Reading this title I'm sure you are wondering: What does your approach mean? I'll admit, its broad but what I want to cover in this post is how you interact with patients. Most importantly however, I want to talk about your subjective. Many of us have taken basic communication classes in PT school but they didn't help much. Practicing as a clinician for a 1.5 years and going through a residency as really made me re-think how I approach new and existing patients.
So what about the subjective exam? Well, for those of you that have studied pain science I'm confident you will agree that the way you go about interacting with the patient will make a big difference in that patient's outcome. Everyone has a different way they interact with patients and many times this can be influenced by the environment of the clinic you work in. However, you must still have your own unique approach. Think about that one PT you know that patient's love but really isn't doing any earth shattering treatment. Why do his or her patient's get better? Placebo? Possibly. We know that placebo's exist and have a certain effect on patients. Knowing this should make you think about how you interact with a patient. Eye contact, handshake, body position, and tone of voice all make a difference. How do you explain things to patients? Do you vary it depending on the level of understanding of the patient? How about the level of fear of the patient? Cueing is another thing. We could talk for hours on coaching cues but instead I'd rather have you watch this interaction with Gray Cook and Kelly Starett. They nail it.
So now you're probably asking yourself, doesn't my patient's personality and/or approach make a difference? Glad you asked. It does. No matter what we think the patient needs, if that patient is not going to respond to that type of subjective or treatment, then it might be a waste of effort. Instead, learning what type of patient you have can make a big difference. Learn about their history, read their body language, and find out about past times in physical therapy. Now you can make a more meaningful impact.
Ask yourself if you vary your approach depending on the patient. Then ask yourself how you interact with the patients your see and how you educate them. I really like this article by Zac Cupples for an in-depth approach on subjective interviewing. Worth checking out.
James Heafner PT, DPT, OCS:
Owner and lead physical therapist at Heafner Health, cash-based physical therapy in Boulder, CO. Areas of expertise include orthopedic and manual therapy, functional movement, pain science, and movement science.
In May 2013, I earned my Doctorate in Physical Therapy from Saint Louis University. After graduating from the Harris Health Systems Orthopedic Residency in October 2014, I moved to Boulder, CO. Since living in Boulder, I have started my own cash-based PT practice, earned my OCS certification, and teach for the OPTIM Fellowship and COMT program in Houston TX and Scottsdale, AZ.
Chris Fox PT, DPT, OCS: Physical therapist at Foothills Sports Medicine & Physical Therapy in Scottsdale, AZ and regularly lectures at the Phoenix Campus for NAU's DPT program and for Optim Manual Therapy's COMT program. Completed multiple advanced manual therapy courses implementing aspects of biomechanical analysis. He received his DPT from Saint Louis University in 2013. Completed Scottsdale Healthcare's Orthopaedic Residency (now Honor Health) in July 2014. He became a Board Certified Orthopaedic Specialist in 2015. Level I Expert in FMS and SFMA , Kinetacore FDN Level 1 certification, and IASTM Technique course completion. He would like to pursue further education in McKenzie Technique, Dry Needling, Strength & Conditioning, Orthopaedic and Manual Therapy.
Brian Schwabe PT, DPT, SCS, CSCS:
- Board Certified Sports Physical Therapist (SCS) at Elite OrthoSport in Santa Monica, CA which specializes in treating collegiate/professional athletes and clientele from the Beverly Hills, Hollywood, and Santa Monica areas.
- USC Sports Residency Trained Physical Therapist (<1% of all PT's residency trained)
- DPT from Saint Louis University
- Future plans/interest include:
1. USAW, SFMA & Catapult Systems technology for NBA teams
2. Pursuing a position as a sports physical therapist &/or Strength coach for a Division 1 athletic medicine department or professional sport team.
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Always evolving, Always learning