❓ Are you considering healing potential when determining prognosis❓
One thing that I see commonly in the PT profession is evaluation notes that report "good" prognosis across the board. How can this be possible given the heterogeneity in the patients we see? My speculation is that many defer to the "good" prognosis because 1) they're not thinking critically and/or 2) they don't want insurance to deny coverage for anything less than "good". The truth is, prognosis is not uniform! We need to be considering a great deal of factors from all angles of the human dimension (biopsychosocial) when determining prognosis, one of which, is the actually physical ability of the body to heal itself.
This graphic highlights patient factors that contribute to delayed healing. I find that many outpatient healthcare providers only consider incisions and open wounds when they think about "healing", but we must consider the role of the immune system in tissue healing in general - muscle, tendon, ligament, nerve, bone, cartilage, synovium, etc. The immune system plays and active role in repairing damaged tissue (this is a constant, unconscious process). If the immune system is functioning suboptimally, then healing, and therefore recovery potential, may be affected.
When you evaluate a patient, consider the follow:
Is the patient taking drugs that are immunosuppressing in any way?
Do the patient fit the profile for "silent" atherosclerosis: age > 40, obese, diabetic, smoker, family history of heart/vascular disease
Does the patient exercise? Have they ever? Are they sedentary?
Does the patient eat a well-rounded diet, rich with antioxidant and anti-inflammatory foods?
All of these factors contribute to systemic inflammation, which can influence normal recovery. Ensure that you are considering the patient's recovery potential, which includes consideration of these factors that contribute to delayed healing, when you determine & communicate your prognosis.
We talk about this extensively in our Foundations for the Primary Care Therapist course. Sign up for one today! https://www.redefinehealthed.com/primarycarept
Comments