6 New Year’s Resolutions for Manual Therapists (estimated 3:45 mins read)

Here we are again: the old year comes to an end and most of us try to make some good plans for the next one, both for private life and for work. What could you change in your daily routine with patients? How would you want it to look like? What would you like to do? What would you rather like to stop doing?

And it doesn't really matter if you are a beginner or an old hand in the business - a good change is always very welcome! Here are some ideas for you:

1. Start the C/O honestly with the main problem and the aim of your patient. With this question we often get a functional problem related to activities of daily living! And with this info we already are on the level of activity and participation of our patients. In other words, close to the ICF world. Remember - reducing pain is not always the aim! Many patients come to me with the need for explanations, or just to check if they should go to a general practitioner or another specialists with their problem. Or they have a request for some home exercises to avoid another episode. The different objectives will lead us to a more individual clinical reasoning (CR) process.

2. Do a proper body chart (BC) for each patient. This sounds easy, and it is easy, indeed, but also very useful for different reasons. Eg. the BC gives you at the 2nd visit a quick overview of your patient. Your colleague, who treats your patients, will be able to get the most important things pretty fast. Getting a message from a drawing is 6 times faster than from a written message. Be precise, Schwarzer et al (1994) showed that central Lx pain never decreased after a facet joint injection. Only unilateral pain decreased after these injections. No other clinical feature of patients with facet joint pain (movement directions etc.) was correlating with the injection; only the unilateral pain.

3. Only a proper documentation will show small changes of the C/O & P/E parameters. Do it! I do not know ANY other documentation system which is as fast and as precise, as the system we teach on the IMTA courses. And it's not hard to learn. Just give it a chance! After 2 or 3 weeks of a serious practicing it on the patients, it becomes more or less natural.

4. Screening: Even when you're on a successful way of treating a hip problem: never forget to screen the Lx. Screening of the other structures often leads to incredible surprises! Especially when the students treat patients under supervision during the courses, we often witness little "miracles". The message behind it - Don't be lazy, go for screening; it will bring some fun to your daily routines.

5. Time: If you're working in a 45 minutes rhythm (many physios in Germany have only 20 or 25 mins time for each patient), you're in a lucky situation. However, sometimes you don't need that much time! Let's say, that after 25 mins the reassessment is as good as it could be and the patient already has enough exercises. In a case like this - feel free to say good bye to your patient. None of us would ever say to our dentists, that there are still some minutes left and we want to feel their drill in our mouth for the payed mins.. with an appropriate explanation - each patients is able understand it.

6. According to point 5: Wellness is nice; most of us love to get a massage.... mmmmmm... Well, sometimes it goes in line with our CR - then it is O.K. But, please, don't mix therapy with wellness. It only increases our patients' beliefs, that we're there just for providing some nice feelings for them... No, nothing like this! We are very well trained physios, we are important people in the health care system and we should be properly respected. Not as mere wellness people...

"Think it over and decide what you could do for yourself, to make your professional life easier and even more efficient. Have a good start to the New Year!!! "

Feel free to post a comment or your thoughts, please.

Yours Thomas

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