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Developing Relationships with Patients When You Deal with Many Each Day

For therapists, building relationships with patients is the backbone of a successful and fulfilling career. Based on trust as much as skill, the patient-therapist bond is one of the most intimate of any that two people can have. Great therapists are constantly looking for ways to improve their people skills as much as they are their professional skills.

When dealing with many patients every day, it’s difficult to maintain individual relationships. Follow this guide to developing a bond with each and every patient.

For therapists, patient relationships are everything. Never Act Rushed

If the nature of your practice requires you to see many patients every day, chances are, your face-to-face interaction time is diminished – but the quality of your relationship doesn’t have to be. Never let pleasantries get pushed to the side.

Don’t appear hurried, even if you are. Patients who feel like they’re being rushed report resenting their therapist for making them feel like they have somewhere more important to be. Refrain from non-verbal cues such as checking your watch, doing two things at once or keeping one hand on the doorknob. Make the patient feel like they’re the center of your focus, even if you can only maintain that focus for a short while.

Don’t Interrupt

Many therapists wait fewer than 30 seconds before interrupting their patient. Hold out for as long as you can. By allowing a patient to speak for a few minutes uninterrupted – that includes you not finishing their sentences for them – you not only get an overall picture of what’s going on with them, but you instill in them a sense that you care about what they have to say.
This is a key element in any relationship. Listen – don’t just wait for your chance to speak.

Don’t Exclude Pleasantries

Busy therapists who have many patients and little time assume – probably correctly – that it’s in their patients’ best interest to get down to brass tacks right away. Although this is probably the most expedient strategy, it diminishes the patient/therapist relationship by omitting the human element of social discourse. By rushing right into the heavy stuff, the therapist fails to show their compassionate, human side – a side so desperately craved for by patients and often lacking from medical professionals.

Resources

Often, inspiration can be found through exposure to media presented by other therapists. Consider the following resources to help your relationships blossom:

Therapists must develop relationships based on trust and understanding.

For patients, their therapist is often their best hope for a better life, and their only human connection in the complex and often frustrating world of healthcare. Building and maintaining trust is difficult, but imperative to a productive relationship with patients. For therapists, your career is built on your relationships as much as your skill.

Andrew Lisa is a freelance writer living in Los Angeles. He writes about the health industry and patient care.

Pump Up Your Autism Toolbox!

April is Autism Awareness month, and we’ve discounted a special selection of courses to help you pump up your autism toolbox. Use the promo code “AAM2014” and save on any or all of these six continuing education courses:

Occupational Therapy for Children Module 5: NICU, School-based OT, Vision/Hearing

The sixth edition of “Occupational Therapy for Children” maintains its focus on children from infancy to adolescence and gives comprehensive coverage of both conditions and treatment techniques in all settings. Inside you’ll discover new author contributions, new research and theories, new techniques, and current trends to keep you in step with the changes in pediatric OT practice.

Innovative Interventions to Treat Children on the Autism Spectrum

This course addresses the recent changes in diagnostic criteria of autism spectrum disorders (ASD) and the evaluation tools that rehab professionals and other professionals may use to assess needs in areas of executive function, sensory, motor, behavioral, visual, social-emotional and communication skills and performance of daily living activities.

New Ways to Communicate with Your Young Client

Children with developmental disabilities – including communication disorders – are at risk for low self-esteem, and one of our responsibilities as clinicians is to ensure that the client will have a more positive view of self. Using praise effectively is one way to achieve that goal..

This course guides the clinician on ways to increase understanding of children’s negative feelings and provides valuable tools to help accept, manage, and empathize with children’s negative feelings in a therapy setting.

Sensory Impairments across the Lifespan

This course aims to improve the therapists ability to provide optimum care for patients, both young and old, who suffer from varying degrees of sensory disorders. Therapists are shown how individuals process sensory information and how these concepts can be integrated into a plan of care. Developing a better understanding of these disorders allows the therapist to design effective care plans, treatments, and goals that address patients’ needs within the boundaries of their specific capacities.

Solutions for Sensory Processing Disorders

In this course, the clinician is led on an exploration of the sensory needs of children, from infancy to adolescence. They learn how diverse environments play a role in sensory needs and behavior of children and be instructed on Sensory Integration principles, with a focus on discovering methods to encourage engagement in occupations and support patients and their families.

Stress Management During Turbulent Times: Understanding, Treating and Managing Stress

Stress is a part of life we all experience. We encounter stress in our daily life that for the most part we learn to manage. However, unacknowledged and unrecognized stress can negatively affect us. Stress education can reduce this effect. This workshop is intended to provide you with information you can use to prevent deteriorating health and work performance that may lead to developing burnout.

