On October 2, 2013, Ann Wendel and I hosted our latest #socialortho tweetchat. This month we discussed balancing the difference between patient and healthcare provider goals.
For those of you unfamiliar with tweetchats, people answer questions posed by the moderator and comment on other tweets using the hashtag specified – in this case #socialortho.
If you enjoy fast-paced discussions about important sports medicine, healthcare, and social media topics, join us for future #socialortho tweetchats. We usually hold these chats on the first Wednesday of each month. The next #socialortho tweetchat will take place on Wednesday, November 6 at 9 PM ET.
Ann Wendel @PranaPT
Welcome to #socialortho We’ll give everyone a minute to check in. I sent @DrDavidGeier to watch the JT/Jimmy Fallon hashtag skit. #hilarious
Ann Wendel @PranaPT
@kmessina15 Glad you could make it to #socialortho I keep annoying my kids saying “hashtag” everything!
Dr. David Geier @DrDavidGeier
@PranaPT That is #awesome #sofunny #yourwereright #socialortho
Mike Hopper @mnhopper1s
@PranaPT @kmessina15 you mean you’re not supposed to say that? #socialortho maybe that’s why my kids all laugh at me 🙂
Ann Wendel @PranaPT
@mnhopper1s Wow – we got Mike and @kmessina15 in the same night during football season! #socialortho
Dr. David Geier @DrDavidGeier
@BubblyHeart @PranaPT No worries Sarah. Ann might be a little snarky herself #socialortho
Ann Wendel @PranaPT
Tonight we’re talking about how to handle situations where your rec’s as a healthcare provider are at odds w pt’s goals #socialortho
Ann Wendel @PranaPT
@DrDavidGeier @BubblyHeart Watch it, buddy! #socialortho
Dr. David Geier @DrDavidGeier
@PranaPT I have to believe every healthcare provider has dealt with this issue. Can’t wait to hear your opinions #socialortho
Ann Wendel @PranaPT
Q1: Have you had patients who seem to want very different outcomes than you do as their PT, athletic trainer or MD? #socialortho
Dr. David Geier @DrDavidGeier
It seems like I have several patients a day who want quick pain relief and not an actual long-term treatment for their injury. #socialortho
Ann Wendel @PranaPT
@DrDavidGeier Me too. Many times patients get frustrated by the process of physical therapy.It does take time. #socialortho
Jeff Zerfas @Zerfas_ATC
I’d agree with Doc most people want the pain gone but not the cause of the pain. Must want instant gratification #socialortho
Mike Hopper @mnhopper1s
@PranaPT Definitely #socialortho my kids all want the fix that gets them back on field ASAP. Not always doable. Must consider long-term
Sarah @BubblyHeart
@DrDavidGeier That was totally me! Thought Doc was one to fix me. Didn’t get that I had to do the work to get well. #socialortho
Ann Wendel @PranaPT
@kmessina15 What do they want you to do to give them the quick fix? Tape? Brace? #socialortho
Steven Kleinman @StevenRKleinman
@DrDavidGeier everyone wants quick pain relief just not everyone understands they haven’t necessarily fixed the problem #socialortho
Mike Hopper @mnhopper1s
@PranaPT @kmessina15 I decided 9 holes of golf was enough of a workout for me today. Was going to lift weights #socialortho
Ann Wendel @PranaPT
@Zerfas_ATC Yes, what are some ways we can discuss this with them? #socialortho
Dr. David Geier @DrDavidGeier
@PranaPT I hear you. I feel like I have to talk them into PT. I’m not big on cortisone shots, but so many patients want them #socialortho
Sarah @BubblyHeart
@PranaPT @DrDavidGeier Takes time! But itty bitty bits add up quick. Key is to be participating in own rehab at HOME. #socialortho
Ann Wendel @PranaPT
@BubblyHeart @DrDavidGeier Sarah, do you feel that there was enough patient education to let you know what was expected of you?
