Physical Therapy – The WORST Kept Secret in Healthcare

This week, I thought I would take a break from talking about micro clinical practice topics that have been discussed over the past several weeks, and talk about clinical practice in a macro sense. Last weekend, I had the opportunity to attend the Washington State Private Practice Special Interest Group (PPSIG) spring conference at Lake Chelan, WA. On Saturday morning, the fresh air was crisp, the sun was shining and reflecting off the tranquil lake. There was still a pink hue in the sky, outlining the mountainous landscape that surrounded the lake. Spring was in the air and created the perfect environment for the ‘Chelan Chat’.

The ‘Chelan Chat’ is a twist on the Annual Graham Sessions hosted by the Institute of Private Practice Physical Therapy. The annual Graham Sessions started as a result of not having a forum to vigorously debate the issues driving our physical therapy profession. This type event creates a safe, non-judgmental, and somewhat anonymous platform for physical therapists to share their beliefs, opinions and thoughts on big topic issues. The topic question posed at this year’s ‘Chelan Chat’ was, “Are stand alone private practice physical therapy clinics a dinosaur and is there space for them in the changing landscape of healthcare?”

Over the course of the weekend, there was great discussion on new payment models and the changing landscape of PT reimbursement. Whether you are in favor of this or not, this will be the new reality. As an example, the Comprehensive Care for Joint Replacement Model (CJR) will take effect on April 1st, 2016. Under the CJR, hospitals will be at financial risk for the care provided during the initial hospital stay plus 90 days after discharge from the hospital. Hospital systems are not in a position to keep their total joint replacement rehab “in-house” and will need to rely on the broader physical therapy network. What this means is that we will likely see contracts between hospital systems and larger PT practices or organizations to manage rehab needs of the total joint replacement population. Many of the participants of the Chelan Chat believe that small PT practices can still exist, but that in order to “stay relevant” in the changing payment models, they will need to partner or band together horizontally through rehab alliances or vertically through mergers and acquisitions. The underlying theme here is that PT’s will need to work together now more than ever. So, I ask the question, is physical therapy the best kept secret or worst kept secret?

Physical therapists are often described as humble, sage practitioners with peace core genes. I think about our profession as a profession that has a hard time standing up for itself in many different circles (legislatively, with physicians, hospitals and other groups). There is no larger proof than the fact that only 37% of PTs are members of our professional association. We are the somewhat small, shy kid in the back of the classroom, who dresses in plain clothes, hoping that no one will notice us too much. But we hope that one of the gown ups will invite us to the big boy table, called healthcare reform. Whether you agree with my interpretation or not, is besides the point. I believe we are the shy kid outside of our profession, but when it comes to intra-professional relationships, we are the bully who is not afraid to step on another PT’s toes and take his/her lunch money. If you do not believe me, I urge you to attend the APTA house of delegates where you can whiteness this first hand. I have always said that the largest hurdle to PT is PT.

Here are some of the hurdles we face internally that may hold our profession back. I realize that these are sensitive topics, so it is ok if you do not agree. There is no malice here, this is simply meant to be a wake up call.

Problem #1: We have an identify crisis. If you ask a group of people what PT is, you will likely hear 10 different answers. The general public does not know what we do and healthcare does not understand our value. Our profession is solely responsible for this identity crisis. The beauty and the worst attribute of our profession is the diversity of care and multiple treatment paradigms. We refer to ourselves by our training not our profession. Instead of placing an emphasis on the most important letters “PT” after our name, we burry them in the alphabet soup. This muddies what we do and who we are, PHYSICAL THERAPISTS, first and foremost.

Physical Therapist - What I Really Do

What you can do: Stop introducing yourself as Joe the ________ (insert paradigm) physical therapist and introduced yourself a Dr. Joe Cook, physical therapist. After all, you did go to school to earn those letters. Dump your alphabet soup. If you want to tell your consumers about your additional training, spell it out on your business cards and website.

Problem #2: We are quick to criticize each other and put each other down. We cannot recognize our own biases and we believe our own personal treatment paradigm is the only way to do things. I am tired of hearing individual PT’s criticize and blame other PTs (and other professions for that matter) for a patient’s failed treatment in direct conversation with the patient. What kind of message does this send our patients and what image does this paint for our profession?

What you can do: Just don’t do it! Simple. Apologize to your patient about their rough go with the medical system and move on.