 

Celebrate Occupational Therapy Month With a Special CE Offer!

Celebrate OT Month

Hey hey hey! Happy OT month, guys and gals! As Occupational therapy professionals, you are an integral component part of a field of rehabilitation that helps people across the lifespan live full and active lives. And we are ever so grateful for that.

Save on OT/OTA CEs

Click the button to save!

Occupational therapists and occupational therapist assistants do so much to give children with disabilities the ability to actively participate in school and in social situations. OTs, OTAs and COTAs are dedicated to helping people recovering from injuries to regain abilities, to providing aging adult with the tools to remain independent, and to offering personalized support and services to people from all ages and in all circumstances.

To help keep you on your game and build up your skillset with the best possible tools and resources, we’re offering up some of our most popular OT CE courses in four specially designed, flexible and affordable packages. And if that’s not enough, we’re discounting these packages even further in honor of OT Month and all the hard work that you do. Simply use the promo code “OT2014” when shopping for your package for an even better deal.

Thanks again for all that you do to keep us going!

With the explosion of lawsuits shining a harsh light on what plaintiffs allege is a long history of poor concussion management in professional sports, it’s no surprise that neurological and sporting associations are rushing to pour effort and resources into developing policies and procedures. These plans guiding sideline personnel on when to approve an athletes “return to play” are not only being developed at the professional level, but all the way down to the elementary school level as well.

These policies and plans essentially boil down to one point: the athletic trainer should be primarily responsible for calling the shots on return to play. Athletic trainers are the most qualified members of a sideline team, with the training, expertise and, most importantly, hands on experience to spot the sometimes subtle symptoms of a traumatic brain injury.

So why, according to a 2010 National Collegiate Athletic Association (NCAA) survey, did half of responding institutions put athletes back in the same game after a concussion diagnosis?(1) Why are athletic trainers like Paul Welliver being fired for refusing to return students to play after concussion? Trained medical professionals feel they are being ignored, bullied and dismissed when trying to do the right thing for their athletes.

So who is really calling the shots?

Is It The Coaches?

There is no doubt that coaches can, and do, exert pressure on their sideline team to keep key players in the game. Coaches are, after all, hired to win.  They are not required to be trained medical professionals. Therefore most coaches make decisions based on emotion and instinct rather than science or research.

It’s also very easy for a coach to question the athletic trainers judgment, as coaches are not generally subject to direct risk for litigation should something go wrong.  When push comes to shove, the responsibility falls on the team physician and athletic trainer to ensure that return to play criteria after a positive concussion diagnosis are fully met.

Another red flag is team hierarchy. In a Chronicle of Higher Education survey of the NCAA’s 120 largest football programs, 11 of the 101 athletic trainers who responded said they are hired by, and report directly to, the head coach(2). 32 of them said that a member of the coaching staff had influence over hiring and firing decisions of team athletic trainers. That’s the kind of team hierarchy that can put pressure on AT staff to choose between the safety of the athlete and their own job security.

One AT opined:

“The NCAA and its institutions need to put checks and balances in place to see that this conflict of interest is no longer a conflict.  Put the athletic trainers under the athletic director or the medical director. Anything else is directly risking the health and welfare of our athletes.”(2)

Is It The Professional Associations?

There is currently an investigation underway that is examining 1,000s of pages of internal documents sent between senior staff at the NCAA regarding the concussion epidemic (1). The investigation is exposing a startling lack of action on the part of the NCAA in enforcing the policies and plans for concussion management and an even more alarming laissez-faire attitude as evidenced by the following exchange:

“(Director of Health) Dave (Klossner) is hot/heavy on the concussion stuff. He’s been trying to force our rules committees to put in rules that are not good — I think I’ve finally convinced him to calm down.” – Ty Halpin, Director of Playing Rules Administration

“He reminds me of a cartoon character.” – Nicole Bracken, Associate Director of Research.

“HA! I think you’re right about that!” – Ty Halpin

The investigation has also revealed that while the NCAA require schools to have a concussion plan in place, that requirement hasn’t been enforced with any consistency:

“The legislation was specifically written to require institutions to have a plan and describe what minimum components had to be part of the plan — not about enforcing whether or not they were following their plan — except for those isolated circumstances of systemic or blatant violations” – Chris Strobel, Director of Enforcement

According to the documents, even in those blatant cases enforcement was never enacted.

