At my high school reunion a few months ago, a friend asked me an interesting question about my job, “Do you ever get ghosted by your patients?”
She was using a common term in dating so it took me a second to realize what she meant, but the answer is yes. In dating these days, “ghosting” has come to mean ending a relationship by abruptly ending all contact. Similarly, we’ve all had patients disappear by either “no-showing” or failing to make additional appointments before they were ready for discharge.
When I first started practicing, I took these ghosting events personally. I figured that patients stopped attending because they didn’t like me or the clinic. Being a new grad physical therapist can be tough, and I sometimes let my insecurities get the best of me. While some patients do opt to try something else or even want to try a different physical therapist (it happens to the best of us), lately, I’ve realized that the reasons for disappearing before discharge can often be more complicated:
Common reasons for a patient no-show incidents in physical therapy:
- Major changes in their condition. Sometimes patients drop off my schedule due to changes in their injury or ailment. For example, they stop because they are suddenly getting surgery (and will reappear on my schedule in a few weeks) or a more serious and unrelated health condition has cropped up unexpectedly.
- Abruptly feeling better. Sometimes patients suddenly feel better well before I would expect. While some people will continue treatment to assure that the problem doesn’t recur, others will halt treatment the moment they feel better. Unfortunately, I sometimes see those patients back in a few months because their ailment has returned. For example, if their core strength didn’t adequately improve, their back pain may return even if it felt initially better when they first started treatment.
- Wanting to go at it alone. Sometimes patients take a break from therapy to see how they function without getting manual therapy or modalities. They’ll often come back a few weeks or months later saying, “I just wanted to see what would happen if I stopped PT for a little bit.” Often this break gives them the motivation they need to successfully finish treatment.
- Personal reasons. A busy season at work, a sick kid or a multitude of other reasons. My physical therapy loving dad likes to say, “It takes a lot of time to actually get better.” Sometimes people pause their treatment if they can’t give it the time they need to get better.
- High copays. While our office offers payment plan options, unfortunately I’ve known of a few patients who decided they simply couldn’t afford their copays.
I’ve also developed a few other techniques to ensure that patients are compliant with the plan of care, in order to get the treatment they need to fully recover. These suggestions have helped reduce the amount of patients who disappear off my schedule:
As for my friend from high school, she asked me about ghosting because she had recently ghosted her own physical therapist and was feeling guilty, but according to Facebook, she recently started going again.
Get well soon, friend!