Problem #3: We lack cohesion and we suck at marketing.  PT is not sexy. We have a brand issue and cannot compete with big firm advertising. Think about it, next time you are watching television, what are consumers being drawn to? You guessed it, drugs, surgery, and cool gizmos that make false claims and come with a hot chick and a puppy (in the words of Lazy Boy). Where is PT? We are still out there competing against ourselves, advertising why our clinic is better than clinic XYZ down the street, and branding ourselves as a disjointed profession sending mixed messages about what we do. A study in 2007 by Stephanie Carter and John Rizzo demonstrated that less than 7% of patients with musculoskeletal conditions utilize outpatient physical therapy services. If we doubled that number, imagine how many more patients we would have!

What you can do: Educate your patients and your community about physical therapy. Set aside part of your marketing budget to collaborate with those in your geographical region to spread the word of physical therapy.

Physical therapy is the best kept secret, and that is the exact problem, it is still a secret! The late Patrick Wall said in the forward of the book “Pain: A Textbook for Therapists”, “I am convinced that physiotherapy and occupational therapy are sleeping giants”. It is time that this secret gets out and our great profession wakes up from its slumber. I believe the solution to all of these problems is to promote physical therapy and tell consumers what we really do. Simple campaigns such as GetPT1st should be our focus. Now is the time more than ever in this changing landscape of healthcare that we come together to solidify our position in healthcare, rejuvenate our brand and establish with our consumers what we really do. Think about it, if every PT put $20 into a hat, we would have $4,060,000. This would be a great start to putting our stamp on society, much like Apple computers did with their 1984 super bowl commercial.

So, how will you be a part of this movement?

I welcome your feedback.

Thank you!

Brett

35 responses to “Physical Therapy – The WORST Kept Secret in Healthcare

  1. Brad Smith says:

    One issue is how to reach the masses to educate them regarding the benefits of physical therapy. PDA’s? Probably not very effective. Well-designed commercials on the evening news competing against the omnipotent pharmaceutical companies? Social medial? We’re competing against M.D.’s and hospitals and their profit driven bottom line. When we prevent a surgery with conservative, non-surgical, and effective care, it normally goes unnoticed with a drop in referrals from the surgeon. Would it help to have the Kobe Bryant’s and LeBron James’, the Derek Jeters, and other professional stars giving testimonials of who helped them return to peak form and extend their careers? Lots of questions. Maybe a high level marketing firm is needed to bring our message to the masses and have patients request PT first. It costs money. Are we willing to step up?

    1. Brett Neilson says:

      Brad,

      Great comments. I think first, our profession needs to unify behind a single message (GetPT1st, Move Forward, etc). Yes, a marketing team is required, PTs are horrible marketers. The APTA brings in nearly $40 million each year. To put this into perspective, pharmaceuticals spend nearly 2 billion each per year on advertising. Even OIC, the medication for the side effects of opioids, made the big stage this year during the super bowl commercials. This is an uphill battle we are facing. However, I cannot help but think that if we were to double our membership, we may be in a better position to get our brand out there. I bet more people would join the APTA if they knew about campaigns like the ones I am proposing. This should be the APTA’s strategy, to market to their potential membership and do a better job “selling” why it is important to be a member. This is only one angle.

    2. Abdurrahman Sulaiman says:

      That was an amazing thought Brad…i reason with u, its a good way to start.

  2. Ekanem Charity says:

    I suppport everything uve said… we nid to wake up.. am in to exposing this great profession

  3. Dr. Ritchie says:

    Amen!

  4. Terry Brown says:

    Well said Brett! Unless we all work together to “out” PT we will continue to struggle with our brand. People need to stop riding on the coat tails of the leaders in this profession and get involved. Talking to the community, patients and being part of the solution.

    1. Brett Neilson says:

      Well said Terry! Thanks for your comments.

