English 250
Matt Beth
As
the “baby-boomer” generation nears the age of retirement, the demand for
physical therapists is increasing at an exponential rate. Physical therapists,
diagnose, comfort and rehabilitate individual’s who have either had an accident
that has impaired their movement or if an individual’s movement has been
impaired due to aging. When a patient goes in to see their physical therapist
the diagnoses that they receive are more often than not negative and hard to
hear. Given these situations, physical therapists must deal with the delivery
of their news with great care and tactfulness. Across the board in the medical
field, including physical therapy, a balance between professionalism and
understanding is crucial in successfully delivering negative diagnoses and prognoses.
Clearly,
a medical professional isn’t going to approach his or her patient saying, “You
broke your foot and you can’t walk for weeks! That sucks man!”. A certain level
of professionalism and bluntness must be kept when conveying such news. When discussing
this topic with a family friend who was also my former physical therapist,
Brian Schmit, he had this to say “The best way we do this is to make sure they are involved in the
process and lay everything out for them so they are engaged with their plan of
care.” (Ryndak). He went on to describe how he likes to be blunt about every
part of the process of treatment and that in doing so, the patient is much more
driven and hardworking. Brian also stated that a big part of what his talks
consists of forming goals with his patients. Setting out a plan of action
leading to an end goal is also conducive to a positive mindset. Without a
positive mindset and consistent hard work, it is extremely difficult for a
client to rehabilitate back to 90 – 100% normal functioning (which is what a
physical therapist’s goal is to reach). In an article entitled “SPIKES—A
Six-Step Protocol for Delivering Bad News: Application to the Patient with
Cancer” six different oncologists came together to describe the methods in
which they deliver “breaking bad-like” news to their patients. While obviously having
cancer and having a torn anterior cruciate ligament are two very different
ailments, the same core concept of bluntness and goal setting can be seen even
in the extremeness of oncology, as well as across the medical field. The
oncologists wrote “Patients who have a clear plan for the future are less likely to
feel anxious and uncertain.” (Baile, 8) which runs parallel with what Brian
Schmit and I had discussed in our interview.
While
having professionalism and being blunt are key factors to successfully
delivering negative diagnosis, one must also have a certain level of empathy.
Empathy in its simplest form is one’s capability of understanding and sharing
the feelings that another person has. This is a crucial characteristic for a
physical therapist because without it, the therapist would come across as cold
and uncaring, thus driving a wedge between the therapist and patient and
leading to a negative attitude towards the recovery process. Empathy is one of
the strongest ways to form a connection or bond with another human being, which
is half of the job of a medical professional. In the article mentioned earlier
“SPIKES—A
Six-Step Protocol for Delivering Bad News: Application to the Patient with
Cancer” the six oncologists also pointed out the importance of support
and understanding. In the process that the doctors describe, they broke it down to the smallest finite details such like body gestures to show
understanding which is exemplified by the quote “Maintaining eye
contact may be uncomfortable but it is an important way of establishing
rapport. Touching the patient on the arm or holding a hand (if the patient is
comfortable with this) is another way to accomplish this.” (Baile, 5). While
having empathy and being understanding might seem simple or common sense, Carol
M Davis would argue otherwise. Davis is a professor in the department of
orthopedics at the University of Miami and has received multiple awards for her
work in physical therapy and human socialization. In her article “What is
Empathy, and Can Empathy Be Taught?”, Davis tackles the fact that most people
struggle with the concept and implementation of
empathy. She continues on to say that empathy cannot be taught but
rather must be learned by one’s self and it comes from within. By having no way
to truly learn empathy and the concept of empathy being as ambiguous as it is,
a physical therapist’s delivery becomes much more complicated and must be
approached with great care, in order to not come off as cold or uncaring.
With
the proper blend of direct information and understanding and compassion, the
unpleasant task of delivering a undesirable diagnosis and/or prognosis becomes
easier not only for the medical professional but the patient as well. When
delivering the news, one should be
honest and upfront about all information regarding the client’s situation, it
is after all their body and they have the right to know all the details. It is
also extremely important to set goals after delivering all the details. This
leads to a positive mindset and the patient is prone to be hardworking in the
road to recovery. Throughout the process, providing support and comfort for the
patient is crucial, no matter the how extreme or minute their medical situation
is. If all three factors can be achieved, bluntness, goal setting and support,
the patient will be in the best position possible, mentally and emotionally, to
start down the road to recovery and rehabilitate as fast and as well as they
can.
I used sources from my annotated bib for my works cited
· Ryndak, Nathan M.
"Interview of a Physical Therapist." Telephone interview. 13 Mar.
2014.
· Davis, Carol M.
"What Is Empathy, and Can Empathy Be Taught?" What Is Empathy, and
Can Empathy Be Taught? Physical Therapy Journal, Nov. 1990. Web. 12 Mar.
2014.
This article breaks down what empathy really is
and how it can and should be used in our everyday lives. Empathy is a clearly
an important contributing factor in delivering bad news to a client and their
loved ones, which is why I added this article
· Baile, Walter F., Robert
Buckman, Renato Lenzi, Gary Glober, Estela A. Beale, and Andrzej P. Kudelka.
"SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the
Patient with Cancer." The Oncologist. N.p., Aug. 2000. Web. 12 Mar.
2014.
This article goes over the step-by-step
methodical process of a oncologist delivering negative cancer diagnosis’. This
will be a good article to use to compare and contrast to they way physical
therapists deliver news that is of a lower caliber.
· Fallowfield, Lesley, and
Valerie Jenkens. "Communicating Sad, Bad, and Difficult News in
Medicine." The Lancet 363.905 (2004): 312-19. Science Direct.
24 Jan. 2004. Web. 12 Mar. 2014.
This article also shows how certain professions
deliver unpleasant news in the medical field. This will also work well in my
research paper for comparing and contrasting methods
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