It is hard to believe how fast the last 8 weeks have gone by. We have been offering video appointments since Monday, March 23rd. When we started, we used the terms telehealth appointments, virtual appointments, or tele-rehabilitation (tele-rehab) appointments. While these terms are still used across the healthcare industry, we felt the ‘video appointment’ description was the most simple and accurate representation of the service.
The feedback we have received from our clients regarding the video appointments has been overwhelmingly positive! They appreciate that the main focus of the video appointments creates a great partnership between the client and their physiotherapist, and promotes independence and self-efficacy, which are both important aspects of improving all health outcomes.
Excellent healthcare clinicians are great listeners, great problem solvers, great educators and great coaches. When you strip away all other aspects of physiotherapy and rehabilitation services (including no hands on assessment or treatment options), your physiotherapists provider can focus on two of the most critical components of client care – communication and exercise prescription.
Communication includes active listening and client education. Active listening to understand the nature and behaviour of our clients chief complaints (usually pain and/or decreased function) as well as their goals and expectations. Five questions we recommend you ask all your healthcare practitioners include:
- What is wrong with me?
- How long will it take?
- What can I (the client) do for it?
- What can you (the clinician) do for it?
- How much will it cost
Keep in mind that healthcare practitioners with extensive clinical expertise may describe your clinical diagnosis (what is wrong with you) in non-specific terms, as that is more appropriate in many instances.
Client education is one of the most important, but overlooked, aspects of treatment. It can include pain education, activity modification, training modifications, explanations of individual client tolerance, capacity, tissue homeostasis, and prognosis for recovery. For example, research on the evolution of therapeutic neuroscience education shows that explaining the pain experience from a biological and physiological perspective of how the nervous system/brain processes pain allows people to move better, exercise better, think different about pain, push further into pain, and reduce their pain.
Exercise prescription includes determining the most appropriate exercises for the specific, unique features of each client’s situation. This includes the clients goals and expectations, their clinical problem/diagnosis, and the particular stage of their recovery (which can change on a monthly, weekly, or daily basis). To deliver the most optimal, beneficial, and efficient exercise prescription, your healthcare provider should have hundreds of different exercises to choose from. They need to know multiple progressions and/or regressions for each exercise. Sometimes the initial exercise prescribed will be too hard, and will need to be progressed. Once an exercise starts to become easy, it needs to be progressed to continue to maximize the benefits from performing the exercise. Once an exercise is prescribed, it is important to adjust the parameters (sets, repetitions, intensity, frequency, tempo/hold times) to find the right balance between workload and recovery.
Video appointments have been so successful that we plan to continue to offer video appointments as an option for our clients even after we physically re-open the clinic. Please contact us if you are interested in booking a video appointment this week.