'Client centred' sometimes means being uncomfortable. written in purple over a faded photo of a doctor on a video call.

Uncomfortable? Good. Use it.

Healthcare has changed radically over the last few years. Moving towards telehealth has been pretty easy for me… I was already doing it! However, through conversations with my peers I know this isn’t the case for many. I’ve lost track of the number of healthcare professionals who’ve told me ‘they’re so glad to be back in-person’.

The first time I heard this was back at uni. The entire class, excluding me was *delighted* to be back in the classroom. When this wave of joy hit me, I burst into tears. The entirety of the ‘in-person’ experience had been back-to-back accessibility failures. Hours of prep, multiple people supporting me, email chains a mile long, more financial outlay than I’m comfortable with and physically relying on the kindness of strangers. Not forgetting the instant onset imposter syndrome of having my mum drive me to school… at age 32. Honestly, I was exhausted by it. It made me want to quit. If it weren’t for the staff, friends and family who took me aside for a chat and a hug I think I might have done.

Telehealth is my element. Video chat is my happy place as an OT. It’s where I’m comfortable. I know I’m good at what I do, I’m confident in my identity as a practitioner. The imposter syndrome is a distant echo of a voice in the ether. I set my work up this way because of my experiences as a patient. Physical healthcare is exhausting, time consuming, disabling and often flare-up inducing for me. I know I’m not alone in that.

Fast-forward to covid times, despite the awfulness of the pandemic a teensy little bit of me was grateful. I still feel awful for thinking it but honestly? Lockdown was the easiest, most accessible and most socially fulfilling time of my adult life.
All the inaccessible things I wanted to do but couldn’t were suddenly online. Friends checked in constantly just to see how you were doing. The world was finally set up for people like me, those who struggle to leave home.
Plus, the practitioners who scoffed at me for running a service via video chat were on the phone wanting advice. Best I-told-you-so ever. I was very literally, in my element.

So, we fast forward again to the ‘learn to live with covid and pretend it’s all normal’ phase. Everyone is back IRL and all I’m hearing is “well I get anxious about video calls”, “the app doesn’t always work”, “it’s not the same if I can’t see everything”. “I don’t now how the buttons work”, “I feel awkward talking to people”.

Let me ask you this. How do you think your clients feel at every single appointment?
Lets flip this around…
“I get anxious about new environments”, “push button door opening doesn’t always work”, “my therapist keeps forgetting I lip read and turns away from me”, “I don’t know what buttons to push on the automated check-in terminal”, “It’s uncomfortable talking about going to the toilet with a stranger”.

The difference here is that patients do their homework. We expect our patients to learn their way around hospitals, navigate public transport, get around inaccessible buildings and communicate effectively with strangers. So, in the absence of options, patients either find ways to manage or they go without care.

As practitioners can we ask anything less of ourselves? We need to do our homework too. Learn to manage your tech anxiety by seeing a therapist. Understand the systems by asking your IT team for training. Develop your own facilitation skills to enable better care. Target your CPD to better support a diverse range of client needs and preferences. Practice with colleagues, friends and family to build your confidence. Train yourself to face the patient at all times. Practice checking pronouns in the real world not when it’s written on the screen. Write an access statement for your service. List emergency numbers on all paperwork and external doors. Offer flexible appointment times. Ask your clients if they’d rather meet online. Check if your client would like transport advice. Set out expectations and etiquette in advance.

As an OT I hear the phrase ‘client-centred practice’ constantly. Well, this is what client centred means.. that you’re the one who’s uncomfortable. You work outside your box so the client can stay in theirs.

Let me know what you think!

As always I’d love to hear from you, the reader. It’s not often I write for the healthcare professional audience but maybe I should do it more? This post has been percolating in my brain for months now. If nothing else, writing it has been cathartic. Regardless of how anyone else feels, I think I needed to write it for me.

2 thoughts on “Uncomfortable? Good. Use it.

  1. I freaking love this!! Yes yes and definitely, yes, please start posting more to an intended audience whjcg is comprised of fellow healthcare pro zebras + those who aspire to be as well. So we’ll done. I’ve often wished I could instruct a guest lecture to medical students on how to interact with your patients.. feel like this is along those lines lol.

    1. Thank you so much! I totally agree, expert patients and professionals with patient experience need much more of a voice in academic settings! So much of my work with professionals is about almost ‘correcting’ bad habits rather than getting in there with students and setting good habits!

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