The Two Faces of Healthcare In most healthcare practices, the phone predominantly rings because someone is in pain. The caller may have initially tried to manage their injury or condition themselves to some extent, but without success or at least lasting results. In this instance, the client typically visits the practice for treatment and expects some degree of relief to their focal point of pain.
“What felt instinctively right at the beginning of my career soon became something I could prove was working.”
Under a traditional model of care, the therapist’s assessment, advice and intervention is characterised by wanting to please the client with immediate results. Typically they commence treatment with strategies to minimise the client’s pain, thereby making the client more comfortable in the short term. After a series of approx. 4-8 sessions over 2-3 weeks, normally the client would experience some measurable relief of their symptoms, albeit not total recovery. It is very common that at this point clients either instinctively discontinue treatment and wrongly assume natural recovery will continue shortly afterward or the therapist (unintentionally) misleads the client to believe the same by prematurely discharging them with the invitation to only re-attend if further problems develop.
Notably, because the emphasis of care under the traditional model is to reduce pain, very often the underlying cause of the problem remains largely undetected or unresolved. The results for the client are incomplete recovery with a false hope that any current symptom-relief will last, and injury re-aggravation when they resume normal activities. The actions of the therapist are mistaken to be in the client’s best interests because they are saving them money on “unnecessary” treatment and not imposing lifestyle changes the client may find intrusive or overly assertive. This situation ultimately reflects poorly on the expertise and intervention of the therapist and, worse, robs the client of any value in the time and money they have invested in their recovery to this stage.
Invariably, what follows this traditional model is a cycle of repeated episodes of treatment as the client experiences re-aggravation of their injury or recurring symptoms. On each of these occasions, if the therapist follows a similar approach of symptomatic treatment only, rendering incomplete recovery, the merry-go-round is perpetuated. If continued indefinitely, it is only a matter of time before the client concludes their treatment is ‘not working’, and opts for a second opinion from an alternate practitioner, or simply ‘cuts their losses’ and decides to live with the pain. The unending costs and inconvenience of perpetual treatment, understandably, become unsustainable for most people.
It’s also not uncommon for traditional therapists to typically prescribe appointment schedules based on such things as their perceptions of the client’s pain (see Chapter 2 for the dangers of using pain as a reliable indicator of health and recovery), practitioner availability, client affordability or textbook guidelines of routine treatment for specified injuries. Whist this may appear reasonable on first observation, what lacks in this model is a thorough understanding of, and appreciation for, the multi-factorial causes that underlie the client’s symptoms. Furthermore, often the comprehensive and individualised treatment regimens necessary to not just achieve a symptom-free state, but rather one of full recovery and optimal health in the future, are grossly underestimated. In my opinion this stereotypical approach to injury management is dangerously reactive and superficial at best and without doubt is ineffective in giving clients real value.
To grasp some early differences between our innovative health philosophy, from that of the more traditional approach, I have provided a summary of the variations in Table 3.1. Notice also the two separate client experiences charted in Diagram 3.2, further depicting the obvious contrasts.
3.1 Contrast of Attributes between Results4Life Philosophy and Traditional Health Care
Our alternative approach with Results4Life is pictorially represented as 6 distinct zones. We believe that for someone to truly achieve long term health they need to pass through these key phases: Discovery, Relief, Conditioning, Learning, Lifestyle and Refinement. No single stage is finite with an absolute start and finish, but rather each stage interweaves and dove-tails with the others, representing key areas of focus that characterise the objectives and activities of the therapist and client. As you follow the megatrend, at the top of the chart of Diagram 3.3, you can easily see where the transition occurs from immediate injury management to more holistic health and wellness.
Discovery Phase Results4Life has, at the core of its philosophy, the acceptance that all symptoms have deep-seated causes that must be thoroughly diagnosed and addressed for long term results. Therapists must discover the relevant information, history and intent of the client during this phase. They must identify the many possible underlying anatomical, biomechanical, inflammatory and physiological reasons why symptoms persist. Often during this process a number of related (and even unrelated) health concerns are discovered, which can be dealt with in due course for optimal benefits. This detailed analysis gives the therapist a clear profile of their client’s current health and wellness state, and offers a critical opportunity for them to identify personal goals with the client to avoid any misdirection in the treatment that inevitably follows. With clarity regarding what is causing the pain and other symptoms the therapists using Results4Life can then confidently design an integrated treatment plan or personal roadmap in consultation with the client to address matters in a prioritised order.
Relief Phase This phase is the period during which clients mostly receive their ‘treatment’. Therapists typically take charge at this point in a very directive role to modify any aggravating activities of the client and get on top of the debilitating symptoms quickly. This can include resolving the pain, swelling, stiffness and instability immediately without any fear that they are masking the true pathology underneath and giving the client a false sense of recovery.
Conditioning Phase As pain reduces and the other symptoms of inflammation subside, many clients are tempted to self-discharge or, worse still, their therapist encourages them to stop treatment. This is premature as generally full recovery has not been achieved. During this phase the treatment transitions into full scale rehabilitation including tailored exercise and modified activity and relies on far more active client cooperation. The tissues and injured parts are strengthened and conditioned for a return to full activity, although it can sometimes feel like ‘two steps forward, one step backward’. Careful persistence and gradual change are essential.
Learning Phase As the client nears the end of the Conditioning Phase, they are likely to have made a full recovery. However, unless there is careful education about all of the ‘big picture’ contributing factors that caused the problem in the first place, and empowerment around self-management of these predispositions, the symptoms are prone to recur. The greatest attribute of successful clients in this phase is an open mind and commitment to lifestyle change. This is also the phase that most traditional therapists undervalue and skip when time is against them.
Lifestyle Phase This is the phase during which real change happens. Having benefited from a clear diagnosis (Discovery), effective treatment (Relief), thorough rehabilitation (Conditioning), and clear education about the necessary lifestyle changes required (Learning), a well-managed client moves into the Lifestyle Phase equipped to perform at their best. The therapist has a far less active role in this stage and is more like a coach who helps guide the development of healthy habits and lifestyle patterns.
Refinement Phase For reasons of accountability and progressive assessment, clients otherwise ‘maintaining’ or developing greater wellness, are encouraged to have semi-regular checkups. These can be monthly,