TREATMENT PLAN I write plans down, and I include the point at which I would stop. Both of those are deliberate.
What is in it. What I think is going on. What I am doing and why. What you are doing — the loading exercises, the positioning, the timing change — with enough detail to actually follow: which exercise, how many, how often, how uncomfortable it is allowed to be, and when it increases. The measure we are tracking. The number of sessions before we should know. The total cost. And the exit: what would make me stop or refer.
Why the exit matters. Without it, a course of treatment continues until the patient loses faith, which is a bad way to make a clinical decision and an expensive one. With it, we have both agreed in advance what failure looks like, and I am obliged to act on it.
What I re-test. The same movements or the same number, at four weeks, rather than asking how it feels. People are generous about progress and it does them no favours.
What is never in a plan: a pre-paid package, a discount for committing before we know anything, or a standing fortnightly appointment with no end. If you have been sold any of those elsewhere, it is worth asking what the review criteria were.
The clinic is in Lane Cove, opposite the library, and the plan goes to your GP.
