In which the question is asked:
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“Paul… I’m having trouble finding a reason WHY one of my patients needs to continue to attend therapy.
She really needs treatment on her knee following surgery – and yet is currently resisting our suggested treatment sessions and is only attending simply because her doctor told her so.
She doesn’t know why she has to attend… and no matter how many questions we ask, she says “n/a” to everything that we might suggest as an outcome goal we could help her achieve.
She’s 84, has lived on her own for 40 years and isn’t all that socially active – so we’re having a hard time connecting what we do to her lifestyle goals.
How would you suggest we talk to this lady?”.
– Coaching Group Member asked to remain anonymous.
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Ok…
Let me start by saying that I hear this type of question a LOT.
Both in my own clinic, coaching my own therapists, and in my work with owners.
See, problems with compliance arise more common than most PT’s would dare to admit and often times it’s because they get lost in their own “verbiage” – or, worse yet, they’re still using language and asking questions they were taught in college.
So lets “psycho-analyse” this patient with the goal of REALLY connecting her to therapy (and getting the 8 more sessions she really needs).
And here’s exactly how I do it:
First of all I shut my eyes.
And I ask the PT to describe this patient to me in detail.
I’m listening….
And I get told she’s 84, that she’s lived on her own for 40 years since her husband died and isn’t socially active… and therefore isn’t particularly motivated to go out of the house three times per week for PT.
On the surface of it, I could see why this patient might give compliance problems.
But in reality, all of these reason are THE reasons WHY she needs to come for PT.
See, this lady is in a FEARFUL place (…home is where she’s comfortable).
Possibly resents being told what to do (…since her husband died, she’s made ALL her own decisions).
Is intent on just “surviving” (…instead of being active day to day!)
And doesn’t want leave the house if she doesn’t have too.
So now lets talk this through:
This lady has lived on her own for 40 years.
So what is she clinging DESPERATELY too?
“Independence”.
And more than that, she wants to preserve her “self-worth”.
And the fact that she doesn’t want to leave the house – that’s in your favour too…
…because if she wants to avoid being forced to live in an assisted living place, or care home, then she needs to attend you therapy sessions which will help her to continue to live in the family home for as long as is possible.
There’s not a more compelling reason for an 84 year old widower to arrive for therapy on her knee, than to preserve all of these things.
The problem is, no matter how many times you ask her “what do you want from PT?”… she will never tell you this simply because she’s never heard of a place where you can walk in and order “independence and self worth” from the menu.
So how does it come up?
Simples.
YOU bring it up.
And you tell her that you see so many other ladies in there 80’s who come to see you (social proof and hope!) and what THEY all wanted to achieve was to ensure independence and mobility is intact, so that they can preserve self worth.
That’s it.
And it works because you’re connecting your treatment plan to the CORE desires of the patient who realise you GET them better than anyone else.
Do that, and you’ll get more compliance AND more profit at your clinic because you’ll confidently and ETHICALLY be able to prescribe as many sessions as is needed, to achieve THAT goal.
All right…
Lesson over for today.
Maybe more teaching like this next time.
In the mean time… if you want some help to be better able to get more compliance (and quickly boost profit), I’m the guy to coach you.
Talk to me about it here:
– Investigate Your Opportunity To Quickly Get More Compliance From Patients! >
Sincerely,
Paul Gough.
