Overservicing patients
Are you guilty of this❓
I’m likely to get a few people off side with this article, but it is something that needs to be shared.
Overservicing our patients is a problem for so many reasons, and we can fall into this trap in a number of ways.
Let’s firstly look at what it is, and then we’ll dive into the issues it raises.
Overservicing is providing a service to your patient when it is not warranted or at intervals that can’t be justified.
At first glance you might think that you most definitely don’t do this, but it really is worth spending time considering how you operate and if overservicing ever occurs in your clinic.
❌ Overservicing trap #1:
Treatments to “maintain” health.
If we tell our patients that they will need our treatment to maintain a healthy functioning body, we are setting them up for failure and dependency.
The human body was not designed to need treatment. Though, there are some individuals who will function better with the support of regular therapeutic intervention, such as elite athletes who are performing at a high level and who walk the line between performance and injury on a daily basis. The application of massage or other treatments may be justified to assist their recovery etc.
However, if your patient has presented with a pain for function related issue, then our goal should always be to promote the healing process, then guide the patient towards self-efficacy. This means NOT relying on people like us.
Maintenance of health through self-managed means should be the goal of the therapist for the patient.
❌ Overservicing trap #2:
Continuing to accept appointments with a patient who is not making progress.
While some presentations can take a little time to demonstrate progress with treatment, we must be vigilant in our focus on progress. Conducting an assessment at the start and end of every treatment, monitoring progress between sessions and observing changes over time, all help to give us an indication of how what we are doing is helping.
If after the first few sessions you have not been able to make any measurable change for the patient, the only ethical thing to do is to help them find someone who can.
While the patient may enjoy the treatments, and likely have a lot of faith in you as a therapist, continuing to accept appointments with them when no meaningful progress is being made, is negligent.
❌ Overservicing trap #3:
Pre-emptive scheduling.
In this trap we see practitioners telling their patient that they will need 2 session per week for 4 weeks, then 1 session per week for a further 4 weeks, then one session per month thereafter… or some version of this.
There is no way to know exactly how the patient will respond to the treatment. There are a multitude of factors that influence patient outcomes including compliance with take home advice, current physical health status, environmental factors, previous injury, tissue integrity, the list goes on.
While you may see some patterns in how certain conditions resolve over time, it is unreasonable and unjustified to state at the beginning of a treatment plan that the patient will NEED a set number of session.
The only way forward is to assess them as they progress and to make clinically reasoned decisions based on those findings.
❌ Overservicing trap #4:
Treatment packages.
This is somewhat linked to trap #3 in that often we see therapists selling a “pack” of consultations with a discount on that bulk purchase i.e. buy 10 sessions and get a 10% discount, or something like that.
This is fraught with danger.
Firstly, there is a legal obligation in this situation that the therapist will be able to provide those consultations in a timely manner and at suitable intervals. This becomes a problem if the practitioner is too busy to make that happen.
Secondly, a package of consultations implies that the patient will in fact NEED all of these sessions. As discussed in Trap #3, we can’t clinically justify this until we see how they progress.
Thirdly, having a patient purchase treatments in advance, without providing an assessed need for EACH individual session breaks your contract with private health funds (if you are a provider of health fund rebates).
While just about every business coach out there is probably advising that you should sell your services in bulk to maximise customer value, this is most definitely NOT something that any practitioner of health services should be doing.
If your Doctor told you that you could buy 5 consultations in advance for the price of 4, you’d probably wonder what they are up to, right?
❌ Overservicing Trap #5:
Pushing rebooking rates.
This is unfortunately common practice in many clinics. Of course, every clinic owner wants to see their staff bringing more business into the clinic, but if that is done by pushing staff to increase their rebooking rates, it is forcing them to encourage patients to have more consultations for the wrong reason.
If the terms of your employment state that your rebooking rates should be 80% or higher, or if you are rewarded when your rebooking rates hit a certain number, you will be motivated to get patients back in the door simply to hit those targets.
This shifts the focus away from clinically reasoned and patient centred care, to purely a numbers game.
The alternative for clinic owners here is to recognise that if their staff provide exceptional service to their patients, and teach them that they will only ask them to rebook if it is absolutely necessary, then those patients will have a far greater level of trust and respect for their health practitioner, AND REFER MORE PEOPLE!
As a profession, we have to move away from trying to get more financial gain from each individual patient, and shift our focus to doing the best possible job we can for each person.
Do that and our job satisfaction improves, the patient feels more supported and will trust your opinion and advice, and your reputation will be the thing that drives greater financial gain, not the number of sessions you get out of each patient.
Shaun Brewster.
