Include the Patient in Your Clinical Decision-Making

One common mistake many new physical therapy graduates make is excluding the patient from clinical decisions. While it might seem efficient to make decisions independently, this approach often backfires. Patients who feel unheard or disregarded are more likely to miss appointments or stop coming altogether. Including the patient in the decision-making process builds trust, improves outcomes, and fosters long-term engagement.

Why Patients Leave

Let’s explore some scenarios where excluding the patient can lead to frustration and disengagement:

• Recycled Treatments: The patient has already tried the classic treatment for their condition (based on their own research or advice from a PT friend) without relief. If you prescribe the same treatment on day one, they may feel dismissed.
• Ignored History: The patient describes treatments from a previous provider that didn’t work, but you recommend the exact same approach.
• Redundant Exercises: The patient has already completed their home program before the session, but you have them repeat the same exercises during their appointment.

These examples highlight the importance of listening to your patient’s experiences, preferences, and feedback before formulating a treatment plan every visit they attend.

How to Include the Patient

Your patients bring valuable insights about their condition and responses to past treatments. By actively involving them in decision-making, you show respect for their perspective and create a collaborative environment. Here are some examples of how to adapt based on patient input:

• Patient Says: “Stretching exercises flare up my symptoms.” Your Response: Acknowledge their experience and adjust by focusing on alternative treatments like strengthening or manual therapy.
• Patient Says: “I think I need more mobility and stretching.” Your Response: Incorporate mobility work into their treatment plan while explaining how it aligns with their goals.
• Patient Says: “What you did last time wasn’t comfortable and left me in pain for days.” Your Response: Apologize, validate their feelings, and pivot to a gentler approach that prioritizes their comfort.
• Patient Says: “I can only manage three exercises in my home program.” Your Response: Simplify their program to three key exercises that provide the greatest benefit.

Building a Partnership

Remember, your goal is to work collaboratively with the patient and their medical team to relieve symptoms and improve function. When you listen to and incorporate their input:

1. You Build Trust: Patients feel heard and respected, which strengthens the therapeutic relationship.
2. You Gain Insight: Their feedback helps you tailor treatments more effectively.
3. You Achieve Better Outcomes: Patients are more likely to adhere to a plan they feel invested in.

The Bottom Line

Patients aren’t just recipients of care—they’re active participants in their recovery. Listening to their concerns, respecting their preferences, and adjusting your approach accordingly will lead to better results for both you and your patients. Collaboration is the cornerstone of successful physical therapy.