The 4-Phased Approach to Care

Your patients generally have a singular goal when coming to physical therapy – Pain Relief!  However, your POC most likely maps out more than just pain relief.

How do you sell your POC to your patient? By presenting your 4-Phased Approach to Care during your initial eval.

The 4 Phases of Care consists of the following:

  1. Pain Relief Phase
  2. Mobility and Flexibility Phase
  3. Strengthening and Core Stability Phase
  4. Endurance and Aerobic Enhancement Phase

The above is not a revelation. I am sure it is what you do. In fact, I would imagine it is what everyone does.

To get a better handle on patient attrition, it is vital that you educate your patient on the rehab process and get them to buy in on day one.

What you could say at some point during your initial eval:

“Most of the conditions that we treat have been brewing in the body for some time before the symptoms present themselves. It is usually when pain or discomfort arises, that our patients will seek some relief.

“As an example, when you catch a common cold, the “bug” has been in your system for some time before you begin to have symptoms. The body has a threshold of tolerance. Once the “bug” overcomes that threshold, you will have symptoms. In a weakened system, you can be taken out of commission for weeks whereas in a healthier individual with a higher threshold, you may bounce back in a day or two.

“The condition that you are experiencing is likely not different than the common cold. We will focus first on reducing your pain and discomfort as that is the primary reason you are here. Our ultimate goal is to raise your body’s threshold of tolerance so that the condition does not come back. In order to do this, we have a 4 Phased Approach to Care.

“Here are the 4 Phases of Care

“Phase I  –   The symptoms of pain and discomfort reducing or eliminated. Our approach to care will initially focus in this area as it is commonly the primary reason that you may be coming in to see us.

“Phase II –   In Phase II, we focus on improving your general mobility and flexibility. This is to make you more resilient and more able to tolerate motion/movement without recreating the pain.

“Phase III –  In Phase III, we focus on improving your strength.” If your problem is in the spine or pelvis : “We will focus on core stability to protect the area and improve the overall support.” In cases related to the arms and legs:  “We will focus on strength and stability so that as you use your body it performs correctly without undue strain on your joints.”

“Phase IV – In Phase IV, we add activity to improve your body’s overall endurance and aerobic condition. This could be strengthening of your core or extremities by using a low resistance with higher duration exercises. This approach is designed to improve your body’s oxygen supply to the area and promoted long-term healing.

“Our practice has a very strong reputation for its results. The smart utilization of this 4 Phased Approach to Care is our “secret sauce”. I hope that you can see the value in this approach.

“So, here is my recommendation to best achieve a long-term or permanent outcome from physical therapy:

I recommend that we see you __________ times per week for a duration of ___________ weeks.

“As your condition improves, I may recommend that we reduce the frequency but extend the duration because no two bodies are entirely the same.

“Does this approach make sense and do you agree that this is the path that we should take?”

Handle any concerns that they may have but get their buy in.

There is more to the 4-Phased Approach to Care and its use during follow up visits that I share in my webinars along for a presentation file for the patient to sign to attest that he agrees to the 4-Phased Plan of Care for his condition.

I hope to see you in my webinars!

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2 Comments

  1. Phyllis Aden on July 24, 2020 at 1:42 pm

    This is very good information. Thank you Shaun. It makes sense.



    • Shaun Kirk on July 30, 2020 at 9:00 am

      Yep! We’ve got many amazing tips!