Good communication is one of the cornerstones of a great relationship—whether that be a relationship with a significant other, friend, or patient. We’ll keep our non-patient relationship advice to ourselves, but when it comes to patients, it’s absolutely imperative that physical therapists have the right conversations—at the right times—to keep patients informed, engaged, and happy. To that end, here are six crucial conversations you should be having with every patient throughout the course of care:

1. The Policies-and-Procedures Conversation

While this may not be the most riveting subject to discuss, it’s critical that you—or someone on your staff—have the policies-and-procedures conversation with every patient prior to his or her first appointment. This would be the time to set expectations regarding appointment attendance, communicate any clinic-specific details (such as where the patient will find parking or how he or she will receive appointment reminders), and discuss the patient’s insurance eligibility and estimated financial responsibility. Surely, you already have all of this information in writing for the patient to read and sign, but communicating the key points verbally can help patients understand just how important it is to adhere to these policies. This will also give your patients an opportunity to get clarification on anything that seems confusing, so you both can avoid misunderstandings down the road.

2. The Rapport-Building Conversation

Building rapport with your patients is absolutely crucial for not only fostering loyalty, but also improving outcomes. As Bijal Shah—the author of this NGPT article—points out, knowing your patients is “the most important thing. You need to know what your patients value in life, what their purpose is, and why they want to get better.” According to this Health Behavior News Service article, a study published in the journal of Health Services Research found that “patients who feel that their [providers] treat them with respect and fairness, communicate well, and engage with them outside of the office setting are more active in their own care”—and that improved engagement translates into big gains for patients and providers alike.

While you’ll want to work on building rapport during every conversation you have with your patients, it’s important to lay the foundation for a strong provider-patient bond early in the treatment process. That means truly listening to your patients—and making it a point to understand how their current functional limitations are impacting their daily lives—from the very beginning. According to this resource, you’ll also want to foster “empathy,” “trust,” and “professional boundaries.”

This conversation also provides the perfect opportunity for you to explain that you value your patients’ honest feedback as well as describe your process for collecting and addressing such information throughout each patient’s course of care. That will set the groundwork for your patients to openly share with you what they like—and dislike—about your services.

3. The Goal-Setting Conversation

Once you’ve taken the time to understand the patient’s condition—as well as how it’s impacting his or her life—you’ll be in a significantly better position to set treatment goals and establish an effective treatment plan. Just be sure to bring the patient into the conversation early, so he or she feels actively involved—and thus invested—in the goals the two of you set. This will not only improve engagement, but also align expectations in terms of progress and results—before you begin treatment. This will also help ensure the goals you’re setting are functional ones. After all, to a patient, a goal of painlessly walking 50 yards to the mailbox with normal gait—without the use of an assistive device—is a whole lot more meaningful than a goal of merely improving his or her ROM.

Shah also notes that while you may not want to get too technical in terms of anatomy and physiology (unless your patients are interested in that level of detail), “simply providing general information like telling patients that they use their quads/thighs and glutes/butt for sit to stand is helpful! Your patients are more likely to engage in wall sits and mini squats when they know the exercises are directly linked to their goals.”

4. The Importance-of-Participation Conversation

We’ve already touched on the importance of patients participating in their care, but there’s something to be said for coming right out and saying it—to your patients, that is. As a provider—even an exceptional one—you can only do so much to help a patient while he or she is in your office. The responsibility to comply with at-home exercise programs and adopt other healthy habits that positively contribute to patient progress falls squarely on your patients, which is why every provider should be explicitly—and consistently—communicating that very point.

While you can’t force a patient to participate in treatment-related activities outside of your clinic, you can positively influence patient participation by fostering patient engagement. According to research mentioned in the above-cited Health Behavior News Service article, “a one unit increase in the measurement of the quality of interpersonal exchanges [between the provider and the patient] led to an almost 10 unit increase in the level of activation by the patient.” And patients with higher scores are more likely to engage in healthy behaviors outside of the provider’s office. But you, as the provider, must make your patients aware that their actions impact their health. The lead author of the study, Jeffrey A. Alexander, Ph.D., said: “The patient takes a cue from what the doctor does. If the doctor conveys an all-knowing ‘I make the decisions’ attitude, the patient will revert to a passive role.”

5. The Progress—or Lack Thereof—Conversation

Hopefully, you’re already taking advantage of patient-reported outcome measures (PROMs) to quantify your patients’ progress—because that makes it significantly easier to have an effective progress discussion with your patients. After all, you’ll have actual patient-generated functional data that you can use to support your progress assessment. So, in addition to having a conversation with your patients to educate them about the importance of PROMs (i.e., “how to complete each questionnaire, how you will use their responses, and how their participation benefits them directly”), you’ll want to circle back with them to discuss their progress at regular intervals throughout their care journey.

Sharing positive progress and celebrating milestones is a great way to keep patients engaged. And if the patient isn’t progressing as expected, it’s important to address it early and have an honest conversation about why. Depending on the reason, you may need to circle back to number four above to reiterate the importance of completing a home exercise program—or, you may need to re-evaluate the patient’s goals and reset expectations, so the patient doesn’t become discouraged and drop out of care.

6. The Next-Steps Conversation

When your patients achieve their goals and are ready for discharge, it’s a perfect opportunity to discuss next steps, whether that be offering the patient additional wellness services—such as a membership to your medically oriented gym or group fitness program—or scheduling an annual or biannual follow-up appointment to provide preventive therapy. This ensures the patients who want to remain engaged with your practice know what’s available to them. You should also use this time to verify that you have an accurate email address on file—as well as the patient’s written consent to message him or her—so that you can provide relevant content and keep him or her abreast of additional clinic offerings. This is a great way to provide value after patients have completed active care, so they’ll keep you top of mind should they need your services again. (Hint: patient relationship management software can be a game-changer when it comes to scaling the re-engagement process.)


There you have it: six crucial conversations to have with your patients. What conversations do you make sure to have with every patient? Please share them in the comments section below. We’d love to know your thoughts on what works—and what doesn’t.