Editor’s Note: This article was originally written by Thea Lavin, interviewing Heather Stone (DPT, OCS) with Agile PT in San Francisco, CA, and published on August 25, 2016. Additional contributions and edits have been made by Katie McBeth on January 22, 2021.

Maintaining patient compliance in physical therapy has always been a challenge. Unfortunately, compliance has only gotten more complicated with our current COVID-19 health emergency, as many clinics have switched to offering remote care. With so many factors out of your control, how can you ensure your patients follow their plan of care and stay engaged in treatment?

Luckily, expert physical therapists have some advice to share. We’ve also included some telehealth tips at the end to help you maintain patient compliance through the pandemic.

But first, we’ve chatted with master PT, Dr. Heather Stone, at Agile PT to get some advice. Heather is known for keeping her patients on track to meet their movement and recovery goals. She specializes in orthopedic physical therapy, primarily treating hip injuries. In the following interview, Heather shared tips for engaging patients as they complete their plan of care.

Tip 1: Keep patients engaged with transparent and proactive goal setting.

While it may be impossible to force your patients to stay motivated during their treatment, you can foster an environment that encourages active engagement. According to Heather, two big motivating factors for patients are complete transparency during the process and letting them be active participants in their goal setting.

Each patient’s goals should align with their expectations and priorities. We’re fans of the SMART goal setting model: Specific, Measurable, Achievable, Relevant, and Time-Bound. Regular communication is also vital. At every step in the patient’s care plan, communicate and check-in on your patients and how they feel their treatment and goal setting are going.

Q: How do you inspire patients to keep them encouraged during therapy and prevent cancellations and no shows?

Heather: “I always, always make sure to connect what we are doing in therapy to the patient’s own goals and priorities. That shows them that this exercise that they have to do is directly related to getting them back to where they were. Taking that extra step to explain the process helps a lot to keep my patients inspired and encouraged.

“And if patients mention to me or someone from the clinic on the phone that they are having scheduling conflicts or anything is discouraging them, it is recorded in their patient chart. Regardless of whom the patient talks to at the clinic, their comment will be a note that pops right up for me in our Insight system. Then I can address it directly with the patient the next time I speak with them.”

Tip 2: Be proactive about helping your patients adhere to their care schedule and offer alternatives.

Sometimes one of the biggest struggles with maintaining a patient’s plan of care is simply getting the patient in the office regularly. For patients with busy schedules, being proactive about setting up appointments in advance can help them.

Q: How do you manage and monitor a patient’s treatment frequency?

Heather: “On a patient’s chart in Insight, there is a tab that tells me if a patient is scheduled for more treatments. So, when I am wrapping up a session, I can easily see if they are already scheduled for their next visit. I am always checking this to see if they are scheduled appropriately for their plan of care. If they are not, I will remind them and the front desk to set up their next appointment before they leave. Being proactive about setting appointments seems to work really well for keeping them scheduled with the right frequency.”

But if 2020 taught us anything, it’s that we should always expect the unexpected. When patients are unable to make it into an appointment, rescheduling can be tricky. If your schedule allows, you can block out time dedicated to emergency reschedules on either a daily or weekly basis. If no patient needs to reschedule that week, you can use that time to catch up on documentation, emails, or other tasks.

And if your patient is still too busy to come in regularly, consider offering them telehealth appointments if their insurance covers the option. Telehealth can be a more accessible option for busy patients, as they won’t have to worry about commuting to the clinic, finding child-care, or getting extra time off work.

Tip 3: Regularly request feedback to maintain engagement and gain referrals.

Maintaining patient engagement requires constant communication. Whether your patients are new or regulars, getting their feedback can be invaluable to your practice. One feedback option is to ask them how likely they are to recommend your business to family or friends, also known as the Net Promoter Score. And if a patient chooses to leave, finding out their “why” can offer a valuable learning opportunity.

Q: How do you determine if you are successfully converting new patients that call in?

Heather: “I focus on giving the patients I already see the very best in treatment. I give them excellence. Then through word of mouth, these happy patients refer people to me, and those people really tend to stay in therapy.

“Now I do also get patients that come to me from other places—not from word of mouth. If these new referrals cancel or choose not to start treatment, I try to reach out and call them to see if they asked any questions. [If] they are not going to come to therapy with me because of out of network benefits or they’ve deciding to go somewhere else, I can follow up one on one with those referrals and listen to their concerns.”

Heather also added that happy patients offer great word-of-mouth referral marketing:

“All of my new referrals are from friends or family members of current patients. Or they are from a handful of doctors that I have a great relationship with and respect what I do. These word-of-mouth referrals and strong relationships with referring physicians came from simply delivering my very best as a physical therapist. I connect with my patients and strive to provide the highest quality of care. The referrals come from this.”

If a patient reports high satisfaction with your clinic and their POC, you can also ask them to leave online reviews for your business, whether through Yelp, Google, or Facebook. Patient reviews serve as great referral sources and marketing for your business.

Tip 4: Use telehealth and other resources to maintain a patient’s plan of care during the pandemic.

If your clinic has had to limit in-person visits due to the pandemic, then your patients’ compliance may have suffered from the sudden change. Luckily, there are some tricks you can use to help maintain your patient’s plan of care, even at a distance.

  • Provide electronic educational material to patients: For some patients, telehealth appointments may be brand new. Before their first appointment, provide them with a tip sheet to help them access your telehealth service provider. You can also include a few frequently asked questions or troubleshooting tips if you find you answer many of the same questions during appointments. Additionally, provide tip sheets that either illustrate or help them understand the exercises you’re going to walk them through.
  • Provide a HIPAA-compliant messaging service or email: If your patient is struggling to access your telehealth service or has questions before or after the appointment, an online messaging portal may help them stay motivated. If you don’t have a messaging service already established, offer them an email address where they can direct their questions. However, ensure someone at your clinic is regularly checking that email so patient concerns can be addressed promptly.
  • Let patients schedule appointments online: Since your telehealth patients won’t pass the front desk during their appointment, remembering to schedule them for their next visit may be more challenging. However, if you let them schedule their appointments online, you can offer them the autonomy to fit the appointments into their schedule. And if they’re still struggling to remember, you can create regular text or email alerts to remind your patients of upcoming appointments or ask them to schedule their next one.

Completing a patient’s plan of care is one of the most significant factors tied to clinic success. While many factors may be out of your control—like pandemics, patient motivation, and time—with these tips you can foster an environment that empowers your patients to complete their plan of care.


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