First, do no harm! Listen first, speak later. The first Golden Rule of a Professional Physiotherapist is “First, do no harm.”
This relates to physical harm. The first aim of the Physiotherapist when in clinical contact with a patient is to never do anything to exacerbate the symptoms they are presented with. This is an enormously important and valuable rule. It makes, clearly, a huge difference to the patient’s experience of Physiotherapy and, more importantly, improves the chances of the patient making a successful recovery. Usually, in contemporary treatment scenarios this manifests itself in the avoidance of unnecessary manual therapy techniques. It can also relate to exercises and activities that the patient is advised to undertake either in the clinical environment or as homework to be conducted between clinical contact sessions.
However, in my opinion, there is a much more important interpretation of this Golden Rule of Physiotherapy.
“First, do no harm.”
The way I interpret this rule, aside from obviously causing no physical harm to my patient, is thus,
Words matter. Words are essential. Unless you are the Physiotherapist sat in front of a patient. In that case, words come later.
Words are dangerous. Words are weapons. Words spoken too soon and without the necessary precursory understanding can cause serious harm to both a patient’s experience and prognosis.
They can severely affect the patient’s chances of recovery and cause irreparable damage to the patient’s ability to develop resilience.
The first step in Physiotherapy should always be to listen first. The patient’s words are much more important than those of the Physiotherapist. The amount of value in a patient’s words is immeasurable. The time taken to listen, unpack, understand and interpret these golden gifts is the primary skill of the Physiotherapist. Without allowing these to be aired and understood the Physiotherapist is potentially serving extreme harm upon the patient. The greatest harm that a Physiotherapist can cause to the patient is to fail to understand them. The complete understanding of the patient will take time. It is a progressive, evolving process that will continually inform the clinical treatment process.
Without developing the essential communication skills inherent in listening, the Physiotherapist is immediately failing the patient.
“First, do no harm!”
Listen to the patient first. Only when that golden rule has been observed may the modern day, Professional Physiotherapist hope to begin serving the patient, delivering enablement and ensuring resilience.