Holiday Gatherings - should one treat a family member?
Let's ask the experts....
My dad after shoulder surgery not following his PROM only restrictions.
The holidays can be confusing for any Physical Therapist, Chiropractor, Masseuse, Occupational Therapist. The reason for this is because family members ask us for advice. Often they are the most difficult patients because they a) don't listen, b) want the quick fix, c) are intoxicated, d) they want a free massage e) don't respect you as a medical professional, (after all they knew you when you were in diapers, who can blame them?). Almost all practitioners have negative experiences that have led them to question the treatment of family members. If you think about it, this is smart. At a holiday get together we cannot chart review, there is not a treatment area, and if the word gets out, you will have a line of folks waiting to get " a freebe." There is also a chance that they will not seek treatment after the holidays thinking that your session was enough. This could prevent them from seeking the care they need. I can recall the Thanks Giving party of 2011 when I was treating a family member on someones bed and after I was done there was a line of 6 people waiting for their session! I have a big family and my day off turned into a work day. Some would call this a rookie mistake. As a Christmas morning blog post, I thought it would be a good idea to hear strategies from some seasoned Physical Therapists and how they navigate their holiday season requests. I hope the decision to treat or not treat is easier after reading this.
Randal Glaser PT, DPT, OCS, co-ofunder JetsetRehabEd.com
Mariam P. Butler DPT,OCS,SCS,FAAOMPT
I personally have no problem telling people "no." I've been known to say "this is my one day off, can we discuss this later?" then plan a date and time to do that. I'd rather have them see me first over someone else honestly. It depends on my mood because our job isn't a 5 minute conversation where we can give some advice and send people on their way. If I am going to help, then I know it'll be at least 30 minutes. Sometimes, if I'm feeling up to it, then I'll just do it knowing I'll have to help that relative eventually. It's easier at my own house where I have a table and stuff I need for treatment. If it's somewhere else, I'll say "tell me what's going on so that I know what to assess later when I have my table set up along with all the measurement tools I need to appropriately evaluate you." That's always a good way to listen to the person so they know you do care about them, but at least you don't have to "work" during a family function. I think overall, it's on us to be the ones to help our relatives because we know what we're doing. What are they going to do otherwise? Go see their MD that will likely just recommend meds? MOST PT's are PT's because they care about people, and want to genuinely help people get better. It's our responsibility to guide them the right way. If we feel they should go see an MD, a PT, or another health care professional, then we should be the ones to advise that, educate them on their body and give them realistic expectations on what to expect.
Andre Chavez PT, DPT, OCS, Movement Science Fellow
Treating your relatives over the holidays can be an interesting task but something that all clinician will face this holiday season. Careful consideration has to take place before doing this. You know your family members better than anyone so you know who is going to listen to what you say and who thinks you don’t know anything. You also have Aunt Mildred who just wants you to push on them because it feels good. Since this is relative, (please excuse the pun) I pick and choose who I treat based off what I know about them and the situation. For example, my dad is stoic so if he is asking me for advice or for a mini-evaluation I’ll give it to him because he wouldn’t ask if he didn’t want to get better. Then you have Aunt Susanne who has Fibromyalgia and spends half of every Thanksgiving and Christmas dinner talking about her new pains and ailment . . . I wouldn’t touch that with a ten-foot pole. And then you have your cousin Ryan who you still must talk out of dumb decisions every now and again and who thinks you just gives massages anyways, I’ll pass on that one too. For me it easy it depends on the relative and the situation.
Michael Curtis PT, DPT, OCS author of Why you have Bad Posture and Turn down your Pain.
founder of the blog: Michael Curtis PT
I’ve found it helpful around the holidays to refer friends and family members to a trusted resource online – and I’d recommend the same for you…
Here’s your script: Memorize it, repeat it, sell it, and you’re golden.
“Wow! it sounds like you’re going through a lot right now. I have the perfect article with videos of exercises you can do that I think will give you some relief. Send me an email to remind me and I’ll give you the link.”
If they follow up with you, you can link them to a good article while also informing them to follow up with their PT or doctor should their symptoms continue.
This tactic has worked well for me because:
It offers them quality information and actionable exercises
It gets you off the hook for treating Aunt Marilyn on your grandparent’s couch
It puts the responsibility on them to email you
It funnels them into following up with someone else in-person
Where do you get these online resources? You can use any trusted resource you know of (if you have some, put them in the comments below for all to see). Also feel free to use what I’ve got on MichaelCurtisPT.com – patient education articles based on body regions with exercise videos for each diagnosis.
I hope this approach works as well for you as it has for me.
If it doesn’t work, I’d go with the “Home Alone” version:
“I’m going to give you to the count of ten to get your ugly, yella, no-good keister off my property… Merry Christmas ya filthy animal!”
It’s funny and bad enough when the just-met stranger at the office party or happy hour finds out I’m a Chiropractor and starts telling me about their neck and back pain and asks for a real quick free adjustment right then and there; it’s worse when it happens at the family party- because I can’t just laugh it off and walk away. These loved-ones deserve my attention and real answers. When I faced this fresh out of school, I would ask all kinds of questions and give them a ton of advice, and usually working on someone on the couch, floor, or someone’s spare bedroom. Looking back, I think I may have been eager to prove myself, or was just so happy to be able to give back to the family that I really tried to treat them as if they were in my office. The smells of a feast, screams of kids running around, and party sounds were definitely a distraction. I know better now. Nothing beats the focus, clarity of purpose, and single-mindedness of practicing in my office. Now I listen and happily give them some basic advice, (like, ice/heat/move/immobilize it) and then tell them they really need to get it taken care of. I don’t care if they see me or someone else. I offer to see family in my office for free, but tell them if they cancel or are chronically late, I will start charging them something. At least half of my family has insisted on paying anyway.
