Patients say the darndest things, they really do. On an almost daily basis I have to stop myself from laughing at some of the things that they tell me, that are not meant to be funny. Whilst it is clearly inappropriate to laugh at them, and I never ever recommend this, I thought I would write this post as a light-hearted look at some patient interactions. Below I discuss my 4 favourite statements that patients said to me this week.
1. “I have a high pain tolerance.”
How often do you hear this? Frequently it is “I normally have a high pain tolerance”, and associated with the patient showing a poor tolerance of pain. It is classic, and makes me laugh.
2. “I have no pain, it’s just sore.”
No pain, and you are here because? Further entertaining (or unfortunate) is if you make the mistake of trying to use a V.A.S on these patients…”I told you, I have no pain…it’s just sore”. A quick serious aside, this does emphasise the importance of appropriate questioning (and listening!) techniques during the subjective examination.
3. Physio: “Did you have any problems with your exercises?”
Patient: “ No problems at all … what were they again?”
Speaks for itself doesn’t it, of course you have no problems with exercises that you don’t do. Interesting though, as I write this I think, I wonder if it is a ‘laugh to keep from crying’ situation. I am sure that some sports physiotherapists out there would be angered when they hear this. Another serious aside (I know, sorry), maybe you should look at what techniques you could employ to improve compliance.
4. Physio: “How would you describe your pain?”
Patient: “A constant and unrelenting ache”
Physio: “Where is the ache now?”
Patient: “Nowhere at the moment”
Another cracker. Questioning technique importance?
Take Home Message
And no it is not that patients are laughable, most of them are not. It is that patients do not think like we do. It really is as simple as that. They are not aware of how we interpret and analyse the things they say and the importance of certain key terms. Thus, it is important to confirm certain (often most) things they say … and never ever laugh at them.
Surely you guys have a few crackers, what are some of the funny things patients have said to you? Let me know in the comments or catch me on Facebook or Twitter
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Great post. Those four points are spot on. Probably experience each at least once a week.
2 of my all-time best:
‘I’ve been taking those anti-inflationaries…’
‘I think I’ve got something wrong with my rotary cuff…’
Shouldn’t laugh I know.
it could be slightly off topic here but I am getting a little bit over the ‘all you physios want to do is hurt people…’ and ‘you just love inflicting pain don’t you’. Any clever gems to diffuse this?
Hmm that’s a good one Lissanthea. I have no great answer for this, but there would be 2 ways to go about it (each of which I tend to use in different situations). The best option is good education on the techniques you want to use, why they might hurt, but what you want to achieve from them should tend to reduce inappropriate patient beliefs about their physiotherapy treatment. Unfortunately, it can be a lengthy and involved process, but definitely worth while to ‘get them on board’ to improve their clinical outcomes.
Alternatively, what I do with a lot of my athletes (generally younger males) who I have great rapport with is choose from:
1. ‘Harden up’
2. ‘No pain, no gain’
3. ‘You know that I’m only doing it to help you…..but I do LOVE my job!’.
I don’t have any great oneliners that work for all occasions, but others might… and may reply to this comment if we ask nicely….
Thanks Sports Physio- yes both approaches are used day in and day out. Perhaps it’s just my patient group that really think i get some kind of pleasure out of ‘inflicting’ pain on them. Surely they get that releasing tight lateral knee structures hurts my hands too? It’s not some kind of perversity!
Surely the collective wisdom has some clever witticism…