The Sports Physical Therapy Academy Podcast · Dr. Chris Garcia

EP173: "The HARD Conversation, Stop Avoiding It"

·33 min·2 clips

Open with 'great, let's look at some options' and put the decision back on the patient.

1. The Sports Physical Therapy Academy Podcast, EP173, covers how physical therapists can handle hard conversations with patients and athletes, such as questions about recovery timelines and cost. 2. Host Chris Garcia is a physical therapist, business owner and residency-trained sports specialist who says he has worked in professional sports and with elite athletes worldwide. 3. Garcia's thesis is that hard conversations are "only hard in your head," and that avoiding them delays the inevitable and leads to noncompliance and poor outcomes. 4. He describes four personality types (driver, expressive, amiable and analytic) and says PTs are typically analytics who love forecasting yet cannot answer "how long is this going to take?" 5. He says the "do no harm" ethos is the bare minimum, and that a PT's purpose should be to point people in the right direction and push them toward the best version of themselves. 6. He teaches forecasting from soft tissue healing guidelines, with grade 1 injuries at 4-6 weeks and grade 2 at 10-12 weeks, then working backward across a 10-visit plan of care, two times a week for five weeks. 7. For surgery and cost questions, he advises presenting options rather than absorbing the decision, such as choosing between surgery or a conservative trial of up to six months, or weighing a $900 gap of 18 sessions at $50 copays against a six-month ACL return. 8. He recommends opening with "Great. Let's look at some options," and reframing an ACL return-to-soccer question as nine months with higher risk versus 12 months with more security. 9. He extends the analytic-avoids-confrontation pattern to relationships at home, saying two analytic partners can end up living "two separate" relationships that coexist, and he tells PTs to stop chasing more CEUs, books and research articles as distractions. 10. Physical therapists and sports rehab clinicians who want to work with athletes will find it most relevant.

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