Why hour long appointments?

by Rosi Sexton

“The last person I saw, I felt like I barely had time to put my bag down.”

I’m sometimes asked by patients why at Olton Osteopathy we allow a full hour for all our appointments. That’s unusual these days – many clinics restrict appointments to as little as 30 minutes. When I used to work as an associate at other practices, the follow up appointment times ranged from 30 to 45 minutes, and I know that certainly, it’s possible to fit a good treatment into that time. So why do we allow longer?

“You’re the first person who’s really listened to how I’m feeling.”

There are a few reasons. Firstly, we find that having more time allows for better listening. Feeling unhurried allows us to really explore what’s going on for our patient; to give you time to tell your story, and for us to get to know more about you as a person. Often, people come to see us after they’ve seen numerous other healthcare professionals without any success. As well as being in pain, they may be feeling frustrated, depressed, struggling to cope or at the end of their tether. Sometimes there might be a complicated medical history, a worrying diagnosis, unusual symptoms, or pain that stretches back for years. Patients sometimes bring in medical notes or scan results that they’re concerned about. The longer I’ve been in practice, the more I realise that allowing plenty of time for these conversations is one of the most important things we can do. It’s crucial for the patient to feel understood; and it’s also vital for us as clinicians to take time to look at all the pieces of the puzzle before arriving at a plan of treatment (or, when appropriate, making the decision to refer to a different healthcare professional).

“I feel like I’m not just getting a treatment, I’m also getting to understand how my body works. I can’t believe I’ve never really thought about it before.”

We also need time in order to explain to our patients what we think is going on in a way that makes sense to them. Some of our patients enjoy learning about how their body works, and like to ask us lots of questions; others prefer to skip straight to the important bit – “what can you do to help?” We know that not everyone wants a detailed anatomy lesson (let alone a lecture about pain science), but sometimes having a simple picture of what’s going on can be reassuring and help you understand how to manage the pain better yourself. Having a bit more time allows us to explain what we’re doing in as much or as little detail as you want.

“I was so scared, I thought I’d done something awful to my back, and I was terrified of making it worse. I’m so glad you explained to me that it was OK to keep moving, and that even if it was a bit painful the movement would help it to get better.”

We don’t believe in “one size fits all” approaches to treatment, and pride ourselves on treating all our patients as individuals. You’re never just another case of lower back pain; despite the fact that your symptoms may be very similar to patients we’ve seen before, your treatment will depend on your individual needs, lifestyle, activities and preferences. This is something we’ll discuss with you, and make sure you’re happy with.

“When I tried to tell that physio that the exercise was hurting me, they just told me I needed to keep doing it. I don’t think they thought I could really be in as much pain as I was saying”.

While hands on osteopathic treatment can help to relieve pain and to get someone moving better, we know that exercise is also an important part of the recovery process. Although some therapists prefer to focus mostly on hands on work, and others do mainly exercise with little hands on, our experience is that patients usually benefit from a combination of the two. A longer treatment session allows us to cover both, without skimping on either. That doesn’t mean we expect you to spend loads of time doing exercises, or that we’ll give you long sheets of things to do; usually we’ll try out a few different exercises with you before picking just two or three that are the right level of difficulty and will give you the biggest “bang for your buck”. We’ll make sure you’re confident doing them before we send you away.

“I love the way you show me things that I can do myself, and I can feel them working. I feel so much more positive now. If I get a bit of a flare up, I know that I can do the exercises you gave me, and it goes away.”

Our philosophy at Olton Osteopathy is that treatment shouldn’t be something that we do to you, it’s something we do with you. We know that changing things about your lifestyle or everyday activities can be hard. We won’t lecture you on what you should be doing, we’ll work together to figure out the best approach. Can’t take time off work because you’re self-employed? Find it hard to rest because sport is how you manage your stress levels? Hate going to the gym? Can’t lie down to do that exercise because your dog or toddler keeps jumping on you? We understand that circumstances aren’t always ideal, and the textbook answers might not work for you – so we’ll do our best to figure out a plan that does.

“It felt like they didn’t try to understand what was going on, they just did the same thing every time I went in.”

This doesn’t stop after the initial consultation either – when you come for a follow up, we’ll take the time to talk about how you’re getting on, and to listen to your feedback. In some cases, things will be straightforward and we may not need the full hour, but on other occasions we may need to adjust what we’re doing or change the plan. Our aim is always to get our patients out of the clinic and back to doing the activities they love, while knowing that we’re here if you need us.

Experience tells me that longer sessions enable me to get people better faster, and keep them that way for longer. I know there are many excellent clinicians who do a fantastic job with shorter appointment slots, but this way of working suits our clinic – and my patients often tell us how much they appreciate the extra time.