16/06/2025
Good communication is paramount in healthcare, but some factors can sway what we say and how we interpret what we hear.
A particularly hazardous area, in my opinion, is with the mostly better person, who has perhaps had several sessions.
They typically ask about future sessions and whether they should keep coming back in to "stop it happening again".
In the past, I have tried to be confident and assertive, telling my patients that we have achieved our goals. I have considered their progress, added on a few more weeks of recovery, and deduced that there might be nothing for me to do by the time of the next appointment. So they don't need it. Save your time, save your energy. Let me get on with seeing someone else who needs it more.
I have also met plenty of new patients, and I notice how often I hear a story of "failed therapy". This person was seeing someone previously, and they were making progress, only to be told that "there was nothing else to do" or that "they couldn't help anymore".
It leads me to wonder whether we're exploring the same conversation from different sides and hearing different motives.
The person being a clinician wants to be effective, efficient, and not waste anyone's time or money. I've done my work, and you're mostly better; I don't see the value in another session.
In contrast, the person who is a patient is still in pain and is worried that things will not clear up completely. They don't want to live like this forever and are desperate to prevent a relapse.
One person is trying to be confident.
One person may be putting on a brave face, but underneath is scared.
Over the years, I have started to recognise these moments, and I do my best to navigate them carefully.
We can debate the merits of "maintenance" treatment. I think that in many cases, people who choose to embark on a course of "maintenance" sessions are actually after a little more companionship on their road to recovery.
There are numerous opportunities in these after-the-event sessions to explore the nature of the injury in greater detail, consider what might have predisposed or contributed to it, and learn how best to cope in the future.
When the person who has been a patient truly starts to feel independent, confident, and empowered, they will most likely stop attending their "maintenance" appointments. And they will tell their friends that they know someone who can help others. Someone who sticks by their patients, listens, cares, guides, and educates.