Receiving a physio treatment written plan is routine for anyone coming to us with a new problem – this is one of our guarantees.
The written plan has our provisional diagnosis of the problem and what we think is the best plan of attack.
It also includes what we recommend the patient do to help themselves, and also our thoughts on how many visits they might need.
I’m not aware of how routine this practice is with other physio or health practitioners in the western suburbs or more widely in Adelaide, but we have been doing this routinely since about 2014.
The 4 answers that every patient wants to know
In my mind this practice of a written plan makes good sense.
It helps to answer the 4 questions that anyone wants to know in their visit to any health practitioner:
- ‘what is wrong with me?’
- ‘how long will it take to get better?’
- ‘what can you, the health practitioner, do to help?’
- ‘what can I do to help myself?’
Ask yourself about the last time you visited a health practitioner, whether it was your GP, physio or other. Did you get these questions answered?
If you did, chances are you were more satisfied with the help that you received.
Otherwise you may have walked out feeling less happy with the outcome of the appointment.
Why recommend how many visits someone might need for physio treatment?
Initially, when the concept of suggesting how many sessions were needed to my patient, I definitely bristled a little bit. I found it confronting, mainly because I didn’t want to sound pushy.
However, we have since found that it is really helpful for a few reasons:
- patients obviously want to have an idea of the number of sessions that it will take to get things sorted out
- it helps to build up a picture of the amount of time a condition will take to get better
- a recommendation makes us accountable to the patient and to ourselves – this is really good, and it shows a transparency to the process
- a written plan demonstrates a real strategy rather than simply going from appointment to appointment (this has traditionally been a frustration of people seeing a lot of physios)
- importantly, it allows the patient to book in appointment times that suit them, particularly if they are limited with their availability with work or family commitments
My, how physio best practice has changed!
Many years ago, routine practice for a problem might have been seeing someone very frequently and for a long period of time.
If we take low back pain for example, I can remember my first employer routinely seeing people 3 times a week for their 15 minute appointments for a long period of time.
It really fostered a sense that they might get worse if they didn’t attend that frequently – a dependence. In more recent times, the evidence is that the best approach for helping is quite different.
Best practice is helping people to NOT be reliant on therapists and to learn how to gain control themselves whenever possible.
It is a strong reminder that the frequent / intense therapy style is outdated, and actually harmful.
You see many practitioners continue to practice this style of treatment because frankly it is financially lucrative.
I always hope that there is a genuine belief that they are doing the right thing for their clients, but I suspect that isn’t always the prime motivating force.
It doesn’t necessarily mean ‘the less the better’ either. Some physios that have spent time in the public health system (like me!) have a motivation to discharge that can be premature, before the patient is ready to be self-sufficient (like the old me!).
The one and only factor that is important for physio treatment
Be assured that we make any recommendation about physio treatment based on one thing and one thing only – what is best for the helping the person in front of us in the best way we can.
This is informed by current best practice, current evidence, experiences of the physio in the past with treatment of the same condition, and co-existing conditions.
When someone attends for treatment and lays down their hard-earned, they are here because they want our professional opinion.
As a health professional, it is our professional duty to recommend the best thing for our patient.
Nothing else should come into that assessment.
I would like to think that every health practitioner can put their hand on their heart and say they make recommendations based on …
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