The cost of ignoring set concussion protocols can be unthinkable. In January of 2011, a young Irish rugby player by the name of Benjamin Robinson tragically died at the age of 14 as a direct result of second impact syndrome. Not only did the team coaches fail to adhere to protocols, it was later revealed many of them were sadly unaware of what those protocols actually were.(3)

Is It The Athletes?

For athletes with visions of fame and glory, the competitive drive can impinge on common sense when it comes to injury, so the decision about return to play needs to be within the purview of someone who has far less at stake in the outcome.

Athletes can be very adept at hiding symptoms and, if they think they may miss out on a career-making play, will go to great lengths to manipulate the system. Former NFL strong safety Matt Bowen explains how easy it can be to deceive medical staff:

 

“When I played, we used to take this test on the computer in August. We called it the ‘concussion test’: numbers, math, memorization, shapes, sizes, etc., etc., etc. The computer tallied your score. During the season, if you suffered a blow to the head, you had to take the test the following week. If your score compared well to the test you took in August, well, then you could probably get back on the field. If you failed, you were most likely out — until you could pass it.

I failed it in August — on purpose.

Why? Pretty simple. Because I knew that if I had a concussion, my scores would be low, and since I intentionally missed questions during my first test, I would score pretty well during the season.”(4)

Bowen admits now that his actions were “Stupid… asinine… idiotic”. So why did he do it? Why did a professional athlete return to the game, risking a potentially life-threatening injury, rather than follow the advice of athletic trainers? “You play because you’re scared for your job.”

Is It The Parents?

Many trainers are met with a pervasive “My child was cleared by our family physician and that means he or she is fine” mentality that has been hard to shake with parents of athletes. What most of them fail to realize, feel the trainers, is that, unless the MD has recently finished residency, or completed an exhaustive review of current research, they are likely a decade behind on their knowledge of concussion management.

One athletic trainer confided “My father is a family practice doctor in the last few years of his career. He tells me all the time that the only accurate things he knows about concussion management for his patients he learned from me, his son, the ATC”.(5)

Putting The Power Back in The ATs Hands

The American Academy of Neurology (AAN) feels that concussion management should be a team effort(6), but is that the right call? Being part of a team carries the danger of pressure to conform to group think, to support the best interest of the team over the best interest of the athlete.

The most logical solution to the lack of consistent implementation of concussion management is to place complete and total authority on return to play decisions into the hands of the athletic trainer directly involved with the athlete.

Many Athletic Trainers believe that they should be a distinctly separate unit, not a part of the coaching staff. The distinction must be made, they say, that they are first and foremost medical providers whose primary focus is the care of injured athletes. And until all ATC’s and administrators are able to differentiate between those two roles, they believe that their professionals “will never be supported the right way to make the unpopular decisions required for the safety of our athletes”(2).

But how best to implement this shift in policy? And who will be responsible for making sure everyone toes the line?

One AT doesn’t put much faith in the NCAA:

“The NCAA has no trouble regulating the recruiting process in excruciating detail, oversees eligibility rules minutiae, but says it can’t regulate rules and procedures to protect the health of the athletes?“(2)

And, with big money on the line, can we count on the NFL, MLB, NHL or any other professional sporting association to regulate themselves if it means risking fan ire and lost revenue when star players miss games?

So why, with mountains of undeniable evidence that brain injuries carry life-altering consequences (7), are associations apparently disinterested in protecting their most valuable assets? And who is going to stand up and force change?

While taking on the collective goliath of professional, collegiate and high school sporting associations to bring about change to concussion management should be the ultimate goal, athletic trainers at every level can affect change much more simply.

How? With education.

Athletic trainers should be working to educate athletes on the long-term consequences of concussions. Parents should be enlightened on the dangers of relying on medical personnel lacking comprehensive and hands-on concussion management experience. Coaching staff need to learn that concussions aren’t just “bumps on the head” and that the signs can be difficult to read to the untrained eye. And associations need to learn that athletic trainers aren’t there to cost them money, or to be difficult.

Most of all, what everyone needs to learn is to trust and respect the training, skills and expertise of certified athletic trainers. Their number one priority is the athlete.


