5 Things to Look for in a Physiotherapist
Thursday, November 4, 2017
Written by: Cora Tomowich
As you may know, it can be tough trying to find the right physiotherapist to suit your clinical needs. Many clients comb the city, trying to find the right fit, but don’t always achieve success. It can be frustrating – not to mention overwhelming, expensive, and time-consuming. So how do you know when a physiotherapist is the right fit for you? What defines a successful patient-practitioner match? Well, in my opinion, when it comes to finding the right physiotherapist, it is helpful to consider the following:
1. Therapist Qualifications
Every licensed physiotherapist should have a Bachelor or Master’s degree from an accredited school. This degree is a general degree, providing all new graduates with a basic understanding of the body’s primary systems, including the musculoskeletal system, the cardiorespiratory system, and the nervous system.
Many physiotherapists then go on to continue their education in more specialized areas such as manual therapy, sports injuries, neurodynamics, or (like yours truly) pelvic health. Depending on the therapist and your specific needs, it may be beneficial to find a physio who has skills in multiple areas, in order to provide a more well-rounded approach to your care.
2. Area of Special Focus
As I mentioned, many physiotherapists choose to continue their education in areas such as manual therapy, pelvic health, sports, running-related injuries, hospital care, stroke rehabilitation, etc. So, when deciding on the right fit, it is important to take note of each therapist’s own area of specialization. For example, it might not be the best idea to see a physiotherapist with a specialization in running-related injuries if you only have needs in the realm of stroke rehabilitation.
So read the biographies that many therapists post online; and feel free to call their clinics to inquire further. Depending on the physio, sometimes they can provide a free, 15-minute phone consultation in order to answer your most burning, health-related questions. Taking advantage of these options can go a long way towards helping you make an informed decision.
3. Treatment Methods
When it comes to how treatment is performed, every therapist is different. This can make it difficult to compare physios, but there are a few things to look for when deciding on the right fit for you:
First, a good physio is an evidence-based physio. This means that he or she will combine clinical experience with recent research developments in order to inform the best treatment practices. Your therapist should always stay up-to-date on the latest research, be able to critically appraise that research, and cite references as needed. All too often I have seen therapists perform old treatment techniques and resist changing their methodologies for the better. As a result, patients receive out-dated, ineffective, and neglectful therapies that belong in the history books.
Second, a good physio will use outcome measures to help direct treatment plans. This means that your therapist should, on a regular basis, use reliable and clinically-tested questionnaires or scales to assess your response to treatment. Outcome measures help to identify areas in your rehab that still need improvement, while also quantifying and qualifying your treatment progress to date.
Third, a good physio will know when to refer to another health care provider. If your particular care requires a multidisciplinary approach, then be sure to have this conversation with your physio. Find out more about what your physio can provide and what needs can be met by an alternate practitioner. Too often therapists ignore the multidisciplinary approach to care and patients suffer the consequences. Regardless of background, a licensed physio in Ontario should know and practice within the scope of physiotherapy as defined by the provincial College. So, if your physio is performing an activity that is not within this scope, or is ignoring your potential need for multidisciplinary care, it may be time to move on.
Last, a good physio will always ask for your feedback during treatment. He or she should regularly check-in to see how you are doing / feeling with a particular modality or hands-on technique. Your therapist should not stay mute and expect you to speak up on your own; and your therapist should definitely not ignore your request to take a break or proceed more gently. Instead, patient-practitioner dialogue should be open and frequent throughout treatment.
4. Patient Involvement in the Treatment Plan
A good physiotherapist is one who believes that a patient is an active member in the healing process. From the very beginning, your treatment plan should be customized to address your specific needs; and your physio should spend time discussing, clarifying, and reviewing your rehabilitation goals and therapy expectations. He or she should not blankly impose an arbitrary treatment plan, just because.
Instead, a good physio will make you feel empowered in designing your treatment plan. You should be allowed to speak openly and ask questions. I always tell clients that my job is to show them the “buffet of treatment options”, while their job to tell me what they wish to “eat”. A good physiotherapist should tell you the nature, risks, benefits, and side effects of every treatment option. He or she should also clarify any alternatives to treatment, as well as, the consequences of having no treatment at all. As the patient, you have the right to ask questions and remove consent at any time.
Unfortunately, I have often witnessed therapists impose arbitrary treatment plans on their clients without proper explanation or goal setting. Consequently, patients find themselves spending more time, energy, and money than originally expected in order to address their clinical needs. If you find yourself in a situation where you have not been given the opportunity to discuss goals, provide informed consent, and are seeing no benefit with ongoing treatment, then perhaps it is time to consider a change in physiotherapist.
As a physio, I have always felt that my role is to support my clients in the best way possible. I am not in the business of making people dependent or reliant on me in order to continue their daily lives. My goals are to help you regain your independence and maintain overall well-being; all the while knowing that I am available, should you ever again need a little “tune-up”.
In my opinion, I believe that clients should like their therapists. All the education in the world cannot make up for a poor bedside manner. If a therapist is cold, condescending, or spends most of the session talking about him or herself, then they are not worth your precious time or money. If you do not enjoy the company of your therapist, then the healing process suffers. In my experience, when I have not liked a therapist, I notice that my muscles become more tense, and I am hesitant to share personal health information. Therapy then becomes pointless.
So instead of dreading your weekly visits, find a physio who has a personality that you enjoy. You should feel comfortable in their presence and safe enough to allow your body to fully relax into the treatment. You should also feel like your therapist is allowing you the space and freedom to speak openly and candidly, without judgment. This will foster a healthy patient-practitioner relationship, which then facilitates healing and overall well-being.