To Ice Or Not To Ice An Injury?

4 – Not Setting Realistic Expectations From The Get-Go

Telling patients that they may not be pain free or make a full recovery is easier said than done. It’s awkward and there’s always the apprehensive feeling of “what if the patient doesn’t want to come back?” That being said it’s better to be realistic from the get go than have patients expect to make a full recovery and be upset when they don’t get there at the end.

It can also be a big problem when dealing with third party insurance providers (i.e. workers compensation, motor vehicle) when clients, for whom a full recovery may not be a realistic goal, expect therapy to continue and continue until a full recovery is reached. Plus, I’d rather be realistic from the get-go rather than have a patient drop off after 2 visits and say “oh Eric’s a bad physio since he didn’t cure me.” A few years back I realized that it’s a bit of a double-standard for us to blame doctors or surgeons who aren’t realistic with patients, yet not expect ourselves to do the same.

The way I go about goal setting occurs through two steps. During my subjective, I ask what goals a patient would like to work on in a more general sense (i.e. improved strength or flexibility, being able to return to a specific activity or do more of a goal activity) and then after my physical examination is done the goals are more refined.