Recently, I conducted an evaluation on a patient with the referring diagnosis of shoulder adhesive capsulitis. Being a new grad, I am still a little nervous before conducting an evaluation; something I know will ease over time. Overall, I believe this initial evaluation went well. I felt confident in my subjective interview and objective exam, and even allowed myself enough time to begin some hands-on treatment with the patient. Initially, I could sense some apprehension and reservations from the patient during the subjective interview. He had knowledge of his MRI findings, which we discussed, and then proceeded to the objective exam. By the time I had begun taking measurements, I could sense he was becoming more comfortable and trusting; still noted slight guarding when handling his arm for passive motion assessment, but even this improved as we had more conversation. I was able to establish some by-in during my treatment by demonstrating improved motion after a few minutes of manual therapy and created an initial HEP for him. By the end of the evaluation, I could sense a big change in his tone. His demeanor changed from relatively stoic to expressing some happiness and excitement about proceeding with Physical Therapy with me. I think he was appreciative of the time I took in creating his HEP and acknowledging his questions about his potential diagnosis he was given.
There is always room to improve in my efficiency with conducting objective exams, however, exuding confidence with each patient is something I have to actively work on improving, especially during initial evaluations. I can tell my confidence is different, and increased during follow-up visits, compared to how I can sometimes feel during evaluations. This is an area I can grow in to make each patient encounter and experience better, and I feel I could’ve expressed better confidence quicker in this evaluation to make the patient feel even more comfortable in my abilities sooner in the process. I believe my actions, patient education, and demonstration of treatment along with the diagnosis he is coming into therapy with all shaped his view of the initial evaluation and framed his idea of the course of physical therapy ahead. I think I was able to educate him enough on his current symptoms and show him the improvement in motion he has available, so that he perceives me as knowledgeable and competent in his care. I perceive this patient as someone who needs to know that I am competent and that he benefits from good patient education with everything I perform and prescribe for him – explaining the “why” behind each process and exercise. A quote that stands out to me that I strive for incorporating with my patients is, “People won’t remember what you did or said, but they will remember how you made them feel.” I hope to continue to build on the therapeutic relationship established, paired with evidence-based practice, to guide this patient through their recovery.