Graduate physiotherapists try and hit the ground running in private practice by utilising all of the assessments available to them from university training. It is similar to having a very large puzzle with all the pieces spread far and wide and trying each piece in the available spot instead of really looking for the piece that best looks to fit that position.
Depending on the University you attend you may have experienced your musculoskeletal placement in the early years of your undergraduate degree or some time in the final year of your degree.
When a graduate secures a position in a private practice upon graduation they very quickly pull out all of their MSK notes and textbooks to brush up on assessments for different parts of the body. They then attempt to walk into a consultation and persist with assessing everything for that particular area of the body, relevant or not. As a result, they have information overload from assessment outcomes and become very time poor, flustered and confused.
When a graduate becomes time poor and flustered they begin to take shortcuts and attempt to pluck a diagnosis from thin air because they can not decipher all the information they have been presented with.
They often have all the information sitting in front of them, they just need to sift through to get to the relevant information. Streamlining of practice for a graduate does not come naturally in the early stages of their career and many of us that started in private practice with no support will know how difficult this process was to master. If you are reading this then you obviously succeeded, but there are many that are not resilient enough to handle this pressure and we lose potentially great future physios.
But, streamlining of graduates for private practice can be achieved very quickly with the appropriate input.
Here are some tips to try:
1. Make it easier for your graduate to listen to their patients in the subjective
This is done by creating an initial consultation assessment template that they just need to fill in the blanks. This stops a graduate thinking about the order of questions and what to ask and eliminate the fear of missing some vital information. This then allows a graduate to ask the right questions and get the right answers. As they develop as a clinician this will be phased out of their practice, but to start with it is a great tool to streamline subjective assessments and get your graduate to actually listen and comprehend what a patient is telling them.
Just as when we start to learn any new skill for example, playing the piano, we need sheet music to follow. As we practice and perfect the art, we can go off and create our own masterpieces, but at the beginning we need to follow someone else's sheet music.
2. Teach Pattern Recognition
At Physiomentor we teach graduates common clinical patterns for common conditions in MSK private practice. Pattern recognition of common conditions in private practice is a vital part of graduates gaining or eliminating a diagnosis. Many graduates lack seeing real life injuries and conditions and how they present and progress during rehab, so we at Physiomentor teach pattern recognition. This teaches graduates to match patterns in the subjective with potential provisional diagnoses, then during an objective to assess with cluster testing those potential diagnoses. It is either in or out and if it is none then you must go back to the subjective data. Graduate physiotherapists are highly intelligent beings so pattern recognition comes very quickly to them and then being able to pick assessments that will confirm or deny a potential diagnosis is vital to streamline assessments. Is this not what we as experienced physiotherapists already do in our clinical practice?? We know there will be the cases that do not follow a pattern, but finding the closest match until proven otherwise is important for planning the next course of action.
3. Prioritising Treatment
Graduates need to prioritise their treatment sessions for better time management in a busy practice. All of the techniques or treatments that require your one-on-one attention in the cubicle need to be first priority so that if you need to overlap patients you can do this by leaving your initial patient to finalise the session with a passive treatment (e.g. heat, ice, dry needling etc) and can then start the next patient. We as private practitioners know how busy your day can get and being able to overlap patients when required to better time manage your day is part of working in a busy clinic. This really depends on whether your clinic has the cubicle availability to work in this way. If they do, then lucky you as a graduate because it just takes the pressure off as a new grad in private practice.
Resource Free Access:
To get you started with your graduate we are offering our 'Initial Consultation Template'.
This includes the subjective, objective, treatment, consents and future plans for your graduate to follow.
Using computerised software for chart notes in your clinic? No problem. Copy this into the templates section so your graduate can easily add the information from the consult.
CLICK HERE - Scroll to the bottom for access to this resource and additional free resources.