FOTO Rehab Outcomes Blog

3 Challenges Clinicians Face Treating Musculoskeletal Injuries

Written by Selena Horner | Jul 28, 2016 9:30:00 AM

A disconnect currently exists between where the health care world is heading and patients' perspectives of what is required in providing care. Patient expectations and how a patient defines recovery after an injury are vital components for a successful treatment outcome. The health care world is beginning to have a strong focus on eliminating waste. Waste being defined as procedures or treatments or imaging or medications that don't add any benefit to the final outcome. What is the final outcome? I think it's safe to say it all depends on who is answering the question, right?

The majority of patients hang their hats on being told an exact diagnosis and expect an exact diagnosis. It seems patients do not appreciate ambiguity. Patients didn't get the memo that X-rays are not helpful for every pain experience. Patients didn't get the email indicating that many times the findings from diagnostic tests are just "nice to know" facts that may not be helpful in determining anything relevant for their condition. As health care begins to eliminate wasteful testing, patients will be psychologically affected by what feels like ambiguity about their condition. As clinicians we have to handle this obstacle. This obstacle needs to be addressed and overcome whether the patient is referred for services from a physician or whether the patient self-refers. 

In a recent study, 56% of patients expected the final outcome of services to be no pain. When pain remained, these patients believed they were not recovered. On the flip side, 44% of the patients wanted to return to function (ideally without pain or acceptable with residual pain). Since the majority of patients with musculoskeletal conditions will be expecting a final result of no pain, how will clinicians tackle this obstacle?

Patients will present with fears or hopes or both. Fears and hopes impact their outcomes. The days of just performing an examination are no longer. Clinicians need to spend time understanding each patient's fears and hopes.

As you can see, patients begin services with their own perspectives. They have beliefs about diagnostic testing; they have expectations of no pain; and they have degrees of hope. To be a successful clinician requires far more than just treating the individual with modalities, procedures and interventions. Clinicians also need to focus on creating thought shifts. The successful clinicians will be able to listen and educate in such a manner that positive thought shifts prevail. The resulting modified expectations will lead to realistic outcomes. At the same time, satisfaction will be enhanced due to expectations aligned with reality.

If you are searching for help to easily and successfully create thought shifts, look no further. Please talk to Judy Holder about how FOTO can help with its patient specific reports. The patient specific reports have been designed to assist you in the conversations you have with your patients to create positive thought shifts.

Carroll, L. J., Lis, A., Weiser, S., & Torti, J. (2016). How Well Do You Expect to Recover, and What Does Recovery Mean, Anyway? Qualitative Study of Expectations After a Musculoskeletal Injury.Physical Therapy, 96(6), 797-807. Accessed July 27, 2016.

Until next time,