What Patients Think Of Physical Therapy

Over the last few months, I’ve had the unique opportunity to talk with patients about their perceptions of physical therapy.  The opportunity is unique because I have no connection to the office they received their care in, making it much easier for the patient to be open and honest without fear of hurting their PT’s feelings.  Here’s the most common thing I’ve heard:

“Physical therapy was horrible.

Ouch.  At first, my highly-biased-PT-brain had a very difficult time processing this statement, and I would rationalize it any way that I could.  I’d immediately think, “She must have had a bad therapist” or “My patients definitely liked therapy- they definitely liked me”.  But, after hearing this sentiment being echoed over and over, I started to realize that I needed to swallow my pride and find out why many patients had a negative view of physical therapy.

My next question was simple enough: What made PT horrible for you?  Again, I received very similar responses, and almost none of them had anything to do with direct patient care. Instead, most patients commented directly on their injury and how it affected their everyday life.  Here’s an example from a 65 year old man ‘John’ that was recovering from a total knee replacement.

“About a month into therapy, I went on a 3 hour plane ride.  When I got off the plane, my knee hurt so much that I could not walk from the terminal to my car.  But, it was 1:00am, and none of the golf carts were around.  So, I had to walk, and take a break every hundred feet.  It took me nearly 45 minutes to get to the door.”

Almost invariably I’d receive answers similar to this.  And, almost invariably, the conversation would continue:

Me: “How was the clinic you went to?”

John: “I really liked my therapist.  The clinic was very clean, and everyone working there was happy and helpful.”

While all of the feedback I received wasn’t necessarily glowing, most of what I heard pointed to high quality direct patient care.  So, the patients I talked with were relatively satisfied with their direct patient care but relatively dissatisfied with physical therapy.  Quickly, I realized that patients have difficulty differentiating between their injury and their direct patient care; they associate the pain that they felt over the weekend while trying to mow the lawn with their physical therapy experience.  Simply put, the public perception of physical therapy is much more than the time spent in the clinic. Rather, patients see physical therapy as their entire injury recovery process.

Knowing this fact, perhaps we need to make some subtle changes to our model of care.  At this point, we don’t put a priority on improving the patient’s experience outside of the clinic.  Our profession’s focus over the last decade has been on evidence-based practice, and rightly so.  Like all medical professionals, we need to continue to refine our treatment techniques and decision making to ensure we are effective in delivering optimal outcomes.  However, injury rehabilitation and physical therapy is unique.  Unlike most other medical treatment, patients come to physical therapy for a high-intensity episode of care lasting weeks or months.  In that time, physical therapy becomes a very important part of their day-to-day life.  One of the ways that we can deliver our value proposition to our patients is to provide them with support inside and outside of the clinic.

We have spent so much time, energy, and money on improving our direct patient care, and it has led to stronger clinicians and improved outcomes.  But, until we look at the patient’s perspective and deliver on their needs, we will continue to miss a huge opportunity to improve upon our public image and ultimately advance our profession.

Ryan Klepps PT, DPT – TheraVid LLC

You can reach ryan by email ryan@theravid.com or via twitter@TeamTheraVid