Dr. Andrew Arnold (Chiropractor) talks about the pros and the pitfalls of providing our patients with home-based advice and instruction.
Best practice is about educating and empowering our patients in a supportive and proactive way. It’s about providing specific tailored instructions which allow the patient to bridge the gaps between consultations and stay on course with their treatment schedule. It’s about giving them the tools so that they can actively participate in their own health journey. It’s about combating passivity by gently but firmly coaching our patients to manage their own health. It’s about the practitioner becoming part of the patient’s process rather than the other way around. It’s about creating a manageable schedule both from a cost and logistics perspective. It’s about providing information to our patients freely and generously, helping them avoid the pitfalls of ‘dr google’ with translation, interpretation, and implementation.
So, what’s the downside?
Providing home care is a good thing to do, this is true however, there are some considerations.
What if the patient fails to implement your home advice properly because they failed to process the information at the time of the consultation?
What if the practitioner failed to adequately demonstrate and/or communicate the home advice to the patient at the time of consultation?
What if the patient took it upon themselves to pass this information onto a friend where it wasn’t indicated?
How much of your advice the patient was prepared to accept irrespective of their feedback at the time of receiving the advice? 
As a practitioner, we all have good intentions one of which may be to limit the number of visits based on assumptions our patients cannot afford either the time or the money to see us. We over-burden them with home advice which ends up causing more harm than good. They sustain an injury, re-aggravate their initial condition and relapse. The whole exercise becomes counterproductive!
It is sometimes best in my view, particularly during initial care to schedule a few more visits and keep them relatively close together. There is value in having a patient follow up just so you can check their home care. I guarantee they will need some tweaks and you will be wanting to add or subtract something.
It’s all about balance. As you get to know your patients you will gain trust in knowing they will understand and perform your advice properly.
Why not survey a control group at your practice and find out more on what works and what doesn’t.
- Kincey, J, Bradshaw, P, Ley, P, Coll, J.R., Patients’ satisfaction and reported acceptance of advice in general practice, Gen Pract 1975; 25 (157): 558-566.
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