  5. Paschal says:

    I wish more physical therapists will take the issue seriously to awaken the sleeping giant

  6. John Childs says:

    Brett, I couldn’t agree more, especially your caution for us to stop bashing each other. We are our own worst enemies when we blast each other over insane minutia like questioning the use of manual therapies, DN, certain forms of exercise, etc. We’re all in the movement business, which is the best business in the world to be in regardless of which camp you’re in or approach you follow. We’re never going to get perfect clarity from the evidence such that treatment decisions become obvious and binary. It’s not going to happen no matter how idealistic we want to think. We have to stop being so naive thinking that if we evolve just enough, we’re going to hit some point of nirvana and discover the magic bullet. Let’s be comfortable being uncomfortable. Let’s normalize the discomfort of not always having enough facts or data. In the meantime, let’s put our hands on patients, care deeply about them, provide high touch service, educate ad nauseam, promote active exercise, and help patients think positively about their outcome. If we do this (who cares about the specific approach), we’ve just exceeded 99% of all the rest of health care at a fraction of the cost. I don’t care what interventions you’re using as long as you’re using them to create a dialogue with the patient that results in them being empowered to take control over their life and be optimistic about their health. What’s bad with health care continues to be too much drugs, surgery, and imaging. No physical therapist is contributing to the worst of the problem. Let’s give ourselves more credit and take our squabbles elsewhere. I’ll fight with other therapists once all the low hanging fruit has dropped from the tree and once PT as a profession has finally been “outed” and discovered.

    John

    1. Brett Neilson says:

      John,

      Well said! Thank you for expanding on my comments and bringing more light to that point. I view this as the first hurdle to overcome before we can move forward (pun intended) together as a profession. “We have to love ourselves first, before others can love us”. The other arena that I did not bring up on this same issue is that of different care models in PT. There is always heated discussions about the use of care extenders and what services should be provided by a PT. There are some very outspoken leaders within our profession that are not afraid to battle to the last breath over this issue. After attending PPSIG, I had the opportunity to hear about different PT settings all over WA state. Some practice in the metropolitan areas, most in the suburbs and some in rural areas. I had an “ah-ha” moment in listening to everyones struggles (mind you the average reimbursement per visit in WA state is $135), it is ok to be different. There is a need for different care models based on many different factors. The bottom line conclusion that I came to is: 1. We need to stop trying to control care models. What works for you may not work for the other guy practicing in a rural setting or in a state where reimbursement is $65 per visit. 2. Practicing under different care models does not de-value what we do (always the argument from those in 1:1 settings). What will de-value our profession is not being able to take care of the patients who need help, not delivering evidence-informed care, not delivering a high customer service experience, not demonstrating our outcomes. None of which have to do with care models. 3. It is all about outcomes, proving your worth. If the PT practice who sees 4 patients at a time can get just as good of outcomes (or better) than the 1:1 clinics, there is high value here.

      So, we need to stop being our own worst enemy and move forward together. Let these small issues die and accept our differences.

      Great points!

  7. James Grace says:

    What can we learn from the craft beer revolution? Instead of seeing each other as competitors, craft breweries consider themselves part of a community, and they band together to take on the mass breweries like InBev (https://en.wikipedia.org/wiki/InBev). They’ve been growing quite healthily by creating new customers and stealing customers from the beverage Goliaths. There’s no way this would be the case (pun unintended) if they bickered and tried to turn consumers against the brewery down the street. Not only is their beer better, but their culture of community is so warm, welcoming, and inviting to enthusiasts like me.
    Why can’t professionals like physical therapists who are so people-centered and compassionate operate similarly? I believe it’s primarily due to a mindset of scarcity. A 2007 study found 6.9% of people with musculoskeletal issues utilized outpatient physical therapy (http://ptjournal.apta.org/content/87/5/497#T2). There’s an abundance out there! Let’s band together to take on the dangerous, expensive, and marginally effective alternatives to therapy.

    “Is there anything beer can’t do?” –Hank Hill

    1. Brett Neilson says:

      Well said James. Nice correlation between PT and beer. We need to create a better sense of community, visit each others clinic and “sample” what they do and work together. I love PT Pub night for this reason.

    2. Tim Flynn PT PhD says:

      James,
      Brilliant analogy. One I know well living in Fort Collins, CO. I know the owners of 2 of the microbreweries and their passion and collaborative mindset is contagious. They also have a pay it forward mentality. The microbrewery movement has kept me sane and passionate for physical therapy!

  8. Steve Anderson says:

    Brett,

    Great to reconnect with you again in Chelan. As the facilitator for the Chelan Chat and the national Graham Sessions, it is so good to get these issues out in the open and debate and discuss them. That’s how we learn form each other. Once you can listen and consider someone’s perspective you gain deeper meaning and understanding to the issue at hand. Both events that occurred in March in Chelan and in Phoenix in January were great meetings. I walked away from both hearing for the first time in 30 years that PT’s were seeing that there is a place for the single stand alone private practice, networks, multiple site group practices and national corporate PT companies and how they help patients may be slightly different but can be very effective. What clicks with a patient in one setting to help them improve may not in another so I celebrate that we acknowledge that one way is not bad or good, that if PT’s work together we can have profound impact on more of our society experiencing the benefits of exercise and hands on care that improves their movement and therefore improves their life.
    Thanks for your blog post and by the way, your kid is too cute! A proud Dad you are I’m sure!

