What's The Plan, Stan?

I have a few pet peeves regarding my profession, or other health professionals that see patients for months with little to no change in their symptoms, function, or treatment!
If you are seeing a clinician, or any other professional who is helping you to attain goals, you should ask them a few questions.
  • How long do you think this will take?
    • Any physical therapist should be able to tell you with either visits, or number of weeks, based on your condition and their relative experience
    • for simple conditions, especially short term or an acute condition you have not had for more than a few weeks, you should question why treatment would take more than 4-6 weeks (there may be a good reason, that your PT should be able to explain)
    • there should be a clear progression of your treatment and exercises, if you are doing the same things over and over, each visit, and could do them at home, why are you paying a copay to be there?
  • Are you going to assess anything other than what I am here for?
    • if you are being seen for your knee, your therapist should not only examine your knee, but your ankle and hip at the MINIMUM.
    • anyone who tells you, "Only your knee is on the script," or "I can't treat your left and right shoulder at the same time because the doctor only ordered one," is too busy for your needs. LEAVE.
  • What does this treatment do?
    • If your therapist is evidence lead, he/she should be able to tell you why any treatment they are choosing will help your pain, movement, or function.
  • What are my options?
    • If you decide against a certain treatment, your therapist should be able to provide you with an alternative
    • i.e. you do not want neck manipulation, but would accept neck mobilization, which is stretching under your control.
  • How much time do you spend with each patient 1:1?
    • If you look around the clinic, and each therapist appears to be running around like a chicken with their head cut off, they are most likely over booked
    • each session should have a minimum of 20-30 minutes of 1:1 time ONLY with your therapist
    • even if you are exercising, your therapist should check to see if you are moving well and correctly for the first few sessions, or anytime you start something new
Some of my former patients have seen me out and about, and stated, you really helped my neck, etc.. last time, but I went somewhere else for my knee and all I did was exercise for an hour without supervision. I ask, "Why did you not come back to me?" The patients reply, "My doctor told me to go to clinic x." 

Here's the thing, your doctor can only order physical therapy as a service. They cannot tell you who to see or which address you HAVE to go to. They cannot tell you to use the Rite Aide down the street anymore they can tell you to see Shake and Bake PT, LLC. Do your homework, before your first visit, take a visit to the clinic you were planning on attending. See how much time each clinician spends with their patients. If it looks like the patient to clinician ratio is out of control, and you see no 1:1 care, you should think about scheduling your time elsewhere. Does your hair stylist, dentist, or ANYONE else you see schedule 2-3 other clients the same time? If you wouldn't put up with it there, why would you for physical therapy?

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