Physiotherapists - Why I hired and fired Private PT

[ManjiB]

Physiotherapists - Why I hired and fired Private PT

I just read another post on the subject of physiotherapy which I found very interesting.
I am creating this post separately as I do not wish to detract or distract from the original posters post, but I have included a link at the bottom of this post for reference if anyone is interested.

I hired a private physiotherapist because Mum had been denied suitable access to NHS physiotherapists after she had her stroke.

I fired the private PT because they had not established goals and objectives!

With no goals and objectives we didn’t know what we were getting and when we would get it. As it turned out they “talked the talk” and failed to deliver.

At a rate of GBP 120 /hour and three sessions a week we had expected to see some results. Instead, we had a distressed Mum by the end of the period when I decided they were clueless and using us as a cash cow.

So for me, it is absolutely essential that a PT knows the objectives/aims/goals/targets so that we can check/measure progress. Without that you are shooting in the dark!

Background - research/consultation:

Physiotherapy Decision - Stroke Survivor Perspective/Dilema

This post is to get you to imagine yourself in the position of a hypothetical stroke survivor based on a real-life stroke survivor and to make a decision as to whether or not you would look to taking on some physical activity assisted by a professional physiotherapist to improve the quality of your life. Major/Key considerations You are in your mid-90s You have been physically inactive for over five years Physical activity may or may not improve the quality of your life Situation You survi…

Background - What happened:

Physio sessions - duration

Greetings! This might be a “How long is a piece of sthring” question, but I must ask it as I do require some pointers. I am looking to get some private physio for my Mum as the NHS / her care plan does not thing it is appropriate or necessary. This is primarily down to her age (very senior citizen in her mid- 90s) and also the fact she has been “immobile” and not weight bearing since she had the stroke. We are hoping that we can find out of there is any potential for her to become more mobile…

Post that led me to create this post to share my views without detracting or distracting from the post.

The importance of words

I am having fortnightly visits from an NHS physio since my discharge in October. She is pleasant and efficient, knows the private physio I am seeing and is not at all phased by the arrangement. However, yesterday she said something that really rattled me. She asked what my “aims and objectives” were. This, to me, is corporate-speak. I am damaged from the stroke, it’s no use me having ‘aims and objectives’ because I am limited by how well my brain is going to heal, which is an unknown. It’s the s…

[Jbob]

I had a severe spinal injury almost 20 years ago , hit and run by a driver and found both NHS and private were a mixed bag. I felt fine but the pain in my left leg was almost permanent 3 of each before 4th private paid for by the other party done a quick assessment told me my pelvis had been forced/ reset out of alignment.

My goal was to walk. run and get back to my hobby of martial arts all done but the resetting of alignment smarted a wee bit. Offered gas and air but declined but the rotation and snap into place hurt like hell. A great physio who I still see now and again worth her weight in gold.

[EmeraldEyes]

Did you ever try an osteopath for your mum Manjib?

If I had the money that’s where I would have gone first. The one I used to go to even avoided having my hip replacement for many years. Got me up and running pretty soon after a car accident many moons ago.

Lorraine

[ManjiB]

It is really great when you find that nugget and they are nuggets!

[ManjiB]

Hello Lorraine - there are many things that I could/should have done which I haven’t. If I could turn back time and go back to day 1 of Mum’s stroke or even 6 months prior things would be so very different as I have learnt and am still learning so much about how to do things.

I guess my biggest problem was ignorance, the fight against ageism which has been a major hurdle and which continues to be a problem today. Almost all my attempts fail as soon as I explain Mum has had a severe stroke and she is in her 90s. No one wants to know and I keep getting told it is too risky to do things. Anyone who offers any hope is then not supported i.e. their bosses won’t sign off.

The private physios I have tried - first one gave an initial assessment and ruled themselves out on the basis they can only help if I could take Mum to their office/surgery which at the time was not possible and even today I would have to think twice. The one who agreed to do the home activities simply was not up to scratch as they made promises/claims which they were not able to support.

I don’t have enough knowledge to think osteopath (do I even know what that means) and until you mentioned it, no one else had.

In a nutshell, to everyone Mum is in “palliative care” and we should just keep her comfortable. Nobody has yet seen the potential and what might be achieved. I am afraid to say, whilst I am not “poor” I don’t have the financial resources to go private and that last attempt with the physio was a strain on the finances but I was willing to take the hit but needed to see some evidence / benefit.

Would an osteopath even look at Mum? I can imagine them saying they same thing - too old, let her be.

But it’s OK, as bizarre as it may sound, Mum is still on the upward path and she is being helped by her natural powers, her strength and desire. She refuses to give up.

She has just badgered me and my sister for an hour to get what she needed and she got it and now she is snoozing!

Sometimes, I am scared to do things but really I shouldn’t worry. If only I had access to some of these things, access to someone who believes what is possible if only they were to look outside their blinkers.

