In any line of work, especially when providing a service, there will always be patients and clients who are difficult or present a challenge. Physical therapy, and healthcare in general, is no exception to having patients that are combative, hostile, or in a bad mood.
Most of the time, this isn’t something you should take personally. There is usually an underlying reason for them to be acting this way towards you, and there are always ways to change the course of the visit and your relationship with them as well.
When it comes to physical therapy, the rapport you have with your patients is integral to the rehabilitative process and plays into compliance for returning treatment sessions. A bad experience could put them off from following through with their plans of care or even doing their prescribed home exercise programs. This can ultimately drive therapeutic outcomes in either positive or negative directions.
Thankfully, there are some ways that you can redirect a bad patient experience to ensure your patient is getting the best care that can be provided for them.
In these situations, it’s easy to get upset and frustrated. We are, afterall, only human, so when people raise their voices or are short with us, it’s easy to respond hastily or take things to heart. We should be careful not to be dragged to that emotional place or to mirror the attitudes of our patients. Interestingly enough, the problem that the patient is having is usually not about us at all.
The patient could be dealing with any number of issues, and we shouldn’t immediately think their anger or frustration is directed towards us. The patient has a life outside of physical therapy, and with the way things are in the world right now, there could be any number of reasons why someone would be in a bad mood.
It’s hard to keep in mind that the way they’re acting is nothing personal because in the moment it can feel like it is; however, once we stop and make sure we are calm in that situation, it is easier to help them and redirect the situation into one that is more constructive and positive.
One of the most effective ways to redirect a situation with a patient that is in a bad mood, angry or frustrated is through communication. By asking questions and being an active listener, you can get to the root of the problem to try to guide the situation to a better place.
Physical therapists, like the ones at Crom Rehabilitation, have a duty to make sure patients get the right treatments they need so asking questions to get to the root of why they may be upset is important, as it may be that their plans of care need to be modified or changed.
For example, if a patient comes in and is argumentative over an instruction or particular intervention, you could try gently showing the patient that you understand they are frustrated and encourage them to elaborate on why they don’t want to keep going. It could be that they are in more pain than perceived, and this is the driving force behind their behavior.
You could also ask the patient for their feedback on what you could do to improve. Perhaps there is something they need from you or that they’re not getting from physical therapy. It can also help you figure out if it’s something irrelevant to their physical therapy session without seeming intrusive into their personal life.
If it is something personal to them and not something that a physical therapist can actually help with, being an active listener and supportive is always the best way to make the patient feel heard and safe, as well as a great way to build trust so that they return for future treatments.
Once you’ve gotten to the root of the issue and have determined that you can help the patient, it is your duty as a physical therapist to find a solution.
It’s here that you can make the decision to change up their treatments by altering the plan of care, especially if they are experiencing more or a different type of pain. Hopefully by adjusting their prescribed exercise routines, you will put them at ease a bit more so that their mood improves.
If your patient is not seeing the results they’d like or have other reasons for being frustrated with their physical therapy, take a moment to figure out why.
If they had seen a previous physical therapist at another location or had a prior bad experience, it can leave them jaded towards the idea of physical therapy in general. Perhaps they saw little to no results in the past so taking the time to explain your rationale for what you’re doing might help improve their attitude and understanding of your chosen intervention.
This will help them understand why they may not be seeing immediate results as well as explaining to them that it will have an impact in the long run.
If their issue is related to the physical therapy treatment, one of the best things you can do is to collaborate on your ideas and exercises. Involve them in the process. That way, they feel like their ideas and wants are valued, and they feel more cared for as an individual instead of “just another patient”.
Doing this is also a great way to set clinical goals and stay in touch with their own personal goals as well. Some people may not tell you what their personal goals are unless you ask so this is a great way to set intentions for your appointments and let them know what and why they’re working on what they are.
By involving them in the process, they’ll begin to better understand the reasons behind what they’re doing, and hopefully will lessen the anger or frustration and create a better working atmosphere. This will also strengthen the patient/therapist relationship.
If they give you feedback, make sure to keep it in mind. If they express certain limitations, make sure to take note of that while changing up their flowsheets or plans of care.
If they don’t like a certain exercise, try to work through it with them and understand why they don’t, and if it still doesn’t feel right to them, figure out a new approach or new exercise altogether.
Doing all of these things lets the patient know you’re invested in their success and recovery, which means they’re more likely to trust you, your staff and your company. This translates into them being a repeat patient and more likely to return because they had a positive and successful experience.
Remember, there are always ways to redirect situations so that not every visit is tense and unproductive. Following up with a patient either through a phone call or at their next visit is a way to remind them that they’re cared about and not just “another number” that gets lost in the crowd.
It’s sometimes hard to get those difficult or skeptical patients to come back for their subsequent visits so taking the time and effort to make sure they feel their opinions are valued is an important step in making sure they return.
When they do, you can follow up and ensure the techniques and exercises you prescribed are working, and if not, you both can work together to find the best fit for their needs.
Keeping in touch with your patient and their overall wellbeing and success is a great way to maintain those relationships, which are so important to growing your business. A good relationship with your patients can lead to positive word of mouth testimonials or satisfied clients leaving glowing recommendations on your business’s website.
Lastly, remember you are human too, and if the appointment gets out of hand and they become verbally or physically abusive, you should not have to deal with that and respectfully remove yourself from the situation. With the right attitude, a calm demeanor, and willingness to help, you can diffuse and redirect a tense visit to help create a more positive outcome for you and your patient.
This article was written by Dr. Roy Rivera Jr., PT, PhD, DPT, MCHES, CEO. Dr. Rivera is CEO of Rehabilitation for Crom Rehabilitation in Houston, TX. Dr. Rivera is a licensed physical therapist and owner of Crom Rehabilitation where he works to provide patient care and physical therapy that emphasizes patient-centric programming.