Answers (9)
3
Hello,
I am new to IDEA and wanted to weigh in on this question as I have experience on both sides of the ball....a third year PT student as well as a NSCA-CPT and CSCS.
First, let me say that I agree with all of the comments posted here in one form or another. As LaRue has excellently stated, you should never interfere with the medical relationship between a patient and his/her PT and/or MD. This is also a standard amongst the professions. As a PT I never question an MD's orders in front of a patient. If I have questions I do as Jeff has advised and open up a dialogue with the MD in hopes of getting him/her into my way of thinking.
Secondly as Joanne has said, and please know I am being objective about this even if I am a PT, we often know much more about our patient's than their trainer (and in most cases we also know more about them then the MD). Not just speaking to their fitness, but also any additional medical factors that may need to be taken into account with respect to exercise. Shawn also brings up a GREAT point. Often MD's know the very basics of an exercise prescription (which is why their patients come to PT), but therapists are much more knowledgeable and in more of a medical sense as well. A PT spends quite a bit of time with patients and gets to know their abilities and limitations quite well.
Is it OK to ask a client to have their PT contact you as Shawn has suggested? ABSOLUTELY! I wish more trainers would! My goal for my patients is to not simply to treat them and send them on their way, I want to promote a wellness lifestyle, as do many PTs. Getting our patient in the hands of a qualified trainer after rehab really should be the norm in my opinion.
So my suggestion is to try to establish that contact. Make the connection and see what comes of it. Believe me when I say that PTs can learn a lot from the fitness profession (I have taught many of my clinical instructors a thing or two about exercise). However if you do come across the PT or MD that is not willing to listen I implore you to follow their script to the letter. Remember that there may be factors involved you are not aware of and no matter what your knowledge base is or how well versed you are as a trainer, the last thing you want to do is go against a script and end up in the wrong. Your client can be hurt, and what's more your reputation and business as well.
I am new to IDEA and wanted to weigh in on this question as I have experience on both sides of the ball....a third year PT student as well as a NSCA-CPT and CSCS.
First, let me say that I agree with all of the comments posted here in one form or another. As LaRue has excellently stated, you should never interfere with the medical relationship between a patient and his/her PT and/or MD. This is also a standard amongst the professions. As a PT I never question an MD's orders in front of a patient. If I have questions I do as Jeff has advised and open up a dialogue with the MD in hopes of getting him/her into my way of thinking.
Secondly as Joanne has said, and please know I am being objective about this even if I am a PT, we often know much more about our patient's than their trainer (and in most cases we also know more about them then the MD). Not just speaking to their fitness, but also any additional medical factors that may need to be taken into account with respect to exercise. Shawn also brings up a GREAT point. Often MD's know the very basics of an exercise prescription (which is why their patients come to PT), but therapists are much more knowledgeable and in more of a medical sense as well. A PT spends quite a bit of time with patients and gets to know their abilities and limitations quite well.
Is it OK to ask a client to have their PT contact you as Shawn has suggested? ABSOLUTELY! I wish more trainers would! My goal for my patients is to not simply to treat them and send them on their way, I want to promote a wellness lifestyle, as do many PTs. Getting our patient in the hands of a qualified trainer after rehab really should be the norm in my opinion.
So my suggestion is to try to establish that contact. Make the connection and see what comes of it. Believe me when I say that PTs can learn a lot from the fitness profession (I have taught many of my clinical instructors a thing or two about exercise). However if you do come across the PT or MD that is not willing to listen I implore you to follow their script to the letter. Remember that there may be factors involved you are not aware of and no matter what your knowledge base is or how well versed you are as a trainer, the last thing you want to do is go against a script and end up in the wrong. Your client can be hurt, and what's more your reputation and business as well.
0
This is a tough question, which i have encountered only a small number of times. Despite better judgement, i always rule with the physician's exercise prescription. Legally, you have to. However, i have on one occasion called the physician to talk with them about it. He seemed flexible and open to my thoughts.
My suggestion would be to contact the physician and discuss the matter. While i wouldn't approach it as "i don't think this is right" but rather "i had some ideas on some other options the client could benefit from. Are you open to hear my suggestions?"
Hope this helps.
My suggestion would be to contact the physician and discuss the matter. While i wouldn't approach it as "i don't think this is right" but rather "i had some ideas on some other options the client could benefit from. Are you open to hear my suggestions?"
Hope this helps.
0
Karin, this will likely sound like a cop out, however, this is how I would handle it.
I'd defer to the licensed professionals.
Let's say that you express how you feel about the physician's or physical therapist's approach to post rehab and/or the exercise prescription for the patient living with a clinical condition. I am sure you recognize they likely know much more about their patient than you do. What would you do if they ask you what protocols do you follow? How would you respond?
