Adventures in practice VII

[ovpt]

john...why not hedge your bet and talk to the docs too? patients telling docs positive feedback is great but if you also follow up, it provides further reinforcement and can lead to actual real therapy conversations. pretty cool in my experience that leads to actual education to the docs of what we can offer their patients.

[Diane]

Originally Posted by ovpt

john...why not hedge your bet and talk to the docs too? patients telling docs positive feedback is great but if you also follow up, it provides further reinforcement and can lead to actual real therapy conversations. pretty cool in my experience that leads to actual education to the docs of what we can offer their patients.

What do you offer their/your patients?

[ovpt]

diane...i would say i am in step with the general philosophy of this site in that its all about neural control...this would be lost on most of my referral sources except for a few which makes for some really fun conversations with those whom are interested.

[ovpt]

i offer my patients education on their pain ( noi based), a hep that addressed their specific needs ( no random core strengthening), manual therapy to modulate their pain, and overall better outcomes then my competitors due to the aforementioned reasons.

[ovpt]

i also offer my services in a friendly, service oriented atmosphere with a caring and empathetic attitude that without would definitely hinder my efforts. i can not say enough about customer service and exceeding their expectations when it comes to my success.

[Greg Lehman]

Hi,

Sorry to stray from a dissection of ovpts treatment approach (even though it seems he just gave encouragement for Barrett to keep talking to these resistant orthopods and didnt epouse some magic that we should all aspire to) i would like to go back to Rods approach as treatment option B. i have no desire to critique it i just want to know how the gentler approach is different than the traditional approach. I am one of the people on here who do somethings similar to some meso therapists but try to inspire/justify/rationalize it based on more neurofriendly terms.

Just curious how option B is different (i will then probably incorporate this monday morningSo thanks for the seminar).

Greg

[ovpt]

greg...dont feel bad about interrupting the dissection of how i treat patients. i wont and cant speak for rod but the idea of gentler treatment works much better with the humeral orif patients due to protective mechanisms. there are many concepts out there that provide a gentler approach to ROM and work better with this population.

[Barrett Dorko]

I'm totally with John on this one.

I was also struck by the comment, "nothing to lose." In my experiance, that's not true at all.

[norton]

Originally Posted by ovpt

greg...dont feel bad about interrupting the dissection of how i treat patients. i wont and cant speak for rod but the idea of gentler treatment works much better with the humeral orif patients due to protective mechanisms. there are many concepts out there that provide a gentler approach to ROM and work better with this population.

Yes like not touching them at all and letting the Wii exercises restore the body map for painfree ROM.
Deb

[pedspainphysio]

On my marketing approach...

I have had a few patients referred from a pain doc in town... the last one (who has had pain for years) told me that she has never made any gains in PT until seeing me... she went back to the doc and told him this... this week I recieved another referral from him... under 'reason for referral' on his referral form he wrote "your magic"...

Keep doing what you do Barrett... people will eventually notice... and then tell others... like treating pain, sometimes we need to be turtles not hares...

M

[Diane]

Originally Posted by pedspainphysio

On my marketing approach...

I have had a few patients referred from a pain doc in town... the last one (who has had pain for years) told me that she has never made any gains in PT until seeing me... she went back to the doc and told him this... this week I recieved another referral from him... under 'reason for referral' on his referral form he wrote "your magic"...

Keep doing what you do Barrett... people will eventually notice... and then tell others... like treating pain, sometimes we need to be turtles not hares...

M

I like it!

Marketing the treatment of pain primarily when pain is the primary problem (as you've pointed out in the past, B), as opposed to burying it under "function", the way PTs have historically been taught to do, might be a way to proceed.

Disclaimer: I'm completely biased because of my involvement over the last 7 years with helping Pain Science Division become established in my profession: i.e., I want the entire profession to move to this idea ASAP.

[Greg Lehman]

I think what Diane is doing is great and i want to be on that train but the "i dont treat pain i treat function" is not only a dominant approach it is gaining. Its what people say if they want to distinguish themselves from the ultrasound and hotpacks people. " Those fools just chase pain and symptoms."

I'm onboard for doing what i can to change these beliefs

[John W]

john...why not hedge your bet and talk to the docs too?

