As our new normal continues, our healthcare system continues to struggle to adapt. As a healthcare provider, I see business struggle to come to terms with the state that we’re in now, some adapting well and others struggling to continue to make the old models work.

However, the Providers aren’t the only ones who need to adapt. Patients are now having to think twice about seeing out care for their ailments, and for some patients with muscuoskeletal injuries, they are being seen via telehealth through primary care providers who are only equipped to diagnose just on subjective symptoms, which, lets be real, are essentially a WebMD search away.

So what is changing, really?

As a healthcare provider, my thoughts are now along the lines of: what is the most efficient and effective way to help people get better…on their own? I think the last part is very much a defining factor. Even before this pandemic, I had already noticed a stark difference in the patients I was seeing via telehealth vs. the patients I was seeing in the clinic. The patients I was seeing via telehealth were MUCH more motivated to learn the “why” behind their injury or pain, and the “hows” to get better on their own with some guidance by yours truly. These patients frequently were e-mailing about questions about their exercises, and you could tell they were truly doing their exercises regularly. I am not longer there to “fix people” but the mindset shift is to more be the guide and the coach to help my patients get back to the stuff they want to do. I’ve been surprised at how much faster these patients get better, and how much more engaged they are with their care.

Now, I’m not saying that patients that I saw in the clinic did not want to get better or learn these things, but the interaction was just…different. I think (and there are studies to back this up) that the different attitudes towards rehabilitation is the presence or absence of the hands on component of therapy.

As a patient, going in somewhere and saying “fix me” is just a much easier mindset to be in than to be told or be expected to fix yourself. However when there isn’t an option (like now, as we quarantine), it’s a much easier mind shift. Don’t misunderstand me, I’m not at all saying that it’s the general patient population to blame. Rather, I think that over the years, physical therapists have perhaps started to rely too heavily on manual therapy.

Remember, I’m saying this as a Fellow of Manual therapy, which means that I spent 3 post doctorate years pursing even more advanced training to do better things with my hands. However, in the last few years, I’ve noticed that I’ve started relying too much on the manual therapy aspect. When this happens, I spend less time talking to people: educating them, encouraging them, and guiding them through exercises. Why do that, when I can spend 15-25 minutes making them feel better until their next appointment? And for that patient who is just stubbornly not making progress, those patients then became the “bad” patients who weren’t doing their exericses at home.

But who’s fault is that? Ultimately, mine. If the patient has been coming to me for help, but aren’t doing what you told them to do, perhaps I’ve done a crappy job really educating them on why they need to do this to get back to their lives. Connecting with people is HARD WORK. Connecting with them and motivating them to do the hard things is even HARDER WORK. It’s much easier to make people feel better immediately, that gratification is instant not only for my patient, but for me as well. When they leave feeling so much better, it’s an ego boost for me. Now, it’s true that some people are not willing to change or get better, but those are really a very small group, and even with that group, it’s about getting to their true motivation.

And don’t get me wrong, there are DEFINITELY people who need the manual therapy component, and telehealth is not for everyone.

So, why this rant?

I think that we, as healthcare providers, need to make sure that we’re emphasizing the right things for our patients. We need to teach them self care, educate them on their pathologist, use language that empowers them to get better and not rely on you. You’re not the hero. You’re just the guide.

For those of you looking for help: patients, clients. Make sure you’re asking questions. I know there’s something to be said about not knowing what you don’t know, but if something that your healthcare provider says doesn’t make sense, ask questions. Understand why you’re doing that exercise, or why you can’t push through pain. Ask questions with open curiosity. Shoulder the burden of your own recovery; remember, YOU are the hero in this story, and if you don’t recover, ultimately, you’re the one who will be the most effected.