I am learning (as a consequence of this course that I am taking with Dr. Mike who has earned in PhD in Physical Therapy), that PT's and physicians aren't too keen when fitness professionals question their expertise. (www.postrehab.com)
In the fitness industry, we do not have protocols and algorithms that we adhere to that fitness professionals agree upon on a national level. Physicians and physical therapists do. Even if physicians and physical therapists don't agree upon the protocol it is highly like that they are aware of the protocol. That's one of the beauties about licensing. Licensed professionals have a governing body that they adhere to.
FYI, I am excited about this course that I am taking as Dr. Mike's medical exercise specialist course is the only post rehab course that has post rehab protocols in place for the many different conditions that we will likely come in contact with.
Hope this is of help to you Karin.
I'd defer to the licensed professionals.
Let's say that you express how you feel about the physician's or physical therapist's approach to post rehab and/or the exercise prescription for the patient living with a clinical condition. I am sure you recognize they likely know much more about their patient than you do. What would you do if they ask you what protocols do you follow? How would you respond?
I am learning (as a consequence of this course that I am taking with Dr. Mike who has earned in PhD in Physical Therapy), that PT's and physicians aren't too keen when fitness professionals question their expertise. (www.postrehab.com)
In the fitness industry, we do not have protocols and algorithms that we adhere to that fitness professionals agree upon on a national level. Physicians and physical therapists do. Even if physicians and physical therapists don't agree upon the protocol it is highly like that they are aware of the protocol. That's one of the beauties about licensing. Licensed professionals have a governing body that they adhere to.
FYI, I am excited about this course that I am taking as Dr. Mike's medical exercise specialist course is the only post rehab course that has post rehab protocols in place for the many different conditions that we will likely come in contact with.
Hope this is of help to you Karin.
0
recommend a second opinion, I run into this all the time. When it comes to physicians, unless they are specialists they really don't know exercise prescription thats why trainers have doctor clients. Physical therapist on the other hand tend to be quite a bit more accurate and all the ones that I have encountered are really surprised about me asking my clinet to have them call me and are more than willing to talk about it with a clients consent. In fact this is a great way to get more referrals from the medical field if its done right.
0
DO NOT interfere with the professional medical relationship of your client and his/her licensed healthcare provider. In my opinion, your options are: call the provider yourself to discuss your concerns, or work within the confines of what the provider has ordered, or do not work with the client if you cannot comply. That's it!
LaRue, CSCS
www.lecfitness.com
lecfitness@yahoo.co
LaRue, CSCS
www.lecfitness.com
lecfitness@yahoo.co
0
Establishing a line of communication with the health care professional (HCP) is usually best. My lead in line with any HCP is something like this: Hello, I'm working with a patient of yours "John Doe" to help him "X", I'm contacting you to ensure that the techniques I'm using are safe and complimentary to your strategy (i.e., Home Exercise Plan). Let them know that they are in-charge and that you respect their professional advice. If you can get to this point, then opening up dialogue is usually easier as the "defenses" are reduced. After that, offer your general strategy and why by using complimentary vs. conflicting language. I always try to ask questions in hopes of making the idea appear as if it is the HCP's and then sprinkle in my own two cents toward the end of the conversation.
Bottom line: View the dialogue as an "opportunity" rather than a "challenge" and hopefully you'll establish a new referral source!
Hope this helps!
Jeff Groh
www.AuthenticMotion.com
San Diego, CA
Bottom line: View the dialogue as an "opportunity" rather than a "challenge" and hopefully you'll establish a new referral source!
Hope this helps!
Jeff Groh
www.AuthenticMotion.com
San Diego, CA
0
Hello Karin,
I havent experienced that situation and have known the Physical Therapists my clients were using. If this were the case, I would call the Physical Therapist and discuss the exercises. Like LaRue stated, "dont interfere" and if are not comfortable, then refer your client to another trainer or back to their Physical Therapist.
Sincerely,
Michael
I havent experienced that situation and have known the Physical Therapists my clients were using. If this were the case, I would call the Physical Therapist and discuss the exercises. Like LaRue stated, "dont interfere" and if are not comfortable, then refer your client to another trainer or back to their Physical Therapist.
Sincerely,
Michael
0
I ask my client to double check with the PT or Physicians assistant and to ask them why the exercise is being prescribed.
If I still don't feel right about it I won't do the exercise with my client but will have them do it on their own by following the instructions given by the PT.
If the PT wants to talk to me they call me, I am totally in favor of communicating!!
If I still don't feel right about it I won't do the exercise with my client but will have them do it on their own by following the instructions given by the PT.
If the PT wants to talk to me they call me, I am totally in favor of communicating!!
