Here is a checklist of things to strive for during that ever important first visit.
You know what they say about first impressions? Here are 5 things I try to do during the first visit.
1) Set the tone
- front office always greets a patient
- introduce myself to the patient as they're filling out the paperwork and tell them I'll be right with them
- ask them, how they are, other than the reason why they are here
2) Reduce the threat
- warning! CNS on lockdown, warning!
- do not look at scans, EMGs, etc... that often leads to verification of some doom and gloom traditional medicine has told them
- quote research that states most asymptomatic individuals have false positives on their scans
- find the directional preference or position of ease immediately after the history
- use cause and effect for symptoms with the above, showing them they can manage it, and cause it
- how many visits you think it will take to accomplish their goals - I set this in 4-6, 8-10 etc
- internal studies and external by trained MDT clinicians classify up to 87% of patients as derangement syndrome, meaning they should respond rapidly
- this means most of the people walking in your door should respond within 6 visits with big changes
- tell them it's a good prognosis to make changes on the first and second visit, normally leading to good outcomes
- the most valuable thing you can give a patient
- let them know the temporary effects of treatments
- they are responsible for themselves
- if they want to get better, it's time for some changes
- posture, movement, pain behaviors are habits that can be broken, but like any habit, take work
4) movement assessment
- use a system to classify them to guide your treatment
- my preferences - MDT and the SFMA
- MDT gives the DP which can be expanded upon easily to immediately help the patient
- SFMA gives you adjacent dysfunction or motor control to work on later after they can manage their pain on their own
- Should be occurring the entire visit, not just in the beginning or the end
- I cap each visit by saying, if you feel better when you leave, but the changes made today do not last more than a day, you are not performing your homework enough
I hope everyone has a great weekend! The voting for Best PT Blogs has been extended, please vote here for Best Overall PT blog if you have not done so already! Thanks again for all your support!