#socialortho
Mike Hopper @mnhopper1s
@PranaPT @kmessina15 #socialortho That pretty pink @Rocktape sure seems to make things a lot better! 😉
Sarah @BubblyHeart
@DrDavidGeier @PranaPT Watched twin sis go through that this year. 2 rounds of cortisone and a scope… Some PT. Still no good. #socialortho
Dr. David Geier @DrDavidGeier
@KeatingSports Very true. I’m all for quick pain relief, & I try to emphasize treatments that prevent problem from coming back #socialortho
Ann Wendel @PranaPT
RT @mjcDPT: yes definitely. 1 of our PTs had issue w ped parent who wants son to walk when indications make it very difficult #socialortho
Ann Wendel @PranaPT
@kmessina15 Exactly. How do you educate them on the need to fix the root problem? #socialortho
Dr. David Geier @DrDavidGeier
@BubblyHeart That’s not to say we can’t fix structural problems surgically or overuse problems w other tx. But pt has to buy in #socialortho
Ann Wendel @PranaPT
@BubblyHeart Is that something that took you a while to realize? The need to do HEP? #socialortho
Zack Duhamel @zduhammy
@PranaPT @kmessina15 thats a big question…trying to tackle a common human problem..we want to things…and we want them now #socialortho
Dr. David Geier @DrDavidGeier
@mnhopper1s @PranaPT @kmessina15 Don’t even know where to start… #socialortho
Sarah @BubblyHeart
@PranaPT @DrDavidGeier No. Had 2 learn thru 20yrs experience as pt. Good thing I knew what I was getting into last go ’round. #socialortho
Ann Wendel @PranaPT
So maybe it comes down to managing patient expectations by educating them about their role in the process. Thoughts? #socialortho
Zack Duhamel @zduhammy
@PranaPT @kmessina15 my inexperienced opinion would say, sell the benefits of LONGTERM health if you fix the root #socialortho
Dr. David Geier @DrDavidGeier
@StevenRKleinman I’m sure you see it too, with modalities, other tx for pain relief but no patient interest in exercise program #socialortho
Ann Wendel @PranaPT
@kmessina15 I think especially hard with teens who have trouble thinking longer term than this weekend’s game! #socialortho
Steven Kleinman @StevenRKleinman
@DrDavidGeier I am not a big modalities guy, stim and taping that’s it and not nearly as much stim as I used to #socialortho
Ann Wendel @PranaPT
RT @EricaMeloe at the IE,I ask what they #value the most,what has meaning for them.That way we follow the same path together. #socialortho
Mike Hopper @mnhopper1s
@DrDavidGeier @PranaPT @kmessina15 haha! #socialortho I take it you’re not sold 😉
Sarah @BubblyHeart
@PranaPT Yeah, the fitness is still new to me. I’m a patient with a sports type injury who had never been an athlete. #socialortho
Steven Kleinman @StevenRKleinman
@DrDavidGeier #socialortho I explain to patients why I don’t do more and they seem to get it
Dr. David Geier @DrDavidGeier
@zduhammy @PranaPT @kmessina15 True. Same in youth sports. Fix underlying issue – mechanics, overuse – for long-term benefit #socialortho
Ann Wendel @PranaPT
@BubblyHeart That’s an interesting perspective – patients who are not used to exercise may not see the value at first. #socialortho
Sarah @BubblyHeart
@DrDavidGeier Agreed. If patient doesn’t buy in is waste of everyones time and resources. There is pride in getting well. #socialortho
Dr. Monique J Caruth @mjcDPT
@kmessina15 @PranaPT #socialortho do u guys ever wonder if our culture created this dependency on passive modalities/treatment?
Ann Wendel @PranaPT
@BubblyHeart @DrDavidGeier sarah,as a patient,what helps get your “buy in”? #socialortho
Dr. David Geier @DrDavidGeier
@mnhopper1s @PranaPT @kmessina15 Honestly I don’t know that particular one. The pink comment tells me what I need to know!
