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A Day in the Life of a PT Student

Patient Preferences - Part II

Published December 30, 2008 10:08 AM by Veronica Haywood

I hope everyone had a great holiday! Now to continue on with last week's blog... I still have timeliness, healing behaviors, and cultural preferences to discuss. Now when I was on my internship these were things that I recognized as being important, however, I never really realized how important they were.

Now in class we were taught that different cultures view time differently, which is why some are more prone to being late for appointments, etc. However, it is very important to realize that this does not apply to everyone and that some people's lives are so tightly scheduled that it makes it difficult to make and keep appointments (which is also why many people don't go to see healthcare professionals until it's too late).  I remember someone commenting that that a friend of theirs owned a clinic and had problems with some of their clients being on time and stating "well the clinic is on... and if you have been over there.... " insinuating that the demographics of the area had something to do with the timeliness of the patients. I was actually partially offended by this comment. Needless to say it is very important to avoid stereotyping. Also as frustrating as it may be, it is important to remain patient. In addition to this it is very important for us to also recognize our time management. During my internship I realized that one of the things the patients hated most was sitting around waiting-even if it was only for 5 minutes.

Another thing that is important is recognizing different healing behaviors. This includes how one reacts to treatment as well as what they practice. It is very important to remain unjudgemental and if possible involve their preferred practices in your treatment as long as it won't do them any harm (one should always ask if they have any certain practices, so you can make sure that it won't harm them or contraindicate your treatment). It is also important to pay attention to the patient's behaviors. Though one may assume that one will be happy when they are close to being discharged, some may actually become saddened, as they feel as though they will be losing a friend or have too much idle time. During my internship the patients loved coming to therapy, just because it gave them more to do with their time and because they got to be around other people. I had one patient who was only covered to receive therapy 3 times a week, but she would have come every day if we let her.

I will save the cultural preferences portion for next week. Have a Happy New Year!

3 comments

To be honest I have no clue what it means to see you in two moons. But I agree everything depends on the person, but there are sometimes similarities. I think for some reason it is perceived as being ok for doctors to be late, but no one else can. I don't know why that is though. But... Thank you both for your comments!!!

Veronica Haywood January 27, 2009 1:51 AM

Keeping the clients informed can go a long way in keeping them patient when delays occur.  We were at the dermatologist a couple months ago and waited for over an hour.  "We" is me with four kids.  The oldest was being seen, so we all went along.  They took us back fairly quickly, so instead of waiting in a carpeting waiting room with ample soft chairs and books to look at, we were in a small, confined space with linoluem floors (read: LOUD), one chair, one rolly stool, and the treatment table.  And no books.  That is where we waited for over an hour!  I had deliberately scheduled the first appointment after lunch to minimize our wait.  We were taken to the room and told, "The doctor will be with you shortly."  By the time she got there my disposition was stormy.  She immediately apologized and said she hadn't even had lunch yet, she got a late start because her refreigerator had caught fire that morning.  I felt bad for her.  IF I had that information an hour earlier, I would have been compassionate to her plight and known I was in for a wait...that would have prepared my mindset and completely changed how I handled our wait.  Information is power.  Most clients (though probably not the "I pay your salary" types) will be grateful to learn what kind of wait they are in for...and why...and be gracious in their waiting.  If you know you will be delayed, go to the patient yourself (if possible, if not send a proxy who has obviously spoken to you, not just the secretary who tells everyone "You therapist will be right with you"), apologize for and explain the delay, and give them a reasonable approximation of when they can expect to be seen.  If it is a huge delay offer them, immediately, the opportunity to reschedule.

You are right about some patients enjoying the social aspect of therapy.  Some of them will come early just to visit with other patients.  Some of them may not mind waiting extra so you can get the less understanding ones taken care of!

Karen,  very good point about showing up in a patient's room unannounced and expecting them to drop everything and work with us.  A clinician having the mindset of infringing on a patient's life and needing to be respectful of their time will no doubt go a long way to smoothing the path.  To the extent possible you could arrange a good time of day to see them...even just am vs. pm...giving them that much control over their schedule.  I know I did that with home health patients, after all I was in their home.  I carried that mindset with me after home health, but I don't know that I had that same mindset prior to home health.  Good point!

Janey Goude January 8, 2009 12:46 PM

Veronica,

Culturals do entertain time differently but again it is not every person in that culture.  This is global, not just in America.  If I tell you I will see you in two moons what is that interpretation to you?  

Demographics does play a role in appointments.  Again, not everyone in that demograpic neighborhood is the same.  The "rich" area patients expected to be seen whenever they showed up from five minutes late to one hour late.  It was the "I pay your salary" routine and we were told to see them because the majority paid in cash.  Its economics at a basic priciple.

And think about this in acute care and in some SNF's PT's/PTA's just show up unanounced and expect the patient to be ready to go - this seems kind of rude doesn't it?

As far a time waiting.  Patients will wait one or more hours for an MD they can wait 15 for a PT.  And what is the rule for a professor?

Karen January 1, 2009 1:40 PM

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