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Managing Expectations_

 

Much like in life, managing expectations with your clients is paramount.  We all know what it’s like when your expectations are not met.  Your emotions may range from hurt to sad to anger to confusion (and I am sure I am leaving out about 100 other emotions but I think those are some of the biggies). So how do we as health professionals help our clients to manage their expectations? It is a huge aspect of the patient care experience and can make a difference in treatment outcomes.1,2

When expectations are managed effectively the client will usually feel more satisfied with their care, display an improved locus of control, and may help to decrease the stress surrounding treatment.

Below are THREE important aspects of managing expectations for your clients:

 

  1. Communication

Ask people what is important to them in a personal relationship and I think most would say communication is very important.  So why would this NOT be important in your client relationship.  In my personal experience, my expectations have not been met due to simple communication problems.  I definitely felt all of the emotions stated above.  This is not a good feeling and it doesn’t leave you feeling all that great about yourself.  Why would you want your client to feel that way about their therapy experience?  You wouldn’t!  The easiest way to manage expectations is communication.  That means communicating effectively, honestly and according to the best possible evidence.  To quote Erin Jackson, Esq from the patient panel session at CSM:

Don’t make shit up!

If you don’t know something, it is not only ok to say you don’t have the answer right now, but also it is your duty as a medical professional to say that rather than to make something up. A possible response to a question you are unsure of could be:

That is a wonderful question.  I am not 100% sure that I have the right answer for you now, but I will do some research and get back to in the next day or 2.

I always like to give the client a specific timeline so they don’t think I will forget about it.  In keeping with the theme of managing expectations, it is of the utmost importance to get back to them in whatever time frame you stated.

When it comes to communication, I think we are always walking that fine line between encouraging your clients without misleading them.  This goes back to be honest and using the best evidence as your guide.

 

  1. Empathy 

Empathy is defined by Merriam-Webster as the feeling that you understand and share another person’s experiences and emotions; the ability to share someone else’s feelings.

I think we all know the importance of empathy as a health care professional. Dr. Larry Benz wrote a great blog post on this subject here.  Empathy has been shown to improve client satisfaction, lower stress related to care, and enable the client to take responsibility for their care.3

 

  1. Active listening

We all listen to our clients, right?  But truly hearing them is very different from listening. You need to be fully immersed in your patient’s story regardless of how long that story is.  You need to be able to redirect the story if it starts to go too far off topic.  You need to be able to respond appropriately and ask pertinent questions based on what you are hearing.  This can be a daunting task at time depending not on the client and the situation.  So how can you become a good active listener?  Here are a few easy tips to follow:

  • Face your client, make as much eye contact as you can and don’t have your head buried in a computer, tablet, notebook, etc.
  • Learn how to simultaneously listen and form responses in your head.  I realize this is not always easy but you can practice this skill.  One of the best things I did to help me with this skill was taking improv lessons.  There are many improv techniques that you can utilize here.  So grab a friend, co-worker or family member and start practicing.  If you want to learn more about how improve can help your PT interviewing check out this interview with improv and acting coach Harris Doran.
  • Learn motivational interviewing techniques. There are plenty of resources to sharpen your interviewing skills. You can start with this two-part interview with Dr. Bronnie Thompson here and here. Or you can checkout Bronnie’s blog HealthSkills for more resources.
  • Paraphrase and summarize your client’s story throughout your session. This is very reassuring for the client, as they will most likely feel like they are heard. For example you can say something like:

So what I am hearing you say is ……… would that be a fair assessment of what you are feeling and saying?

I use this phrase a lot! It can go two ways: the client may say “yes that is exactly what I am feeling/saying” or they may say, “actually that is not quite what I meant. I really wanted to say this.” Either way you are getting clarification of what is going on with your client so you can then communicate with them more effectively. That takes us right back full circle to the importance of communication in effectively managing expectations.

 

As you can see these tips are very much related and will intertwine throughout the entire patient experience (from the initial evaluation to discharge).  You should be mindful of your communication, level of empathy and your ability to listen at every encounter with your clients.  Actually, you should be mindful of these three things in every encounter you have with another human being….regardless of whether they are a client, a friend, a family member or a stranger.

With the move to outcome/value based care in the medical world, managing expectations by utilizing these suggestions may help to improve your outcomes.  For those of you who are business owners it may also help improve your bottom line.  When expectations are met, clients are more likely to feel positive about their experience and will happily spread the word about you to their network.

 

What else do you use to manage your client’s expectations?  I would love to hear your thoughts in the comments below!

 

xo

Karen

 

 

 

References:

  1. Mahomed NN, Liang MH, Cook EF, et al. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. The Journal of Rheumatology. 2002;29(6):1273–1279. http://www.jrheum.org/content/29/6/1273.short. Accessed June 10, 2016.
  2. Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Social Science & Medicine. 2001;52(4):609–620. doi:10.1016/S0277-9536(00)00164-7. http://www.sciencedirect.com/science/article/pii/S0277953600001647. Accessed June 10, 2016.
  3. Derksen F, Bensing J, Lagro-Janssen A, Radboud, Center NM, Netherlands T. Effectiveness of empathy in general practice: A systematic review. Research. 2013;63(606):76–84. doi:10.3399/bjgp13X660814. http://bjgp.org/content/63/606/e76.abstract. Accessed June 10, 2016.

 

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©2019 Karen Litzy Physical Therapy PLLC.

©2019 Karen Litzy Physical Therapy PLLC.