The Softer Side of PT

It’s been just over six short months since I graduated school and stepped into the clinic as Joe Rinaldi, PT, DPT for the first time. Trading the title of “student physical therapist” for “new clinician” brought with it a simultaneous sense of excitement and anxiety. In an instant, I found myself feeling overwhelmed, questioning my decision making and doubting whether or not I was capable of being a good physical therapist.

I’m happy to report that the initial wave of newness has faded and I have since found a rhythm. I know that I have a lot to learn and a (very) long way to go, but right now, I feel confident and that has done wonders for me. I wanted to use this current wave of confidence to help other healthcare professionals and that led me back to Drexel University where I had the incredible opportunity to present to the current students concerning what I learned in my first six months out of school.

The “soft skills” are the “hard skills.”

I talked about how new clinicians have limited experience in the field of physical therapy and how that can lead to a loss of confidence. The presentation centered around the “soft skills” that we can all control as new clinicians to provide patients with better care. I argue that the “soft skills” are the “hard skills.” I understand that these skills can’t be measured, but I believe that they make the biggest difference for our patients. The best part about these “soft skills” is that they are entirely within our control no matter where we are in our careers or our lives.

Here is what I’ve learned.

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Words Matter

Sticks and stones can break your bones but words can do some damage too.

Coming out of school, it can be easy to focus on what is “wrong with the patient.” We are trained to look for deficits, problems and impairments and there is value in that. However, discussing these things at length brings with them negative language that can instill fear in the people who hear them. I’m not arguing that we should ignore the “negatives,” but what I am saying that we should make an effort to spend more time focusing on the “positives.” I believe that we should emphasize strengths just as much (if not more) than we point out “weaknesses.”

We are the stories that we tell ourselves and as healthcare professionals, we are in a perfect position to help people re-write their stories in a way that benefits them. Our words hold immense power to the people that we tell them to and we (as PTs) are in the perfect position to reassure our patients, encourage them and empower them. Through our dialogue, we can help shift their perspective, build their confidence and foster resilience. Those things are all associated with more positive outcomes, and that shouldn’t be a surprise. It is imperative that we choose our words carefully.

Embrace Uncertainty

If there’s one thing that I’ve learned since being out of school, it’s this: we don’t have all of the answers. To be more precise, we don’t have most of the answers.

The world of (outpatient) physical therapy (as well as life in general) is filled with uncertainty and that can be a scary thing, especially for patients who are experiencing pain, feeling vulnerable and are suffering. It’s important to realize that even when we don’t have all of the answers, we can still make a positive difference for the people that we treat. We can still choose to have confidence even when we don’t feel confident because deep down, we can choose to believe in our ability to be compassionate human beings who do their best for the people who need us the most.

Even when we don’t have all of the answers, we can still make a positive difference for the people that we treat.

It’s become apparent to me that we don’t need to “figure things out” right away. It’s even become clear to me that sometimes, we don’t even have to figure things out all the way. I’ve come to realize that a large part of our job (as PTs) isn’t to fix people or find all of the answers, but rather, to walk hand in hand with our patients through the uncertainty that they are experiencing. People need a guide.

Meet Them

Everybody in this world is coming from a different place. Our job is to meet people where they are so we can take them where they want to be.

Meet people where they are. We all see the world through a different lens. Everybody has a different perspective and no two people are in the same place. Because of this, different people need different things. To maximize effectiveness, communication need to be tailored to the individual sitting in front of us. In order to do that, we need some level of social awareness. We need to be able to understand where people are coming from so that we can meet people where they are, not where we expect them to be.

Take them where they want to be. Whether you think so or not, [outpatient] physical therapy is a customer service profession. It is our job to help take people where they want to be, not where we think that they should be. If a patient wants to be able to do something, it is our job to help them get there, not to tell them that they can’t [exceptions exist].

Know Them

Creating genuine human connection drives positive patient experiences (and outcomes). What’s important to the patient should be important to us, and we can’t know that until we know them.

