Ruling Out Serious Pathology By Asking Your Patient This Simple Question
Posted By: Andy Barker
When you see any patient for the first time, the first thing you must do is make sure they are in the right place!
The physio room is NOT the place your patient needs to be if they have something sinister going on and they may need a quick onward referral to get the right care.
This is why asking those important red flag questions is key.
Failure to identify possible sinister problems is not great for you or your patient as you might start treating something out shouldn’t…
And for your patient, this means you could make them a whole lot worse!
As important as these red flag questions are for you to screen the major sinister problems, 99% of therapists fall short when screening for sinister problems during the assessment.
You see, it is all well and good you knowing what is going on with your patient and being happy having cleared any major sinister problem with your red flag questions…
But is this clear to your patient?
Have you ever asked your patient what they think is going on?
I teach the therapists within my membership to ask a simple question with each and every patient they assess, not just those with neck or lower back pain, but every patient…
Do you think something sinister is going on?
Unless you ask your patient this, do you really know what they are thinking and if they think they have something more serious going on?
If you do not explain your findings well to your patient they most probably will leave your treatment room just as confused than when they arrived.
Your patient is always be the most important person in that treatment room and you must always do everything you can to ensure they 100% understand what is going on with their body.
But how do you really know what they think is going on with their body unless you ask them?
Back pain is a great example and patients will often have misconceptions about what is causing their back pain.
They’ll say things like…
‘I’ve slipped a disc in my back’ (you can’t do this by the way) or…
‘I’ve got a hamstring injury’ (pain referred from their back to the posterior thigh).’
These are just two of so many patient misconceptions.
The internet and Dr Google and Dave down at the pub have a lot to answer for!
There is so much information out there nowadays it can be hard for patients to know what it is good information and what is poor information.
The key thing here is…
If you know they have certain misconceptions about their injury then you can educate them and reassure them that they do not if that is the case.
Otherwise they will leave your treatment room still thinking they have a slipped disc, or a hamstring injury, or something else, even though it is clear from their assessment that they don’t.
And it gets worse than this.
You’ve screened your patient for serious injury and cleared symptoms for cauda equina and cancer using your red flag questions…
And your happy they have no clear signs of these sinister issues.
You document this in your notes.
That’s great that it’s in your notes but is it in your patients head?
If you’ve cleared these type of issues you need to tell your patient.
You will only truly know what your patient is thinking by asking them this directly…
Do you think something sinister is going on?
Ask this simple question in your next (and every) patient assessment and you will see an immediate difference.
When you can reassure patients nothing sinister is going on you will see their mood change, they are happy it is not something more serious…
It’s like a weight has been lifted off their shoulders…
Then you and your patient can then get stuck into their rehab to start getting them on the road to recovery.
Hope this helps.
The New Grad Physio
PS. There are some more important quick fire questions like the one I mentioned above that you should also ask in your subjective assessment with each and every patient that you see.
I explain these in detail within the subjective assessment module of my new grad physio membership.
This is the first module I advise therapists to complete when they first join as ultimately it is the most important.
Do a bad job with your subjective assessment and it makes your objective assessment much more difficult…
And it makes knowing where to start with your treatments and rehab after the assessment almost impossible if you do not know what your patient’s problem is!
Feel like your missing something in your subjective assessment?
You most probably are.
Find out what it is here.