back so you can't just be focused solely on your presentation you have to read the audience.

    Also it's important to find the people in the audience that agree with you. And this may not be as much of a, you know, in delivering a medical lecture. But when I was running for office in politics, there are lots of people that agree with you and lots of people that disagree with you. And you want to find the people that agree with you because they make you feel more comfortable and usually they're nodding their heads whenever you say something. So you look at those people, you don't want to look at the people who are giving you the negative body language because then that just makes you nervous.

    And then you can also identify in some of these situations who the leader of the group is. If you're speaking at a – doing a dinner symposium for a device company. Everybody in the room is usually going to look to whoever the leader is. They do this subconsciously like if the residency director is there, they're going to look and see how this person is acting to your presentation. And so, you can identify who the leader is by looking at who everybody else looks to occasionally because they want to see what that person's reaction is.

    So it's also really important to prep the audience for who you are to give yourself more credibility so that they listen and trust you when you're speaking. And the first part of prepping the audience is your biography. Sometimes your biography is printed in the conference pamphlet, other times it's read by the moderator who's introducing you. And you should change your biography for almost every lecture that you're about to give, because every time you want to accentuate a different area of your expertise. So let's look at this, for example, here's one bio that I could have put for this lecture and this would be: Dr. Lee Rogers is the Medical Director of the Amputation Prevention Centers of America, a Restorix Health Company overseeing 215 wound centers and Limb Salvage Centers in 35 states. He is a director of the American Board of Podiatric Medicine, chair of the Certificate of Added Qualification Committee for amputation prevention and wound care and he is the past chair of the Foot Care Council of the American Diabetes Association. He's a fellow of the Royal College of Physicians and Surgeons in Glasgow.

    So that seems very impressive, but does that tell you anything about my ability to convey to you how to speak better? It doesn't, really. So instead, a better biography that I would create for this particular talk would be - Dr. Lee Rogers has delivered more than 400 medical lectures in all 50 states and over 30 countries. He has given countless other speeches on topics related to healthcare and politics. He was a candidate for US Congress in 2012 and 2014, campaigning fulltime. He's made many on-camera interviews including as a guest on ABC's the Doctor Show and Al Jazeera's The Cure. And he's been interviewed by the Wall Street Journal, Washington Post Politico Roll Call and the LA Times. And you can see how those two bios are completely different. But it's important to set the stage for yourself so that the audience knows your expertise in delivering and trusting the material that you're about to give them.

    So you want to provide a written bio, usually a paragraph, something like this. Not a CV, because if you provide somebody a CV, if they say oh, send us your CV, we'd love to have you come to speak. Well, your CV, depending on what you've done in your life, could be very long. My CV is about 65 pages. David Armstrong's is about 80/85 pages. And so, I'm relying on somebody else to just look through there and pick and create a bios that they can introduce me. Instead, you're the expert. Write your own bio and so what they're about to say. And then sometimes you'll need to supplement after the introduction. So if they make the introduction, they miss something up that you remembered something else that you thought would be important that helps to create your expertise then go ahead and say that as well.

    So you want to create a presence in the room. And really in this situation you're acting and that's why actors make good politicians like Ronald Reagan made a great politician, you know, and he was acting the whole time. And we all are acting in different scenarios in our life; probably even when you're a doctor in front of a patient, you're acting. You're acting like a doctor because the patient expects you to act that way. When I testify in court cases…

    [10:00]

    …I act like what I would expect the jury to expect me to act like. And so, it's important to realize that. And so, the first part of acting is your costume. So you want to make sure that you are dressed appropriately. And I'm violating the rule right now because one, I don't have to and there’s not very many people here and nobody's recording me. But, no, you want to dress for the job that you want, not the job that you have. So look and see what other people would be wearing at the conference. And if it's a conference in Hawaii, and you’re here ahead of time that it's Hawaiian wear appropriate, then dress that way because that's what everybody else will be wearing. But if it's a conference in New York City, where they tend to wear three-piece suits and cufflinks, then you want to make sure that you're dressed appropriately for that. And you should, if they are going to be recording you should always take your badge off because you can probably notice even now there's a lot of glare on the badge and so then that affects the light from the cameras.

