Is communication between physical therapists (PTs) and doctors a problem in hospitals?

Communication Between Physical Therapists and Doctors in Hospitals: A Significant Problem

Poor communication between physical therapists and doctors in hospitals is indeed a significant problem that negatively impacts patient morbidity, mortality, and quality of life. While guidelines specifically addressing PT-physician communication are limited, evidence suggests that communication barriers between healthcare providers directly affect patient outcomes 1.

The Nature of the Communication Problem

Current Communication Challenges

• Physical therapists report wanting increased accessibility to and communication with physicians 1
• Physicians desire brief, clear, objective data from therapists 1
• Time constraints significantly impact provider communication - in a typical 15-minute clinical visit, providers spend only 8.8 minutes in face-to-face care, with the remainder devoted to electronic health records and administrative tasks 2

Impact on Patient Care

• Poor interprofessional communication can lead to:
  • Missed critical patient concerns
  • Medication interruptions
  • Decreased patient adherence
  • Lower patient satisfaction 3
  • Increased post-surgical complications 4
  • Extended hospital stays 4

Evidence-Based Solutions

Structured Communication Approaches

• The American College of Physicians emphasizes that patients should be "active partners in all aspects of their care," which requires effective communication between all healthcare providers 3
• Physical therapists should:
  1. Identify physicians with whom they can communicate most easily
  2. Learn physicians' schedules
  3. Organize information beforehand for clear, concise communication
  4. Be polite but self-assured
  5. Seek advice from supervisors or other staff therapists
  6. Use telephone communication discriminately 1

Interprofessional Communication Training

• Communication training should be integrated throughout healthcare education and practice 5
• Training should focus on both technical skills and reflective practice 5
• Effective communication training has been shown to reduce hospital length of stay (by 1 day), decrease post-surgery complications (tachyarrhythmia reduced by 15%), and improve patient ratings of care 4

Electronic Communication Considerations

• Guidelines for electronic communication between healthcare providers need updating to reflect current technology and practices 2
• Focus should shift from technical concerns to relational aspects of communication 2
• Secure messaging systems have shown promise for improving adherence to evidence-based guidelines, particularly for chronic disease management 2

Practical Implementation

For Physical Therapists

• Take initiative in developing rapport with physicians 1
• Recognize that each physician differs in personality, philosophy of patient care, and expectations of physical therapy 1
• Provide clear, objective data in communications 1
• Use the "I'm Late" mnemonic for effective communication:
  • Impression: Invest in first impressions
  • Minute of silence: Listen fully before responding
  • Listen actively
  • Acknowledge concerns
  • Touch appropriately (physical examination)
  • Empathize 2

For Healthcare Organizations

• Implement integrated clinical programs with multidisciplinary providers 2
• Ensure flexibility in scheduling and minimize administrative inefficiencies 2
• Establish "communication report cards" for providers and healthcare practices 2
• Provide formal training programs to enhance specific communication skills 6

Conclusion

The communication gap between physical therapists and physicians in hospital settings is a significant problem with direct implications for patient outcomes. Addressing this issue requires structured approaches to communication, interprofessional training, and organizational support. When implemented effectively, improved communication between physical therapists and physicians can reduce hospital stays, decrease complications, and improve overall patient care 4.