My biggest mistake in practice so far

Two words: expectation management. I had a pretty big "Aha!" moment during rounds at Shift the other day. That moment was immediately followed by an, "Ah, shit." moment. Brock and Jamie had been sharing their wisdom on the biggest things they've learned while building their practices over the past decade, and made me realize that I ought to change the way I talk to my patients.

Of the many things I learned that day, the biggest one was how greatly our word choice can impact patient expectations. The biggest no-no, I learned, was asking patients "How does your <insert body part> feel NOW?". This question alone creates the expectation of instant gratification and change during a physiotherapy session. The truth is, the body doesn't work that way. It takes time for our bodies to adapt to manual therapy or exercise interventions and this change is far from instantaneous. Asking this question is the equivalent of your personal trainer asking you after each exercise set if you're stronger yet.

I realized that I've been setting myself up for failure. Best case scenario, the patient is feeling better and I've convinced them they're fixed already which is FAR from the truth. Worst case, I've planted the idea that what we've been working on for the past half hour didn't work, wasting their time and money. On top of this, putting a patient in that position can be extremely awkward as they feel pressure to please you, resulting in an, "Ummm I think it's better?" type response.

If you've been asking these types of questions, don't be too hard on yourself. It's only natural that as we build up our bank of normal ranges and movements, we struggle to label things as abnormal. As this bank grows we rely much less on feel and more on what we see.

So now I've started to ask, "What do you notice?" when assessing movement rather than pumping patients full of "How do you feel" questions. This small change in wording provides the information we seek without the added expectation that it SHOULD feel different. It encourages patients to assess their own movements with less pressure to please us by telling us they feel great.

Stay tuned for more of me making mistakes and learning from them! This "Ah, shit" moment certainly won't be the last.

#practicetips #expectationmanagement