Hip Tip 1 – Make sure you listen

If you find yourself halfway through an initial consultation with still so much important information to discuss, find an opportunity to pause the interview briefly to explain to the patient the importance of following through with the interview and that treatment may be best delayed until the second appointment. It is important to shift expectations and gain agreement from the patient – ensure they are happy with this plan. This is most appropriate for persistent pain presentations. For severe, acute onset pain, your priorities will be around gaining priority information including screening for red flags, prior to assisting with alleviating pain and developing an acute pain management plan.

Offer both standard and longer initial consultations, educating patients via your administrative staff or website, that longer appointments are recommended for long standing or complex conditions and explain why.

While this was not practical in Australia previously, the pandemic has had a silver lining in providing insurer support for telehealth appointments. For long standing/complex cases, particularly for patients who may have high fatigue levels, conducting the initial interview online allows the patient to sit comfortably in their own environment while you focus on their story. Part 1 (patient interview) is achieved online with no expectation of treatment. Part 2 (physical assessment and development of a management plan) is provided face-to-face.

In my clinic (Physiotec, Brisbane, Australia), we have in place a comprehensive pre-assessment patient questionnaire that is filled in online prior to the initial consultation.  The survey is sent by the administration team to the patient at the time of booking. We use a secure data management platform. The survey results are collected and provided to the physiotherapist for review prior to the consultation.

This gives clinicians a great head start, allowing us to use the interview time to clarify information, delve deeper and even address beliefs and expectations early. It also means that the patient has had time to think about those questions that can sometimes eat away at your in-session time, while the patient reflects or deliberates on their answer. The survey has been through many iterations over the years, as we have removed unhelpful items and added other important questions about goals, beliefs and expectations. Our statistics tell us that we have a 97% completion rate and that on average it takes patients 16minutes to complete. A great investment!

Our questionnaire won't suit all clinical environments and there may be other information you would like to collect. You can develop a questionnaire that best reflects your needs and the needs of your patient. To get you started, I'm going to share ours with you today as my first Christmas gift to you. Merry Christmas!