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Lorrimer Moseley asked us today to share practice about inclusion of pain strategies and delivering the message in msk outpts. I& #39;m just putting some thoughts together. My observation is people arrive in msk outpts often not knowing what we can offer with...
2/a variety of expectations some influenced by Gps, ahps,prior experience. There is sometimes a story outside of the room or opinion that influences the conversation ie the nhs is not fit for purpose, there& #39;s no money for scans. Diagnoses may be held onto which have adversely...
3/ influenced their outcome or sometimes helped them accept certain things. The challenge we discussed as a clinician with morals and ethics how far do you go to challenge these beliefs what strategies can you use. I& #39;m no expert but some things that have helped my practice...
4/a conversation about the conversation what& #39;s on offer, what we can do, what& #39;s on the table. Education often starts for me just about whether there is even a conversation to be had. I try to plant seeds considering the long game for future conversations, try to identify ....
5/ discrepancies in their understanding with best practice or evidence informed practice. I try to use analogies to help explore concepts or to offer an alternative narrative. I avoid being personal about a previous health professional s diagnosis or explanation if historical..
+accurate acknowledge medical advances + the complexity, if reductionist try to help build this into a larger model so still has a part to play but zoom out to explore the bigger picture. I use humor as a vehicle sometimes to explore contradictions in thinking. I explore anatomy
6/ to help understand why things hurt. Thing I don& #39;t often do is ask for permission to get into conversations around more complex concepts. I do probe to explore prior knowledge and understanding. I do look to promote 2 way dialogue and invite information...
7/ to be challenged. I set scene for 2 way process today and with other clinicians I look to promote a more collaborative involvement in their own care. I explore options to get differing opinions or acknowledge sometimes we as health professionals have the right message but..
8/ don& #39;t click with a person or are clumsy in delivery. I acknowledge life and difficulty but also give my opinion as to adequate dosing. I write down lists of things tried and key words on a piece of paper between us so can revisit and recap with their own phrases and explore
9/ these or explore how when and what a particular treatment involved and whether it can be discounted or whether it was suboptimal in some way. I try to explore expectations they had for treatments and clarify what we would expect in line with diagnosis. I utilise opt in, ...
10/ sign posting and safety netting acknowledging the time may not be right but door always open. I highlight resources to echo my messages or reinforce them and also to allow people to go away and further their understanding and challenge me. I include more complex ideas even
11/ if simple resolving pathology i think if I have the rapport today I may influence future thoughts and beliefs if more serious issues, again this is only planting seeds. Mostly i try to be human and act with compassion but opening the door to change i see..
12/ my role as an msk physio as one of a coach facilitating a recovery through education, understanding and demystifying care. Anyway as a thread not sure if I addressed the qu in hand or just did a brain splurge anyone who has made it this far sorry!
