You are the best person to offer your patients video-based telehealth treatment.
As an osteopath, currently on maternity leave, I had the privilege of handing each of my beautiful, valued patients on to practitioners we selected together. We had the time to discuss and plan. I thought about who would have a manual therapy style and personality that would best connect with each patient and was able to cherry-pick from a wide range of practitioners before I said goodbye.
The current situation, unfortunately, does not offer manual therapists that option. At this time of uncertainty, you may have already had to close your clinic doors. You might have patients with the kinds of preexisting conditions that makes it unwise for them to come and see you in person.
What is the best option for them?
How do you manage your duty of care?
As a manual therapist, you might feel ill-equipped to transition to a video-only format, but this is the position you likely find yourself in. In the event that no in-person treatment is possible, are your patients better served by you—with your prior knowledge of their history, established rapport, and your experience of how their muscles and joints feel and respond under your hands—or are they better off with an unknown practitioner, likely also new to telehealth?
The value of your established therapeutic relationship, particularly for patients with chronic pain, complicated clinical presentations, and mental health co-morbidities, makes you—their regular therapist—the best person to support them through this time.
You are more than just your hands. Your clinical reasoning does not always require you to touch your patient. You already gain a significant amount of your clinical information from your observational skills, history-taking, and the ability to listen and empathise. Much of your standard diagnostic assessment can be easily converted to a video setting. Postural assessment, motion testing, and many orthopaedic tests can be performed hands off.
You are more than just your hands.
Many therapeutic tools are still available to you. You can still offer comprehensive ergonomic advice. You will still be able to instruct and support your patients through therapeutic stretching and mobility exercises, and many of your treatment techniques, with a bit of creativity and imagination, can be adapted to self-applied techniques.
A telehealth appointment could even offer the opportunity to take more time to focus on educating your patients. Emphasis on correct stretching and exercise technique and an understanding of how they relate to a patient’s condition, combined with the knowledge that you can’t work hands-on “magic”, may inspire them toward better home exercise compliance and greater accountability for their own health.
In transitioning to telehealth—either in part or in full—there are of course many things to consider, such as the technology required, setting up a professional and secure location for your calls, pricing, and specific assessment and technique adaptation. None of these things present a substantial road block. Your biggest obstacle is telling yourself you can’t help your patients without touching them.
Although, as a manual therapist, telehealth would not be your first choice, at a time like this, telehealth may offer the only path to continuity of care.
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