    So be ready for your introduction. You're always going to know when somebody's going to introduce you. So you don't, so for example, if you're seated at a table and you know that you're about to be introduced next, it doesn't make, you know, you don't want to be sitting there like this with your legs crossed and all relaxed because when they make the introduction for you then you're going to have to fumble around and people are looking at you at that point. So instead, people are going around the table, oh there's doctor so and so, there's doctor so and so, doctor so and so and they come over to you. Well, you get ready and you need to get ready by being ready to stand at that point. And instead of, most people when they stand, they stand up like this and so when they're introducing you the first thing they see is the top of your head as you stand up. So instead they tell you to keep your back straight, you're ready, you know that they're going to introduce you. Keep your back straight and stand up so that they see your face, because it's usually only a couple of seconds then they move on to the next person.

    In this situation where you know that you're about to be introduced for this type of talk, you can stand over to the side. One side or the next, you should face the audience so they can see you while the moderator is introducing you. And then understand where your position is on the stage. So whether it's a real stage like this or you're in a conference room or you're in a dinner type of setting, know where you're going to be standing at that time and you're the one that sets the stage, because you're the speaker. So you can tell people this is the kind of microphone I would like, this is, this is where I would like to stand for this and you evaluate the room and you say okay, this is going to be the best place for me to stand. If you're in a restaurant and it's noisy, which happens a lot, you might be in a private dining room, but it's very noisy in some of these restaurants if you've been to some of these industry events. And in that case, you might want to stand in the middle and not in front because then your voice, if you don't have a microphone especially you can project your voice to everybody in the audience.

    So you're the expert. Nobody else in the room should know more of what you're talking about than you. And that should give you a little comfort. And so, you shouldn't be so nervous about speaking because you're the expert. You want to convey a sense of power and we would do this a lot of times in – I was trained by a speaker trainer when I was running for office and they would tell you when you're speaking about different topics you have to have different body language. So when you're speaking about national security, you don't want to stand there with your hands like this, which is a very like open and welcoming type of body language. But it also kind of is a very quick way to say I don't know. Instead, they said you want to stand there kind of like this with one hand as a fist and the other hand open but covering the fist right at your stomach level and that conveys a sense of power to the audience and so then they trust you more when you're speaking about certain topics.

    I think it's a little different in this type of setting when you're speaking about healthcare and medicine, but certainly you want to convey power to a group of patients so that they understand that you're a doctor or surgeon, you're in charge. Your body language is so important. You can do, you know, not only your posture, you should always think about maybe a hook on the top of your head and somebody pulling you up by that hook and that'll help to keep your back straight and keep a firm posture. But people have difficulty thinking about where to put their hands, especially if there's no podium in front of you.

    [15:00]

    And then it's just kind of awkward that they here at my side or do I fold my hands like this, do I stick them in my pockets. In politics, they tell you never to put your hands in your pockets, it makes you look dishonest. So you won’t see politicians putting their hands in their pockets. But you can have, I guess if you're Italian it probably comes easy right because they're always talking with their hands and doing things.

    The one thing that makes you look nervous was something else you did, Roger, which was the oh shit podium grab, kind of like this. And you're tall too so you're up high, but you were kind of leaning into the mic but you were grabbing it, grabbing at the podium because it's hard to know what to do with your hands. If you're on camera, you actually don't want to move your hands much. You want your hands to just be in your lap and you're usually seated, even if you're standing. And there's a standing, you know, an interviewer, your hands aren't going to be on camera. And so, if you, unless they're up here by your face, so they're not going to be on camera so don't move your hands around and it just makes your body wobble back and forth.

