Table 3 Clinical support illustrative quotes

(1) Surgeons as a source of clinical support

 “[My surgeon] has a good reputation. The hospital thinks the world of him…So I went to visit him and it was just a great match. He covers all the bases and tells you everything. There’s no secrets, no big surprises. He said if everything goes well, I’d only be in the hospital three days. That’s what it was.”

 “[My surgeon was] not really reassuring or anything. Very matter of fact…very ‘It’ll be this way. If that doesn’t happen, this will happen and we’ll do it that way.’ And basically that was it…he wasn’t very personable…It wasn’t any kind of conversation. It was very quick.”

 “[The surgeon] said, ‘I just wish I had more patients that were like you, that were healing quicker.’…I felt good because he did a good job and I felt good because I’d done a good job doing my exercises and everything. It was a win for both of us.”

 “[My surgeon] is so caring…even when I am crying he is like, ‘Oh, we’ll do this. We’ll get through it.’…I knew that he was going to help me.”

 “I think the minute he heard or saw my psychiatric file, I think he probably thought this person isn’t worthy of a knee replacement.”

 “The surgeon is useless to get information out of…6 weeks [after the surgery] I went in there and he said to me something which I didn’t understand and I’m sorry I never pursued it.”

 “I’d saved up these questions. I wanted to know if it was cement or screwed in. I wanted to know if the scar was the way it should be, if the numbness should be there. He answered my questions but in a very different way than I would have assumed he’d answer them. I would think that rather than make it sound so ordinary—this isn’t an ordinary thing.”

(2) Physiotherapists and physiotherapy as a source of clinical support

 “Physiotherapy is the one thing you can count on.”

 “I went to physio twice a week and each week I could tell, getting in and out of the vehicle and walking into the hospital, I could feel that it was getting stronger.”

 “[The physiotherapist’s] attitude was all help. If you needed help, she helped. Very positive, saying things like ‘Work through the pain, you’re doing great, just push a little harder.’”

 “I went to rehab at the hospital and I could have done it as long as I wanted. They were fantastic. And it was all covered. I never got asked to pay for anything, it was all covered.”

 “One of the things they worked on [in physiotherapy] that I found very helpful, so did other people, was they developed a camaraderie, this big family get-together type of thing, to talk to people, compare notes and get a little encouragement from patient to patient. So it wasn’t just an isolated one-on-one therapist to patient. There was a lot of dialogue between patients.”

 “They were sending in a referral to [hospital name] for physio. I was given a phone number to call. So the first week home I called and they said there is nothing available yet…I was getting very desperate and in about the fourth week I started calling other hospitals… I was almost in tears. I was at my wits end, didn’t know what to do. And the woman in reception there said, ‘This isn’t acceptable, I’m going to talk to the physio and I’m going to call you back. I’m sure we will fit you in.’ She phoned back the next day…Without them—if they would have taken the same attitude as everybody else—I probably still wouldn’t be able to bend my knee.”

(3) Family doctors as a source of clinical support

 “I have a GP who has been with me through the whole pain medication process, to the reduction of opiates, to the pre-surgery consult through the referral. He took my staples out at the end of the surgery. He followed me along through the recovery process post-surgery to make sure there was no infection. He followed along with the physiotherapist’s recommendations.”

 “I think my GP does know [that I still have unresolved pain in my knee]. I think he does. He knows I am under a lot of stress, a combination of the pain and being a caregiver. But there is nothing he can do. He can only give me so many Prozac and so many painkillers.”

 “I did go to the GP about my knee and asking him for advice on what I can do because the system isn’t doing it. And he suggested Aquafit.”

 “I don’t talk to my family doctor about it because he’s not interested. That’s the surgeon’s problem. [My family doctor] doesn’t want to get involved.”