Old school physio

Hey gang
The outpatient department im on at the moment primarily deals with chronic pain which is often very hard to treat and if there are improvements if often takes a prolonged period of time. This kind of brings me to the point of this blog which is based around one of the older musculoskeletal physios at the outpatient department.

On my second day i was assigned to sit in with her as she assessed a patient with chronic neck pain for the first time. Through the subjective the physio was really loud and almost confrontational towards the patient and once the subjective had been done did a brief objective. Treatment wise after the assessment on this first session she educated the patient for about 15 minutes about the condition, her posture and exercises to be performed at home. The patient hadn't been given an oppurtunity to practice the exercises or ask questions through the session and there wasn't any exercise sheet given at the end.
A few days later the physio called me in to see how this patient was going following her first session. The physio ask her to recap the exercises and to no great surprise she had completely forgot the exercises and when she attempted to perform them it was done poorly. Instead of the physio being understanding and trying to correct her she proceeded to blast the patient about not caring and accusing her of not wanting to get better. The patient was speechless and so was I. The patient left the cubicle at the end of the session seemingly in a worse mood then when she came in. I doubt very highly as to whether she would like to see the same physio in the near future.

Now, im definetely no gun but this physio had pretty much abandoned the basics and when it all went pear shaped blamed the patient. From my point of view i don't think the patient was to blame at all as she had been given very little direction with her home exercise program and not surprisingly didn't do them that well.

What i've kind of gathered following the interaction between this physio and the patient is that you need to build rapport initially with your clients and go through the processes we've all been taught. Trying to explain the key points concicely is of upmost importance as education seems to be a major role when it comes to treating certain patients. If i blabber on for 20 minutes the pt will not remember much of what ive said and it becomes pretty pointless. If exercises are explained well or an exercise sheet is given a situation like the one explained above can be avoided.