A Hands-On Profession
When I take a step back and think about the concept of "personal space," I realize that it doesn't exist in the PT world. Three years ago, if I had to poke around a stranger's greater trochanter or get up close and personal for a transfer, I would have heard that natural alarm in my head saying "you're way too close to this person right now... and it's awkward." I'm amazed at how desensitized I've become. That being said, recognizing this type of physically based interaction also makes me realize that for patients, it may be something completely foreign.
There's no getting around the fact that PT has to be hands-on. I remember reading an article about expert vs. novice clinicians, and one of the major differences was that experts had a lot more "hands-on" time. It's important. For a patient, I can imagine that the 10 minutes you have between first introduction to the therapist and the start of the physical exam is surely not enough time to feel comfortable with a complete stranger trying to find your PSIS. I've made an effort lately to say a sentence or two about the way PT works, why and when I'll be putting my hands on the patient, and what I'm looking for. It seems to help, but I'm sure it's still slightly alarming for some patients.
Inevitably, there are going to be people who just don't feel comfortable with the invasion of personal space. In that case, I'm not sure what to do. I think hands-on skills and interactions are an invaluable piece of what we do, so I've taken the approach that it's my responsibility to make people comfortable and knowledgeable about what to expect during their physical therapy course.