Putting Professionalism Aside

Don't you sometimes wonder what would happen if we could place all professionalism aside and really tell people how we feel. Not just our coworkers, but our clients and patients. Could you imagine how effective our communication would be?

Please don't take offense to any of the following.

Scenario A: A 300# male presents for initial evaluation w/ diagnosis of LBP (low back pain). He tells me "my back really hurts."

What I really wanted to say: "Lose some weight."

What I had to say: "Well, as you know, the more weight you carry in front, the more stress and pressure is put on your spine which in turn can lead to back pain, not to mention hip, knee, ankle pain."



Scenario B: A 72 year old female attends her second appointment w/ diagnosis of R hip pain of insidious (no known cause) onset. The first words out of her mouth were "I really don't see the point of this."

What I really wanted to say: "Then go home."

What I had to say: "Well, you want to get better don't you? The only way to do that is to perform these exercises to strengthen your hips."



Scenario C: I took over the care of a patient who had had a rotator cuff repair. No protocol or op report were sent over. The primary PT left nothing in the chart to indicate that he had contacted the MD regarding the protocol/op report. So since I wanted to be sure that I caused no harm to the patient, I called the MD office to get more information such as the protocol and/or the op/surg report. I've never had an MD office call me back so fast. Nor have I been so belittled and demeaned. This is what happened:

"Have you worked w/ this type of patient before?" [which being said to an outpatient PT is like asking someone if they've ever eaten an apple before]

Pissed off me: "Yes, but not a whole lot since this is my first time in a traditional outpatient orthopedic setting."
Polite me: "Yes."

"Do you know what an acromioplasty is?" [this is one of the first things we learned in orthopedics class]

Pissed off me: "Yes, jackass."
Polite me: "Yes."

"I've been doing this for 30 years and have never had anyone ask me for a protocol. Do you know how long that would take me to make a protocol for every patient?"

Pissed off me: "First of all, you've been doing this for 30 years and you don't have a protocol. That's either negligence or ignorance. Either way, it's just stupid not to have one. Secondly, I can't believe no one has ever requested a protocol from you. That's one of the first things we learn in school--get the protocol. Thirdly, you wouldn't have to write a separate protocol for each patient. You'd just have to make one for each surgical procedure and then modify it as appropriate based on what you did during the surgery. Are you going to pay me for this advice? I mean it is pretty much common sense, but since you are making more money than me, I could use a little extra cash flow. Finally, would you rather have me protect the patient and the "stupendous" surgery you did, or "f" it up, hurt the patient ('cause remember you took an oath to "first do no harm") and then have you really pissed at me?"

Polite me: "I am only acting in the best interest of my patient and would prefer to err on the side of safety. I do not want to do anything to compromise the status of the surgical repair. Also, I've had several surgeon's gladly fax over their protocols without question, jackass."

NO, I really did not call the MD a jackass. Well, not to his face.

I'm interested to hear what some of your conversations would be like if you put professionalism aside. Please feel free to share.