what is most important treatment or note keeping?

[newphysiokatie]

Dear All

who can help me? I graduated last July and have since been working in private practice I have decided to try and work for the NHS and I am not doing very well with the clinical question at interview.

Does anyone know the expected answer to this question.....

What is most important treatment or note keeping?

thx for your help

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[gcoe]

Hi Katie

I am not from the UK so I don't really understand the context of the question. However to me it seems extremely bizzare.

Note keeping may improve a record of practice, it may help one remember important details, provide transparency of practice to colleaugues leaders and outside authorities and also for patients should they request them. There are medicolegal requirements of note taking.Over many decades notetaking has taken on an increasing importance

However the reason I find the question bizarre is if you don't treat the patient, more importantly if you don't treat the patient well. then what on earth have you achieved?

Whether you believe in God, the great spaghetti monster in the sky, in your self or in the great NHS that created physios, were physios created to write notes?

Very strange question.

If you were working on an island devastated by a tsunami, where there was no record system, no pen or paper and definitely no laptops, PDAs or I phones, and you had people who desperately needed your care would you halt all treatment until you were able to take notes?

[Fyzzio]

If you were working on an island devastated by a tsunami, where there was no record system, no pen or paper and definitely no laptops, PDAs or I phones, and you had people who desperately needed your care would you halt all treatment until you were able to take notes?

No, certainly not.

But have you ever been the subject in an enquiry in regards to a patient complaint about you? Bet, you wish you would have done less treatment and better/ more note taking.

Treatment and note taking are two completely different aspects of our job and, as gcoe said both have legal and ethical requirements attached. You cannot compare them or say that one is more important as the other.

I believe that the purpose of the question is to check your awareness of the need for documentation, patient rights and risk of ethical breaches.

Good luck,
Fyzzio

[gcoe]

thanks phyzzio

You gave a much better answer than my own and I am sure what NHS employers may be looking for.

Katie - don't take my response too seriously - just a momentary expression of lament for the passing of a simpler age which no longer really exists. I feel better for my outburst :-)

[estherderu]

Dear Katie,

Why notes.....

well for starters our mundial organisation, the WCPT has strong ideas about this.
Draft Position Statement - Appendix to Physical Therapy Record Keeping, Storage and Retrieval | WCPT.org

In more and more countries it is mandatory and can be used by Health Insurance Companies to "check" the quality of the therapy given. I know this to be the case in Holland and the U.K.

A good article more or less answering your questions on this topic can be found on NDTA Network sept/october 2003 called: Productivity: the value of evaluations. Documentation as the basis of problem solving. By Marcia Stamer.
http://www.ndta.org/downloads/NetworkSepOct03.pdf

On a practical and personal level:
1. for me, notes are necessary because I cannot remember every detail of every test of every patient every day
2. writing your notes makes you stop and think, sometimes this can lead to decisions to change your therapy modalities and rethink you whole therapy goals and plans
3. if you cannot work for some reason and your job has to be taken over by someone else, good notes will help ensure proper continuation of treatment.

Hope this helps....

Esther

[physiobob]

I too feel this is a little silly a question. Are they really asking it. Neither is more important, they are BOTH essential. That is the first answer and is part of the roles and responsibilities of you as a PT. More than that if you don't do the former you might find yourself going the way of several others and ending up banned from the PT register with the HPC.

Notes are fundemental to the treatment of the client. They set up the path to a good initial treatment plan, document the results of that treatment and highlight the progression. More than that they lead the way for someone else who might find themselves treating your patient when you are not there. They are also a medicolegal requirement.

So a bit of a silly question. But maybe if they are asking it the answer is that they are synonymous i.e. note taking is part of the treatment.