#socialortho
Ann Wendel @PranaPT
@DrDavidGeier @mnhopper1s @kmessina15 Don’t hate on pink! #myfavoritecolor #socialortho
Ann Wendel @PranaPT
@mjcDPT Well, that is what people used to think of when they heard PT – ice, stim, US #socialortho
Mike Hopper @mnhopper1s
@PranaPT @DrDavidGeier @kmessina15 It’s #ThinkPink October! Gotta have the pink! #socialortho
Dr. Monique J Caruth @mjcDPT
@PranaPT @kmessina15 #socialortho we should adopt a “scared straight” strategy. If root issue isn’t taken care of now longterm issues costly
Ann Wendel @PranaPT
@EricaMeloe had a good point about asking the patient at the first visit about what THEY value to get them on board. #socialortho
Dr. David Geier @DrDavidGeier
@StevenRKleinman Most PTs I know use modalities sparingly, if at all. Think same issue with convincing pts to do home exercises #socialortho
Steven Kleinman @StevenRKleinman
@PranaPT @mjcDPT some still think that thanks to Dr Oz #socialortho
Sarah @BubblyHeart
@PranaPT @DrDavidGeieras Personality! The right Doc who takes interest in making me well. Same with PT. #socialortho
Ann Wendel @PranaPT
RT @BubblyHeart: @PranaPT @DrDavidGeier Personality! The right Doc who takes interest in making me well. Same with PT. #socialortho
Mike Hopper @mnhopper1s
@PranaPT @EricaMeloe our PT eval has spot for “goals” and “patient’s goals.” #socialortho
Dr. Monique J Caruth @mjcDPT
@PranaPT roommate of college rugby player had ACL reconstruction, surgeon rec PT, he refused so works out at gym to heal self #socialortho
Ann Wendel @PranaPT
@StevenRKleinman @mjcDPT #truth #socialortho
Dr. David Geier @DrDavidGeier
@BubblyHeart I see it w athletes, people who like to exercise too. Yes, there is pride in healing, avoid recurrence of problem #socialortho
Ann Wendel @PranaPT
So taking the time to ask about patient’s goals and taking an interest in them helps get them on board. #socialortho
Mike Hopper @mnhopper1s
@kmessina15 @PranaPT @DrDavidGeier You can send it to me, but you better hurry. Our #DigForPink volleyball game is next week! #socialortho
Sarah @BubblyHeart
@PranaPT @DrDavidGeier My 3rd ACL should have never happened. That Doc was NOT interested in my outcome, only his as academic. #socialortho
Steven Kleinman @StevenRKleinman
@mjcDPT @PranaPT can’t fix stupid #socialortho
Sarah @BubblyHeart
@DrDavidGeier I would think that’s a delicate balance. Twitter drives me nutso sometimes. Opposite end, ppl push too much! #socialortho
Dr. Monique J Caruth @mjcDPT
@PranaPT #socialortho education is definitely huge. We have to find ways to communicate with clients better. Get to know them, reach them.
Dr. David Geier @DrDavidGeier
@mjcDPT @PranaPT I hear that from patients all the time. They don’t need PT because they workout at the gym. #notthesamething #socialortho
Ann Wendel @PranaPT
@DrDavidGeier @mjcDPT For things like a knee scope I often suggest that MD offer patient a “3 visit program.” See PT 3x. #socialortho
Steven Kleinman @StevenRKleinman
#socialortho had Pt recently say why do I need PT if I can go exercise at gym….oh I don’t know….cause ur not feeling better
Erica Meloe @EricaMeloe
@Zerfas_ATC @PranaPT Not all athletes, especially the ones who are out of the playoff races. #socialortho But I agree, most athletes get it
Ann Wendel @PranaPT
@mjcDPT And we need to show the correlation b/w the exercises/treatment and pt’s goals #socialortho
Dr. David Geier @DrDavidGeier
@BubblyHeart Push too much, as in trying to recover too fast or working too hard? #socialortho
Dr. Monique J Caruth @mjcDPT
@DrDavidGeier @PranaPT #socialortho so crazy but again goes back to the culture we’ve created. Some MDs make PT/AT seem non essential to pts
Dr. David Geier @DrDavidGeier
@PranaPT @mjcDPT 1 of my early mentors sent athletes to PT for one visit before surgery. If they didn’t go, he wouldn’t operate #socialortho
Ann Wendel @PranaPT
RT @kmessina15 I find that explaining how the body works & everything must do its job like a “team” that ath respond well! #socialortho
Erica Meloe @EricaMeloe
@PranaPT Education, cognition, and emotion all a part of the healing process. And of course, matching their goals with yours #socialortho
Sarah @BubblyHeart
@DrDavidGeier Both. Have to have respect for the work of the Doc ya know? Stitches, grafts, all take time to heal. #socialortho
Steven Kleinman @StevenRKleinman
#socialortho I like my patients who I tell them they can be D/C’d and beg to stay longer cause they saw benefit of my supervision
Ann Wendel @PranaPT
@DrDavidGeier @mjcDPT Yes,ideally 1st visit is pre-op then 2 post-op.Pre op visit allows education when pt not in pain/on meds. #socialortho
Mike Hopper @mnhopper1s
@mjcDPT @DrDavidGeier @PranaPT unfortunately I agree #socialortho Drives me nuts!
