You know the old saying, right? Assumption makes an A$$ out of you and me.
It’s never truer than when performing Functional Capacity Evaluations (FCEs)
Most therapists operate on the fly. They come into the clinic, take a look at their patient load and start calling patients into the treatment area. That may work for day-to-day patient treatment but, unfortunately, if you try to perform FCEs on the fly, you’ll likely run into some pretty significant obstacles.
- Patients whose resting blood pressure or heart rate are too high to be tested.
- Patients taking narcotics…but can they be tested on narcotics?
- Patients who are wearing clothing or footwear that impedes their performance.
- Patients who are pregnant…should they take the test?
You can avoid these problems, if you do some advanced preparation in 3 basic areas.
- Patient education & communication.
- Referral source requests.
- Job description.
Patient Education & History
Most patients will know very little about the FCE process. Starting with some pre-test communication and education will greatly improve the chances of patients being properly prepared and will make the FCE to go smoothly. If you A$$-UME too much…
- patients will show up in high heels, tight jeans, cowboy boots, flip-flops, short tight skirts and all sorts of inappropriate attire for a functional capacity evaluation.
- the patient’s only transportation will be planning to pick them up in 30 minutes
- the patient didn’t take medications or eat breakfast/lunch.
Make sure that your office has communicated with the patient, as soon as possible after the test is scheduled. That way the patient can make the appropriate plans and you aren’t stuck with rescheduling the test. Ask them what their resting blood pressure runs. If they don’t know, advise them to have it checked and to contact you with the results. Ask them about medications, transportation, etc.
Referral Source Requirements
Every FCE is different, so why would you A$$-U-ME that you know the questions the referral source is trying to answer with the test. Asking questions such as: “What are you hoping to learn from this FCE?” or “What influenced you to order an FCE?” are important to help you to create a meaningful report for the referral source. Do they want you to compare the patient’s abilities to a former job? Are they requesting recommendations for treatment or work accommodations?
Will they need an impairment Rating performed along with the FCE? Are there lifting restrictions contraindications to any parts of the test? If the patient is taking narcotics, do they want them tested with the narcotics on board or should you ask the patient to abstain? Consider having a list of questions that either you or your front desk staff ask the case manager, insurance adjuster or physician.
If you are being asked to compare the patient’s abilities to the job’s demands, you can’t A$$-U-ME that you know the demands of the patient’s job. You’ll need a job description. Oftentimes, you’ll need to go through the case manager or adjuster to request the job description. And many times, even when you get a job description, the descriptions of the physical requirements are vague or incomplete. In which case it’s best to talk to the employer – someone who knows the job - to get the specifics.
Advantages of Preparation
In addition to helping you provide a superior FCE product, advanced preparation nurtures referral relationships. It’s a fantastic way to grow your FCE referrals. A smooth process with the patient and referral source satisfaction will bring them back to your clinic when the next FCE is needed. Clarifying the purpose of the FCE and answering the referral source questions, is great marketing!
Take the time for advanced preparation. It’s part of being the expert.
The moral of the story is, don’t A$$ume. Do a little advanced preparation for your FCE.
Want to learn more about incorporating FCEs into your patient care?