Hi guys,
im currently treating a pt w/ a chronic shoulder problem/ Cx problem and while i won't go into the details of his exact condition, i wanted to discuss some of his "psychological issues". The pt is extremely hypersensitive and his symptoms do not improve from week to week, although we do make improvements w/in Rx sessions. I have tried to emphasize the importance of his HEP, and altho I dont want to assume, it almost seems as if he does not want to improve. He even called the clinic after I had booked him in for a weeks time and made an appt for 3 days after his first one. When i try to do passive mvmts of his shoulder he resists me and i have to "trick him" to get an accurate assessment. My question is how long do i go on treating this patient and not making any gains? I realize there are some pts who take comfort in coming to physio and have someone listening to them about their problem and paying them attention they may not otherwise get. Is there any place for us to be referring these types of patients to psychologists or should we solely aim to treat their musculoskeletal problem?
2 comments:
Hi Lil, assuming this guy is a private pt? I've encountered this and if the patients progress has plateaued (or maybe never started improving in the first place) you tell them that physio has taken them as far as it can and refer back to the doctor for review. It is supposed to be a learning experience for you too and seeing a pt like this every few days isnt really appropriate.
Hi Lil,
I have seen this type of patient before, my patient refused to imporved since he was on a work compensation. After a few sessions of treatment, i felt he was not going to get better, so i discussed with my supervisor and we dicided to D/C him but in our discharge letter to his GP, we clearly explained this patient was not compliant with treatment.
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