5 things I didn’t learn in Physical Therapy School
I wrote this post a few years ago after being inspired by a fellow PT’s blog about the same topic. I decided to take the time and reflect on my first few years out of PT school and what I learned “on the job” as opposed to in the classroom. I think it was a great exercise for me at the time and one we should all do periodically, no matter what career path we have chosen. Hope you enjoy!
5 Things I didn’t learn in PT School
1. Confidence is Key
I remember on my first orthopedic internship and being very nervous. I was in Arizona at a busy clinic where most of the therapists there held advanced degrees and certifications which prompted a high degree of anxiety for me. After all, as students we all want to impress our instructors with our knowledge and I had it in my mind that this was going to be a difficult task. After about 4 weeks we had a faculty member from Northeastern visit the clinic to do a “midterm review”. I was surprised at what came out of that experience. The biggest “negative” from my instructor was my lack of confidence. Not my knowledge of rotator cuff injuries or what joint mobilization to use at a particular joint but confidence. I remember taking several days to digest this feedback, attempting to put in perspective how my behavior was being perceived when working with patients and how that might influence their confidence in me as a caregiver. This was definitely one of those “a ha” moments for me. I began to understand just how important my communication with my patients was, both verbal and non-verbal. I started to realized that this concept was one of the most important factors in distinguishing yourself from your competitors and fellow therapists. It’s not just about how much you know, but how you are able to convey information to your patients in a way that makes them understand you but also doing so intelligently.
2. Patients are Consumers
This is probably the most important concept that I learned that has aided me in growing my practice and evolving as a therapist. We are all consumers, we hire people every day to help us with services that we ourselves can not do, or at least very well! We hire mechanics, financial advisors, dentists, plumbers, electricians etc., the list goes on and on. How do we choose who we trust to do the job well? Typically we make these decisions based on referrals, usually from friends and family but also from co-workers, neighbors, and various forms of advertisements. So we as therapists need to also be salespeople for ourselves, our practice, our profession, and even the particular approach you are taking in your treatments. We all need to constantly be thinking this way when treating our patients. It can start with a simple “hello” when a patient walks into the clinic, or taking the time to call that patient that you discharged 2 weeks ago to see how they are doing. Our best sales team is our current and former patients, if we do not treat them as such we will miss out on not only their future business but we can not expect them to be advocates for us.
3. “Less is More”
Anyone who knows me knows that I like simplicity. Often when I look at a particular patient’s case I choose to break everything down to basic concepts, not trying to “over think” things. Of course this can also come back to haunt you as a therapist if you try to be too simple in your processing however I believe it is a crucial part of understanding how the musculoskeletal system works. When we graduate from PT school we are all anxious to get out there in the clinic and start using all of those cool techniques that we learned along the way. I think we have a tendency to try to do too much sometimes. During my first year of practice I fell victim to this many times, deciding to use a manual technique on a patient in pain or a particular exercise when really the best remedy would be to do less. I think this is a very hard concept to learn but it’s also harvested through clinical experience. I now find myself being much less aggressive and being more conservative in my treatment choices than I once was, although I am constantly trying to find a balance between the two.
4. Don’t Forget about Home Exercise Programs
Besides providing extensive education to my patients both on their first visit but also throughout treatment, I also try to provide home exercises to my patients on starting day one. What I think gets lost is that home exercise programs should be always evolving. We shouldn’t just give our patients a few exercises day one and then expand upon it on discharge. We should always be “tweaking” the home program so that it reflects where the patient is in their rehab. If you are ever wondering why your patient is not improving even though you believe that the in clinic treatment you’re providing is efficient, look to your home exercise program.
5. Remember Your Past but Don’t Rely to Heavily on it
If you work in a busy outpatient orthopedic clinic you have probably seen many patients with shoulder impingement come into your clinic. For the most part their symptoms will be the same across the board however how they present clinically will vary tremendously. That is in part because the cause of the impingement is not always the same. This is where we as therapists come into play. We must not only find the cause of the pain but also the factors that are contributing to the cause. The hard part as therapists is to not get to caught up in relying on former patient cases and our own biases in determining how to treat a particular patient. Respect our knowledge of a particular pathology (rotator cuff disease, lumbar disc herniation) but also approach every case with an open mind so that you can provide that particular patient with a individualized treatment.
Cray Physical Therapy offers treatments, management and general information for several types of pain related to work, sports or everyday living injuries. Give us a call at 339-987-4856 so we can help you get on the road to recovery! You can also fill out our contact form by clicking here and we will be back in touch.