Whenever I give friends from other cities physio advice, it always ends with them asking the same question: "How do I find a good physical therapist?"
This is a question I have had years to ponder, and still have difficulty answering. As a patient, it is very difficult to tell if you are getting quality care, or if you are just being viewed as another dollar sign to help a clinic reach its bottom line. The whole reason for seeking help is because you are not a medical expert. So without being an expert, how can you tell if you are getting the treatment you deserve? After much thought and deliberation, here are two simple questions to ask when deciding where to book your physiotherapy treatments.
- Question 1: "How many years of experience does the therapist have?"
Canadian universities do an excellent job at training new physiotherapists to be safe to treat the public. However, it is quite difficult to train them how to be effective. Physiotherapists have a very broad scope of practice and many of the years spent training in university are not applicable to the private practice setting. In my eyes, a new graduate can be viewed as a good generalist, but not quite a medical expert yet. What most people are looking for when they book an appointment with a physiotherapist at a clinic is an orthopaedic specialist. The vast majority of physiotherapists (if not all) will continue on with specialty education following graduation, expanding their skills at both assessment and treatment. A new graduate will have a smaller toolkit to draw from than someone who has been working for a longer period of time. The smaller toolkit of a new graduate generally works quite well for acute injuries and post-operative rehabilitation, but may be limiting for more complex or difficult to diagnose conditions. If you are someone who has already tried several courses of treatment (physio, or other forms), my recommendation is to try to find a therapist with a bare minimum of 2 years experience. Even after 2 years and significant post-graduate training, a diligent professional may not have all the skills required to deal with everything that comes their way, but at least they will have a good idea of who they can refer you to if you require treatment that is outside of their current repertoire.
- Question 2: "How much one-on-one time with the physiotherapist is allotted for me at each treatment session?"
In my eyes, time is the most important indicator of quality of care (and also the easiest to pre-screen for). Often the reception staff at a clinic will be trained to say something like this to you: "Expect to be in the clinic for 45 minutes to one hour for an average appointment". This is not an answer to what you asked. Find out how much time the therapist has to spend one-on-one with you. In my experience, the bare minimum required in a follow-up appointment to maintain quality service is 30 minutes. This at least gives the therapist time to reassess you during each appointment and then make appropriate changes to your treatment plan. Some clinics (that will remain unnamed) will book up to 6 patients an hour per therapist. In my opinion this is entirely unreasonable. To maintain this level of volume, your care will often be delegated to someone who is not a physiotherapist and who has significantly less training and education. Currently at Priority Massage and Health I book 40 minutes for follow-up appointments. Time is really essential to find out the cause of your problem and help you to make changes in your life to recover. In the past when I had less time with people I found it very difficult to address these causes and would often be limited to just treating people's symptoms.
Happy Searching!
Dave Zelibka, BScPT, GunnIMS, CAFCI
Registered Physiotherapist
London, Ontario
London, Ontario
Phone: (226)777-7111
Email: dave@elevatephysio.com
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