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David J. Conti, DPT, NCS, CSCS is the owner of Revive, Boost, Rebuild, Physical Therapy, LLC (RBR PT), and an adjunct professor at St. Augustine’s University. He has practiced physical therapy for 10 years, with a clinical focus on orthopedic and neurologic patient cases. He is a certified strength and conditioning specialist, and one of only 57 PTs in NC who is board-certified in neurology.

RBR PT treats patients from infants to geriatrics. RBR PT is known as an inclusive clinic and a strong community resource.

Interpreting Symptoms:
It Demands a Skilled, Listening Ear

By David Conti, DPT, NCS, CSCS

A thorough examination is vital in the process of maximizing differential diagnostic accuracy. It is the first and hence the most pivotal component, with respect to the elements of patient/client management (examination, evaluation, diagnosis, prognosis, intervention, outcome). A comprehensive examination includes collecting all the valuable data—the patient’s history, a gross review of systems, and appropriate tests and measures—that, ultimately, will be evaluated.

David Conti

I would argue that, despite the immense technological advancements in what we now refer to as the digital age, our most valuable tool as rehabilitation practitioners continues to be our capacity to listen and hear. Patients generally have the answers that we seek, but are frequently unaware of the significance or value of specific clues. The skilled health care provider can foster a level of communication that will make this process as fruitful as possible. That means asking the important questions and allowing the answers to dictate subsequent inquiries.

While communication efficiency is undoubtedly influenced by the patient’s ability to describe their symptoms, the onus remains on the clinician to find a way. The absolute best way to make a long-term, positive impact on a patient’s symptoms is to identify and address the specific root of the problem. The patient’s subjective reports about their symptoms can paint a vibrant picture of the situation. It allows for a clear distinction between the root and a mere manifestation. This is essential if the problem that produced the symptoms is to be solved. In other words: if the boat springs a leak, you can run to your bail bucket, but if you don’t plug the hole, you’ll be bailing forever.

The value of a rehabilitation specialist can be measured by their ability to find and correct the most central components of any given impairment or functional limitation. An individual can be highly skilled in any number of therapeutic strategies and intervention approaches, but without first finding the root, they are at best, throwing a blanket out and hoping it covers enough ground. Increased diagnostic accuracy yields increased therapeutic efficiency and it all starts with a skilled, listening ear.