Dr. David Geier @DrDavidGeier
@mjcDPT @PranaPT I just don’t get that. If we all work together as a team, we can achieve patient short-term & long-term health #socialortho
Ann Wendel @PranaPT
@StevenRKleinman Do you have a cash based Wellness option for them? #socialortho
Dr. Monique J Caruth @mjcDPT
@DrDavidGeier @PranaPT at POPTS suggested to surgeons that surgical candidates should receive min 3-4 PT treatments prior #socialortho
Steven Kleinman @StevenRKleinman
@PranaPT yes I so offer that #socialortho
Dr. Monique J Caruth @mjcDPT
@DrDavidGeier @PranaPT #socialortho improved outcomes drastically & follow through with PT after surgery also improved.
Erica Meloe @EricaMeloe
@mnhopper1s @PranaPT So does mine but you have to ENGAGE the patient with what has MEANING for them. & this of course changes! #socialortho
Howard Luks MD @hjluks
@DrDavidGeier @PranaPT @mjcDPT I test people all the time 🙂 patients need to hold up their end #teamwork #socialortho
Dr. David Geier @DrDavidGeier
@StevenRKleinman You should shoot video testimonials of patients talking about the value of their PT for patients just starting #socialortho
Ann Wendel @PranaPT
The benefit of my practice is many patients have tried everything else by time they get to me.So they listen #socialortho
Quality Physio @QualityPhysio
@CNN Most states have Direct Access to Physical Therapy, Insurances are blocking it! No need for HealthCare Systemcrash #bizPT #socialortho
Dr. David Geier @DrDavidGeier
@mjcDPT @PranaPT Agree. His point was that he wouldn’t operate on anyone who wouldn’t at least try nonop tx/PT #socialortho
Dr. David Geier @DrDavidGeier
@PranaPT @StevenRKleinman Actually that makes sense. Those patients that are so happy with their outcomes in PT would buy in #socialortho
Ann Wendel @PranaPT
@hjluks @DrDavidGeier @mjcDPT How do you test them, Howard? #socialortho
Dr. David Geier @DrDavidGeier
@BubblyHeart Yeah I usually can figure out pretty quickly which patients/athletes I will be fighting to hold back. #socialortho
Ann Wendel @PranaPT
@DrDavidGeier @StevenRKleinman Yes,especially those not yet ready for unsupervised exercise,or don’t know where to start. #socialortho
Howard Luks MD @hjluks
@PranaPT @DrDavidGeier @mjcDPT reading @CentranaHealth info, attend PT or if TKR also try cane etc #socialortho
Erica Meloe @EricaMeloe
@DrDavidGeier Yes,but the buy in is prevention and getting back into the game LONG TERM. I mean look at Peyton Manning!! #socialortho
Sarah @BubblyHeart
@PranaPT @StevenRKleinman I’d buy into that. Got kicked out of PT by insurance- can go back now 6 mos out but time in btwn… 
#socialortho
Ann Wendel @PranaPT
Has anyone ever had a patient leave their practice b/c they wanted to find someone who would give them what they wanted? #socialortho
Dr. Monique J Caruth @mjcDPT
@kmessina15 @PranaPT some just have to learn the hard way. I use to be one of those. #socialortho
Ann Wendel @PranaPT
@BubblyHeart @StevenRKleinman Didn’t they offer you a cash based option to continue? Or a Wellness program? #socialortho
Howard Luks MD @hjluks
@PranaPT of course .. But I sleep well at night #socialortho
Ann Wendel @PranaPT
@hjluks Me too! #socialortho I tell them what they need to hear,not what they want to hear. #socialortho
Mike Hopper @mnhopper1s
