Friday, 7 September 2007

Time

One major thing i find hard about private practice is sticking to time. My appointment times were 1hr initial and 30min follow-up, but are now 40min and 20min for the last two weeks of prac. The first couple of days i was running behind time by about 10mins but through the week i have managed to get close to finishing on time. I have found that the section which takes the longest for me is the S and O. Rx can be completed fairly efficiently because by then you have your head wrapped around what you are doing. Some pointers i have been given to get through S quickly are, if your pt starts to ramble, say you need to get something and leave the cubicle, as soon as you get back ask your next question. Remember though you need to be polite because if you are rude they wont come back no matter how good a physio you are. If people are rambling use leading questions to get them back on track, but begin with open questions so as not to limit the info they give. Get your head around the current history (ie: mechanism of injury, time frame etc) because this gives you the best idea of what may be going on. Then you can really focus in on asking appropriate questions for the remainder of the form. After S you should go into O with options of what is going on and one of those should be you "gut" feeling. This i find really speeds up your Ax because you have in your head exactly what structures are possibly affect and you can test and knock them of the list untill you get a +ve which you can run with. Anyone else got handy hints? From what i have been taught S is by far the most important section of your initial Ax and get that right and you can see pt in 40mins and 20mins.

1 comment:

Lil Johns said...

Hey Dickie,
just some tips ive learnt along the way. Don't cut down the S, bcoz it actually gives u the most information. My supervisors have said to me that after some practice, you should already have a good idea of what is wrong with the pt, the O just confirms it. Really try and hone in on the important things and control the subjective, ask leading q's! Once you're done with the Sx do a quick clear of other jts for differential dx then hone in on the thing that u really think it is, once you've reproduced the pt's presenting pain, treat it! Its a hard concept to get used to coz we get taught to assess absolutely everything, but as we progress into professionals this is how we should be conducting our sessions! good luck!