Hello all. Well this is a blog post that I am sure will hit home with many manual medicine therapists of all types out there, and I hope patients too! I want to comment on the concept of therapy, patient expectations (both realistic and unrealistic) and the partnership of care.

So what am I talking about? Well, I am talking about the person that is sitting in front of us as a patient looking for help, for answers, for hope for whatever it is that they are seeing us for and of course their expectations of what we can do for them. Read what I wrote … the PERSON. They are not an elbow, a lower back or a knee. I think you see my point. As such, both parties must understand and respect the fact that the life and lifestyle of that person without question should and will influence the partnership of care they are entering into.

Let me be more specific with some examples. Is it realistic for a lower back pain patient who let’s say is a de-conditioned individual who sits at a desk all day and then comes home and eats potato chips on the couch while they watch 3 hours of television to respond to care in a timely manner without taking some personal responsibility to make some changes to their lifestyle. Is it not also partially the responsibility of the care provider to encourage those changes rather than blindly continue to just rub, prod and crack? Does the chronic headache patient who is under high stress levels not need to find ways to manage those stress levels in order to assist in the care process?? Of course! Yet, too many times there is an expectation or hope by both patient and care provider of some magic technique or procedure that will be the answer to all.

Areas of the PERSON that I have learned in almost 17 years of practice that will absolutely influence patient response include:

• Level of conditioning (this is huge and in most cases can offset almost any obstacle)
• Adequate sleep and regeneration
• Overall mental attitude and stress management
• Overall nutritional habits

I challenge anyone out there who is struggling with some sort of health challenge to think about this. Perfection in any of these areas in unrealistic and that in itself can be a problem for some, but complete dependence on a health care provider to “fix you” while other areas in your life are in disarray is an unrealistic expectation. This is the simple truth. Test it yourself if you don’t believe me. For a month or two start walking 30 minutes a day, schedule your sleep to be more consistent, bring your lunch to work or school every day instead of buying it and try to focus on the good things in your life instead of dwelling on the bad. Then build on what you started. I promise you – the outcome will be worth it!