    And so, you know, also be different. Have your own identity. It's that people say oh, I know that guy. He, oh that guy wears a bow tie. I see him at every lecture or that guy always smells good or something, but be different.

    So this is your show. Make sure that you set the stage how you want it, you know, wherever the podium is going to be, the chairs, the mic. It’s different at a more formal thing like this versus if you were in charge of your own symposium and you want to make sure that everybody knows where the screens are and that the audience will be able to view it. This is really important when you do dinner lectures in restaurants because the restaurants, these people aren't experts at setting up these rooms and you want to make sure that that nobody has their back to the to the screen. And so, at lectures like these they always have your – they would have a computer screen or in this case a TV down here, so I don't have to continually look over here. And that was something that I think it was you, Lucy, that did that, where you constantly turned your head to look over here and…

    Lucy: I have a question in that situation, I couldn’t see the TV.

    Dr. Lee Rogers: Oh, you couldn't see it. Oh yeah.

    Lucy: So what do you do in that--

    Dr. Lee Rogers: Well, you could stand over to the side. Yes, she said she had trouble seeing the TV because she was vertically challenged. So, but you can move the microphone like this and stand over to the side and that's fine. But, the problem with turning your head a lot especially when there's a microphone on the podium, is that I turn my head like this and now you can't hear me as well. And then I turn my head back over here and you can hear me better. So if you have to do that, if you're using a pointer, you know you can point but then I would lean into the mic a little bit and point like this.

    Roger, I think you kept trying to advance the slides by pointing at the screen and your body language looked a little bit weird when you were doing that. Well, this is an RF slide advancer, it's not even line of sight, but the receiver is all the way there in the back. So you don't have to do that. It can just be right here or you could have it down by your waist in your pocket, wherever.

    The timing of interruptions is important because there are going to be interruptions in some types of settings where you're talking especially if you're speaking at a restaurant. Now I talked to the servers ahead of time and I say look, what I'd like you to do is to take everybody's order before I start speaking and then once I start speaking, you can bring out the salads and all that and usually I'm done speaking by the time they're bringing out steaks and other things definitely by dessert.

    So microphone skills are important because that's how everybody's going to hear you and you can also use your voice as another tool to emphasize an important topic. So you either have - you have a few different kinds of mic, so you have a podium mic like this one. You have a handheld mic, which gives your hand something to do when you have this other mic, so now you don't feel like your hands are kind of just in the way and doing nothing. So, if you have a handheld mic, you can hold it and then you have Lav mics. And if you have a Lav mic, just be careful because whether you're at a conference like this or you have a Lav mic on because somebody is recording you for a TV interview, the mic is always hot, is always being recorded. Even if it's not being projected, it can always be recorded and that's how they catch these people saying things on hot mic. So even if you lean over and tell somebody something about somebody in the front row. Don't do it because they'll catch you on the hot mic.

    Always adjust the mic when you first get to the podium, so adjust it up. You want it to be fairly close to your face.

    [20:00]

    You can move the mic back and forth if they’re handheld mic like this. If you have a handheld mic like this, I can put it down here further and talk and you can still hear me. But if I have something really important to say then I can bring it up here closer and then it almost feels like I'm right next to you, like in your ear. And you can even talk softer. I don't have to yell into this mic because it's right here by my mouth, but I could talk softer and I'm right there. So people who are singers or other people who do public speaking for a living, they are constantly moving the mic back and forth to keep the audience engaged because you can change the volume of what they're hearing. You can change your pitch. You want to avoid feedback of course, so if you do have a handheld mic I don't want to be walking around next to the speakers because that's going to cause some feedback. So just be aware of where the speakers are.

    So another thing people ask is, how do I open. They're nervous. You get up there, you're about to open that's probably the most nervous you're going to be during a talk is the very beginning. And I'll tell you what not to say. What not to say is, thank you, I'm so happy to be here in Teaneck New Jersey, everybody knows that's wrong, but I'm so happy to be here in Teaneck. I appreciate the invitation, that's such a blah way to open any type of talk. And if you're going to thank people, you can thank them not at the beginning. You can thank them in the middle. So you're going through your talk and by the way, I really appreciate Steve in the back for all the hard work he does in keeping the booth running and all the presentations on time. And you can do that in the middle and then that helps to break up your talk a bit.