1. “Internal NCAA emails raise questions about concussion policy”, Nathan Fenno, The Washington Times, July 20, 2013.
2. “Coach Makes the Call”, Brad Wolverton, The Chronicle of Higher Education, September 2, 2013.
3. “Death of a schoolboy: why concussion is rugby union’s dirty secret”, Andy Bull, The Guardian, December 13, 2013
4. “The High Cost Of Football”, Matt Bowen, National Football Post, October 01, 2009
5. “Athletic Trainer Removed from Post for Standing Ground on Concussions”, Dustin Fink, The Concussion Blog, March 1st, 2013
6. “Summary of evidence-based guideline update: Evaluation and management of concussion in sports”, Neurology June 11, 2013 vol. 80 no. 24 2250-2257 March 18, 2013.
7. Steven T. DeKosky, M.D., Milos D. Ikonomovic, M.D., and Sam Gandy, M.D., Ph.D., N Engl J Med 2010; 363:1293-1296, September 30, 2010

If you’re headed out to AOTA 2014 at the beginning of April, you may find yourself with some free time between educational sessions and the exhibit hall hours. Here are some of the wonderful things you’ll find in the historic city of Baltimore, Maryland.

American Visionary Art Museum

A museum dedicated to exhibiting remarkable outsider art, the AVAM hosts slightly off-center sculptures and paintings created by self-taught visionaries. Many of these eclectic pieces overpoweringly communicate their creators unique visions. Pieces range from matchstick ocean liners and tinfoil altars, to the whimsical, wonderful and the downright weird.

National Cryptologic Museum

Maryland is also home to the National Cryptologic Museum. Associated with the NSA, this museum presents a comprehensive history of intelligence work in the US. Originally designed to house artifacts from the Agency and to give employees a place to reflect on past successes and failures, the Museum quickly developed into a priceless collection of the Nation’s cryptologic history.

National Museum of Health and Medicine

The National Museum of Health and Medicine was established during the Civil War as the Army Medical Museum, a center for the collection of specimens for research in military medicine and surgery. The museum hosts a collection of fascinating exhibits and artifacts related to Abraham Lincoln and his assassination by John Wilkes Booth.

Edgar Allan Poe’s Grave

Fascinated by strange and spooky places? Visit Poe and his wife, Virginia Clemm, in the Westminster Hall cemetery and keep a look out for the gravestones of some other prominent Maryland citizens. The cemetery is located at 519 West Fayette, on the corner of Fayette and Greene.

Basilica of the National Shrine of the Assumption of the Blessed Virgin Mary

The Basilica of the National Shrine of the Assumption of the Blessed Virgin Mary was the first metropolitan cathedral in the United States. This historic site contains neoclassical architecture, a 17th-century organ, stunning artwork and more. The Basilica is also one of Baltimore’s beloved cultural institutions, offering educational tours daily, as well as hosting uplifting concerts and informative lectures.

The Cylburn Arboretum

The Cylburn Arboretum is a city park and nature preserve that spans approximately 207 acres where you will experience the feel of a grand estate in a rolling countryside, all within city limits. The park boasts expansive arboreal collections including Japanese maples, hollies, conifers, Maryland oaks, tree peonies, maples and magnolias stand on vibrant green lawns and colorful gardens that surround an elegant Victorian mansion.

Civil War Museum

Step back in time at one of the nation’s oldest surviving big-city railroad terminals. President Street Station, once an important rail connection during the Civil War, now houses the Civil War Museum and its permanent exhibition focused on Baltimore during the Civil War. The museum also features exhibits focused on Maryland’s railroad history and President Street Station’s own role in the transportation of slaves escaping to the north.

Davidge Hall at the University of Maryland Medical Center

Davidge Hall, constructed in 1812, is named for the first dean of the University of Maryland School of Medicine, Dr. John B. Davidge. Noted for its unique classical appearance, it is the oldest building in the country used continuously for medical education. The Medical School, established in 1807 by the Maryland General Assembly was the fifth to be founded in the United States. Following mergers with Baltimore Medical College, 1913, and College of Physicians and Surgeons, 1915, the school became part of the State University System in 1920.

Patterson Park Pagoda

While known as the Pagoda because of its oriental architectural appearance, the design was intended to reflect the bold Victorian style of the day. From the top of the tower one can view downtown, Baltimore’s many neighborhoods, the Patapsco River, the Key Bridge and Fort McHenry. It was designed as a peoples lookout tower. Today you can climb to its full 60 feet and have a view of the Inner Harbor and surrounding neighborhoods.

The Walters Art Museum

Ranking as the #1 must see attraction at Trip Advisor, the Walters Art Museum is home to a collection that presents an overview of world art from pre-dynastic Egypt to 20th-century Europe, and counts among its many treasures Greek sculpture and Roman sarcophagi; medieval ivories and Old Master paintings; Art Nouveau jewelry and 19th-century European and American masterpieces.