The Physical Therapist's Guide to Successful Patient-Provider Relationships

Last month on the blog we discussed why patient engagement matters to physical therapists. We talked about the importance of creating touchpoints throughout the customer lifecycle to increase engagement between patient and provider. We shared our belief that the relationship a physical therapist develops with their patient is a vital component to care, and to creating a lifelong customer who has an excellent outcome.

Although the care of patients is a multi-faceted endeavor, the two main aspects of care are the technical and the interpersonal. As the physical therapy industry continues to push for evidence-based practice, we as therapists are doing a better job of providing technically-improved care. We are taking a hard look at the way we have always done things and asking if the evidence really supports the continued use of certain modalities and techniques in practice. This is vital to advancing our profession. The trick is being able to focus on the interpersonal aspect at the same time.

Evidence suggests that by encouraging patients to take an active role in their health care we can increase the effectiveness of their therapeutic activities. This article from 1985 presents an idea that I believe is still relevant to this discussion. The title says it all: “Building an effective doctor-patient relationship: from patient satisfaction to patient participation.”

The article states that “physicians are urged to involve patients in an informed decision making process by eliciting and including patient preferences in a health program that incorporates an active patient role.”

This quote truly gets to the heart of the matter: in order for our evidence-based treatments to actually lead to good outcomes (and lead to patient satisfaction scores that are truly representative of the quality of care), we need to get the patient to “buy-in” first.

The best way to get buy-in is to involve patients in the decision-making process and educate them about the treatment plan. How many times do we conduct a technically perfect initial evaluation and then give the patient the “correct” home exercise program, only to have them come back for the next appointment stating that they haven’t tried the home exercises? We then feel frustrated and often blame the patient for non-compliance, when the real problem is that the patient never bought into the plan in the first place. Thus begins a negative cycle of patient non-compliance and therapist frustration that ultimately leads to poor patient satisfaction scores (and poor scores when using measurement tools like the NPS®).

When we involve patients in the healing process from the moment we meet them, we increase the chances of a true partnership. In the initial evaluation, we need to ask our patients “How can I help you?” and “What can’t you do now that you want to do?” Next, we need to educate them about our findings from the assessment and tie those findings into the goals we are setting in the treatment plan. During treatment sessions, we need to make sure to explain how a specific exercise or technique will assist them in reaching their goals, and then we need to hold them accountable for doing their part in the process. We must emphasize the importance of the patient’s active participation in the success of the treatment plan.

We also need to connect in an authentic way with our patients. Things like making eye contact, offering a firm handshake, and projecting confidence (ahem…not arrogance) is a great way to start. Follow this with carefully, actively listening to the patient’s concerns, addressing each one, and continually asking the patient how THEY feel therapy is going. As one patient recently shared, “Subjectivity is underrated.” The patient’s perception of their progress is very important to take into consideration.

This month we will continue the theme of the patient-provider relationship with a twist:

We will be sharing real stories from real patients about their experiences in the healthcare system and tips they have for creating an authentic patient-provider relationship.

We will also have one guest post about creating the ideal patient experience, and another guest post from a patient who is now a patient advocate (and a firm believer in physical therapy).

As our profession moves toward patient-centered care, we need to ask patients what this term means to them. We need to stop assuming that we know what patients want and need, and we must involve the patient in their care from the onset. Last month, Nick Adkins shared that patients must have a seat at the table from the very beginning when it comes to developing technology. When we involve patients from the beginning, we get a better understanding of the problems they have, and a much better chance at solving those problems.

Patients can no longer be an afterthought in healthcare – they are the reason we do what we do.

We’re excited to hear that more and more conferences are beginning to invite patients to share their stories, and patients are even beginning to sit on advisory boards in health systems. When we connect, we build trust, and trust is the foundation of every successful relationship. Join us this month as we explore more of what patients want in the patient-provider relationship.

If you're interested in learning more about how patient relationship management can drive growth at your practice, click here:

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Ann Wendel

Physical Therapist, Writer, Speaker, Consultant, Kettlebell Lover. Director of Brand Marketing for @strive_labs and @APTAtweets Media Spokesperson.