Patient Education

Through out this year, across a majority of the clinical settings, in particular the musculoskeletal environment, I have come across numerous patients frustrated with the lack of explanation they have received from their doctor/source of referral as to their condition. The most recent patient to express their frustration is a 34 year old woman that has been referred for outpatient physiotherapy treatment post excision of the (L) radial head.
This patient was diagnosed with RA two years ago, affecting only her right wrist (which is to be fused when she recovers from this surgery in 6 months) and her left elbow. She reported that the only education received from the surgeon was pre-op, regarding the actual procedure and only briefly addressed the reasons for the op. She received very limited education concerning functional outcome post surgery and the likely prognosis of the surgery. She has presented to the physiotherapy outpatient department, now two weeks on, quite devastated as to her lack of strength and functional use of her L elbow and wrist. She has only just stopped wearing the sling recommended by the surgeon, but with not explanation as to how long it is necessary to wear.
The initial assessment findings included no active ROM of elbow flexors, severely restricted pronation > supination and wrist extension. Finger mobility is also limited due to strength and it feels chronically swollen. Following the physical examination, she simply asked- why can I not lift my L hand to my mouth, brush my hair or write with my left, because I am usually left hand dominated and it is quite hard to cope at the moment. This was the final piece of information I needed to realise this patient has been mistreated in the hospital system, in particular by the medical team. How can she have a piece of bone removed from her dominate hand without any explanation as to the repercussions?
So the initial treatment session was based very heavily on education regarding the operation, why she is experiencing these symptoms and the likely outcome/functional recovery of her L upper limb. I then provided a HEP addressing not only her elbow, but preventative exercises for upper limb mobility following two weeks in a sling and hand exercises. At the conclusion of this session she was quite emotional and expressed her gratitude for the time spent explaining this whole situation. As she is a mother with three children, it made a huge impact on her goal setting and future preparations. From this experience, and the many other similar ones throughout this year, I am beginning to question the patient care pre- and post op within the hospital system. If anyone has an opinion as to who is responsible for this almost negligent case, it would be appreciated.