    Silence is a really powerful tool as well. Have you ever seen somebody that got up to give a talk and they don't say anything for 10 seconds, seems like minutes. So if they get up there and they just stand there and maybe they're fiddling around with papers or something there on the desk, but they just stand there and they're just silent. And that's like five seconds, but in five seconds everybody else in the audience is silent because they think oh, are they going to mess up, do they forget what they were about to say. Is this going to be one of those and maybe I should get my phone out, start recording this. So silence is a really powerful tool, it gets everybody to be quiet and pay attention.

    You can start with a statistic sometimes. You can just say 72% of amputations are preventable with good care. And so, you just start with something like that. That's the first thing you could say when you walk on to a stage. You can start with a relatable story. It's got to be really short but relatable story. May be about a patient or even something about your family or something that you did recently, but something short and relatable. And that one that makes you more comfortable and it helps to get the audience to see you as a real person and be more endeared to you. You can do something that's shocking. So you could say something – you could walk up and you could just say with the very first thing, oh shit where's my leg and people are going to look at you and you could say that's what my patient said when they came out of anesthesia and they had an amputation. And so, that may not be the best example, but you could do something like that and that's really shocking and one, everybody's going to shut up when you say something like that. And then when you give a little bit of silence and then you follow it up with what it was you're meant to say.

    You can tell a joke, jokes can bomb. You don't really know who's in the audience and what their sense of humor is and whether or not the joke’s going to be appropriate or not. I think humor is fine without fully telling a joke, but you can be humorous in a talk without going all the way down the joke path.

    Props and slides are important to have. So you can have regular slides like a PowerPoint, I use keynote. Roger I saw you used Prezi. And I think Prezi is good, but you used it on a PDF here is it because they didn't have the internet in the back or – okay, yeah. So Prezi is a great tool too, because it's new and people are looking at it and they think wow, I haven't seen a presentation like that before. Having handouts, if you're going to be in a restaurant it's noisy and maybe you're not able to project something, just print some handouts and hand those out. On the slides, it's always better to have…

    [25:00]

    … your presentation be shorter than longer. And you don't want it to be too busy and you don't want it to be word for word. You don't need me to read for you word-for-word on the slide, you can read it. So you just put notes on there, essentially bullet points and then you elaborate on those. I noticed Roger your text was way too small in your presentation. I thought your text was great. Your text was way too small and it was hard for me to read and it was also very, instead of being bulleted, it should really just be bulleted. And yours was more word for word, recreating the pathology report. You want to choose something that's easy to read with the colors and backgrounds and I thought both of your presentations did that well. I think yours was white with a blue lettering and yours had black lettering or white lettering sometimes, but then a blue background. You have to choose what type of aspect ratio. This sounds really ridiculous but you do have to choose whether you're going to do a 4:3 or a 16:9 aspect ratio, some screens, this is a 4:3 screen. This is a 16:9 screen down here and it's converting it automatically but sometimes you get big black lines along the top and the bottom and it eats up a lot of your screen and then your words don't appear as big. Photos are very good, but make sure that the photos aren't too small. And if you have multiple photos in a case just use transitions and help to move the photos through.

    The proper use of a laser pointer, some people are using the laser pointer like this. Oh yes, and you know you want to make sure that if you're using props there's a lot of different new presentation tools that are out there. We've got handouts, you can do electronic media and that's not really effective at all. Nobody can read when you're doing this and instead, use the laser pointer and just put it at one thing. You can stick it next to the side. If you're illustrating something on a photo, if you have a pathology slide, it's okay to do that. But this is really not helpful.

