There is a phrase that is relatively well known now. It is one of those cliches that get thrown around now and then. To make a change to someone, or to connect to someone, ‘you have to meet them where they are’. This is used a lot in a psychology context, in a business or leadership context, but it is something that I live by within physio as well.
There is value to medical jargon as a health professional. It adds to the cognitive biases of the patient that you are an expert, and hopefully just that will translate into adherence and compliance to your program. But what research tells us is that rapport building and creating a robust and strong relationship with the client is more important to clinical outcomes (Leach, 2015; Klaber, 1997), and that use of medical terminology can actually serve as a barrier to patient understanding and therefore compliance.
I’m not saying the throw the baby out with the bath water. There is a time and a place to show off your fancy lingo, explaining just exactly what the zygo-apophyseal joints are, and using the word nociception, but to me it isn’t where understanding is formed. This is one place where the ‘meet people where they are’ idea comes into it. If the patient is that way inclined, go for it, but a majority of our patients (or at least mine) just want to know in lay terms, what is happening.
Now this isn’t ground-breaking, it isn’t anything new and if it was my main contention, this piece would be relatively pointless and frankly quite an arrogant blog post to share.
What I have found is the value of physically meeting someone where they are. The value of taking the time constraint out of the patient’s hands of dropping the kids off, or getting someone to look after their elderly parent while they go for a physio session. The time of organising, driving, parking, waiting for the physio to be inevitably 5 minutes late, then paying, booking another appointment and driving home doesn’t always equate to the time in the physio’s care. Especially if we are talking about 20-minute appointments.
During my time doing home visits, I have found patients to be generally much more receptive to information, much more adherent to programming and grateful for the effort being made to come to them. Like above, this doesn’t apply to everyone, and there are times where I recommend people go to a rehab specialist with larger facilities.
But for those that find it difficult or find going to a facility a barrier to entry, the ‘meet people where they are’ principle is a huge tool in rapport and trust building. As they are in their own comfort zone, I have found patients to feel much more in command of the journey of the program, which is what client centred practice aims for everyone.
Community based work, can create a massive boost in rapport and relationship building, and therefore, trust, compliance and ideally, good client outcomes.
Nathan Orenstein B.Physio (Hons)