I would firstly suggest that this answer could be responded in many different ways and involve a number of factors! However, the following 3 domains is what I would consider my treatment as an accomplishment:
1. Decrease in Pain (symptom) Rating
This one is obvious but honestly makes a lot of sense. It is one of the most objective measures a patient can provide you in a quick and reliable way. Pain is what brings people in to see us so it has to change! I usually inquire about pain in the clinic on a verbal, numeric scale from 0 to 10; rather than on a 10cm visual scale. It is instant and simply gives me the data I need. A clinically meaningful change is 2 points so I would strive for at least this much improvement (patient arrives with 5/10 pain and it decreases to 3/10 upon departure).
I place ‘symptom’ in parenthesis above as some individuals do not considering their complaint ‘pain’, but numbness/tingling/burning or discomfort, etc. Also, I have been striving to talk more about symptoms, rather than constantly asking about pain. It is a better psychosocial approach.
I normally encourage my students to strive for better than 2 point improvement. Shoot for the stars and try to abolish all pain, but we know this is not always possible.
Another tidbit is that I always assess the pain or symptoms with the movement pattern that was assessed earlier in the treatment. Absent pain at rest is meaningless if not changed with movement.
2. Patient understands how to manage their symptoms
In short, I feel much better about a treatment if I know the patient can relieve their symptoms independently; rather than rely on me. Don’t get me wrong, I love giving people relief by something I do and absolutely feel manual therapy is needed in a lot of cases, but I always encourage self-treatment from the moment the patient enters the clinic. I try to have 1-2 exercises (or activities as I talk to patients as sometimes ‘exercise’ can be perceived as a unfriendly term) that they can perform consistently. I normally do not try to give more than 3 exercises at the most as I feel adherence rate decreases with a heavily loaded exercise program.
3. Know that the patient’s money & time was well-spent that visit
This is more of a gut feeling and self perception by myself, the therapist. I want to know deep inside that I gave it all.
Patients come to us for a service. I encourage my students to think of what we provide is a more of a service but of a product, and we want that product to be of upmost excellence. I want that patient walking out of the door knowing the co-pay, or self-pay, or 20% that they may owe after insurance was well worth it. Everyone’s time is valuable too. Make sure you give in abundance. Go above and beyond what they would expect from seeing a physical therapist. If you enjoy what you do, then you will remember ‘if you can satisfy yourself, you can satisfy your patients’.
I have left out many more options! I would like to hear your feedback on what you think is a successful treatment.