  9. Brett,

    Enjoyed the post. I agree with the primary points you raise. We have always been our worst enemy.

    Interesting stat on membership. Last I checked, comparing numbers of PT members to total numbers of PT’s in the US, the APTA membership was about 22%. I’m not sure it’s even that high now, but I don’t have access to some of the stats the APTA has. Have to say, even if I did have that access, the fact that when CMS told us that they were only going to pay 50% of the procedure value after the first code and the APTA told members that this would only create a 2% to 3% loss, I lost all faith. After the disaster with the 2005 change in our practice act, and other enormous missteps, I have to say the we must add the APTA as one of our great problems.

    While being disrespectful of another PT to a patient lacks an element of class, this didn’t produce the problem we have today. All of the issues you raise have been raised over at least the last 35 years. Our biggest problem is our ineffectiveness with CMS and elected officials.

    Today, I suspect that most practicing PT’s graduated less than 20 years ago. As a result, there is a loss of understanding about how our problems have been push along by the APTA and CMS. You reference the new reimbursement system and make reference to ” whether you are in favor of it or not….”; I doubt that anyone who has a fundamental understanding of the old RBRVS system can be ” happy ” about it. CMS has avoided the legislative process of changing our reimbursement schedule, used statistics to force limited treatment under the threat of investigation and have always pushed to have private practice PT become a dinosaur. They’ve been doing this for as long as I’ve been in practice. The difference is that they now have succeeded.

    It’s hard to say what is the biggest problem in PT, but I theorize ( at considerable risk of being declared a conspiracy theorist ) that MD’s associated with CMS have never wanted to see PT emerge as a competing interest. They have advised CMS on reimbursement procedures for all of this time and the reimbursement regulations consistently favored PT in hospitals where we could be supervised.

    Among insurers, where their boards are made up of MD’s ( for the medical side ), insurers have allowed MD’s for decades to bill PT procedures through their ID’s at a rate of 3 to 4 times our reimbursement rate. How does that even make any business sense? How can we, as private practitioners, compete with this when we have to pay for personnel at a market rate and the market is fixed against us?

    Research for decades has demonstrated increased costs and increased utilization of PT when MD’s own the practice. Many decades ago. MD’s owned pharmacies and that conflict of interest was outlawed. What’s different today? Owning PT is OK but not a pharmacy? Now, years have gone by and we are largely a kept profession. Since MD owned PT wasn’t eliminated, PT’s kept working for them…at a slightly higher salary. I’d say this is pretty high up on my list of issues.

    The current change in reimbursement seems to be the result of horrible judgment on the part of the APTA, but their lack of transparency on any business dealing with CMS prevents anything but pure speculation. So the question really is how long can the profession last when we’ll only make $75 a visit for 8 visits? Lets look at how that plays out.

    First, how much change can we make that fast and how long will that change last? We don’t really know because the research hasn’t been conducted, but from my experience we’ll land short of making any patient very impressed with a 45 minute service that mostly educates them about their condition and then tells them to go home and exercise. After years of this poor quality of care, how long is it before both patients and those ordering the PT ( which includes everyone on the planet except perhaps my mother ) finally realize that PT isn’t really helping? Of course that leads to surgery, or implantable pain products, TEI’s etc…. In fact, that is already happening. MD’s aren’t really making any money off PT, so the orthopedists are now hiring ” Pain Management Doctors ” to perform procedures at a huge profit and they continue to use PT only as a means to declare that ” conservative care ” failed, thus allowing them to perform more invasive and expensive techniques.

    While your list of problems are in fact problems in this profession, I’d say that the group in Washington lacks the historical perspective to even ask the questions that have led us down this path. ” Banding together ” isn’t going to save private practice. No matter how many PT’s belong to a practice, at $75 combined with an administrative burden that is crushing and regulations that seem to increase geometrically, we just can’t survive. Hospitals have to employ us…it’s mandated, at least for now. But they are losing money on our service. How long can they afford to employ us when we’re not really effective and we cause them to lose enormous amounts of money each year because even hospitals aren’t being reimbursed anything for PT.

