Charting Success: Effectively Treating and Retaining Patients

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By David Kent, LMT, NCTMB

Whether you perform massage in a medical, clinical or spa setting, it is important for clients to feel they are benefitting from treatment. Using visual aids is an excellent way to chart and evaluate a client’s progress. Charting allows you to show a client his/her progress. It also helps you and the client stay focused on which course of treatment to pursue.

In my last article, “The Power of the List,” I presented my goal-setting questions and Power List to help you kick-start the process of identifying and achieving your goals for your practice and all areas of your life. In this article I will share tips for using visual aids for your client’s benefit, no matter what type of massage setting you work in. I also will describe how I use visual aids in my own practice. These tips will help you gain, maintain and increase the momentum you need to attain your professional goals while you subsequently help your clients.

Few goals are ever achieved in one step, and one massage therapy treatment is rarely going to resolve the core cause of a client’s stress, pain or dysfunction. Many clients want instant gratification—the “magic bullet” or the one-treatment fix that will immediately solve their problem; however, it is incumbent upon us to educate our clients about the accumulated benefits of a series of treatments versus a single treatment here and there. Clients who make a commitment to regular treatment often are quickly amazed at the positive impact it has on their quality of life.

Here’s a brief quiz. Imagine you are driving down the highway and the “low oil” warning signal displays on the dashboard. You take the next exit and drive to the nearest gas station where you check the oil level and see that the engine is low by two quarts. Should you:

  1. Buy just enough oil so that the warning light will turn off; then drive the car until the warning light comes on again, only to do the same thing again. This is the human equivalent of taking over-the-counter (OTC) medication.
  1. Pull the fuse so the warning light doesn’t annoy you. This is the equivalent of seeing a doctor for prescription medication that masks the pain.
  1. Locate the wire that connects the light to the dashboard and cut it so it can never send the warning signal again. This is the body’s equivalent to surgery.
  1. Add one quart of oil and drive until the warning display lights up again; then add one more quart of oil. This is the equivalent of a client with headaches, neck and shoulder pain scheduling an emergency massage therapy session. Upon completion of the session, you recommend follow-up sessions, simple stretching techniques, ergonomic changes, and other methods of self care; however, the client doesn’t follow any of your recommendations and the next time you hear from the client is when his/her pain is at the crisis level and he/she needs to “get in as soon as possible.”
  1. Immediately add two quarts of oil at the gas station and then schedule an appointment to have your car serviced as soon as possible. Think about it. Maybe there is an oil leak or maybe something is drastically wrong with the car. Over time, the oil in the car breaks down. This is what the experts call “loosing oil viscosity.” Could that be similar to loosing range-of-motion?

Obviously, the best answer to the question is “E”.  You need to schedule the car for service – not only for a filter and oil change, but for a complete checkup. You make this decision on simple information that would be obvious to any person. It’s not too hard to see that the car in this scenario is a stand-in for the human body. And this valuable machine needs attention and care to run correctly and last for the long run. Ultimately, it’s cheaper to maintain the body’s health than to “pay” for a complete “breakdown” in the long run in the way of lost work, doctor bills, medication, pain and a reduced quality of life.

The point of this exercise is to demonstrate the importance of gathering information the right way at the right time. For example, a client complains of headaches that occur three to four times a week and require prescription medication; however, even with increasing medication, the client frequently misses time off work. This client also has secondary complaints of neck, shoulder and upper back pain that disrupt sleeping patterns. In this example, my short-term goals are to reduce the headaches and the neck pain intensity, frequency and duration, as well as to improve sleeping patterns.

Here is where I start collecting my visuals to create my starting point of reference so that I can measure the client’s progress from this point forward. To begin, I have the client fill out intake forms, questionnaires and a pain-scale chart before and after treatment. Other aids I use to establish a baseline include documenting range-of-motion; conducting muscle and orthopedic assessments; using trigger point charts; taking postural analysis photos; and evaluating gait.

Depending on your massage therapy setting, you will probably adjust which visual aids you use in your practice; however, most clients, regardless of the setting, find it both useful and comforting when the therapist uses charts and models to describe their condition and note their progress.

Lastly, we all need a little encouragement to produce the results we want in our lives. Often, however, we have no one around to motivate us. Every day, I list the things I am grateful for, as well as the things I did to move myself closer to my goals. I also ask my clients to do the same. A client with chronic headaches might be grateful for finding you, the massage therapist, and—thanks to continued treatment—he/she might be grateful for missing less work and sleeping better at night. This client might be following your recommendations and stretching and exercising every day as a means of reducing the frequency of the headaches.

As for me, I am grateful for my health and my practice. And whether it’s learning a new skill, following innovative practice-management techniques or using visual aids, I make a point of doing something every single day that will help me reach my professional and personal goals.

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