    And then it's also good to summarize at the beginning of your presentation and at the end of your presentation. You should really give a summary at the beginning. This is what I intend for you to learn during the course of this talk. And at the end this is what we learned during the course of this talk. And then one thing I do a lot is, I make sure to share my presentation with anybody that comes up and asked me, can I have a copy of your presentation. I find that a compliment. And some people think oh, I put so much work and effort into this presentation. And yeah, of course, I did put a lot of work and effort, but I find it a compliment that somebody else wants to have a copy of my presentation to look at it later because that's part of my job is to make sure that that people are learning. So I usually give like a web address or something at the end where they can download a copy of the presentation.

    Troubleshooting is important too. Nobody ever wants - you don't want your PowerPoint to fail or the slide advancer not to work. The mic, sometimes you can have problems, so you have to be prepared for failure. And if you're prepared you can avoid things. So if you don't have – make sure you have all the right adapters for whatever computer that you have. They may not have all the right adapters. I only use a Mac, I use a MacBook and I have to have all the adapters every time I go give a talk. You have to be prepared in case there's a technological failure to present without slides. The worst failure I've ever had was just about a month-and-a-half ago, I was at the American Diabetes Association meeting. I was giving a presentation on the ADA, I wrote the ADA paper on Charcot foot. I was using my Mac. For some reason the screen wasn't picking up the computer output. And there was like 15,000 people that were at this event and at the Convention Center in San Diego. And I gave it without slides because I knew the information because I'm the expert on that. So if you're the expert you know the information. I remember how my slide order went and just gave the presentation without slides. And I thought it went fine actually probably better than if I would had slides.

    So mic, if you either don't have a mic or there's a mic failure or you're in a loud venue even with the mic, walk around and that'll help to keep people interested as well. Make sure that you don't run overtime. And I am going to run overtime but I already cleared it, by the way, because I said I had evaluated you guys and I'm going to give you these pointers. If you start to lose an audience then get them involved. If you start to see people not paying attention, fiddling with their phones, other things, then maybe ask some questions of the audience or…

    [30:00]

    …walk around them and then they're a little embarrassed to look at their phone if you're walking around. Or you can just end quicker. And I've done this several times in lectures at dinner presentations where people are reading, it's too noisy, they can't really hear, they start talking to one another and then I just go through some slides very quickly and then end quicker.

    This is a good one, how to deal with hecklers. The first thing is to be polite. So you'll get hecklers in this type of situation where somebody will and usually they have some type of interest in whatever it is you're about to say. So you give a talk about Carausius, fish grafting and maybe these people don't like fish and they like something else better. So they they'll come up and they'll say, well but doctor don't you know anything about this other graft or don't you know that the - I was just in Iceland actually a week ago, I was fishing with the Carausius people. And the Icelandic people said, they said, it would kill the economy in Iceland if cod could scream because they pull them out of the water and their mouths are open and, I mean they’ll say, you kill so many cod every day. And they said, if cod had a voice and they could scream nobody would ever be fishing for cod. But if somebody could say something ridiculous like that, about the mistreatment of animals or something like this.

    So you have a few choices at that point. First is always to be polite. You don't want to get in an argument. You're never going to lose or you're never going to win if you get an argument with somebody up here at the podium. And so, the other thing is everybody in the room expects you to manage that situation. So you have to manage the situation with a heckler. One thing is to just acknowledge their concerns and then move on quickly. You bring up really good points and I'd love to sit here and we could talk more about this, but I have to move on and get everybody else's questions. Why don't you catch me as I'm leaving and I'd love to talk to you more about that in the back. Now that kind of diffuses the situation and if I were you I would leave at the front and don't leave at the back and you'd be fine in that case.

    You can always offer to follow up by email. I can say look my email address is down here, please, if I don't catch you send me an email. I think you bring up great points I'd love to talk about this more. You can also just pivot to your own topic. If it's something it's off topic and they bring it up. You say, well that's not really part of this presentation or you could even say I don't really consider myself an expert in that area. But there are other people here and maybe on the podium and on the panel that are experts and maybe they can answer your question later.

