We’ve all been on the receiving end of medical care that left us unsatisfied. Personally, I feel like a lot of my visits go something like this: Me: “Hi, I … ” Physician [interrupting]: “Oh good. You’re not actively dying in my office. That would involve even more paperwork. Stay alive! Bye!”
With interactions like that, no wonder we lie to our medical professionals. (Click the link to see why it’s important not to lie to your medical team and to learn how to spot a patient lying to you.) They can’t give us the time of day to work up the courage to really get to the heart of our problem. They can’t because of issues with the system. They are pressured to meet a certain level of efficiency–number of patients in a day– to keep the doors open. Which is often a rather high number. Thankfully, my employeer doesn’t look at that for inpatient therapists like me (they do for outpatient therapists though), so I can spend as much time with my patients as I like. In fact, they even encourage us to spend extra time beyond what is required by their payor source, which is usually Medicare in my place, treating them! Not because they will get paid more (they get a lump sum, no matter what we actually do), but because we will get better outcomes. Which ultimately reflects well on the care we provide on industry checks, patient satisfaction and word of mouth referrals.
*Ding!* Why doesn’t that model click anywhere else? Even in outpatient therapy we get to spend an entire hour on evaluating a patient. Is a physician so much better at assessment than we lowly therapists that they only get 15 minutes? I would argue no. That’s why I feel like they over rely on imaging to make diagnoses. They aren’t allowed the time to sit and actually listen or use their eyeballs to diagnose, which is why we therapists are phenomenal at it, if I do say so myself, because we have no access to order imaging in our professional license. We have to use “antiquated methods” (which is what a nursing friend called using a physical test in lieu of imaging.) This is why it is important for we therapists to really know our “red flags.” Maybe the stupid imaging didn’t show anything at the time, but the patient is definitely showing signs and symptoms of something that needs to be addressed medically, not therapeutically. For example, I had a patient once that came into inpatient rehab for… I think it was post some kind of abdominal surgery. Anyway, in my evaluation, he happened to mention he had fallen in the bathroom about a week before going to the hospital with stomach cramps and had had severe back and side pain since then, leaving him unable to walk. Lo and behold, I had found me a hip fracture that NOT ONE other medical professional in the 2 weeks he had been in the acute hospital had found. Simply because I had listened when he casually mentioned the fall that was way before the stomach cramps that sent him to the hospital. Another example: almost every vestibular course instructor I’ve had has had a story about someone referred to them for “dizziness, eval and treat” and they find the patient has had a small stroke.
The lucky ones come to therapy. The unlucky ones get recommended for back surgery like the example in the article. This is also why it is important for us to advocate for the patient’s right to direct access to physical therapy– so we can fill this gap in the medical sphere. Then the root of the problem can be located and the right treatment performed. And also to make sure we provide the patient with the correct referrals when therapy is not going to help them. Patients who have empathetic medical professionals behind them are also more healthy overall– lower blood pressure, less pain and anxiety, actually heal faster. (I wish the above article had linked to the actual research article there, but instead they linked to another news article about that research.)
Empathy is a foundational component of therapy services. If you are interested in this topic, or feel you could use a boost, maybe consider taking a course, like this one: Empathetics, which was recommended in the article as well. Its online and covers the neuroscience of emotions. Sounds interesting to me!
If nothing else, make sure you put your listening cap on when on the job!