What do our patients picture when they think about physical therapy?

……..

Maybe a person in pain?

Someone stretching or doing an exercise?

Ice or hot packs? People with electrodes sticking on their skin?

Are they picturing a person wearing khakis and a polo?  We therapists love our khakis and polos…PTs keep the poorly fitting khaki industry in business. You’re welcome Dockers.

Hopefully what our patients are picturing is one of us helping someone get back to feeling great and doing what they love. It’s a great image and it’s a great career, and while I’d love to tell you that this is reality…

It’s not.

You see, physical therapy has a dirty little secret. That secret is that only about 10% of the people who come to see us actually complete the process. Our reality is that most people end up settling for something that is less than they were able to do before. 

It may be a mom who got hurt training for a half marathon. She gets back to running, but now she has to stop at two miles, or her knee starts to hurt and swell.

It may be a grandfather who hurt his back when his giggling 2-year-old granddaughter ran to him and jumped into his arms. He can walk around without back pain now, but his reality is that he’s not sure what’s going to happen next time that little girl runs at him. So, he’s forced to do everything he can do avoid that situation – missing out on a lot of fun while he’s at it.

The truth about physical therapy is that most of our patients drop out of our care because they decide that it isn’t worth their resources – their time, energy, and money – and they aren’t getting the results they are looking for. The results, or even lack thereof, stop being worth it to 9 out of 10 people. This means people overwhelmingly do not see value in PT. Interestingly, while our patients don’t value what we do, they are overwhelmingly satisfied with us. In fact, while only about 10% of people value what we do enough to make it through the course of care, more than 90% of people say that their care was very good or excellent (link).

So here we come to an interesting crossroads. How is it possible that people are overwhelmingly satisfied with the service we provide and choose to consume it so little? 

I’ll pose another question…one with the same answer… Why wouldn’t you be upset if you had gas station sushi for dinner last night, and it wasn’t very good?

Low expectations.

Unfortunately, physical therapy is the gas station sushi of healthcare.  Our patients will consume our services when it’s convenient, and some of them may even like us…but they sure don’t expect much from us.

Physical therapists are smart, kind people, who are just that – people. Our industry will rise, or sink, to meet expectations.  We need our patients to expect more out of us, and we need to be prepared to deliver it.

The exact experience of delivering “it” will vary a bit from person to person, but Miciak et al did some wonderful research and provided us with the conditions we need to facilitate great therapeutic relationships with our patients. Our patients will only expect more from us when we demonstrate we can actually deliver what they are looking for. Those necessary conditions for engagement with patients are as follows:

Be present

Simply put, when you’re with a patient, be with that patient. I once read a line where someone asked what else you could do while listening to be more productive. The answer – NOTHING

Be receptive

You know PT, your patients know themselves. Don’t underestimate the importance of that expertise. Your patients will give you a lot of the information you need to help them. Will you be open to it when they do?

Be genuine

Be open and honest. Invest in the person in front of you, not just their objective measurements. How your patients are doing mentally and emotionally will absolutely affect them physically.

Be committed

A great way to demonstrate your commitment is to make sure you know where you’ve been and have a plan for where you’re going with every patient prior to the start of the session. Share that commitment with your patient at the start of a session. “So, last session, we did _____, that really helped with _______. I think that is a great step toward (your goal). Do you think we can make even more progress on that today? How did things go for you at home since last session?”

So, the next time you evaluate a patient, get to know her goals and agree on a plan to get there. Then tell her that you fully believe that seeing a physical therapist is the right choice for her, and if she doesn’t meet those goals, she should blame you.