Question of the week: Can we, as physios, do anything about Orthopaedic surgeons treating their patients like an annoying fly in the room???
I've been treating this wonderful patient who had a TKR a few months ago and she went to see her surgeon last week. As she had quite a few questions regarding her progress, she was looking forward to the appointment. We had discussed her progress and how she is basically right on schedule, if not ahead, so she was looking forward to seeing the surgeon. She was looking for validation and confirmation from the surgeon.
Upon seeing her this week, it was clear that her appointment did not go well at all. Firstly, the surgeon was about 45 minutes late. Secondly, the surgeon simply tapped her knee and said that it was looking good without even asking her a question. Then he read my review summary and told her that she should be working harder with her exercises. Thirdly, he didn't even give her a chance to ask any of the questions because he was already walking her out of his office and simply told her to keep up with the physio. When she went back out to the front desk even the secretary was surprised at how short the session was and had to ask if he was done with the patient. It lasted all of a few minutes.
Throughout this blog we have discussed the importance of encouragement and keeping the patient motivated to do their rehab/exercises. This patient was as motivated as I've ever seen. She was a gym rat and couldn't wait to be allowed to return to the gym. After the appointment with the surgeon, she was so deflated and felt as though her progress was not enough.
For the remainder of our session, I had to do damage control and get her motivation back. This program have stressed the importance of multi-disciplinary team work and I don't think surgeons are getting preached the same message. Is there anything we can do about the way surgeons treat their patients?? This is an issue that really affects the progress of our patients. Sometimes it almost feels like whenever we get the patients to take a step forward, the surgeons come in and force them to take two steps back.
2 comments:
Hey Sabrina,
I completely agree with your comment, but it is not only surgeons. I have found myself facing similar brick walls with other health care professionals so I think it depends on the person, not the field. Some people even have that perception of physios as some physios in private practice often get accused of not spending enough time with their patients. I think you did the only thing we can do in a situation like this: damage control.
Hey sub,
my experience with surgeons has been varied but as a very general rule, if the surgeon is fairly young ie usually a resident or registrar seeing the pt on behalf of the consultant, sometimes I broach my concerns in a very laid back and friendly manner. Often they are just tired or having a bad day and they are usually much more tactful the next time they see the patient. If the surgeon is older, ie over 60 (I know, generalising huge here but its my experience none the less) there is absolutely nothing you can do. They are usually stuck in their ways and received no form of communication education in their schooling. The only thing you can do is point out to your patient that they are doing fantastically and try and prove to them in some measureable way how much they are improving. I would say something like "wow, do you really have concerns about my patient's progress, I thought they were doing really well because of this..and this..." or maybe, "Ms ..... has been really down since you spoke to her, she thinks she is not progressing as she should, do you mind putting her mind at ease next time you see her so we can get her motivation back for her exercises.. thanks" Saying this, I wouldnt attemt this as a student. It is always best to build a rapport first. Once you have built a good rapport, you can always start to get a bit cheeky. Alternatively, approach the junior doctors to speak to your pt.
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