This article is not going to be about manual therapy, exercise prescription or reviewing recent literature. Today I want to share with you some of the key concepts I have learned over my first 2 or so years as a Physiotherapist. This article was inspired by a bright young physio student (soon to be physio) named Dave Leyland… read his latest article for some motivation in case you feel like you might be lagging behind. In essence, this article will just be me talking about what I have changed and what I want to change as a physio since graduating almost 2 years ago.
I started practicing September 8th, 2010. I remember my very first patient like it was yesterday (to those who have been in practice 20 or 30 years, I bet 2 years ago does actually feel like yesterday!). Her name was Nancy and she had an MCL and medial meniscus tear. She was a great first patient to have started my career with…friendly, nice, open to having a newbie work on her…she was a pleasure. I treated her with “the best” care I knew how to provide at the time. She got better and I felt like a super star…. Until my 2nd patient! My 2nd patient (ever) was the son of a relatively famous former NHL hockey player. He had a full AC joint separation after being hit in the boards during hockey. I remember going home at night a researching “the best” rehab protocols for such an injury. UnlikeNancy, this young man had been to other, more experienced therapists and actually knew a thing or two about therapy. He questioned me insensately and his surgeon called me to inquire about exactly what I was doing, why I was doing what I was doing, and what were my objective outcome measure after each session…these are all valid questions, but as a new grad I was forced to be very on the ball… it was rough…it was then I realized that knowing what I knew was just not going to be enough…and the more I learned, the more I realized that what I knew was just not going to cut it in this field…not by a long shot.
Over the past 2 years I have made huge gains in my skill set. I am more confident as a therapist. I am better able to recognize clinical patterns, and I know I can help most anything that walks into my door. Here is a list of the most important concepts I have learned over the pat 2 years in practice.
Looks a bit like me after work some days
1) I learned nothing in physio school! Well alright, maybe that’s a bit dramatic… but in reality, coming out of physio school I knew just enough not to hurt anyone. I thought I knew a lot, but when what I was doing as a physio wasn’t providing consistent and positive results I realized I needed to step up my game. The second I embraced the fact that the learning only really starts after you get the degree was the second I became better at what I did.
2) “The foot bone is connected to the leg bone… the leg bone is connected to the hip bone”. Remember that song from back in the day? Well who would have thought it would form the basis for my philosophy as a therapist. I learned only after school just how interconnected our bodies truly are. The “joint by joint approach” or regional interdependence model of care is now a corner stone of my practice. Simply put, most times pain in one area has contributing factors from other areas as well. This sounds simplistic, but it has and will continue to take me years to figure out all the reasons why people develop pain.
3) Patients do not care about the letters after your name. They only care about results. I used to think that having “MSc.PT” after my name made me credible in the eyes of my patients. I now know that they couldn’t care less. They care about how much you know to get them feeling better. They want to feel taken care of and that their problems are meaningful to me as a therapist. I am currently in the manual therapy stream of courses held by the orthopaedic division of the CPA. Once I complete the entire syllabus system I will get the designation “FCAMPT”…and will a single patient care? Probably not. I do these things for my knowledge and skill set…if you do them to impress patients you will be surely disappointed.
4) Confidence is king. This relates to my 3rd point, but clients need to know that their therapists knows exactly what is going on and how they will “fix” them. They need a game plan to follow and someone to coach them along the way. This is hard to do as there are some times clients that walk in my door that have very odd conditions. And I for one will not lie to a client and make something up just to give them an answer. That would be the easier route, but I rather tell them I don’t know but will figure it out. Does that always work? I’m not sure, but at least I can go to bed knowing I’m 100% honest with all my clients. The #1 way I have learned how to gain confidence is to LEARN! Always read, ask questions and then read some more. So much info is out there…you just have to wade through the B.S to find it.
5) The over arching theme I have learned over the last 2 years is that I will never be comfortable knowing what I know and leaving it at that. The second you become stagnant is the second you become obsolete as a therapist. Having an internal drive to know more is a gift I guess. I force myself to stay up to date and read as much as time always. Blogs, books, webinars, articles…I always wind up getting something from everything I invest time into. What you get out what you put in is never truer than with my career as a physiotherapist.
6) This will be my “rant” point off the list. I have come to realize that treating clients who are unmotivated is both physically and emotionally draining! I want to cure the world and make everyone 100% better, but I have learned that just isn’t always possible. The greatest exercise means nothing if the client doesn’t care enough to do it. This is an epidemic these days with some clients. I could write an entire blog on how everyone wants the quick fix, but that’s not the point of this article. Essentially I have come to realize that if I care more about my patients’ well being then they do, I will burn out quick! So I make a point of telling each new client I see that they have to be committed to therapy for optimal results to be achieved…it’s a two way street. Passive care is great, but it can’t all be that.
Can’t be all about the money
7) Money will come. I used to think I wanted lots of money right away and many of my decisions were based on how much money I could make. I’m lucky to have realized very quickly that money will come when I deserve it. Being the absolute best therapist in my client’s eyes is what creates value. This is something that takes time to achieve…you know, the whole “always learning stuff” I keep talking about… that’s what makes money. When people deem you to be so essential that they will spend their hard earned dollar to have you work on their body…that’s when money will come (more money that is).
8) I am a puppet on a stage EVERY single day I go into work. My patients don’t care how tired I am or how bad my night was. They have their own problems to deal with and are paying me to worry about their issues…not mine! Each day I go into work I have to put aside any and all problems in my life and become 100% sympathetic to my clients needs. There are no off days for me. I can’t afford to be indifferent with even one client because you never know who that client knows and how they might help your career one day. This was a hard pill to swallow because lets face it…as much as I love my job there are definitely days where I MUCH rather be elsewhere. Learning how to “act the part” day in and day out was tough…but that’s just the way it is!
9) Customer service customer service customer service! Writing down the names of my patients kids, their birthdays, when and where they went on vacation, what their favourite sports teams are…these are the little “tricks” that really help solidify relationships with my patients. Think about it…wouldn’t you love it if the next time you walked into your doctors office and he or she asked you how your trip to ‘insert destination here’ was? That little extra care really goes along way. I make a habbit of emailing clients videos of exercises to make sure they fully get them. I call clients back ASAP if they have any questions. I always tell clients to call or email me when and if they need me for anything physio related. That kind of selflessness is what drives customer service. If you do just this I think you are ahead of the game.
Overall, I am happy to say that I love my job and I feel honoured to be able to do what I get to do each day. It can be a hard job, but it can also be immensely rewarding! I can’t wait to see what I learn in the next 2, 4, 10, 20 years!
What have you learned since becoming a therapist? What tips do you have for newer grads like me to ensure success in a demanding industry such as ours?
Have a great week!
Great post Jesse! I have to say I agree with all your points. I especially like the customer service and not initials behind your name. I have learned you have to pass the test of the person liking you, and they don’t necessarily do that if you have more alphabets behind you. Results are what matters too, no matter how you get them.
Thanks Harrison. You’re completely right. Clients need to like you as a person if they are going to buy in to what you want to do with them. Thanks for reading! Oh, and I’m looking forward to seeing what happens with your golfer with the radiocarpal joint issues…the hand is always a tricky area.
Hi Jesse, Great post. As a Podiatrist I would suggest that you look at foot mechanics plenty. Most physio I know miss the importance of it. Great resource for this is http://www.podiatry-arena.com although plenty of closed minds there too. Best of luck.
Lorcan @ Achilles Podiatry & Physiotherapy Clinic Cork.
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