    You can do two things about approaching them. And this is different, you wouldn't do this in this type of setting. But if you're in more of a town hall setting or in a restaurant, if somebody is heckling you and you're not afraid that they're going to hurt you, you can walk closer to them. And if you're closer to them it really disarms them and they don't raise their voice as much, because there you're right next to them. So they or you could do the opposite. You could look at the audience, you already have an idea of who you people are that agree with you. So if you're questioning me and asking me all these questions, I might say, I think I saw somebody over here that had a question too. I want to make sure I get to everybody and now I'm not even looking at you. And I'm over here talking to somebody else. So that's another way to get away from a heckler.

    Yeah you can - then you could actually just ask an audience member a question. You could say, you asked me something and you kind of give me trouble and I'd say, you know what, I think I see that, I think this person may have an opinion about that too. What do you think about that? And so, I'm away in that situation as well. You could also put an end to it pretty quickly if you know that their idea is really ridiculous. You could say, okay, let's just do a quick poll, who in the audience would do an amputation for an ingrown toenail. Just raise your hand and if nobody raises their hand you say, whoa, I don't think you really have the audience in this case.

    So this is another thing is fighting your physiology, if you get nervous. And I think you got a little nervous and you got a little nervous too. I couldn't really see if you were nervous or not. But not being nervous is normal actually and you should use that those nerves as energy. I mean, if you're not nervous and you're just blah, then you're not going to be very interesting. But you should instead convert that nervousness to energy so that you become a more interesting speaker. So there's a few things, most of the time nobody's going to notice if you're nervous because you really notice it, you feel your heart beating and maybe your palms are sweating. But other people aren't really going to notice that. So just keep that in mind. If you make a mistake about something…

    [35:00]

    …most people probably aren't going to notice that you made a mistake either, like if you fail to mention something about your own slides, they don't know what your slides are, you put them together. You advance too quickly. They don't know just move on. Don't acknowledge the mistake, don't say, oh I'm sorry I made a mistake. Let's go back a few slides and let me cover something else. Just move on, nobody will notice. If you feel like you have a racing heart rate, there's a couple of things you can do. One is that you can do the valsalva maneuver, where you can blow against a closed glottis. So you don't have to pinch your nose but just blow against your glottis as closed like you were going to blow out and you had your nose pinched. So it's almost like holding your breath but blowing it out. And if you do that and you also feel your pulse at the same time, your pulse drops pretty much right away. It'll drop by 20 beats a minute. And so, that's one way to get your heart under control at that point.

    Some people are so nervous they have to take beta blockers before they speak. So if you're one of those people maybe you should do something besides public speaking. But dry mouth, have water available in case your mouth gets dry. You probably shouldn't be drinking coffee or milk right before giving a speech because it does make your mouth very dry. And alcohol, alcohol I think is okay. I had a few scotches with Dr. Schoenfeld [phonetics] before we got up here. Alcohol is okay in moderation and depending on what part of the country you're in like in restaurants and on the West Coast, I have a glass of wine while I'm talking and I think that's fine. And then also yeah definitely, if you have to go to the bathroom, use the toilet first, but don't have the Lav mic on you when you're going to the bathroom.

    So just a couple more things, TV skills when you are sitting for – first you have to know what the frame of the camera is going to be. We used to record these presentations here. And now we record the presentation and we record the audio, but we don't record the speaker anymore. We used to record the speaker. We had a camera in the back every time. But you want to know what the frame is going to be and it's okay to ask the camera operator what's the frame. And the frame might just be your head. And if the frame is just your head then don't worry about your body language in that case. It's okay to use make up even as a guy if you are going to be on camera. And we constantly would use makeup for TV interviews and actually if you're going to be in the studio they have a makeup person come because they don't want the scene reflecting from the cameras. If you're on camera and they're doing a split screen, so two people are on camera at the same time. And this happened to me, I think it was on Al Jazeera TV station, you can also communicate with your face even though you're not speaking. So if somebody is saying something that you disagree with, you can convey that to the audience with what your facial expressions, or if you do agree with them you can nod. And everybody will see oh, they agree with this person.

