By Kylie McKee, WEBPT
Oh, parting ways is such sweet sorrow. And that certainly holds true when a patient leaves his or her physiotherapist—particularly if that departure is premature. After all, patients who stick with physiotherapy typically experience high success rates. But, as any PT knows, patient success in therapy hinges on consistency in the plan of care as well as the patient’s stalwart adherence to his or her home exercise program. And when patients throw in the towel before completing their plans of care, it’s hard not to wonder where things went wrong.
Here’s the thing: there are plenty of reasons for self-discharge that are beyond your control. Sometimes, life just gets in the way. Still, there are steps providers can take to mitigate preventable patient dropout and keep more patients on the road to recovery. To that end, here are the major reasons why patients leave—and what you can do about it:
1. Results don’t happen overnight.
In the age of “one-click” purchasing, same-day delivery, and on-demand meals, instant gratification is no longer the exception, but the rule. When it comes to therapy, though, patients who enter treatment with this mindset are bound to get discouraged. In fact, a study on high attrition rates from Marquette University identified a lack of immediate results as one of the major catalysts for therapy self-discharge. That’s because patients who don’t experience instant gains often get frustrated and start to question whether therapy is making a difference.
The Fix: Set realistic goals.
When patients stick with therapy—and adhere to their home exercise programs—they can achieve outcomes that are comparable to, if not better than, those associated with surgery, injections, or prescription meds. Plus, they don’t have to deal with the unpleasant side effects that often come with more invasive treatment options. But, do your patients know that?
During each patient’s initial examination, it’s absolutely crucial that you not only explain what kind of treatment results he or she can expect, but also establish concrete, achievable goals. Restoring function requires effort, consistency, and time—three things not typically required with those other pain management methods I mentioned. So, make sure your patient begins therapy with the right frame of mind and that he or she understands the advantages of choosing movement over meds.
As an experienced physiotherapist, you don’t need a crystal ball to know what the future holds for patients who don’t follow their home exercise programs: goal-setting is an exercise in futility if a patient is a passive participant in the therapy process. Conversely, if a patient shows steadfast adherence to his or her home exercise program, then his or her gains will likely be faster—and better. That’s why it’s crucial that your patients understand the vital role they play in their own recovery process—and the risks that come with bowing out early (namely, very little improvement and a whole lot of wasted time). And if your patients aren’t prepared take your word for it, consider leveraging your own outcomes data as a tool to prove the efficacy of your treatment.
2. Patient lifestyles can be counterproductive.
According to this 2011 study, Canadians spend approximately 69% of their waking hours sitting down. There are a multitude of reasons for this, including a decrease in the number of manual labor jobs and an increase in desk jobs—not to mention long commutes. These environmental factors can have a huge impact on a patient’s ability to stay compliant with his or her home exercise program. So, what’s a physiotherapist to do?
The Fix: Find therapy “hacks” for your patients.
If your patient is recovering from a major surgery or injury, he or she will likely need to alter his or her regular routine to some degree—at least until he or she achieves a certain level of function. This could mean taking leave from work or taking a break from activities that could counteract therapy (a rigorous exercise routine, for example). If this isn’t possible, then you may need to get a bit creative. Start by looking into different techniques or exercises—desk exercises, for example—that better accommodate a patient’s lifestyle. Or, recommend assistive devices that help patients stay on track without totally altering their current daily activities. Remember: Patient caring often goes beyond the clinic.
3. Chronic pain can negatively impact attitude and emotional well-being.
Studies show that physical health isn’t the only thing affected by chronic pain. According to the US National Library of Medicine, pain patients frequently experience increased levels of stress and symptoms of depression, which can impact their ability to stay motivated. That’s not exactly shocking news: the Marquette study I mentioned previously also found that patients who dropped out of therapy had higher depression scores than those who stuck with it.
The Fix: Prioritize mental health.
I won’t mince words: change is difficult—and it’s even more difficult for someone who’s in constant pain. But, change is often integral to the healing process. Still, the combination of chronic pain and dramatic alterations to a patient’s lifestyle can significantly impact his or her emotional well-being. That’s why it’s crucial that physiotherapists who treat chronic pain patients not only pay attention to their patients’ mental health, but also continually emphasize the outcomes those patients can achieve when they stick with therapy. And truly, even the most motivated patients need a guiding hand. Remember, just as it’s up to your patients to adhere to their HEPs and treatment plans, it’s up to you—the therapist—to lead the way.
Some patients vanish into thin air for perfectly valid—and unforeseen—reasons. In other cases, patient attrition is preventable—especially when therapists employ a proactive, patient-focused approach to stopping dropout. After all, putting a heavy focus on providing quality patient care is one way to instill patient loyalty. And when your patients are loyal, they’re more likely to return to therapy—even if they have to hit the pause button on their treatment.
Kylie McKee is a content writer at WEBPT specializing in all things health care—from software and legislative reform to clinical and business best practices. She is passionate about empowering providers to improve patient care, optimize clinic efficiency, and boost financial performance.