@PranaPT definitely. We have some who decide that chiro works better than PT #socialortho Or some who go to both…
Erica Meloe @EricaMeloe
@DrDavidGeier This takes 2 posts sorry! Look at how Peyton has benefitted from PT and hard work and a long term game plan! #socialortho
Dr. David Geier @DrDavidGeier
@EricaMeloe Yes we have to think ahead. And nice job with the Peyton mention! Maybe Derrick Rose vs RGIII similar comparison? #socialortho
Dr. Monique J Caruth @mjcDPT
@PranaPT #socialortho if we can’t explain 2 client why doing a particular exercise helps we’re already disengaging. Fascinate with knowledge
Steven Kleinman @StevenRKleinman
@kmessina15 @PranaPT @DrDavidGeier I don’t trust most unsupervised if not given direction and supervision irat #socialortho
Ann Wendel @PranaPT
@mjcDPT Yes, back to staying engaged,educating on the WHY behind what we do in treatment. #socialortho
Dr. David Geier @DrDavidGeier
@EricaMeloe It was worth two tweets! Yes, especially when that injury could have ended his career #socialortho
Christopher Stewart @cbs301
@PranaPT Difference in patient seeking therapy and MD sending them to therapy #socialortho
Dr. Monique J Caruth @mjcDPT
@StevenRKleinman #socialortho do you have a wellness program after discharge?
Sarah @BubblyHeart
@PranaPT @StevenRKleinman Felt like lots of my time as PT was spent on re-evals and PT paperwork. #socialortho That’s not time well spent…
Ann Wendel @PranaPT
@cbs301 True,but even those who are “sent” may be able to share their goals and we can show how we can help them reach it #socialortho
Sarah @BubblyHeart
#socialortho Occurring to me that PT can be both patient and physical therapist, am I missing a piece of lingo?
Ann Wendel @PranaPT
RT @srharris22: this was HEP given to pt by ortho sx, no review, and told to be NWB 4 hip/ankle injury #socialortho pic.twitter.com/f5NhwuyEZp
Erica Meloe @EricaMeloe
@DrDavidGeier Absolutely!Love Basketball! A little fear avoidance with Derrick? “I’m not ready yet” WHAT? RGIII-total opposite #socialortho
Ann Wendel @PranaPT
@BubblyHeart Sorry! Usually PT = phys therapist and pt=patient #socialortho
Christopher Stewart @cbs301
@PranaPT Definitely. Personal focus and education on potential. We have to fire them up! #socialortho
Ann Wendel @PranaPT
@cbs301 Help them see the WHY not just the HOW or WHAT. #socialortho
Dr. David Geier @DrDavidGeier
@BubblyHeart Hmm. Good point. I use PT for physical therapist and pt for patient. Not to suggest one is more important, though #socialortho
Christopher Stewart @cbs301
@PranaPT Just like we’re in sales. #socialortho
Dr. Monique J Caruth @mjcDPT
@PranaPT yes but I’ve had to grow on dealing better with that & not take it personal. For the clinician it is best #socialortho
Erica Meloe @EricaMeloe
@DrDavidGeier I know!!! What an inspiration!! Since I am #Giants fan, this is going to be a long year for us here in NY! #socialortho
Ann Wendel @PranaPT
@mjcDPT Yes, not every patient is “my” patient. Back to UVP and target population. #socialortho
Ann Wendel @PranaPT
RT @cbs301: @PranaPT Just like we’re in sales. < We are! Selling physical therapy as the solution to their problem 🙂 #socialortho
Dr. David Geier @DrDavidGeier
@EricaMeloe Better watch it. I can talk famous athlete injuries all day. #socialortho
Ann Wendel @PranaPT
RT @DrDavidGeier: @EricaMeloe Better watch it. I can talk famous athlete injuries all day. < Stay focused, Grasshopper #socialortho
