WHEN TO DISCHARGE YOUR PATIENT

You’re patient is now out of pain and essentially has reached the outcome they wanted when they first starting seeing you.

So you naturally discharge them, telling them when you next need me, when you’re next in pain, or this or that returns give me a call and I’ll take care of you.

Sound familiar?

I would like to offer my views here, emphasis on ‘my view’, and would ask that you at least give this some thought if not already.

Let’s talk about pain perception first. Pain is just that, perception. The body is an amazing coping machine. It will protect you at all costs which also means helping you get on with your day despite something going wrong in the background. Pain therefore, is generally the last cab off the rank and the first thing to go. Most allied health professionals understand this. Pain is NOT an accurate indication of your patient’s health status.

Now I’m not talking about our intuition, our instinctive sense of our own bodies, this is very different. Let me explain.

A patient may fumble around where they think they’re pain is however, they’re gut tells them something is not right and they need to get to you. Never argue with a patient’s gut sense, they are always right.

Let me now talk about the medical model. For the most part medicine is funded by 3rd parties, namely you and I via Medicare, Workover and TAC and/or private insurance. The common intention is to reduce claims. These are all businesses with a bottom line. This means supporting the ‘You are cured, fixed…’ model and can now be discharged, NOT the wellness, prevention model.

What’s interesting here is pathology, signs and symptom patients make up a very small part of the overall population and in fact, sub-clinical signs and symptoms before pathological change has been reached is the majority. The latter is far less funded and yet could significantly reduce the medical and insurance burden, but that’s a conversation for another day.

So getting back to case in point. Discharging patients.

In my view health management is a continuum, there is really no end point. The goal of the Allied health professional is look beyond the signs and symptoms and address the deeper cause. This will involve many, many layers which makes sense. We are the accumulation of many years of abuse, from occupational, dietary, drug, accident stress’s to name a few.

So it doesn’t make sense to ever discharge a patient.

In my practice, I am always thinking of the bigger picture, and we subscribe the ‘best practice’ model which is about creating a patient centre, empowered wellness program. I always have a recommendation…product, referral to another colleague, referral to an outside provider, down scheduled maintenance program etc. Sometimes it may be apparent I’m not the best practitioner moving forwards, so I refer.

In all cases my intention is to support my patients towards a patient centre model where they get to drive their own bus. This is my duty of care.

My patients ultimately need to discharge themselves which is their right however, in my practice every patient who leaves is armed with my recommendations…for the record.

About the author:

Dr. Andrew Arnold (Chiropractor) is a Chiropractic Doctor, and Owner, Cranbourne Family Chiropractic and Wellness Centre. He is also a Wellness Leader Mentor working with the Wellness Leadership Revolution and running his own program, the Million Dollar Wellness Practice. Andrew shares this ownership with his wife, Dr. Linda Wilson.
www.cranbournefamilychiro.com.au
www.drandrewarnold.com

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