3 Ways Every Therapist Can Improve Patient Engagement

Have you ever treated a patient in the clinic you knew just didn’t want to be there? Or do you know a home health patient who works hard when you’re around but neglects therapy when you’re not? Patient engagement—or lack thereof—greatly contributes to a patient’s outcome. In this post, I’ll unpack three ways you can better engage those patients and help them achieve their goals.

The Value of Patient Engagement

Patient engagement is a critical component of the care process. An engaged patient understands the importance of therapy as well as their role in its success, with an earnest desire to meet goals and make progress.

Not only is an engaged patient easier to treat, but research also shows they’re more likely to succeed. Data from this cross-sectional study imply a direct relationship between a patient’s engagement and their health outcomes. So many rides on the patient’s follow-through, in the clinic, and especially at home.

But not every patient is enthusiastic about therapy. In fact, patient adherence to exercise rehabilitation is reported to be as low as 35%. Many patients cite pain or a dislike of exercise as the reasons for non-adherence, while others don’t expect therapy to help and are unwilling to put in a sizable effort to see results.

Engaging an unmotivated patient, whatever their reason, can be a challenge. But with these three tips, you can help them make the most of their time in therapy.


1. Create Relevant Goals and Review Them Often

Goals are the backbone of everything we do in the therapy clinic. If the patient doesn’t have a goal, they’ll have little motivation to continue therapy when it becomes challenging. Research suggests that relating therapy to meaningful goals is one of the best ways to build engagement in the clinic.

So sit down with your patient and help them identify a few good goals. The best goals reflect your patient’s lifestyle and favorite activities. Perhaps they need to focus on knee flexion not only to ascend the stairs in the clinic but to get up the steps to their daughter’s front door. Being able to walk further for longer will not only qualify them to discharge from PT but will also allow them to go on that walking tour of Paris they’ve been dreaming of. As the therapist, you can help break down these goals into achievable milestones for the short-term and long term. You can also ensure the patient understands a realistic timeline, given their age, injury, support at home, and other medical conditions that could impede recovery.

Come up with a few goals—whether it’s to return to work without pain, to play on the floor with grandchildren, or to resume a favorite hobby such as tennis or golf—and write them down. Researchers believe writing goals down improves the likelihood of completing them. In the popular book The Power of Habit, author Charles Duhigg cites a study in which patients were asked to create goals for their recovery following a knee or hip replacement. The patients who wrote down their goals were able to walk almost two times earlier than those who hadn’t written them down. Milestones such as getting up and down from a chair unassisted came nearly three times sooner for the goal-writers than for the non-writers.

Importantly, these written goals were specific, such as walking a certain distance each day, and covered foreseeable obstacles, such as pain or fatigue, and how to overcome them. Some goals also included a reward for motivation. For example, one patient resolved to walk to the bus stop each day to meet his wife; seeing his wife was a built-in reward as well as a source of accountability. This goal also incorporated details such as what he would wear, what time he’d leave, and what pain medicine he would take if needed. 

Now, you don’t need to aspire to that level of specificity with each patient. But take from the study the simple fact that written goals hold more power than imagined ones.

Once you’ve identified, outlined, and written down a couple of therapy goals, keep them in your patient’s file and review them regularly with your patient.

2. Incorporate Interactive Accountability

When it comes to patient engagement, setting a goal is a great place to start. But some patients need a little more encouragement throughout the week to keep them on track. That’s where interactive accountability comes in.

Simply put, interactive accountability encompasses the many ways you can support, motivate, and encourage your patient in-between visits. One example is to use an interactive home exercise app like MedBridge Go. This handy interface displays your Home Exercise Plan or HEP, complete with demonstration videos, in daily doses that won’t overwhelm the patient. You can program the app to gamify your exercise treatments and automatically remind patients of their daily goals.

Besides making your HEP more fun, an interactive app like MedBridge Go helps patient track their own progress. With each day that your patient performs their HEP, they’ll recognize the role of incremental milestones in their overall recovery. That may be why the MedBridge Go app helps improve outcomes in 90% of its users.   

Some patients might not need all the bells and whistles of an app to be held accountable, however. For low-tech accountability with walking, for instance, you could give your patient a pedometer to wear and ask them to hit a certain number of steps each day before you next see them. Other patients might benefit from a midweek “check-in” call when they can voice a complaint or ask a question that would otherwise prohibit their progress.

Therefore, consider offering telehealth appointments in-between visits. With both audio and video feeds, you’ll be able to monitor your patient’s tolerance of therapy, assess whether they’re taking appropriate medication, and coach them on their home exercise plan.

For example, suppose your patient is having trouble performing a particular exercise at home. In that case, you can address the issue right away by either coaching their movement on the screen or suggesting a modification. Being able to tweak a HEP mid-week can help keep the patient on track so they aren’t discouraged by something that they feel is too hard or painful. 

Whether it’s through an app or over the phone, the interactive accountability you do in between visits is legitimate, valuable work that CMS now recognizes as remote therapeutic monitoring or RTM. With the new RTM billing codes that CMS rolled out in 2022, many therapists have been able to increase their efforts toward enhancing patient engagement while being compensated for it. Check out this post for more info on RTM!

3. Provide Education Resources

Education informs and fuels a patient’s engagement, and educational resources can empower your patients with the knowledge they’ll use during and after therapy sessions.

What kind of information should they know? To start, patients should have a basic understanding of their condition, from diagnosis and complications to treatments and prognosis. They should also learn about any lifestyle changes that can help support their therapy, such as medication, home preparation, dietary choices, and sleep habits.

With the glut of information available online, you may wonder whether you even need to provide these additional resources to your patients. Can’t they just find out online? But keep in mind that not all information online is accurate or relevant to your patient. It’s better for you to supply the information, even if unsolicited than to leave it up to a curious patient’s internet search.

Your clinic might have its own library of information sheets to give patients but don’t forget to check online yourself for helpful handouts. The CDC has a lot of resources for chronic diseases such as heart disease, arthritis, and diabetes, as well as tips on creating easy-to-read materials of your own.

Every patient is different, and yours may not be interested in the extra homework. But the more your patient can learn about their condition, the more empowered they’ll be to do something about it.

Final Thoughts

As the expression goes, “You can lead a horse to water, but you can’t make it drink.” Educational resources, written goals, and interactive accountability are each tools for patient engagement, but ultimately it’s up to the patient to put in the work. As the therapist, the best you can do is set up each patient for success. With the right arsenal of resources and accountability, you’ll equip your patients to track their progress and take charge of their health.

If you are looking to put patient engagement into practice on an Allied healthcare travel assignment, learn more about opportunities with Club Staffing.   

Tim Fraticelli is a Physical Therapist, Certified Financial Planner™, and founder of PTProgress.com. He loves to teach PTs and OTs ways to save time and money in and out of the clinic, especially when it comes to therapy documentation or therapy continuing education. Follow him on YouTube for weekly videos on ways to improve your physical and financial health.

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