Can we please stop telling our patients "NO"? & a promise to all my future patients
As many of you know, I recently quit my corporate job at a physical therapy company. I realized it was no longer aligned with my views and I have a bigger vision for myself and my patients. Essentially, I grew over time and I realized what was important to me and what was not (read more about it here)
Over the past couple of months, this decision has led to a lot of reflection on my part and a lot of introspection. It has caused me to evaluate what I like about my current position and what I don’t like. It has also caused me to reflect on aspects of clinical care that don’t sit well with me.
And now, I have a bone to pick.
Can we as physical therapists PLEASE stop telling our patients NO?
Can we please stop taking everything they LOVE away from them?
Can we stop preventing them from EVERY movement because they MIGHT irritate their symptoms?
Can we STOP fear mongering movements, especially yoga?(I might be a little biased)
The amount patients that have told me something such as:
I will never be able to run again
I am too old to run
I have bad knees
I was told to never squat or bend down
I can’t do yoga- It is bad for my shoulders
I am not allowed to squat
Oh, I can’t do that- it’s bad for you
I don’t know how to do that so I shouldn’t
And so on and so on
You get the picture. I don’t know about you but, this drives me nuts!! There are too many people out there afraid to move and afraid to do the things they love. I can tell you first hand, that living your life in fear is not fun.
The fact that healthcare professionals gaslight this fear in their patients hurts my heart. We have the power to help people move happily in their bodies. We have the power to make people feel good. We have the power to encourage, uplift, and empower our patients. We have the power to help our patients live a good life, in fact, live their best life.
And isn’t that what everyone wants? To live a good life?
So how can we as healthcare professionals inspire?
Education, Empower, and Encouragement.
Now don’t misunderstand me here, I do think it is important to look at mechanics and daily habits. I think it is important to decipher where and when a patient is having pain. I like to break down movements and go over them with patients. I educate them on why they are doing an exercises and how it can help. I explain where I want them to be engaging and encourage them to wobble a bit. I make them an active part of their rehab and have them show me what hurts and try to explain why they think it hurts.
For my Healthcare professionals, here are my goals for each session:
(Future Patients: Keep reading or skip the next three paragraphs, I have a love note for you at the end)
Educate the patient as to what you think is going on but don’t get to “science-y”. Don’t scare them with big terms or use words like “massive tear” or “gross instability” or “extremely weak”. That’s just mean and at the end of the day is hurting them more than it is helping them. Educated the patient on what you are doing each visit and why. Connect the what back to their why! Example: We are doing step ups because you have so many stairs in your apartment and I want you to feel comfortable going up and down stairs. Educate them on your thought process, and let them know where you are headed with your plan of care to keep them an active part of the process. Educate them on the healthcare system and how they can best be served by it. Let’s be real, most people don’t know they can advocate for themselves. Teach your patients to advocate for themselves.
As physical therapists, we are huge part of a patients support system and cheerleading team. We have the ability to inspire and empower or breakdown and hinder. The words we use in our practice go a long way to shaping how a patient views themselves and their injury.
It starts as simply as not calling their injury their “bad leg” or “bad shoulder.” I mean, come on, my graduate program even taught me that. I know it’s a pain but it’s also a habit. Drop the word “bad” please.
One thing I have been working on is how I explain my findings to a patient after my assessment. If I come in guns blazing scolding them for their weak muscles or decreased Range of motion, do you think they are going to like me much and feel super pumped to kick ass in PT? NO They are going to feel shitty and weak and be embarrassed. My new technique is to highlight each patient's strengths and then share some “opportunities for growth” that I want to target. So far, I have done it on every evaluation over the past two months and it’s been going well.
My personal goal is to help patients set empowering (and realistic) goals so they have something THEY want to work towards, not just a goal I made up because 5/5 quad strength sounds good. I then do my best to track this patient set goal and measure (at most) weekly so they can see their progress over time. The more you empower patients to be an active part of their rehabilitation, and not just bystanders going through the motions, the better they get.
This piece kind of goes hand and hand with empower but I think it deserves its own point. I believe that we are here to encourage our patients through the highs and lows of rehabilitation. Let’s be real, it is not all sunshine and flowers after an injury. Some days you’ll feel great and some days you won’t feel as great AND THAT IS OKAY. My job is to support you in the lows and the highs. It is to remind you of how far you have come and encourage you to keep pursuing your goals. It is my job to celebrate your highs and put your lows into perspective.
On top of that, my goal is to encourage you to push your boundaries and to learn to deal with discomfort, pain, and stress so you can learn from it and manage it. I am here to give you tools to take care of yourself and to supply you with knowledge that you are capable.
I am your cheerleader and greatest fan, I am your coach. I am here to show you how strong, capable, and badass you truly are!
My approach might not be for you and I am okay with that. This is how I have evolved over the past year as a physical therapist and I am going to continue to evolve. In fact, I reserve the right to change my mind and continue to evolve. I truly believe that these three pillars will always be with me though. That is how strongly I believe in educating, empowering, and encouraging my patients.
So I challenge you, what is one way you can educate, empower, and encourage your patients this week?
To my patients— This is my promise to you:
I promise to work WITH you to achieve your goals. I promise to always take your life and your goals into consideration. I promise to be on your team the whole time we work together. I promise to lead with “yes we can figure this out.” not “no, that is bad for you.” Most importantly, I promise to recognize you as the complete person you are, not just the injury or diagnosis on the paper.
I promise to:
Educate you! I will help you understand what is going on in your body and why. I fill in the blanks and help you feel like less of a stranger in your own body. I explain why I want you to do that plank that you hate so much or I recommend a rest day between running sessions. My goal is for you to leave each session with a little more information, a better understanding of your body and a little less confused.
Empower you: I will be your greatest coach and cheerleader. I am not here to baby you but I am not here to beat you up either. I am here to push you and make you feel stronger and more powerful. I am here to show you how capable you are and how bad*ss you are. I’ll let you know what we need to work on but I won’t berate you for not foam rolling after every run (that’s a promise).
Encourage you: I will show you your progress when you cannot see it. I will encourage you to keep going when you feel like you can’t. I will put your rehabilitation journey into perspective because sometimes it is so easy to get lost in the day to day and not see the bigger picture.
I promise to be there for you to bounce your fears, concerns and worries off of. I am here for you and with you. I want to get you where you want to go.
I promise I am on your team.
But most importantly, I promise to help you live a good life so you can feel good in your body.
If you want to book an online or in person (Boston) session with Kerry, click the link here.