    If somebody's interviewing you, there's usually a camera here. Especially if the most common type of interview that doctors get is that you're doing something amazing at the hospital. You just start using this new fish graft and it's pretty new and the hospital PR people called the TV station, and the TV station says, hey we'll come out and we'll do an interview. So when they come out to do an interview they have a cameraman and an interviewer. And usually the cameraman is standing right behind the interviewer. And the interviewer is asking your questions and they have the microphone and so they're saying, well tell us what is new about this type of fish graft. And they put the microphone in front of your face. When you look, you shouldn't look at the camera. Some people are like oh, I need to look at the camera because I'm talking to the audience. You actually want to look at the interviewer which means that you're going to be a little bit off from the camera. But one of the ways you can do it is you can cheat by taking the eye that's closest to the camera and keeping that in line with the camera and your other eye in line with the interviewer. So you're kind of cheating in between because it's always best to have your face straight on but you still want to look at the interviewer.

    And the other thing with TV and with newspapers is to speak in sound bites. So if you're ever going to get an interview by a TV reporter, prepare ahead of time. What are the three most important thing I want to convey and you write them down and make sure they're no longer than seven seconds. And then just you could actually say them multiple times.

    [40:00]

    Even exactly as they are, politicians do that all the time. You don't want to come off as a politician. But if it's something, they only put seven seconds on TV of a question usually. So you have seven seconds to get through what you want to say. So if you end up spending three minutes responding to a question, you have no idea what the editor is going to pick. So you want to just say, what the most important thing is in seven seconds and that's it. So a lot of times you can pivot and repeat your messages, by saying – and this happens in newspaper and in TV. So if they ask you a question about something and let's say they're getting a little critical, yes, but you know, obviously these fish grafts are very expensive and why are we running up the medical bills on these patients with these expensive grafts.

    You can pivot to something else. And you could say well, there is an expense for that but let me tell you what's even more expensive is taking somebody to the operating room and doing and using their own skin and putting them under anesthesia and all the risks that go along with that. So that's really like pivoting off from what they are trying to get you to answer to move on to something that you want to answer.

    And then the last thing is, most of the time these interviewers are not going to be really trying to get you. They're very busy, they want to get a positive fluff story about some medical thing and then they just want to leave. And so, you could just even at the beginning say, you know what let me just tell you what's really important about this. And say these three things are really important. And they might just print that and that happens a lot. So then I have this – you can download this presentation if you'd like. They are either on the web address or you can take the QR code and download it. This just happened the other day, but yeah, so anybody have any questions about public speaking or to deal with difficult people or anything like that?

    One last thing, another good thing with difficult people is if you know somebody's going to be difficult, usually if you're speaking for a company and they're like okay, well Dr. Smith is going to be here. And Dr. Smith is kind of an ass. So what you can do is, you can position yourself right behind that person. So there are a room full of people and you can even put your hand on their chair. And then you can give your speech right behind that person and everybody feels uncomfortable with somebody right behind them. And so, you're making them uncomfortable because you're standing right behind them. If you're in a conference room and let's say you're trying to get - you're meeting with the VAC committee, you want to get a new product on the VAC committee or your meeting with P&T because you feel like you should be able to prescribe a certain drug and they said you can't do it. You want to find out who the person is that really opposes you. Maybe it's the infectious disease doctor, doesn't think you should write for his eye vox. And the natural thing is to sit far away from that person. You walk in the room and you're like I don't like that guy, I'm going to sit over here. But you should sit right next to them. And that disarms people when you sit right next to them. They have a harder time criticizing you, when you're sitting right next to them.

    So I hope I wasn't too critical. All righty, thank you very much.


    TAPE ENDS - [43:34]