Blog #67 I don’t want my client to get attached to me for physio?

Ever felt like you have to ‘break up’ with your client?

Are you getting results with your client and pretty sure you are nearing the end of the road with management, but your client does not want to leave you and keeps coming back for treatment? What should I do? This feels so wrong to keep treating….

We experience two types of clients in private practice.

Client 1:

We often get enquiries from people in pain, needing help, but worried about how long they will need treatment for. When we start to get results, they can feel great and don’t want to go back to the way they were. They feel like they need to keep having treatment and without it they will experience pain and dysfunction again.

Client 2:

Wants to come for minimal sessions and expects a full 100% recovery in 1-2 sessions and if this does not happen they leave and find another practitioner.

Both can be very frustrating, however both need clear education early on in the relationship.

Explanation of a clear treatment plan from the therapist, and the Physio clearly explaining what your journey to reaching your physical best will entail from the very first visit. This is a skill that will need to be learnt and trained as a graduate physio. This is not taught at university-level training and often grads take a session-by-session approach and patients are not sure where the end is.

Setting progression criteria and exit criteria is extremely important. Not just subjectively asking the client and not just the therapist deciding based on how many sessions a client has had to date. Clearly measuring outcomes either physical or surveys to gather data to make a decision when potential has been reached or plateaued for discharge.

Without this knowledge, you are flying blind and not able to design a clear roadmap for recovery.

Be upfront and honest in the very first appointment about what your treatment journey with them will entail. As a graduate, leave yourself breathing room and overestimate rather than underestimate. You will need extra sessions and time to get the same results as you may not be as efficient yet in your skills, exercise progression and prescription to make the rehab journey a swift one. Don’t put yourself under the pump with time constraints. More is required, not less as a graduate.

You should not paint an illusion to your client that we have magic hands and can fix you in a few visits. By early discharging a client, this can be the perception you are giving clients without a full recovery.

Most graduates send their clients off maybe 70% better and hope the rest recovers on its own. This is not how it works. You got the results by seeing the client and adding value with treatment, exercise progression and prescription timed at the right moment in the process. If you stop adding this value to the process, the process stops too.

The cold hard reality of treating musculoskeletal pain is that pretty much EVERYTHING will take between 8-12 weeks of treatment to gain a long-term outcome. This is simply how long the body takes to consolidate healing and adapt with meaningful change.

Over this 8-12 week, the first few weeks usually entail getting your client out of pain and feeling more comfortable. Then it’s onto regaining mobility and range of motion before commencing a tailored and specific strength and conditioning program to ensure the injury doesn’t return and they can participate in what they love at the level they need to whether that be sport, work or life. Injuries are usually the manifestation of weeks, months and years of cumulative load, so unfortunately they take time to fix.

As Physio’s, we can do OUR BEST WORK once you are out of pain and moving well. So don’t just get clients pain free or 70% pain free and discharge, because you are not doing your best work. Educate your client why after the pain subsides we still have an underlying deficit to modify to get a prevention strategy in place.