Elevating Person-Centered Care in Physical Therapy
The art of connecting with people is an implicit skill honed throughout our educational journey as providers who practice patient care. From the knowledge gleaned in educational programs to our clinical practice, we scaffold the art and experiences necessary to evolve as providers who listen, connect, support, and care.
As physical therapists, we treat patients who are in pain and experience limits. We engage with patients who live alone, who’ve suffered, and who have lost human interaction in their lives. Physical touch is incredibly powerful; however, kindness, the human connection, and relationships might be more powerful than the numerous clinical interventions we’ve mastered as providers. This connection with our patients helps us grow and provides professional satisfaction.
Focusing on and prioritizing patients using the technique of person-centered care demonstrates authenticity to our patients and encourages trust and confidence in our ability to heal. In this article, we’ll take a look at person-centered care and how to incorporate it into your practice.
Person-Centered Care: What Does That Mean?
Person centered care refers to a philosophy or attitude in the delivery of care that reflects the needs of the individual and places the patient at the forefront, prioritizing their goals, values, and preferences throughout the rehabilitation process.1 The person-centered approach emphasizes shared decision-making and ensures that physical therapy techniques and interventions are tailored to align with the patient’s needs, ultimately leading to more meaningful and satisfactory outcomes.
At times, person-centered care is at odds with our trained clinical approach, which is grounded in science and objectivity. But sometimes this approach lacks focus on the relationship, resulting in detachment from the people we intend to heal. The person-centered approach requires us to fully engage in understanding all the factors (biomedical, psychological, and social) that bring people to our clinical practices, including their goals and desires. It’s important that we follow an evidence-based approach while also discussing and addressing all of the factors that might contribute to a person’s musculoskeletal presentation during the course of care.
What Does Person-Centered Care Look Like in Practice?
Person-centered care is something I personally reflect on consistently when seeing patients in the busy hospital-based outpatient practice where I provide care. I believe reflection is a critical component of patient-centered care, yet often the pace of the clinic, the unforgiving nature of documentation, and the constraints of time afford little opportunity for such reflective practice. Maintaining a steadfast focus on the patient as the guiding compass or North Star throughout our sessions ensures that I’m focused on their needs.
Frequently, I initiate a clinical session with prompts such as, “Tell me what you think we should focus on today,” or “Share a challenge you encountered this week that we can address today.” Initiating each session of care with a person-centered statement keeps me tuned in to my patient’s perceptions and needs over mine as the provider. Person-centered care may only require modest modifications to the learned routines we execute as providers.
Person-Centered Manual Therapy: A Modern and Evidence-Based Approach
In the 10-course Certificate Program that Dr. Chad Cook and I have created, we provide a sensible, balanced, pragmatic approach to manual therapy assessment and treatment, yet throughout the series, we emphasize the importance of the person. We discuss when manual therapy is and is not appropriate based on a patient’s presentation and expectations for care. We jointly acknowledge and promote a person-centered approach to care by emphasizing ways to effectively communicate with patients, observe their movements, prescribe augmented exercises, set shared goals, and foster an alliance.
The certificate program builds on a strong foundation of four introductory courses that provide a comprehensive overview of person-centered care and introduce key topics such as social determinants of health, therapeutic alliance, and motivational interviewing.
We take pride in our eclectic approach, which is informed by research from scientists worldwide and complemented by a messaging strategy that places patients at the forefront. The primary goal of our certification series is to provide learners with the knowledge and skills to confidently deliver quality manual therapy and augmented exercises while fostering knowledge of the core tenets of person-centered care. We believe that manual therapy is an option that nicely fits the constructs of person-centered care and the evidence for its use is strong; however, we encourage clinicians to provide patients with choices with regards to interventions and let them decide.
References
1. Hammon, R., Stenner, R., & Palmer, S. (2022). What matters most: a qualitative study of person-centered physiotherapy practice in community rehabilitation. Physiotherapy Theory and Practice, 38(9), 1207–1218.
