Our patients and clients are motivated to see a health professional both with and without pain. Pain is the obvious motivator, but no pain or symptoms might relate to a test result where there are nothing visible.
With pain once it’s gone or in the case of no or little pain, once the test result returns to normal, clients generally drop out.
This is Dr. Andrew Arnold, Founder of My Allied Health Academy and in this article, I'm talking about how to engage your patients and clients in a way that transcends the mere resolution of their pain symptoms or test results.
Engagement beyond pain is a critical facet of healthcare quality. Not only does it guarantee better health outcomes, but involving patients in their own care is also vital for increased satisfaction, reduced costs, and enhanced clinician experience.
Now, the question is: how do you keep your clients engaged beyond pain right from the outset?
Pain is generally not considered an accurate indicator of health and wellbeing. Pain is often the last thing to happen, and, in some cases, there can be a long build up without the person knowing anything is wrong, e.g. a tumour is often the first thing that is noticed when in fact it has been growing for some time without any pain or symptoms.
Pain generally is the first thing to go and again, this may not mean the person's health and wellbeing are restored.
So, how do we communicate this effectively to our clients? How do we tell them what you are feeling is not the whole picture and everyone's pain perception is different?
Subjective pain perception is influenced by many factors: the weather, the stress in your life, male vs female, time of day, medications, other health conditions, mental health etc. We all experience pain differently.
It is virtually impossible to be objective of ourselves.
I use several metaphors to try and convey this quickly and powerfully to my clients.
The 'pin in the arm' metaphor: If I put a pin in your arm, you would probably say that's a 10/10 on the pain scale but if I ask you in an hour, you might say it's reduced to 5 or even lower. If I wiggle the pin, you will most likely say, back up to a 10!
The 'Mack Truck' metaphor: I have had many patients over the years tell me they have been pain and/or symptom free for years until now, when they present with significant pain. For some people their pain thresholds are so high it literally takes years for their brains to register something is not right, thus the 'hit by a Mack Truck' metaphor.
The 'Tip of the Iceberg' metaphor: You've all heard this. Your symptoms are usually the tip of the iceberg. The water level is your pain threshold, and this can go up and down depending on many factors as discussed. Just because your pain is gone this doesn't mean the problem (the iceberg) is resolved.
The 'horses have bolted' metaphor: Those patients who consciously or otherwise, ignore their symptoms and eventually have a 'Mack Truck' experience will usually also have a healing reaction or crisis experience as soon they begin treatment. The practitioner must make it clear this is not an aggravation rather, a healthy healing reaction that whilst uncomfortable is a necessary part of the healing process. Sometimes, this can be severe, thus the 'horses have bolted' analogy and should be a reminder to the patient to actively maintain their health rather than wait until it’s too late.
I encourage my patients to differentiate between subjectivity and intuition. They may feel worse as they journey through a healing crisis but instinctively and intuitively know they are on the right course. Our intuition should be a key fundamental to guiding both practitioner and patient.
Let’s review the basics of patient engagement and its importance in clients’ healthcare experiences.
Engagement refers to the interaction and partnership between our clients and healthcare practitioners. The word "engagement," means the active participation of clients in their healthcare despite the absence of pain, i.e. taking an active participation in their healthcare process.
Why do we advocate for client engagement?
Here are top three benefits of client engagement and how this can boost healthcare quality and safety:
Clients involved in their health are more likely to comply with treatment plans. Compliance with treatment and recommended health practices can reduce complications and enhance clinical outcomes.
Engaged patients are inclined to communicate effectively with their healthcare providers. They may be more comfortable asking questions about their treatment plans, providing feedback, and raising concerns. Open communication allows healthcare practitioners to address problems as they arise.
Engagement encourages clients to comply with treatment and communicate with their providers. This ensures a satisfactory healthcare experience because they can guarantee optimum care and excellent healthcare delivery.
Recognising the importance of engagement is one thing, but implementing ways to achieve this feat is another. So, here are 8 effective ways to keep your clients engaged beyond pain resolution:
You know that feeling. The patient has one foot out the door, and you're breaking a sweat chasing them. On average, around 40% of people will stay with the treatment plan after their pain has abated.