    I know, I’m just old and don’t understand the new order of things. I used to practice at a time when we saw the patient until they were either pain free or had achieved Maximum Medical Improvement ( MMI ). Most PT’s today have never even heard of this. How radical…practicing PT on a patient until they are satisfied. Next time you see someone on the APTA BOD, thank them for me!

  10. Lucy Bousfield says:

    Great read! As a current Physiotherapy student in England I have found in my experience that the general public have little understanding of what we do. I also believe that as the profession and practice scope increases, whilst time spent with our patients decreases, we are losing our identity and need to redefine ourselves for what we learn to do and what evidence has suggested that works; manual therapy and therefore treat our patients until they are better.

    We also need to emphasise the importance of education, ensuring we are up to date with current evidence and practice which will fuel us with the power to educate others in their bodies and movement.

    1. Brett Neilson says:

      Lucy, Thank you for your comments and sharing your perspectives from across the pond. I would love to grab a virtual coffee with you sometime to learn more about physiotherapy in the UK. Email me and I would love to dialogue further – bneilson@eimpt.com. Thanks for reading.

  11. PT. ABBAS SUFIYAN IDRIS says:

    To be frank all the physiotherapist should believe that its there responsibility to promote and enlight the general population on how important physiotherapist are in health promotion ………..

  12. Omar Ross says:

    We MUST stop eating our young in the presence of the predators, thus making it easier for us to be eaten as a whole! By supporting one another, we strengthen ourselves, individually and collectively, and increase the chances of awakening the respected, patient-focused, cost-containing, evidence-based, hands-on and movement restoring profession that we are meant to be!

    1. Brett Neilson says:

      Omar,
      Thanks for reading and for your comments.

    2. Regi, PT says:

      That’s interesting phrasing, “eating out young.” How do you think we do that?

  13. John Seip says:

    We have consider what we have to offer as legitimate medicine and then market it as such. For example I took a post surgical patient who had an ICU stay for a walk. I asked them if there was a pill that could feed their joints, relieve pain, reduce stroke, prevent pneumonia, turn their GI System back on, and increase quality of life, would you take it? The obviously said yes. I replied that walk you just took did that. Movement IS medicine. Further more so is relationship or as it is being called Therapeutic Alliance. Humans don’t thrive alone. When we give a patient our time and attention it strikes at a very core need. Our lives are best when our needs are met. We as PTs are in a prime position to market the medicine we give. Medicine that reaches into the very basics of what it is to be human.

    1. Brett Neilson says:

      John, Well said. Thanks for reading.

      Brett

    2. Regi, PT says:

      I hope you don’t mind that I steal that line of questioning. It’s on the money.

  14. Nadiv Gonzales says:

    Hello all

    My analysis of the industry is coming purely from the financial and economic side of thought per I am a graduate student in financial economics. I recognize that there might be communication barriers between therapists and difficulties promoting a strong understanding of what PT’s actually do.

    Have we ever considered the industry from a pure business perspective? Barriers to entry are extremely high for private PT practices, the industry is highly fragmented with less than 10% owning the total market share, and reimbursement rates are always on a practitioners radar in order to stay solvent.

    If you look at it from this standpoint, the industry is built in a manner such that every physical therapist should be fighting tooth and nail for referrals and caring less about relationship building and caring more about volume. I know that this is not the case by any means, but the system is built in a way that promotes less communication, more secrets, and more put downs.

    I could be completely wrong but that is what i see coming from the fragmented community of physical therapy. Maybe this is the root cause of your problems and should be blamed on good ole capitalism.

    Anyone is welcome to weigh in!

    1. Tyler Donnelly says:

      Curious as I am always looking for good data. Where did you get the statistic of private practice making up 10% of the total market place?

      1. Brett says:

        Tyler,

        There are a couple references.

        Carter SK, Rizzo JA. Use of outpatient physical therapy services by people with musculoskeletal conditions. Phys Ther. 2007;87(5):497-512.

        Email me and I will send you the full text.

  15. Jesse Kent says:

    It ‘s really great to know.Thank you for sharing.