Ann Wendel @PranaPT
@kmessina15 @mjcDPT I know that’s right! #socialortho #teenagers
Dr. David Geier @DrDavidGeier
@PranaPT @EricaMeloe That was #rude #socialortho
Ann Wendel @PranaPT
RT @DrDavidGeier: @PranaPT @EricaMeloe That was #rude
Erica Meloe @EricaMeloe
@DrDavidGeier Me too!! a couple of basketball players having knee surgeries over the summer. Hum…..I wonder!?? 🙂 🙂 #socialortho
Dr. Monique J Caruth @mjcDPT
@PranaPT @hjluks #socialortho I love @SandyHiltonPT slogan of the uncomfortable truths…target population
Ann Wendel @PranaPT
#socialortho So in a nutshell: set goals WITH patients,tell them WHY,educate on HOW,encourage them to DO! #socialortho
Erica Meloe @EricaMeloe
@PranaPT @DrDavidGeier Sports get the best of me Ann!! 🙂 🙂 #socialortho
Heather Milligan @HMilliPT
@PranaPT @srharris22 definitely not ideal way to manage a pt,sadly have seen some PTs operate in similar way, we can do MORE #socialortho
Ann Wendel @PranaPT
@EricaMeloe @DrDavidGeier I just try to keep him on track! #lolololol #shinythings #overhere #socialortho
Christopher Stewart @cbs301
@PranaPT I think too many PTs do not think of it like this. #socialortho
Dr. David Geier @DrDavidGeier
@PranaPT I think we got to 1 of the 6 questions we had on short-term vs long-term goals of patients, athletes. What a group! #socialortho
Ann Wendel @PranaPT
@cbs301 Sadly, I agree. #socialortho Marketing is not a dirty word.
Ann Wendel @PranaPT
@DrDavidGeier No, I got at least 3 in there,I just forgot to number them! #socialortho
Mike Hopper @mnhopper1s
RT @kmessina15: @mjcDPT @PranaPT I’m fascinate with knowledge – I keep myself engaged lol #nerd #foreverstudent #socialortho
Dr. Monique J Caruth @mjcDPT
RT @kmessina15: @mjcDPT @PranaPT I’m fascinate with knowledge – I keep myself engaged lol #nerd #foreverstudent #socialortho
Mike Hopper @mnhopper1s
@PranaPT @DrDavidGeier He’s a doctor; he’s got nurses to count for him! 😉 j/k #socialortho
Ann Wendel @PranaPT
Great group tonight! Thanks everyone for participating! See you on Nov.6 at 9pm ET for next #socialortho
Dr. David Geier @DrDavidGeier
@mnhopper1s @PranaPT Wow. Tough to recover from that… Maybe I need cheerleaders instead? #socialortho
Erica Meloe @EricaMeloe
@PranaPT @DrDavidGeier Excellent! Thank you both for being here !! What fun!! #socialortho
Dr. David Geier @DrDavidGeier
@EricaMeloe @PranaPT It was fun. We should do it again next month! Thanks! #socialortho
Mike Hopper @mnhopper1s
@kmessina15 @PranaPT @DrDavidGeier We’re all hilarious. Sarcasm is just one thing we’re good at! #AT4ALL #laughterbestmedicine #socialortho
Dan E Timm PTA CI @danetimm
“@PranaPT: #socialortho So in a nutshell: set goals WITH patients,tell them WHY,educate on HOW,encourage them to DO! Beautiful #socialortho”
Jeff Galloway @SprtSolutionsBG
@mjcDPT thanks for the follow-back, I was stalking #socialortho. Always good to connect to other Christian PTs
Ann Wendel @PranaPT
@ptguy2001 That’s a winning combination. We need to partner with patients for success. They need to feel heard and understood. #socialortho
Remember to join the #socialortho tweetchat every month. We hold them the first Wednesday of each month at 9 PM ET unless we announce a change. Follow me on Twitter, and follow co-moderator Ann Wendel, for more information!