Until then, it is Mum, Mother Nature and whatever me and my sister can cobble together

[Dexster]

Professionals do vary in competence, so kudos to you for investigating who could best help your Mum, regardless of job title. A good osteopath could well be of help. So could a better physiotherapist. Your Mum sounds the sort of personality that would get the best out of whatever treatment you find for her. I hope the right professional comes your way soon. I’d say “Don’t give up on this” but you don’t sound the kind of son who would.

[EmeraldEyes]

I know my osteopath specialised in stroke patients. Whether you’d get the ageist reception, I don’t. I do suspect a good one would have got some movement to your mums stroke side. With some of the muscle work and manipulation, it can be weeks before you notice any real result. I think that’s why so many give up, aside from the cost, they’re looking for instant improvement and feel its a waste of money. Don’t get me wrong, some improvements can be instant but that depends on the nature of the issue.

But it can be as costly as a private physio and how much good they could do for your mum is anyone’s guess. I know there are plenty of videos on the net of the kind of things they do. There is one Scottish guy who teaches it whom I find fascinating to watch, I watched him Tiktok but I can’t find him youtube. And actually, we were talking about this in another post:

Is Stroke Impairment Ever Really ‘Forever’? Rethinking Plateaus and Long-Term Impairment.

I went to a College of Osteopathy rather than a private clinic. Because it’s a teaching school, the treatment cost me well under £30 per session. Appointments were longer, around two hours, and I was treated by final-year osteopathy students under the supervision of experienced lecturers. If you’re struggling with costs, it’s worth looking for a reputable osteopathy school or teaching clinic in your area. You can still receive high-quality care at a much lower price.

You live down south don’t you? You might have better luck than I did finding a teaching college, as they all seem to be down that way.

The difference between an Osteopath and a Chiropractor

And I’m just going to throw this one in that I’ve just come across just because I do these and my back feels so good afterwards

Lorraine

[ManjiB]

Hi Lorraine - thanks for taking the time to follow up on this. I appreciate you doing that

The difference between an osteopath and chiropractor graphic is very good and it clarifies for me. I must try to see if any are available locally and if they are willing (non-ageist).

I was thinking of going to another PT having concluded that last one is not going to be able to help. I believe there might be one locally but again, the issue will be Mum’s age as I know they are highly recommended but the person recommending them is 40 years Mum’s junior and better able to communicate than Mum.

[Rups]

One hundred and twenty quid an hour I realise people need to make an income but considering the going rate for an NHS physio is about £15, at £120 you’d not only expect physio but a glass of complimentary champagne and a massage as well.

[Dexster]

We arten’t paying for what they do, but for the fact they know how to do it. and have had the right training. Compared to other professionals, it isn’t a lot of money, though a lot for us to find nevertheless.

[Rups]

I think service based fees should be offset to the client’s income I think that would be a good system and would work well across the board.

[ManjiB]

Unfortunately for us, this was not proven.
I gave them one month to demonstrate or prove they knew what to do and how to do it.
Sadly for us the failed miserably.

This is not my first experience of NHS vs Private.

I have found that NHS consultants moonlight as private consultants and I expect the same applies to other professionals such as PTs.

So the NHS consultant puts on a private hat and in the example Rupert gives, he charges 10x the rate (rounded for simplicity)? Yet, he has brought nothing new to the table i.e. if he is doing it privately why was he not doing it when treating me under the NHS? Same person, same knowledge/training.

This is just my experience and maybe others have benefitted from private treatments. Personally, I will stick with the NHS.

I even had one doctor who wanted to charge me £15 or something (it was a few years ago) to write me a sick note on some fancy paper (private rather than NHS) - absurd. There must be a sign “FOO” tatooed on my head !!

I am glad I had the sense to ask for a review after a month to justify what they were doing, had done and intended to do and I believe I made the right decision. They even had the nerve to say we can “work the way you want” - read into that what you will.

In closing, I should add we actually had a wonderful PT who came to us via the NHS, but he was not able to support us as he would have liked because his NHS boss would not sign off the suggested treatment plan.

[AlisiaGayle]

I started out with private while waiting for NHS. Cost me £100 an hour. Then got NHS and realised that the excercises given by private had zero chance of working.

[AlisiaGayle]

Yes, I do live down a south.

[Dexster]

My experiences were entirely opposite - the private practitioner was streets ahead of the first NHS ones, though the NHS one I see now is very good. Maybe it isn’t just the training but the Continued Professional Deverlopment, as it’s called. Same as I used to see a private chiropractor - then he retired - who did far more for my sports injuries thsan anyone on the NHS. In any profession, individuals will vary in competence. They may have passed the same exams, but it’s about how they work with the information in front of them. And the restrictions their professional body imposes.

[harimanjaro]

Last year I had a mixed experience of NHS and private. I saw an NHS stroke consultant, who was at best adequate, and a private cardiologist who was fantastic. Then I took my daughter to see private physiotherapists (one good, one really good) who referred her for an NHS scan which wasn’t going to happen so a private MRI (very good), private consultant (useless, waste of money), NHS consultant (brilliant) and now she’s on an NHS waiting list for arthroscopic surgery (frustrating).

I think it’s a lottery.

[AlisiaGayle]

Seems like it which is a shame when you are spending so much on recovery.