  16. Pissed Patient says:

    As a PT patient, I wish you would recognize that not all patients fit your financial models. I do not get anything out of a PT session in which my PT is also working with another patient. I need manual therapy for 40 min and exercises for 20 min. I need a PT–not a PTA–to watch me and my form during those exercises. When PTs come at me wanting me to be a 15 min manual therapy sort of gal, they get frustrated when I won’t put up with it. I have lots of bones that have to be put back into place each time and lots of muscle spasms that have to be calmed down. There is going to be a widespread revolt of patients AND insurance companies against this bullshit you’re pulling. PT isn’t a series of exercises to be assigned. It’s a constant evaluation of the patient, constant feedback, micro changes in approach to create long term success, PERSONALIZED care. Taking bones and muscles that are in the wrong place and do not respond to anything else, and manually putting them in the right place. You went to school for a reason. Assistants are NOT an acceptable replacement. If I am in agony for 5 days, and get to the appointment and you tell me you don’t have time to fix what’s wrong because you’re trying to see 2, 3, or 4 patients an hour, you’re not doing your job.

    1. Regi, PT says:

      I hear you say that you don’t think you’re getting the kind of care you think you should get. That’s not a good thing at all.
      All patients/ clients/ whatever deserve good care and attention. It sounds like you and your therapist never got on the right page about what kind of care would most likely benefit you. Now, I don’t think 40 minutes of manual therapy and 20 minutes of exercise is a magic formula. The number of minutes don’t really correlate to the quality of care, but there would be no way for you to know if you’re receiving quality if you and your therapist are not on the same page. That’s his or her fault to a large extent. Not everyone needs a lot of manual therapy – perhaps that’s what your therapist assessed to be true, but did not tell you that. Again, not your fault. You should have been informed about your plan of care during the assessment. There’s also the small, but pesky, issue of whether or not it’s possible to have a rehab-treatable bone or muscle “out of place.” That’s a phrasing that I know a lot of people use, but doesn’t usually correlate to any real event. But you’re right. You do need PERSONALIZED care. Any therapist is tasked with using his or her brain to try and help you the best they can. It’s possible your therapist decided what was appropriate, but didn’t explain it to you. The last issue: PTAs. PTAs are licensed and qualified to carry out any physical therapy intervention that the PT has prescribed. They’re trained and tested. If I were you, I’d have a serious chat with your PT about what your expectations are and you two can get a good handle on how to move forward so that they can help improve your life. It would be unacceptable that you not be cared for properly due to a long of time. I hope I’ve made sense. And I do hope you benefit from your rehabilitation going forward.

    2. Thank you for taking the time to share your thoughts. It is important that we hear from patients about their experiences with PT. I could not agree with you more that individualized care is essential, built trust in your provider is essential and your provider needs to meet you (the patient) where you are at (figuratively) at any given time. I would encourage you not to give up on physical therapy as a whole. I often use the analogy of a hair cut to explain any medical profession. If I get a bad hair cut, I do not say “I am never getting a hair cut again!” but I will likely not go back to the same hair dresser/barber. The same hold true here. Not all PT clinics function the same way, not all PTs are the same. If you would like my help, please email me and I would be happy to help identify a provider for you in your region. I wish you well on your journey ahead and thank you for stopping to share your thoughts.

    3. J, PTA says:

      It is very rare for any PT clinic to do 40 minutes of manual therapy on their patients. If you want 40 minutes of manual work because you have “bones that have to be put back into place”, then you should seek out a chiropractor or massage therapist. Every outpatient clinic I have ever worked in, is geared towards 15-30 mins of manual work to help reset the body, decrease joint dysfunction and ultimately decrease overall pain. Exercises are an integral part of the PT treatment, as strengthening and stretching all helps to restore muscle imbalances throughout the body. My biggest pet peeve is lazy patients. While PTs and PTAs are there to help you get better, keep in mind that the patients that see the best results are the ones who also do their part! As for “ASSISTANTS,” maybe you are mistaking them for AIDES? I can see your frustration in being handed off to an aide who watches you do your exercises, and doesn’t seem capable or interested in correcting your posture or form when needed. But…..assistants are most definitely an acceptable replacement! Assistants are also licensed professionals who can carry out the treatment plan just as well as a PT.

  17. Ellen says:

    I work in hospitals and created an exercise positioner for use at bedside. I performed a study and found patients who used my exercise protocol were discharged 1-2 days earlier. Yet many hospitals are disinterested. It was an eye opener to realize what a swamp healthcare has become!

  18. Thanks for giving us such a useful information. After reading your blog regarding Physical Therapy, I am satisfied and got some useful information that will help me a lot. Thanks a lot.

  19. Great and complete agree with article.

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