Why we shifted to 60 minute initial physiotherapy consultations
We believe that longer is better when it comes to initial physiotherapy consultations.
We believe that spending longer with a client during the initial physiotherapy consultation is instrumental in determining a clear and accurate diagnosis. An accurate diagnosis is imperative as it then allows for targeted treatment with no guess-work and an overall much more effective and expedited physiotherapy rehabilitation process.
Sadly, I’ve observed a general trend in healthcare towards practitioners spending less time with health care consumers. This trend is not just limited to the physiotherapy industry. Take for example the bulk billing General Practitioner who is mandated to consult patients in as little as ten-minute increments. My experience is that anyone who has experienced short medical consultations, even if they got what they wanted, typically can’t help but feel underwhelmed in terms of the ‘get them in, get them out’ type of experience.Sadly, I’ve observed a general trend in healthcare towards practitioners spending less time with health care consumers. #performbetter @pogophysio Click To Tweet
The Initial Consultation Must Do’s
When it comes to physiotherapy there is a lot that needs to be accomplished inside a client’s initial consultation in order for the best possible start to the rehabilitation journey to occur. I believe the quintessential components of an initial physiotherapy consultation include:
- building rapport with the client to engender a confidence and trust in the therapist
- a clear understanding of what the client is trying to achieve
- a clear understanding of the client’s expectations regarding treatment
- a thorough assessment in order to diagnose the injury/condition
- identification of a diagnosis in combination with the key contributory factors for the injury onset
- the beginning of immediate effective treatment for the client’s pain
- the dispensing of advice to immediately assist the client
- the prescription of a targeted and time-effective home exercise program
The Four Questions That Need to Be Answered
Additionally, over the last 11 years of practice we have discovered that during an initial physiotherapy consultation all clients need answers to four key questions. The questions being:
- Can you help me?
- What is wrong with me? (the diagnosis)
- How long will it take? (the prognosis)
- How much will it (treatment journey) cost me?
Failure to answer these questions during the initial consultation will detract from the client’s initial physiotherapy experience, and quite likely lessen the overall effectiveness, and ultimately outcome of rehabilitation.
Rehabilitation and Physiotherapy finish lines
Our years of practice experience in helping over 18,000 clients has taught us that when clients initially come to see us that are trying to get one of two things done. They are either trying to:
- Get out of pain, having no great interest at addressing the injury or pain’s causative factors (Out of Pain)
- Rehabilitate their injury or pain in full by addressing the causative factors, thereby getting back to their physical best (Into Performance)
In 2015 we started referring to these outcomes as our client’s finish lines. A client’s Finish LineTM is the date in the diary at which they will have completed their physiotherapy process. That is on crossing their physiotherapy Finish LineTM the client no longer needs to return, the outcome has been achieved either out of pain, or into performance, and they have received the very best treatment available.The outcome has been achieved either out of pain, or into performance. #performbetter @pogophysio Click To Tweet
These outcomes are illustrated in the below chart we use with our clients during the initial physiotherapy consultation to get clear on what it is that they want from attending physiotherapy.
Initial Consultation Length Trial and Error
Over our 11 years of practice life we have trialed various initial consultation lengths. In our early years as My Back’s Physio we offered 45 minute initial consultations. I found the 45-minute initial consultation length to be ‘good’, however often lacking and still feeling time pressured in wanting to give my absolute best.
Forty-five minute initial consultations were followed by a very brief trial of 30 minute initial consultations when we were understaffed with physios, and struggling to keep pace with the large number of new clients attending the practice. This was not effective, nor in my opinion maximally beneficial to the client and their desired outcome. It was not only I who disliked this ‘quick turnaround’ initial consultation, the already stretched physiotherapy team shared my sentiments around the ineffectiveness and excessive pressure borne of a shorter initial consultation. We quickly discontinued the practice of 30 minute initial consultations.
Then in the middle years of our practice’s life cycle while part of a national franchise chain (Back In Motion Mermaid Waters), we were required to deliver 40 minute initial consultations. I can recall how the loss of 5 minutes from the client’s initial consultation, with going from 45 minutes to the required franchise consultation of 40 minutes, caused me anxiety. The anxiety was borne from a desire to give the client the very best of what I had to offer, but now having 5 minutes of less time available in which to deliver it. Professionally I often felt unsatisfied. I would often feel like I could have helped a lot more if I had the time available to me.I would often feel like I could have helped a lot more if I had the time available to me. #performbetter @pogophysio Click To Tweet
In 2014 after we left the national franchise we returned to a period where we once again did forty-five minute initial consultations. We were now trading as POGO Physio.
Physio With A Finish Line,
Brad Beer (APAM)
Author ‘You CAN Run Pain Free!’
Founder POGO Physio