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Transition to Rehab Management

Putting Patients on a Pedestal

Published April 19, 2012 9:45 AM by Karen Schiff

In a large outpatient facility that houses physical, occupational and speech therapy, you are bound to hear conversations that attract your attention. A large, open rehab gym, curtained rooms and closed rooms separate patient/therapist interactions, while trying to keep privacy for the patient. On more than a few occasions, I have heard a history being taken that has sparked my close listening. Most of the time, I take note as to the professionalism and train of thought of the therapist. Even more interesting is the information the patient gives, or even the family.

On this particular day, I am performing manual lymphatic drainage on my patient, when I hear one of my peers taking a history and reviewing the intake form in the next (curtained) room. A young man of 33 years old, s/p ACL reconstruction two months ago. He had been attending "physical therapy" at a chiropractor's office, when the "PT" was busy and the technician had to measure knee ROM. From the patient's description, the ROM was not acceptable to the technician, and when the measurement was taken, the knee was pushed to achieve 120 degrees of flexion. At that point, a "pop" was heard, and the patient was told that scar tissue was being broken. Since that incident, the patient had some instability and swelling, and a significant decrease in ROM. A visit to the surgeon followed, as well as a referral to our department.

By this time, you've probably come up with the same thoughts as I did. In this day and age, there is enough information and education available to help therapists help their patients. However, it is our responsibility to keep "technicians" in their role. Even the best technicians should not touch our patients. The result could be devastating to the patients, not to mention our careers. Put your patients on a pedestal and give them only the very best, and base it on your knowledge and the latest evidence-based studies. Never should we be so busy that we use unskilled hands to perform techniques we arduously train for.

What conversations have you heard behind closed curtains?


I KNOW!!!    I know this orthopedic surgeon VERY well... the type that is very conservative, professional, and not the easiest to talk to.  I am sure he was mortified!   Cases like these are the ones that work against us, but with hard work, determination, and education, we can help people from being injured....     By the way, this young man was in our clinic today, already feeling better and confident that he will be handled by professionals..

Karen Schiff April 23, 2012 11:30 PM

My first question is why was that patient getting physical therapy for an ACL reconstruction at a chiropractor's office?  Is that the definition of insane or what?  

Toni April 20, 2012 7:40 PM

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