A Little Conversation Walks a Long Way: Ryan G., PT

I often find conversation to be one of my greatest, most valuable tools in treating patients.  Doctors are allowed to have a poor bedside manner; they can spend 5,6,7 minutes with a patient and not see him for another 6 months and be fine.  In physical and occupational therapy, however, a poor bedside manner will translate to low productivity, low patient satisfaction surveys, or worse, the patient decides he is better off without the PT as to avoid another interaction with that therapist.  Sure, a guru of his or her specialization can be the best, hottest thing in town to where people are forced to come to that person regardless, but in most instances there are several options and competition can be fierce.  This is a good thing though, competition breeds excellence and excellence is what every patient hopes to have when they begin their therapy. So, to get to the point, a light-hearted conversation can be the difference between a successful therapy practice and a bankrupt one.

One example I can think of is dealing with disgruntled or short-tempered patients.  Making conversation can be hard, and frustrating, but once you break through that rough exterior the person you come to know may end up being one of those patients you look back on and say, “He was a favorite of mine.”  I recently had a moment such as this where I had admitted a patient at home after a TKR.  He was a rough, gruff, and to the point New Englander who, when conducting my interview, made me excited to end it and be on my way. Nothing seemed to work as far as small talk, he simply wanted me to give him his exercises and leave.  This all changed one week later, when, thanks to the football gods there looked to be a season this year, I brought up some New England Patriots trade and free agency talk. Now, mind you, I am a Colts fan. I have absolutely no feelings of affinity to the Patriots; I respect their organization, but come football season, I want to see them loose every game so the Colts don’t have to face them in the playoffs.  Back on task, I brought up the patriots thinking he would jump on and begin to talk about all the gossip. Instead I received a rather unexpected reply,” Ah I don’t care about any of that crap, cars is my thing.”  I was taken aback, I thought for sure he was on board with the Patriots, but he had revealed something about himself that I could get my foot in the door with…cars.  SO I took another chance, the same session and began to ask about his experience with cars and talk about the Indy 500 back home.  To my pleasure, he opened up and began to tell me all about his refurbishments.  In fact, the completion of our session that day, he escorted me to his garage where he showed me two classic cars he had acquired and rebuilt.   I left the session that day triumphant. 

My patient had opened up a door to the world of automotives I never thought existed with him, and I was able to learn a many new facets of the automotive world.  More importantly, the sessions to follow were nothing like their predecessors.  My patient was more eager and willing to participate in therapy and increase his walking distance with out a second thought.  His knee range of motion made much greater gains than before and his overall report of function increased.  After discharging this patient to outpatient PT services, I began to look at others on my caseload and try to find that little unique certain something that every person has that would allow us to connect and build on with our sessions.  Though not a reimbursable treatment modality, conversation can supplement the reimbursable ones and create lasting effects for patients with much improved treatment outcomes.