The One Thing That Patients (And Head Coaches) Hate

Posted By: Andy Barker

I’ve learnt this the hard way. 

Earlier in my career working in sport I did not appreciate the important of something so simple and because of this it led me to a lot of problems.

This was in sport, and when I got it wrong and the coach took the news the wrong way…

It ended badly, usually in a barge of questions and shouting from the coach.

At the time I thought it was just him being a *#&% but it was actually my fault.

As time has gone on I have realised that this not only applies in sport but in any other setting where we are communicating medical information.

This might be giving a patient a diagnosis…

Telling a player a prognosis and how long they will be out for…

Or updating a member of the MDT on the current progress of one of your patients.

So what is it?

The one thing patients and any staff member you are working with does not like is…


Let me give you an example…

You have a patient that has lower back pain.

You assess them and they have an extension related lower back problem and is affecting their sleep and is made worse by running.

They want to get back to doing their weekly 5km park run and to be able to complete a couple of gym based workouts a week, all things they have had to stop because of their back pain.

In the first session, you told your patient that it would take ‘a few’ sessions to get them back to full fitness.

So you get to session 3 and your patient is at that point NOT back to full fitness.

Maybe the pain is loads better, maybe it has even gone, but you know they have work to do before you give them the green light to restart running.

So you tell your patient they need another 2 or 3 sessions.

Patients will often NOT take this well.

And rightly so…

As you told them in that initial assessment that they need 3 sessions, now having already had 3 sessions, you are telling them they need another 3.

This is going to cost them in terms of time, effort and if paying privately, financially.

They can often be frustrated, confused and sometimes even angry and they think you have got it wrong and dare I say it, you have.

The big issue here is that if you are not sure, do not give assurances or commitments you can not keep.

I’m away on camp at the moment with a national football team.

As I write this blog we have our final training session today, then we play Belgium tomorrow in our final game, the winner qualifying for the European Championship in the Czech Republic this Summer.

One of the teams big players sustained an injury in our last game v Iceland.

Obviously this player was assessed and I gave the head coach an update on the players injury, prognosis and plan to give them the best chance to be fit for this final fixture.

The first thing the head coach asked was…

‘Will they be fit to play on Tuesday?’

The worst thing I could of done is said yes, because at this stage I do not know.

‘I think…

‘All being well…

‘He or she should…

These are all predictions not facts.

Every part of you wants to tell your patient or a coach, or someone else in the MDT, positive news.

But unless you are 100% sure you should never ever do this.

You need to give facts and not speculate.

My response to the question ‘Will they be fit to play on Tuesday?’ was…

‘Today we will spend some time together in the treatment room and in the gym doing x, y and z to work on x, y and z, to give the player the best chance on getting back on the field tomorrow…

We (physical performance coach and I) can modified a few things in the session to achieve this.

The plan would be to get back on the field tomorrow. This may mean the player starting the session with me and going through some drills 1:1 to make sure they are ok to join the main team session…

Does this sound ok with you?’

Whilst not committing to an answer and declaring the player fit or not, the head coach was fine with this and this is why.

I gave them a plan.

Clearly some thought has gone into how we are trying to do everything we can to get the player back on the pitch as soon as possible.

Also we are prepared in the sense we as a team (physio and physical performance coach) have already had a discussion around what is the best plan for this player and presented this to the coach.

The coach is also aware early that this player might not be part of the early part of tomorrow’s session as they will be working with me 1:1 on the pitch to start with to determine their availability and fitness to train.

This helps as the head coach and their coaching team can then plan numbers in the session and for their drills which may need to change if the numbers of players changes or important players are missing from certain drills. 

Facts not speculation.

This is the same whether you are working with a professional footballer or your everyday patent in the clinic.

People do not like surprises.

Do not set yourself up for failure but promising too much when in reality you do not know how your patient will progress until you get going with the treatment plan. 

Hope this helps.


The New Grad Physio Mentor

PS. Want to learn how to clearly deliver clinical information to your patient, so they understand exactly what their problem is and what steps are needed to get them back to full fitness, all in the very first session?

I have some specific teaching on this in the introductory content of my new grad physio membership.

Click here to find out about my new grad physio membership and how it can help you, to help provide the best service possible to your patients, even as a young and inexperienced new grad physio.