I talk to them- about sports, Jazz Fest, possible research projects. We commiserate that the building still doesn't have wireless. I'll call a doctor once in a while to let them know I'm referring a patient to a different therapist with more training and skill in, for example, vestibular disorders or Parkinson's disease (where pain is not the primary complaint).

I don't talk to them about what I do because they don't care. They live in a different universe. We may as well be exchanging hand signal greatings like in the movie Close Encounters of the Third Kind.

I can't even talk to most PTs about what I do.

[Barrett Dorko]

Again John, I'm right with you.

Funny thing, I'm really good looking too. You'd think that would count for something.

[John W]

I'm really good looking too. You'd think that would count for something.

Only with the female docs, and then only if you remind them of their daddy.

It's complicated.

[Sheffphysio]

Originally Posted by John W

I can't even talk to most PTs about what I do.

I hear that.

[pedspainphysio]

My practice is now humming along... this week I am at capacity and am a little worried about having enough space for everyone next week (a nice problem to have I guess!)... as I look forward to the summer and a couple of weeks of family holiday in August I am wondering how all you sole practitioners handle your time away from the clinic... I can't just have anyone cover, but am worried about shutting things down while I am away... what do others here do?

Would love some advice....

Mike

[Diane]

Explain as graciously as possible. Firm and kind.

[pedspainphysio]

Wondering what happens to the patient numbers in the summer months? I am still on target as July ends (actually a bit above target) but have a sense that things are slowing and my cancellation reschedule rate is the higher in July than for all the 4 months prior combined... I am thinking that this happens in clinics as the waether improves... wondering what the rest of you are experiencing? What are your patterns?

I am not really all that worried and am using the 'slow down' as an opportunity to take a couple of weeks off... my plan is to do a little marketing in September and bring the numbers up a bit...

Thoughts?

[Diane]

It goes up and it goes down. It all evens out. Don't worry about it. You're established now. Once in awhile you get a rogue wave and feel swamped, actually have to book people way off in the future. I've got so I really welcome time out, a "hole" in the schedule. I use that time to think, or nap. Or both.

[Ken Jakalski]

Hi John!

In over 17 years of practice, I've yet to encounter a physician who gave a rip about my contribution to his positive outcomes.

I think this has to do with the fact that they have no idea what I do, nor do they care.

From my perspective, this is indeed accurate. PT or trainer outreach to schools is often simply a convenient way to get orthopedic referrals. Kids and parents like the trainer, and take the trainer's advice when asked about a good bone guy.

Since the essence of what a good bone guy does is when the patient is asleep, I always ask kids what is there first impression of a "good doctor."

The respone is always the same: "he seems like a nice guy."

My next question: What do you mean by nice?

One of the best reponses to this:

"He talked to me and not my mom."

[Ken Jakalski]

Hi Barrett!

I’m not moving into this directly; head-on will not work here. I’ve decided to move sideways, providing everyone involved with something thoughtful.

Using a title from one of my favorite Dorko essays:

With death comes food.

Maybe bake something that you offer them on the way out.

I continue to be amazed at how much food fosters socialization.

[Kyle Ridgeway]

Originally Posted by John W

In that case, I'd just let the patients do the talking...

Simple. And, true. I posted the following in another thread, but it applies to this discussion:

MD's and other professionals have such a poor understanding to even the most generic practice of physical therapists, that I truly believe that the it is the results and patient reports that matter most to referral sources. MD's and referral sources don't care so much what you do as much as the perceived outcome and what the patient tells them. Show them the outcomes, and then they may be open to the explanation....

Recently, an orthopaedic surgeon (who refers quite a few patients to our clinic) told a questioning and doubtful patient "To be honest, I don't know what they do over there, but it's magic." While we appreciated the compliment no doubt, I cringed a little. As Barrett and Jason have discussed (openly, in the literature via JOSPT, although not open access) The Method is NOT the Trick. This concept took me a long time to understand...

Method and Trick is a nice read.

I guess, the issue becomes how to get the patients in the door in the first place...

Cory's comments about convenience, easy solutions, and not sucking make sense.

[Diane]

Originally Posted by Ken Jakalski

I continue to be amazed at how much food fosters socialization.

Women have always used this trick to:
1. Avoid being killed by men (the idea being that food makes men less grumpy)
2. Raise babies to become decent humans by linking food as a reward to good socially acceptable behaviour
3. Tame/domesticate baby companion and herding animals
4. Compete with each other at fairs
5. Celebrate everything