Dear Friends,
Alf Nachemson, MD, an expert in the field of back pain, stated that the key to managing patients’ injuries is to increase their coping skills and the sense of control that they have over their treatments. He also stated that having patients do so would improve outcomes significantly in a much more cost-effective manner.
I would like to bring up three of our recent patients’ cases. All three chose to take control of their individual care. The first was very unusual, and I do not recommend ever trying this! I received a call while a patient was heading down to Indy to have rotator cuff surgery. He thought he may have decided to have shoulder surgery a bit too quickly. When he called, I had no idea he was actually driving to surgery! On the call, this patient informed me that he may have been in need of shoulder surgery. I asked him some key questions.; the kind of questions that would be a red flag and, thereby, making surgery absolutely necessary. Surprisingly, the answers were not the answers that would force one to get shoulder surgery. As a result, I informed this patient that I would be glad to examine him within a week. The final results: this patient didn’t have rotator cuff surgery and now is back to his normal lifestyle!
The second patient was seeing me for a shoulder injury, and called to inform me that he had injured his knee and was going to need knee surgery. I asked if he would like me to examine his knee when he came in for his shoulder. He agreed, even though he said that he was 90% sure he would be needing the knee surgery. After his exam, he realized he might not need it. Long story short, he has no knee pain and was able to avoid knee surgery.
My final case was a severe back pain patient. She had excruciating pain in her back and down her leg. She had had an MRI which had shown a herniated disc and severe spinal stenosis. She had, originally, been told that she needed back surgery. We were able to get her into a spine surgeon who is extremely conservative. He puts himself in the patient’s place and, most often, falters on the most conservative side of trying alternative treatments before cutting. This patient hadn’t been able to sleep in a bed for 2 months. She had been unable to walk more than 5 minutes, and she was walking bent over and shifted to the right because of the excruciating pain.
A friend had recommended us, and this patient walked in hoping to avoid surgery, yet very fearful. We saw this patient daily for 6 consecutive days, including the weekend and a Monday holiday. After 3 days she was sleeping in her bed. By the 4th day, she was sitting and walking without being bent over and shifted. In the end, she did extremely well and did not need back surgery.
With these patient cases in mind, I would like to ask you all to rethink how you handle your physical therapy care. As I stated in the July issue, I am very much “into” taking responsibility for oneself. My parents made sure their ten children were aware of the importance of taking responsibility.
Our clinic has developed its great reputation because of our service and the wonderful physicians who believed that we had something unique to offer. I can never express how thankful I am for all the physicians and patients who believed in us.
That said, I still think, as Dr. Nachemson stated, we all need to take more control of our care. You may not realize it, but you do have the option to choose which physical therapy group you go to at any time. Just because a physician recommends us does not mean you have to go to us (not even if the physician writes the referral on McDonald Physical Therapy referral pads.) No physician can control where you get your care. It is against the law! And although, I am thankful for all the physicians who prefer to direct you to our clinic, I still believe Dr. Nachemson is correct; patients need to start taking control and start learning about their rights in the medical world.
We all have children, spouses, and family that get sick or injured at inopportune times. It is during these times that we are most vulnerable. We need proper direction, and sometimes do not know our rights as consumers. Some common questions we hear are: Can I get another opinion without the physician getting angry at me? Can I get a record of my physician’s notes? Can I get a copy of my x-rays or MRI? Can I go to a different provider for physical therapy? These are just a few of the many questions that our patients have been asking us for years. The easiest answer to all these questions is, YES!
Everyone in the medical profession has been asked to give or accept another opinion at one time or another. It is actually a wise and healthy practice to get 2 or 3 opinions for something serious. Each of us has had patients who have sometimes chosen to switch to another medical provider. This is not offensive to your physician or physical therapist. The key to this entire article is to, hopefully, help you all realize that you are in control of your care! You can say to any of us in medicine that you want to go in a different direction or receive care from a different provider. It is your right, and furthermore, it is your duty to yourself and your family.
Enjoy, and know we are here to help you get stronger every day!
Fran McDonald, PT,DPT,OCS
