MIA Newsletter - Autumn 2022

Tells us about your current work

I run a private Physiotherapy and Allied Health practice in Geelong.  Our case load is predominantly spinal / musculoskeletal and Vestibular Rehabilitation. We also offer physio led group exercise sessions; for conditions such as hip/knee OA, low back pain and other chronic musculoskeletal injuries.

I am a Credentialled McKenzie therapist and am fortunate enough to work alongside Anne Africa (Cred.MDT), March Cheel (Dip.MDT & MIA Faculty), and other physiotherapists who have undertaken some of the MDT training. It is a great to work in a practice alongside experienced practitioners who share a similar MDT philosophy and approach to patient management. This ensures great continuity of care for our patients; particularly if they need to see different physiotherapists at our practice at the same time. As a clinician it is always reassuring to know your patients are in good hands if they need to be seen by one of your colleagues whilst you are away from the clinic.

How did you start on your ‘McKenzie Method of Mechanical Diagnosis & Therapy (MDT)’ journey?

Bev Dalziel (former MIA Faculty member) was invited to present on the McKenzie Method in Geelong one evening in 1998. I was not long out of university, working in private practice and really struggling with my assessment and treatment of back and neck pain. Anne Africa, who had had recently commenced her training in the McKenzie Method, suggested I attend. I was blown away by the philosophy and logic behind the McKenzie Method – it just seemed to make so much sense! I booked into the next available part A, loved it, and kept going from there. I became credentialed in 2000.

How has the McKenzie Method influenced your clinical practice?

The philosophy of patient empowerment through education and active involvement in treatment continues to underpin my approach to clinical practice. It never ceases to amaze me how much better patients cope with pain and injury once they better understand their condition and feel that there is something they can do to help manage it.

As a result of my MDT training, I place a very large emphasis on a very thorough assessment. The MDT assessment, with its very structured subjective and physical examination (including repeated movement testing) has brought a higher level of safety and effectiveness to my clinical practice. In particular, I am more confident in knowing when to refer a patient on to exclude a medical cause for their pain and better able to predict the correct directional preference for treatment strategies and the safest and most effective amount of force and load use with treatment. When introducing other exercise programs into my clinical practice, I have done so within this same framework, ensuring the same level of safety and effectiveness.

MDT has influenced me, where appropriate, to move away from using a specific pathoanatomical or radiological based diagnosis when assessing my patients. I have found that this has been associated with far less patient fear and apprehension, and improved patient outcomes.

My background in MDT has also meant that I incorporate functional restoration and injury prevention strategies into my treatment approach. In practice I have found that this has often be associated with patients achieving far better long-term functional outcomes and a reduction in the recurrence of their condition. In recent times I have found that more and more patients are now expecting this approach as opposed to quick fixes.

What are the challenges your business has faced over the last 2 years due to COVID 19?

During the numerus lockdowns in Victoria, we were restricted to providing “essential care” in the clinic and advised to offer telehealth services as an alternative. Face to face physio led group exercise was also deemed non-essential during these periods; hence could only be offered via telehealth. Determining what was essential care (often via a quick telephone screen with reception staff and /or one of our physiotherapists) and communicating this to patients proved to be very challenging. I also found the appetite for telehealth services from private clients varied considerably; with many preferring to delay treatment until the end of lockdown. Ironically using MDT as part of telehealth consultations, despite challenges, forced me to sharpen my MDT approach and be more imaginative with exercise base strategies. This in turn led to an improvement in my practice when I returned to face to face care.  

Other challenges to our business included following and keeping up with the continuous changes to COVID related health advice and communicating these to practitioners, admin staff and patients. Applying some of these health measures in the clinic; including continuous cleaning of surfaces, rigorous hand sanitizing and social distancing; whilst trying to continue to offer an efficient service was also very challenging. Managing the diary also became a real juggling act in the face of rolling patient cancellations and/or staff calling in sick after being identified as a COVID close contact or returning a positive test result.

What changes have you made to your business to move forward in the current environment?

Patients are required to ring before entering our practice so we can ensure that we keep density quotients to a minimum in our shared common areas. As a result, our waiting room has extended onto the front porch and patient’s vehicles. I have found that patients quite enjoy having their own space when waiting for an appointment; and it’s something we’ll continue with into the future.

Patients are also screened for COVID and/or other cold and flu symptoms when they make an appointment and this is something we will also continue with as means of reducing the risk to our staff, practitioners and patients. Linen is gone for good and rigorous cleaning and hand sanitisation are here forever; which is also a good thing. Telehealth consultations will also continue to remain an option to ensure continuity of care, for COVID and non-covid related circumstances. I recently completed a course of telehealth-based physiotherapy treatment for a patient with low back pain in Melbourne and some post operative rehabilitation for another patient who was working out of Sydney. Both had great outcomes and really valued the service. Who would have imagined doing this 2 years ago!!!!