With great power comes great responsibility…

Posted: November 11, 2011 in Uncategorized
 
Spiderman had it right!

As some of you may know, as of September 1, 2011 Physiotherapists were given the legal right to communicate a diagnosis to a patient. What does that mean? Well, before we were given this right we could tell patients what our clinical impression was, but we couldn’t come out and say “Mr.Smith you have a herniated disc at L4-L5 leading to lower limb weakness, paresthesia and pain”. As of September 1st, we are allowed to and obligated by law to give a proper diagnosis. This is what I call having “power” for the sake of this post.

So…just because we are allowed to do something, does it mean we should do it? For that disc herniation example I just mentioned, would it be smart to tell Mr. Smith that’s what we think they have? The correct answer is it depends. If the disc herniation was severe leading to constant/sever pain, drop foot, weakness, or worse..cord signs, we MUST tell them this is what they have and send them right away for medical care. However, if this same client comes to me with a pain that travels down the back of their leg from their butt area, and they have a positive SLR and Slump on the side of the pain, should I tell them they have a disc herniation. In my opinion, no! What good does it do to tell the patient they have a herniated disc? All it will do is instil needless fear and panic in the patient. Chances are, they will go home and google what you said and scare the crap out of themself. No one wants to hear they are broken! It’s better to say that have irritated their nerve but it is simple to fix with the right care. This

I googled “disc herniation” and look what comes up! Not good for a client to see

will not panic the patient and will not instil fear thus creating a cycle of what could turn into chronic pain. Also, it gives you instant credibility because you are calm and collected which makes the client trust every word you say…and rightfully so!

Overall, if a client comes in with an acute ATFL sprain then yes, it’s fine to diagnose that…but don’t make things worse than they need to be. Don’t say “wow, your ankle is a mess”, or ” That looks bad!”. It’s just not productive and will not yield optimal clinical results.
Please Be careful what you say…you have power!

My 2 cents

Jesse Awenus B.A Hons (Kin), MSc.PT
Registered Physiotherapist

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