Why do some graduates rush through a consultation to get the patient out the door in 15 minutes?
This has always baffled me as a mentor and private practice owner, especially when we so generously offer our new graduate physiotherapists the luxury of more time to fulfil consultations initially with their caseload.
Some graduates have never experienced a private practice placement (40% in fact), whilst others had their placement 8-9 months ago, so getting back into the swing of MSK assessment, diagnosis and treatment can be a challenge. Most private practice owners will understand this and offer their new graduates longer consultation times in the first week or two of practice for a number of reasons:
1. Build rapport with their patients to build a recurrent clientele
2. Learn the processes and systems within your business
3. Have time to process clinical information and make clinical judgements
4. Time to practice manual therapy and prescribe exercises
5. Time to orientate to equipment and practice surroundings
Giving that extra time initially allows a graduate to settle into the position without getting overwhelmed and flustered. When a graduate is time pressured they tend to convey that message to their clients and their clinical judgement goes out the window and they start to panic and tend to jump from trying lots of alternatives without rationale.
It is a smack in the face when a graduate is given this extra time and they do not use it. I have seen many graduates offered 1 hour for initial consultations and have the client out in 15-20 mins. Does that impress me in the first week? Absolutely not.
That tells me a number of things about this graduate:
1. They are not confident in their clinical skills and therefore are doing the bare minimum.
2. They associate being a quick treating therapist as a good trait (not what our clients want - 5 minute medicine)
3. They are unrealistic in their skills and abilities at this point in their career
If you have a graduate that is rushing consultations and sending your patients out the door in 15 - 20 mins then you need to deal with this immediately.
They need to understand that as a graduate their practice is not streamlined and therefore they need this time to practice their subjective, objective, treatment skills, language and communication with a client and adhere to the processes and systems that need to be followed after a consultation e.g. clinical notes, letter to GP, phone calls, PMP Workcover, treatment action plan, patient rescheduling sheets.
The options are to sit your graduate down and get to the core of why they are completing short consultations already in their career. Because if they are taking shortcuts now in the first week this will only get worse. This is the best time to complete a baseline Performance Appraisal to raise your concerns.
Tip to Graduates:
Even the most experienced clinicians would love more time with their patients, so take this opportunity while you can.
You get one chance at being a graduate. Your boss or mentor will have had a lot of experience in training and mentoring graduates in private practice, trust in them and the learning opportunities you are given. If you do not utilise these, don't expect many other opportunities to come your way as we will get the impression you know it all already.