Since my best friend’s wife (who is owner of her own beauty shop and I’ve seen for 5 years) is out on maternity leave, I’ve succumbed to go to one of these generic haircutter businesses near my home. Now most of the time when I am dealing with other businesses (local coffee shop, tailor, haircut, pool guy checking on our pool, etc.), I critique internally how this individual interacts with me and reflect on my daily interaction with patients to see how I can improve. You know the old saying, “treat others as you wish to be treated”. Today, it was not the verbal communication I want to comment on how this young lady could have improved, but the nonverbal exchange.

Getting your hair cut is a one of a kind business. It is a service that you need every few weeks to months, you can make your own decisions on who you go to (and not pressured such as in healthcare) and a one of the few businesses that has a personal relationship. If you have read something similar to this before, you may have. Mike Reinold wrote a piece quite a while ago on “What We Can All Learn From a Barbershop”, a great post and one of which I share with my interns and since its not a topic search engine keyword, it is worth sharing his post again (find it here). This post is intended for all therapists, but especially young grads and students or ones who have to treat a colleague’s patient, with the example of how to approach a patient through a manual approach who has…say…local cervical pain. I will break it down into 3 components:

Comfortable, for you and the patient

Start with an approach that you are comfortable with, and even more importantly, comfortable to the patient. This can be a “way in” even if you feel they need something more (such as mobilization, manipulation, more local soft tissue work). I will typically teach my interns to start with suboccipital releases or light traction to get a feel of the tissues, the interplay between the patient and your hands, and simply to work your way in. Let the patient get comfortable to you, especially since they know you are still learning or even for experienced therapists if you are filling in for a colleague. My experience today began with a rough (I felt it was rough!) clippers to my occiput such as a hedge trimmer to weeds. This initial nonverbal interaction leads to my next element.

Build Confidence

I usually zone out while getting a haircut as I am relaxed and basically trust the hair dresser’s skills. However, after having the non-comfortable initial contact, my confidence in her immediately sunk. This led to me staying heightened as I wasn’t sure what would come next and knew this wasn’t a master beautician. You don’t have to be a master clinician and can’t jump to 10 years of experience, but you can build confidence, and you need to build it fast.

Come to an agreement on success with you and the patient

The interplay with the patient in front of you should be a two way street. It is a constant assessment both from your standpoint and the patient’s viewpoint. Give consistent feedback through the session on how the tissues feel, how their symptoms are responding, etc. Instead of “is this cut enough”, provide your experience too, such as “this area is much less tender and you have less muscle spasm than before we started” or something to that extent.  If you can satisfy yourself with your work, then you can satisfy your patients.

So the interaction all starts with being comfortable.  This is the invisible road to opening doors and creating outcomes.  My dad always said the difference between a good haircut and a bad haircut is 3 days.   However, first impressions (and not bad haircuts) do not go away.

I am sure the readers have tens of other examples of this and I would like to hear back. It is always a good teaching tool to create analogies for our everyday services so we can all learn to be better clinicians.


  1. I’ve frequently had this comparison in my head when I think about the interaction between PT and patient in the insurance based model. There are some clinics that spend about as much time with the patient as the barber.
    I hadn’t thought so closely about the “what you can learn from” angle though.

    Thanks for sharing, there’s a lot to be learned from the barbershop!

  2. Sticking with the barber shop theme. If you walk into a barber shop and you are deciding who to go to, you want to avoid the hyper/jittery guy all alone in the corner. I think that initial contact with the patient, especially when you are covering for a colleague is crucial. When you go out to the waiting room it is so important to present yourself confident and calmly. If someone is about to have their neck/back worked on, they don’t want the confused looking therapist or the drill sergeant. I have all my students go get the patients from the waiting room because I think it is such a crucial skill for a therapist to have and probably one that is overlooked too much!

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