Your management is great but your patient isn't getting better? This might be why.
Words by Craig Hankridge
It isn’t a condition acquired after too many mojitos but could be a major hurdle in getting your patients to be the healthiest version of themselves.
Defined in a complex way, solution aversion is where people are motivated to deny problems if the solution to that problem seems undesirable.
Solution aversion in action:
Think of a patient with a 2-week history of Achilles tightness, the solutions here are relatively straightforward. Hands-on treatment to target causative factors, simple at home, daily exercises that will take less than 10 minutes focusing on healthy loading and in no time they are back to full health.
From the perspective of a health professional, this couldn’t be easier to implement.
For the accountant who thinks of themselves as time poor, the thought of adding ‘one more thing’ into their day is an ordeal.
So what happens? They get one treatment, do the exercises once, maybe twice, then stop.
Four weeks later, tightness has turned into daily pain and they are now unable to get through their normal gym activities.
This is a prime example of solution aversion.
Because the solution to their problem is averse they simply ignore the problem that requires that solution!
Getting ‘cut through’ to get results:
So our Achilles patient has a legitimate issue, that requires significant treatment. He has failed previously in adhering to our management so instead of doubling down and trying to force this patient to follow our instructions (and causing him to fail again) why don’t we create a more attractive solution?
If at home exercises and committing to making time for these is so undesirable we could:
focus on twice weekly, in clinic treatments before or after work
pair our exercises with a regular part of his day (e.g spiky ball use at work, foam roller prior to gym sessions)
outline a more averse solution if treatment is avoided (e.g further pain, lack of mobility, surgery etc)
This approach is less about focusing on the problem as it is about creating an environment to let the patient get out of their own way.
Communicate with your patient as to whether they think what you are suggesting for their management will work within their current weekly schedule
Follow up with your patient within 3 days after your first session to recognise roadblocks early (and create less averse solutions)
Go rogue, the goal is better health so you don’t always have to follow the textbook. Be creative and commit to helping the individual in individual ways, they will love you for it!
Next time you’re dealing with a patient who doesn’t seem to be able to follow ‘simple instructions’ try to find a way to make the solution to their problem as attractive as possible.
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References, further reading & props to these guys: