Impatient Clients

On my musculoskeletal outpatients placement I was required to treat a previous patient who was presenting with a new complaint. This patient had been identified by the previous student as demanding and difficult, which I soon came to realise myself. Prior to commencing the session the patient complained about the lengthy sessions and the discussions with the supervisor which interrupted the session. She demanded the session should be short with no interruptions. Throughout the subjective assessment the patient was impatient and uncooperative and presented with “yellow flag behaviours”- such as being very pain focused and assuming her problems could be fixed by manual therapy alone.

Initially this patient needed to be managed by explaining the reason for the lengthy sessions and the discussions with supervisors and that we would not compromise on these issues. An explanation as to the importance of subjective assessment was also required, which I explained repeatedly throughout the session. Throughout the session I gave the patient detailed explanations to the rationale behind my assessment, treatment and management. By the end of the session the patient was pleased with her treatment and management plan.

The behaviour of the patient posed a challenge for me as I knew it would be difficult to gain the confidence of this patient. It was also difficult to be confronted with a patient who was impatient and did not see the value of assessment.

This incident raises the issue of how to deal with patients who are very demanding and those who come to physiotherapy with a very clear idea of what their treatment should involve. This is important because if these patients do not receive the treatment they were expecting without having a very thorough explanation to the reasoning behind it, their confidence in your skills may be affected and they may not return.

I believe it is necessary to identify patients who may present with barriers. It is essential to identify strategies to break down these barriers to ensure patients are satisfied with your treatment. Also it is important not to allow a patient to bully you into certain treatments. It is vital to come to a compromise with these patients to ensure both therapist and client are happy. Thorough explanations are also important as the patient may receive treatment that they are not expecting and include a management plan that is just as vital to decreases pain as the treatment.
A thorough explanation about the importance of assessment is particularly important with impatient clients. Thorough explanations into rationale for treatment and need for ongoing patient management is also vitally important.

IF I WAS TO ENCOUNTER AN IMPATIENT AND DEMANDING CLIENT I WOULD ENSURE I TAKE THE TIME TO EXPLAIN THOROUGHLY THE IMPORTANCE OF EACH ASPECT OF MY SESSION SO THE PATIENT DOES NOT LEAVE DISSATISFIED WITH YOUR TREATMENT. I WOULD ALSO IDENTIFY WAYS TO BREAK DOWN THEIR INDIVIDUAL BARRIERS.