Discharging patients

On my recent Musculoskeletal Outpatient placement, I often found it difficult knowing when to discharge patients. I found patients were generally kept on longer than they may traditionally be in a private practice setting, with patients often been re-booked on a weekly basis for months on end, and for ongoing, follow up appointments every 2, 3 or 4 weeks. While I realize these patients are often kept on for our own good, so that we get as much exposure to as many patient conditions as possible and that we may not achieve improvements as quickly as experienced Physio’s, I often felt guilty for continually booking patients in, especially when they were private patients paying by session. I didn’t however feel so bad when they were public patients who weren’t paying for the service.

I started to think, that we should really be giving patients a more ‘acute’ bout of physiotherapy in order to see if we have a positive effect on their condition, and should they not be showing ongoing improvements over a month or so, they should probably be referred onwards. While not all patient conditions fit this criteria, it seemed quite obvious that many of the public patients especially were being kept on for much longer than required. I don’t know how right my way of thinking is, and I guess booking patients for more rather than less sessions is always going to be better, although it may not be the best practice.