Video Consultation vs Hands on Treatment
Research has shown that patient satisfaction with video consultation is as good as face to face and in some cases has a higher satisfaction rate than direct hands on treatment. How can this be the case?
To understand this we need to explain how the “hands-on” treatment makes you feel better. What the general public may not necessarily know is that a treatment is made up of two parts, ie it’s not all about the hands on massage or manipulation.
As we see here it can be summed up:
Treatment = (i) First Aid + (ii) Explanation of problem & Self-care Advice
Breaking this down further we see that (i) First Aid is what the hands-on bit is: the massage, manipulation, the stretching, relaxation, moving of muscles and joints etc. For many people who have experienced a physical therapy such as Osteopathy, Physiotherapy, Chiropractic they would relate to this.
But if you ask the opinion of a healthcare professional, it is actually the second bit (ii) the Explanation and Advice that denotes how successful any recovery is ever going to be. First aid can help you over the “hump” but what happens if you slip back again. That is what (ii) tries to address.
Expressed simply, the first aid treatment helps the body take a step forward. But if the patient goes back into daily living without taking care they may take 3 steps backwards. In other words “if you always do what you've always done, you will always get what you always got” – and that’s how many of our patients ended up seeing us in the first place. We work to break this cycle.
So to get better and stay better (which is what this is all about), the patient needs to go through two transformations. One is to understand what has happened to them and the other is to understand why they are not getting better. Once a patient understands this intellectually and emotionally, the next step can be completed: taking the advice. It’s only when a patient takes ownership of the situation do they make the lasting changes needed to get back to their former great health.
As I say to my associates when they join the Living Centre Clinic here in Raynes Park, back pain is won and lost not on treatment tables, but inside the hearts and minds of the patient. Because there is no motivation like self-motivation, and once a patient has understood what to do, when to do it, what to avoid, when to rest, what exercises they can do etc, that’s when they buy into healing, and that’s when healing happens.
From a medical point of view, the second part of the equation is really about creating a safe and stable environment in which the body’s own healing juices get a chance to work, unimpeded by wayward demands of life or sudden physical insults on the body. I often say healing is like a tank of petrol you get each day. If you squander that doing “silly” things, you don’t fully complete your healing cycle for the day.
When one understands the importance of the equation I have outlined, one can see how the video consultation emphasises the second part of that equation. And arguably it’s the most important in helping the patient to complete the body’s healing cycle. In fact a well delivered video consultation should be able to deliver both components: First Aid Information & Explanation/Advice.
On a personal note I have an estimated 50,000 treatments to my name and have been practising massage from my childhood. With these years and treatments to my name I think it’s fair to say one develops dexterity in managing patients and their conditions. Some patients need direct instruction, some don’t like to be told what to do, some prefer you to guide them, some need to change just one to two things in their life, and others may need to take a complete review of their lifestyle. Some patients are better at following exercises, some better at following advice – and some neither.
Like one patient said to me years ago “It’s hard being good just to get better!”. So, by listening to the patient, the tone of their voice, the way they express themselves, facial expressions, body posture and so on, I build a way forward for them. These all go a long way in helping me to curate a tailor made healing package for the patient.
Its all part of looking after someone, taking a personal interest in their welfare. And that I feel is what I do best. Working together with the patient on their healing journey. No matter how short or long. Motivating, supporting and guiding the patient through what can be a vulnerable time in their lives.
So I hope you can see the key part of healing is the second part of the equation “Explanation and Advice”. And whether a patient knows it or not a successful clinician will deliver on this. And that’s why video lends itself so well to healing. Much of this can take place in the comfort of your own home or office, at a time to suit your diary, and if you need a face to face or a hands on treatment you can always book you in.
Vispi Jamooji DO PGCert SPOP, GOsC (1986)
Osteopath, Cranial Osteopath, Specialist Paediatric Osteopath