Gabrielle PT, DPT, OCS, Woman's Health Specialist
Surprisingly the holidays are pretty smooth sailing for me! Yes, I’ve made that rookie mistake of opening the can of worms, but for each family member I’ve treated:
1) usually they only need one treatment and if they follow my directions, they can usually prevent it from happening again, or know how to manage if symptoms return or
2) they don’t follow my directions, symptoms return , they come back to me, I ask them if they did what I told them to do, they say “no”, then I say “do what I told you to do”, then they never ask me again. I don’t know if the latter is a good thing or bad thing!
My husband is also a PT, so there is double the chance that one of us will get summoned BUT I can say that my family and my in-laws are very respectful of my personal time at family functions (thank goodness). Their respectfulness of our time makes me more inclined to help out if the situation does arise!
My advice is, just like life, find a healthy balance, and don’t end up opening Family Room PT, Inc during holiday dinner (unless you want to and you’re charging co-pays!)
Happy Holidays,
Gabrielle
------------------------------------------------
Happy Holidays from the Jetset Rehab Team
Please check out our courses, hope to see you next year!!!!!
We went to a Physical Therapy meeting in a brewery.
We went to a Physical Therapy networking event in a brewery!
Monica helping spread the word about our upcoming class!
The memo on the office bulletin board peaked my interest. It highlighted a meeting organized by the GLAD district of Los Angeles for the CPTA. . The location was to be located in a brewery in Santa Clarita. See our photo diary below.
As anyone who reads this blog or follows Jetset Rehab Education on social media knows, we feel the networking is ESSENTIAL to clinicians.
By the way, this is why our classes are built around a great instructor AND a strong networking component built in.
Here are some reasons why networking is important for Clinicians:
- Referral system. Example: This particular night I met someone who is a Lymphadema specialist. I had been on the lookout for a specialist in this area for quite some time. Now I have someone I can send patients to if they need this service. These opportunities are everywhere! Perhaps your business or clinic provides a specialty service. After talking face to face you are more likely to get a referral vs. email ads and other forms of advertising. Think of this as word of mouth recommendations for your own business.
Mike and his two assistants.
- New Friends. Like minded people are more likely to develop friendships due to common interests. Friendships are great for having emotional support and understanding. Think of your grad school friends. They were the only ones who understood the intensity of school work and your lifestyle. Just as important are the friends you meet in a profesional setting. More friends = always good.
Long lost friends
- Tips/Advice. "That mistake you are about to make, I've already made it."
Wouldn't it be nice to know Clinicians who have been through your path before? Who understand your struggles because their's are the same? Trust me, if you just look, you will find them.
If you need advice, friendship, or opportunity this is the place to be.
Paul, Hudson and Kristen PT, DPT, OCS. Little Ones first networking experience and first brewery.
Robin and Valerie
Special thanks to GLAD and the Wolfcreek Brewery for the great night!
Thanks for reading.
Check out our classes here.
3 things that online education providers do not want you to know...
The 3 things online education providers don’t want you to know…
- Devoid of clinical pearls
Online classes have to be combed over by lawyers and often several staff members. For this reason the info must be: a) backed up by the research b) doesn’t say anything that can lead to a lawsuit. But think about this: How many times were you given a clinical pearl that wasn’t mentioned in the research? I know for myself this has been the case multiple times. After tearing my Achilles tendon last year I was instructed to give Russian muscle stimulation early in the rehab. It felt so much better after this modality that I added it to my Achilles post-surgery protocol with great results. There is no research on this and you will not find this info in online education because it is not backed by the research or literature. When in the same room as an expert clinician however, they will mention the treatments that have worked for them. Online classes will not.
- You don't get to see treatment in action or get feedback.
I attended a class taught by Clare Frank of movement links a few months ago (One of the best Physical Therapy instructors ever by the way). Often she will use a student in her class at a “patient” to demonstrate her exam/treatment. In this class one of the students had buttock pain and low back pain on the same side when running. After the exam she performed PIR (post isometric relaxation)on the piriformis muscle and the positive tests that reproduced the low back pain were pain free on reassessment. The mechanism for why this worked is not reported in the literature and many of the students were pretty amazed. It was simply something that she was utilizing in her practice and she was sharing it with the class. Now, ask yourself, would this clinical pearl work in an online class?
Everyone in this class was able to practice this technique and get feedback on correct performance. In our TMJ class with Nancy Adachi, every single student was able to improve their manual therapy technique with her feedback. These instructions can only be given to a student in person.
- Many professions are hungry for education and are doing a great job at improving. With online classes, you will fall behind.
Lately I have been seeing a lot of personal trainers, Chiropractors and athletic trainers in my Physical Therapy CEU classes. This is great! Often they are very motivated to get better and make their business more marketable. We need to understand that there are plenty of patients to go around for everyone and if more people benefit, this is great. I am here to say however that the profession that is able to settle for getting their clinical education online is the profession that will fall behind. As health care goes through the many transitions that are inevitable for the future, the consumers will have a big say in who lands on their feet. The profession who gives the best results in the least amount of time will be the public’s choice.
Randal Glaser PT, DPT, OCS, CEAS I
is currently designing courses for Jetset Rehab Education, www.jetsetrehabed.com , working in the clinic and researching tennis elbow.
In the Lab.