Discharge from care

Neil - Doctor of PhysiotherapyUncategorized0 Comments

The concept of ‘discharge from care’ in Physiotherapy is an interesting one.

If we’re ever unfortunate enough to end up in a hospital, we will eventually be ‘discharged’ and sent home i.e. we no longer require the assistance of a Physiotherapist or we at least have the means to take care of ourselves.

A lot of Chiropractic models are based around receiving periodic ‘adjustments’ to maintain good health; recommended indefinitely. Some models of Osteopathy have similar concepts around ‘wellness’; receiving periodic treatments to stay well. Chiropractors and Osteopaths typically don’t operate within a medical (hospital) setting where most people are eventually ‘discharged’ home or moved elsewhere.

Because the Physiotherapy profession has traditionally revolved around rehabilitation from injury, there’s always been a finite end-point; nobody remains in rehab forever! Injuries repair whether we like it not and symptoms resolve, then it’s “bye bye until you need us again”. *One* measure of success in hospital Physiotherapy (and to a lesser extent private practice) is patient discharge as a KPI – how quickly and how many. If someone has been discharged from care, our job is done – right?!

Who wants a client-for-life?

Well, I do!!!

Injuries heal, aches and pains are typically temporary and people learn to live with persistent pain. It’s almost like ‘wellness’ is a dirty word in Physiotherapy. Every second practice these days though offer clinical Pilates and yoga, albeit with a Physio hat on – it’s generally sold as a tool for rehab or to ‘reduce the risk’ of [insert fear du jour].

Insurance companies aren’t interested in Physiotherapy helping their customers if they’re not in pain or broken. They don’t pay for ‘maintenance’… and maintenance of what exactly? It’s one thing preventing someone from going backwards, but it’s an entirely different challenge to ‘improve’ ones physical health – I’m over 40 and it’s f’ing hard work! It’s also worth noting that the health of the average joe is generally a long way behind where it should be.

What happened to us helping people *improve* their physical health when they’re not sick and injured? What happened to the adage of ‘prevention is better than cure’? Why isn’t the profession helping people to get into the best physical shape they can – empowering them with the knowledge and skills to become independently healthy individuals – to reduce the burden on the medical system?

Injuries and non-medical aches and pains don’t kill people but decades of physical inactivity, heart disease and the unforgiving age-associated decline in physical health – that shit is killing us in droves. I wish my dad was still around, but he became a statistic at 67.

Early last month I shared a study published in the American Journal of Medicine in which Assoc. Prof Dr. Arun Karlamangla said “we should be trying to maximise and maintain muscle mass” because building muscle mass is important in decreasing metabolic risk. And another study published in ‘Circulation’, the Journal of the American Heart Association, had some sobering statistics:

More than 70% of total cardiovascular events, 80% of coronary heart disease events, and 90% of new cases of diabetes appear to be attributable to just a handful of basic lifestyle factors: poor dietary habits, inadequate physical activity, and excess body fat.

The benefits of physical activity are remarkable and widespread. Physical activity and fitness are associated with 30% to 50% lower risk of cardiovascular events with great benefit achieved with only modest activity, e.g., 30 minutes of brisk walking on most days.
http://circ.ahajournals.org/content/117/23/3031

Prevention IS better than cure. We Physiotherapists can and *should* be addressing this and making ‘health’ our priority instead of ‘selling sickness’. The solution is to address lifestyle choices, not the subsequent symptoms!

These days, Physiotherapists typically graduate with a double-degree including an exercise-based Bachelor of Science. In private practice, we have *so* much more to offer than just ‘rehab’. We can teach and inspire people to become independently healthy. We can reduce the risk of someone become a statistic – that is immeasurably more important than patching them up and sending them on their merry way.

It’s not just about the client in front of us either. If a good Physiotherapist can INSPIRE their client to live a healthier and happy life, their behaviour will likely impact the lives of those nearest and dearest to them – parents, partners, friends and children.

Ask us how we can inspire you to live a healthier life and get more fun and enjoyment from the life you live.

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