As health professionals we must lead rather than push our clients. Ensure your treatment plan is based on the best available evidence, i.e. clinical justified. Show your clients the research and field questions. Remember, the consent process never ends. Make sure you continue to provide clinically justifiable evidence supporting your proposed plan. Be a beacon of optimal health and wellbeing. Stand for what you believe in and don't be swayed. You will attract the 40%. This is the universal law of attraction.
I know you turn up to your shifts and see your clients, but are you truly present?
Turning up is much more than your physical presence. Take time to ground yourself prior to your first appointment. Meditate, practice positive affirmations, visualise a full and smooth flowing day, manifest new and returning clients booking in and filling your day. You’ll be surprised at the results.
Nothing is more irritating than having someone promise they will do something and not follow through. Keeping your promises gains trust and nurtures engagement.
Create a reminder system where you can follow up on everything, including phone calls, information, referrals, reports, or just simple check-ins. It's about paying attention to the detail that will ensure your clients feel cared for.
Don't take it personally. If a patient drops out, it may not be entirely your fault. In general, our clients won't tell us the real reason they either want to or feel they need to drop out of care. For the most part it's usually a perception they cannot or have chosen not to afford your treatment or they can't afford the time or both. For many, feeling good enough is good enough! You've heard the saying, 'focus on what you can control'. Focus on those clients who are choosing their health, you and your practice. This is where your energy needs to be. This is where you have the most influence. Once the client has decided to leave it's very difficult to turn them around.
When our clients are actively involved in setting goals, these tend to be more client centred. Encourage the client to share their needs and preferences and make sure you really listen to them. This approach effectively influences treatment when there is an environment that supports and values client-centred objectives.
The consent process should never stop. Whilst this is a signed declaration at the initial visit, a verbal consent process should continue through-out the treatment journey. Clients involved in the consent process feel more confident about the practitioner and the treatment. Actively and regularly checking in with the client helps foster engagement particularly if you support your treatment process with good, evidenced research.
The client-practitioner relationship is a partnership of sorts insofar, as a collaborative approach to achieving the best clinical outcomes. Empowering the client with home instructions and self-care management strategies helps keep them engaged beyond the acute phase. This may include exercise or nutritional prescription, or a mental health plan for example. This is founded upon clear treatment goals agreed upon from the outset.
Finally, don't be afraid to show your clients what they need. It is not up to you to judge what they can or cannot afford. Your duty of care is to show them what they need, whether a cream, a supplement, or a referral etc. Be firm but compassionate. Remember lead, don't push.
Engagement is a critical part of the treatment journey. It is the glue that helps the process stay on course. Engagement creates an opportunity for more effective communication between the clients and practitioners, resulting in more insightful information that can help support the treatment plan. Moreover, clients involved in their healthcare are more likely to comply with treatment and exercises, leading to an improved healthcare experience.
In short, engagement allows healthcare practitioners to enhance their service delivery and results.
So, next time you're in your practice, try these techniques and tips and see the difference in your appointment book.
To know more tips and suggestions, visit http://www.myalliedhealthacademy.com or sign up.
References:
Coulter A, Engaging patients in their healthcare; HOW IS THE UK DOING RELATIVE TO OTHER COUNTRIES? ANGELA COULTER, PHD CHIEF EXECUTIVE PICKER INSTITUTE EUROPE, 2006, Picker Institute.
Cameron L.J. et al, A qualitative investigation into the patient-cantered goal-setting practices of allied health clinicians working in rehabilitation, Vol 32, Issue 6
Krist, A.H. et al, Engaging patients in decision-making and behaviour change to promote prevention, Issue title: Selected papers from the forthcoming book Health Literacy: New Directions in Research, Theory, and Practice; Journal: Information Services & Use, vol. 37, no. 2, pp. 105-122, 2017; Published: 26 June 2017
About the author
Andrew Arnold is an Allied health professional and founder of My Allied Health Academy or MAHA.
