Quality of Care in Rehab by Ian Campbell

What Quality Care Means in Rehabilitation

One can drive through their city and likely notice multiple physical therapy (PT) clinics.
Some may be privately owned and operated, others run by local hospitals. In the United States
alone, rehabilitation is estimated to be a $30 billion industry, with an annual growth rate of 5% or
higher. Due to the booming industry, clinics are likely going to continue to pop up in your area.
It used to be that a healthcare provider held all the cards in the patient-practitioner
relationship. However, within the last three decades, a massive shift in power towards the
patient has taken place. Due to the choice of providers now available to the average consumer,
the patient is now in the driver’s seat of their own healthcare. The variety and competitive nature
of rehab has left consumers with numerous options with whom to entrust their physical health.
So with all of these options for providers, how can a consumer be sure they’re actually getting
quality service? And what sets rehab providers apart from one another? To me, it all comes
down to three important things: listening, education and touch.

Listening IS therapy. Every person seeking healthcare services has a story to tell. Their
story is unique to them, and tells the tale of how they came to require help. Each individual has
a right for their story to be heard and understood by their provider. I hear frustration from
patients who report seeing their physician or physical therapist for only 10 minutes. How can 10
minutes be sufficient to hear and understand someone’s story?
Listening is a skill all humans being should cultivate, especially healthcare providers.
Proper listening gives a certain amount of intimacy to a conversation, and tells others their time
is valued. When human beings feel others are listening to understand, and not purely respond,
we tend to feel empowered through their support. We can all tell when others aren’t listening:
they seem distracted, their eyes might gloss over, or they’re asking you to repeat yourself. None
of these show care or compassion. They show disinterest and can make us distrust our
provider. Listening is something all good physical therapists do well, and it shows our patients
their time is valued.

The education provided by healthcare professionals forms one of the cornerstones to
effective care. A well delivered and appropriately dosed educational intervention should
accomplish three main goals. First, it should explain what the provider expects to accomplish
during your time in rehab. Setting proper expectations for care can make the difference between
an unsatisfied patient and a glowing word-of-mouth recommendation. Secondly, it should
explain why the practitioner is choosing to emphasize certain procedures over others. For
example, being given therapeutic exercises to perform at home is a common occurrence in PT.
Being aware of why these exercises are helpful, and what they intend to accomplish is
paramount for the patient’s adherence and therefore outcome. When people understand the
WHY, the rest typically comes quite easy.

Lastly, good education should empower the patient. Often times people come to rehab
afraid of movement, because they’ve been told nasty stories about their bodies. They’ve been
informed about a slipped spinal disc, that their joints are “bone on bone”, or that their hips are
out of alignment. These statement are rarely true, and end up doing more harm than benefit. In
PT, we cultivate beliefs about the innate strength and resiliency of the human body. Though
people often come to us in fear, and it’s our job to get you back moving and doing the things you love in life.

Most of the time, that involves education about the facts of our body. Sometimes we
just need a trusted source to let us know it’s safe to move. A skilled and value-driven physical
therapist will guide you along your path toward safe movement. Often, we use our hands as a
way to facilitate this, because the importance of physical touch in rehabilitation cannot be

When our bodies hurt enough to seek help, we expect our provider to use their hands as
a tool to understand what we are feeling. If you’ve ever gone to a physician with reports of a
bodily ache, and that provider didn’t place a single hand on you, it’s easy to feel as if something
was missing from that interaction. That’s because physical touch between a patient and provider
helps to validate the concerns about our pain. A physical therapist of quality will use their hands
to both understand your issue and to help create space. This space can take the form of
reduced pain, increased motion, or even increased strength and function. Touch is such an
important part of skilled PT because it can give us the space to move. And without movement,
there’s little chance our bodies can heal and adapt.

There are many more attributes and habits that make a great physical therapist. These
are just three of my own personal staples for quality care. What do you think makes a great
healthcare provider or physical therapist?

Ian M. Campbell, DPT