After over 30 years of PT practice and 20 years of teaching the Mulligan Concept, Brian Folk shares some clinical thoughts:
What are we trying to accomplish in the clinic? What is perfect health? What are our patient’s expectations?
After over 32 years in clinical practice I finally started to learn some keys to being that person that patients want to see. Here’s what I’ve learned:
Human beings are extremely complicated. If you happen to embrace any type of spiritual cosmology, then you might be willing to say that they have spiritual/emotional, mental and physical dysfunctions that ALL may need to be treated for optimal health. “Well I’m just a physical therapist, I don’t “do” mental or spiritual work”. Here’s the problem: spiritual, mental and physical dysfunctions are not seen in isolation. They permeate our being. They overlap and have roots in all three “worlds” and if you don’t at least recognize, acknowledge and refer out to qualified therapists when needed, then you may not be as ultimately successful with your patients.
1. Patients don’t care if you are the most technically skilled clinician (they do care to a degree and you must have those skills, but it goes so much further than that).
2. They just want someone to LISTEN to them completely. They want to be heard (read spiritual/emotional, mental and physical). Clinical research on patient satisfaction at Kaiser in previous years indicated that patients felt more listened to with one simple act: The clinician came into the room and SAT DOWN! I heard that previously, but didn’t FEEL it until it happen to me when I was in need. That one act jaded my feeling about the visit and that clinician.
3. Patients don’t react to what you say, they react to your body language and if we are “in- a-hurry-boy” they will notice. if that’s your agenda, man, you better have wicked manual skills to compensate for that lack of CONNECTION. But it still won’t fully compensate.
4. If we want to be successful with our patients, what did Brian Mulligan always stress? “
“Always treat with confidence”! Why????......... I had a doctor speaking to me about a very serious condition many years ago. He stopped me, got my attention, looked in my eyes and said: “I’m going to take really good care of you, don’t worry”. I have never forgotten that. It had a huge impact.
5. What are we stimulating when we treat with confidence? Placebo effect? That’s potentially a 30% gain in improvements if you listen to the physical scientists!
6. Is this “placebo effect” just an imperfect label for the phenomenon of the innate natural healing potential endowed deep in every single soul? Could it be significantly more if skillfully nurtured?
7. What does treat with confidence mean: good listening, good handling skills, realistic optimism, affirming health with your patient in every way you can.
Looking at the hierarchy of needs as I see it in human beings: our desire to be heard, understood, and thereby, loved is paramount. It is the ultimate goal of all human hearts, no matter what their stated desires or pursuits. If you can do this with your patient, you will leave a positive impact in the world. That’s what I’m going to spend the rest of my days doing. The rest is fluff.
Brian R. Folk PT, MCTA, FAAOMPT
Certified MCTA Teacher