Great Expectations: The hidden influence of expectations on patient care

May 8, 2023

People in pain have generally done their research, talked to friends, and read everything they could find online. They form an expectation surrounding what their condition is and go on to develop a preferred treatment option. Now, this could be a good thing… or not.

Patient expectations might not be accurate as they might not fully understand their condition, the possible treatment options and the expected outcomes. That’s where things can get tricky. If there’s a mismatch between what patients expect and what healthcare providers can actually offer, patients might feel disappointed or dissatisfied with their care. Unaddressed expectations can have a negative effect on treatment acceptance and adherence (Kee et al., 2023). This is definitely not good!

“What you suggest, is not what I expected”. 

There are several reasons why understanding and addressing patient expectations is crucial to providing effective treatment and achieving positive outcomes.

  1. Understanding patient expectations can help to establish a therapeutic alliance between the physiotherapist and the patient. This alliance is built on trust, respect, and collaboration, and is essential for achieving positive treatment outcomes. By understanding the patient’s expectations, the physiotherapist can work with the patient to develop a treatment plan that is aligned with their goals and values. (Unsgaard-Tøndel & Søderstrøm, 2021)

  2. Understanding patient expectations can help to manage patients’ expectations. Patients often come to physiotherapy with unrealistic expectations about their treatment and recovery. By discussing these expectations with the patient, the physiotherapist can help to manage them, providing a realistic picture of what can be achieved through treatment. (Lateef, 2011)

  3. Understanding patient expectations can help to improve treatment adherence. Patients who have a clear understanding of their treatment goals and what is expected of them are more likely to adhere to their treatment plan. This, in turn, can lead to better treatment outcomes. (Stetler, 2013)

  4. There is evidence to suggest that addressing patient expectations can improve treatment outcomes. One study found that patients who had their expectations met had greater improvements in pain, disability, and satisfaction compared to those who did not have their expectations met (Bishop et al., 2011). Another study found that patients who had higher expectations of their physiotherapy treatment had greater improvements in functional outcomes and quality of life while also reducing pain intensity and duration (Mohamed Mohamed et al., 2020).

So how can physiotherapists effectively elicit and address patient expectations?

One approach is to use patient-centred communication techniques, such as motivational interviewing and shared decision-making. These techniques involve actively listening to the patient’s concerns and goals, exploring their values and preferences, and collaboratively developing a treatment plan that addresses their expectations.

I hope by reading this, I have unveiled the hidden influence of patient expectations on patient care. If you feel as though this approach is totally foreign to you, perhaps searching for a physiotherapist or health provider that treats you as more than a passive element in your healthcare – I’m here all week.

Sam Taylor
Physiotherapist | Caloundra Sportscare