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Raising the Bar in Rehab

Which Patient Would You Rather Have?

Published January 13, 2011 4:12 PM by

One of the other PT bloggers on the ADVANCE team wrote last week about not getting along with one of his patients. His perspective on the relationship between patient and therapist made me think about all the situations we encounter at work. There are times when I try to alter my conversation style to better fit the needs of the patients, and there are some times when the conversation flows very naturally. Just like personality types, there are some diagnoses I prefer over others and certain age groups I seem to click with better than others.

I remember when I first started my career and a patient commented on how young and naive I was. I had commented on how much progress she was making despite her lengthy hospital stay (she also had multiple comorbidities). She shrugged off my compliment. While I thought my optimism was a strength, it had obviously bothered my patient more than it had helped.

Have you ever thought about your preferences in patient types? Often our answers can help us recognize our biases and help prevent misconnections.

Do you prefer:

● A confused patient or an oriented one?

● A younger patient or older?

● An optimist or a pessimist?

● An introvert or an extrovert?

● A chronic back patient or the acute stroke?

That is one of the joys of being a new graduate working in the physical therapy field - not knowing your preferences. Each patient is a chance to learn more about your style of therapy and an opportunity to enhance your skills at establishing rapport. Early in your career there are a few interactions that will define your specialty and the fun part is enjoying the journey that brings you there.



What a fun post!  I enjoyed variety.  I loved not knowing what personality I was going to encounter on any given day.  

I enjoyed the easy conversations, because they were...easy.  Those were nice when my brain needed a rest.  But I also enjoyed the crusty patients who had already decided they weren't going to benefit from therapy.  I took those as challenges.  Not ones to be overcome with aggression, but chances to practice my powers of persuasion.  Opportunities to sell the profession I so believed in.  

I enjoyed the optimist for the energy they could add to my day, but I looked at the pessimist as an opportunity to give back.

Confused patients were a challenge until I learned how to interact with them, then they became enjoyable.  Combative patients were frustrating because there was so little I could do.  Most often, I had to rely on timing my therapy with medication.

As far as patient types, the one patient type I was sure I'd dislike most intensely, is the one I came to love most passionately:  burn patients.  I had amazing coworkers, from techs to therapists to nurses to physicians who opened this new world to me.  By default, I ended up treating wound patients on weekends.  Those I wasn't so keen on.  Seemingly so close, yet so very different.

With the exception of the pediatric burn patient, my preference is the older adult population.  I love the rich tapestry of their stories.  I enjoy seeing their faces light up when they have someone who will listen to those stories with appreciation.  And I love that such a small act on my part can have such a profound impact on their rehabilitation.

Initially I had a negative predisposition to chronic pain patients.  Fortunately, I had encounters with physicians and other medical professionals who educated me in a way that brought understanding and compassion toward that patient population.

The only personality group I can say I don't like is whiners.  Be it patient or coworker.  Listening to whining is like fingernails on chalkboard to me.

Thanks for the opportunity to reminisce about the variety of patients and medical caregivers who have colored my world!

Janey Goude January 13, 2011 9:21 PM

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