Stop Babysitting Your Patients!

Let me paint the picture for you.

There is a patient who is suffering from persistent lateral elbow pain.  He has had several injections to ease his pain.  None have really helped.  Now he is out of work due to the pain.

He was told to go see a physical therapist to have this condition addressed.

Awesome, right?

Well…not so much.

The patient went to the see his physical therapist who performed an evaluation – the history, range of motion, muscle strength and palpation of the elbow.  The patient was told he has “tennis elbow”.

The plan of care: Come in 3 times per week for 4-6 weeks – roughly 12-18 visits.  Interventions will include soft tissue work and exercise.

This is a story I heard just last week.  But it is the next part that frustrates me.

The patient had a $50 co-pay.  He wanted to get better and trusted that the PT dosed his visit schedule appropriately, so he came in 3 times per week. That is $150 per week…while he is out of work.

Maybe what is being done during the treatment sessions will make the co-pay worth it.  Apparently not.

The patient saw the PT one-on-one for the evaluation, but from then on, he mainly saw him from across the gym.  He would come in to get a quick subjective catch, and then told to run through his exercises while the PT watched from afar.

This continued for 4 weeks – $600 later, he self-discharged.

He was not getting better and was frustrated of doing 3 sets of 10 of exercises that he could do at home.

Here is my issue: why do we do this?

Why do we not engage with our patients enough to make it worth their while to come in?  Why do we create plans where patients come in and do their home exercise program with little input or progression?

If we prescribe exercises that can be easily found on the internet – with the exact same dosage – are we truly movement experts?

If exercise is medicine, this example is a pretty terrible way of prescribing it.

Having a patient come into your clinic and go through this scenario is the same as babysitting them.  There is no empowering of the patient.  There is no value given.

Patients do not want to pay $150 a week to be babysat.

So – prove your worth.  Stop prescribing exercises that any patient can look up on the internet and start to give a damn about what we do.

@ShepDPT

4 responses to “Stop Babysitting Your Patients!

  1. Tonya Olson says:

    Exactly!!! How do we spread this message outside of those who typically read this blog? How do we empower PTs who are stuck in the “turn & burn” PT clinics where productivity metrics are the primary measure of success used by management? It’s hard to keep giving a damn when you’re beat down every day and treated like a number?

    1. Mark Shepherd says:

      Hey Tonya! I think we have all felt this way when many of our meetings are surrounding productivity numbers vs. the quality of what is done. I hate that we have a payment system that rewards this behavior. I guess that is why we are seeing a rise in out-of-network practices. I think we need to empower people to stop working for companies that “turn and burn” – you may get paid more, but you will only last so long.

  2. Lily says:

    thank you for this. This is exactly why most of us stop physical therapy. I have seen 4 therapists. they either made my pain worse, or just didn’t help at all. I was lucky enough to have the therapy paid for. So I had no constraints. I came to every appointment wanting help and willing to work. But I got no help. How many therapists should I try before i give in? for me it was 4, and that’s probably 3 more than the average patient, the one who has that $50 co-pay.

    1. Mark Shepherd says:

      Thanks for reading, Lily. On behalf of my profession, I am sorry that you have had this experience. Just know that there are many great PTs out there and I hope you have not lost hope in your journey.

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