The Sports Physical Therapy Academy Podcast · Dr. Chris Garcia

EP165: "I'm Stuck & I Don't Know What To With My Patient"

·22 min·1 clip

I don't think you need experience to go through this.

Chris Garcia opens by asking what a clinician does when a case is unfamiliar and the next move is not obvious. He frames it as a real cash-based physical therapy problem, not a theory problem. The pressure is immediate because the patient wants an answer right now, while the clinician may need a day or a week to figure out what makes sense. He says the first reaction is usually to search for everything possible and reach out to anyone who might have seen the same pattern before. That means local surgeons, peers, mentors, old professors, PubMed, Google, clinical prediction rules, protocols, and guidelines all become part of the work. He keeps coming back to the gap between what the clinician wants tonight and what the patient needs today. His answer is not to fake certainty. It is to buy time honestly and use that time well. He gives a conversation with a patient. In that conversation, he acknowledges that the case is extensive. He says he wants to give the most accurate information possible. He also says he does not want to hand over poor information just to sound confident. The next step is to do the back-end research before the follow-up visit. He makes the research itself sound like part of the job, not an admission of failure. He also makes the patient aware that the clinician is actively working on the case instead of hiding behind vague reassurance. The message is that trust grows when the provider is direct about uncertainty. The clinician is not supposed to pretend to know everything. The clinician is supposed to know how to find out. Garcia treats that process as a sign of professionalism. He also treats the conversation structure as something that can protect the relationship while the answers are still forming. The whole episode stays focused on practical decision-making, communication, and accountability in a sports PT setting. It is less about a polished protocol and more about how a good clinician behaves when the protocol is not obvious. That is the point he keeps hammering home.

As heard by us

When the answer is unclear, honesty and research are the clinical move.

Chris Garcia centers the episode on the strain of facing a complex case, a new body part, or a new procedure without knowing the next move. His advice is plain: slow down, do the work, and tell the patient what is known and what is not.

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Why you'd press play

When you are stuck with a patient and need a clean way to buy time.

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