Perception is everything

by humam, September 26, 2017

The title of this blog is mostly click bait, but the messaged portrayed in this article should resonate with health providers, patients, and the general public.

This is a story about a patient with a history of neck pain and current presentation of neck pain with concurrent R-shoulder pain with intermittent R-upper back pain. The pt originally presented to the clinic through referral from a local pain medicine physician and she had a pretty poor opinion of any interventions helping her with her pain, especially physical therapy. She openly admitted that she had about 3 rounds of physiotherapy (global term for PT), and had no success in the past and that she even felt ignored by her last physio.

Let’s fast forward about 4 visits from her initial evaluation to her current presentation. I am going to leave out some tid bits regarding her lack of exercise compliance, poor perception of PT and how that impacts her progression in this instance. She showed up to the clinic on a Monday, informed the front desk personnel that this was her last day and she wouldn’t hear of any other opinion.

So in typical Monday fashion, this was the second patient that was going to halt PT, but we maintained resilient to her objections. I proceeded to discuss with her that she should at minimum finish the last 2 weeks of her care and that she might be pleasantly surprised by her results. I explained to her multiple reasons of why she wasn’t seeing an immediate reduction in her pain; we discussed movement and physio as the solution to her symptoms. She continued her resilience and was convinced that she was done after she finished her session but thanked me and my staff because she felt like she received superior care at our clinic compared to her past experiences.

Fast forward 30-40 minutes of treatment later with intermittent patient education. To be honest I had given up on convincing the patient to continue the course, but I had given it my all. Whilst I was preparing her exercises for discharge, she approached me and asked “Chad, do you think I am making a mistake”?  I said “ABSOLUTELY, we have seen these types of symptoms in the past and I was confident that you can find relief.” Even a 50% reduction in symptoms is better than none at all.

The end result: She decided to maintain the course for the remainder of her visits. She felt that someone genuinely cared about her pain and that she wasn’t just a number. I fault myself for missing that component earlier in her care, but we connected with her on a deeper level which was meaningful enough for her to change her opinion and hopefully her perception.

Moral of the story: As a provider, it is a little bit about what you do, but it more about the words we choose and how we make our patients and people around us feel.


-Chad Shafer, DPT, CSCS

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