If we want to be an effective physical therapists, we need to build a relationship with our patients that is set on a foundation of genuine interest, compassionate caring and empathetic love. In the most basic terms, we need to get to know our patients and actually care about them so that they feel comfortable and compelled to invest their time, energy and effort into letting us help them.

If you can’t connect with your patients, then the rest doesn’t matter.

With few exceptions, people who seek healthcare are vulnerable on some level and it is a privilege to be able to help people who are in that position. One way to strengthen therapeutic relationships is to be open and vulnerable as healthcare practitioners ourselves [in an appropriate manner]. The bottom line is this; each person is a new story that we’ve never heard and our job is to understand that story so that we can have a positive influence on it.

Care More

Compassion can’t be measured but it makes a real difference.

Before being a good healthcare professional, our job is to be a good human being. If we can care about the people sitting in front of us and choose to do what is best for them, the rest will fall into place. Sometimes all that someone needs is to know that someone cares about them. You never know what someone else is going through below the surface and that is why part of our obligation as PTs is to be there for people. The truth is that even the most “evidence-based” treatments in the world, won’t reach their full potential if the patient doesn’t feel valued and cared for on a human level.

Not Everybody

This is still the hardest thing for me to accept.

There are patients who never come back to the clinic. There are patients who don’t get better under our care. There are patients who just don’t click with us. While that can be hard to accept, all of that is ok.

These things are normal and we won’t be the right PT for every single person in this world. It happens to everyone; we can’t take it personally.

It’s Different

Pain is not the same as suffering.

I’ve always known this deep down; I think we all do. However, it didn’t take a long time for me to be reminded that while pain and suffering can happen together, they are by no means the same thing.

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” Viktor Frankl

Pain has been defined as “an unpleasant sensory or emotional experience.” Suffering is how we respond to that experience. Part of our job as PTs is to recognize suffering and to help people respond differently to their pain. Part of our power as PTs is our position to reassure patients and help reframe their perspective. It is our job (and privilege) to be there for our patients and to help them rewrite their narratives.

Make People Smile

Whether you know it or not, every single person in this world is battling something that you can’t see. Whether it’s a patient or just somebody passing on the street, be the reason that someone smiles today, because a smile can make someone’s day and even save someone’s life.

In the PT profession, we are surrounded by people could use a smile. We all have the incredible opportunity and privilege to interact with people who are in pain, who are suffering and who are vulnerable. If you can’t do anything else for a patient in a given treatment session, make them smile.

Listen More

There is something therapeutic about listening.

Patients will often tell you exactly what is wrong, if you let them. What they choose to talk about is what is important to them. it feels awkward at first, but there is a lot that can be learned in the silence. Don’t be afraid of it.

Listening is an art and it is worth making a masterpiece.

People aren’t used to healthcare professionals giving them time to talk. However, sometimes it just takes another few seconds of silence for someone to build up the courage to say something that is really important to them (and to you). There is a lot that lies beneath the surface and if we want to get deeper, you have to not only listen to patients, we have to make them feel heard. You have to give them space, make them feel valued, give them time and make them feel comfortable.

I had to include a clip from The Office in my presentation. If you’re in need of a laugh, or just want an example of how not to listen, click here.

It Depends

It’s true.

Each patient is a unique individual and it is our job to treat them as such.

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These skills are bigger than us.

These words are about how to connect with people, how to encourage people and how to care for people. These so called “soft skills” are anything from soft. I would argue that these “soft skills” are more important than any other skills. I would even go as far as to say that any other PT skill is useless if it is not accompanied and held up by “soft skills.”

I want to remind us that each interaction, no matter how small or how brief, has the potential to lift someone up or bring someone down. That’s powerful stuff. Being more aware of the power of human interaction is something we can all be better at [myself included]. It’s time that we take that to heart, put effort into honing those “soft skills” and do better as humans first.

“You might not be able to change the world, but you might be able to change the world for one person.” Paul Shane Spear

Go change someone’s world.

Thank you for taking the time to read – I appreciate you!

Joe Rinaldi, PT, DPT

IG: @joearinaldi

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