Is therapy worth it?

“Value is defined as cost divided by benefits”

 

This is very elementary in definition, but many of us in healthcare don’t do enough to sway this equation to make the benefits match the costs. When patients come to see me they receive multiple benefits during the session: educate, educate and over educate, personal care as much as possible staying within the realm of the evidence, and entertainment during the whole process. When I teach students, I make them tell me if they believe that they are worth $100/hour. Although we don’t get paid this much, that is the average payment to the clinic. We may have an excellent front desk staff and only have to provide the same amount of value as the cost of our salary, but I believe that we should be conveying the cost of the session, which may be up to 3 x the amount we actually receive in payment.

 

“What are the costs associated with the care we deliver? Co-pays, coinsurance, and deductibles question? ”

 

These are the basics to consider when treating patients. Patients sacrifice their times to come see us. Patients sacrifice time away from family to come see us. Are we providing the value, beyond the monetary value, to the patient? Human connection has value. I provide value to my patients not just through treatment, but also through that human connection.

 

“Now look at the benefits: what are the benefits we offer our clients through physical therapy?”

 

It’s easy for me to say functional outcomes. Patients at this point in time, do not know what that means. My job is to take the patient’s wants and needs and turn those into results. I have my own functional needs, but it would be wrong of me to impose my functional needs onto the patient. Some patients are quite content to sit in a wheelchair all day long instead of putting the work in to stand up. The best I can do is to educate the patient. If after education, I can’t motivate, then I can’t help that patient. We make the assumption that patients coming to therapy are ready to get better. This is not always the case. I see patients frequently that are only coming to therapy because their doctor told them to go to therapy. There was no indication as to what therapy would actually do to help the patient. If they are not ready to change, then it is very difficult to help that patient.

 

“patient’s assume they will get better when they see us”

 

Malarkey! At no point in time am I providing divine intervention. No one gets better simply by breathing the air I breathe (although this is one of the jokes in my repertoire). I am sure that my patient understands they will only get better when they take ownership over their problems.

 

If you are that patient, and you are ready to change, then there is help. When patients understand the problem and takes ownership of the problem and then performed the treatments in order to treat the problem, there very few patients that will not improve. Some physical therapist, such as myself, believe that we hold the answers to fix our patients. Robin McKenzie many, many years ago stated that the patient has the answer, our job is to bring that answer out. I would be arrogant of me to think that I am that answer.

 

Again, I went off on a tangent, but I did not believe that the rest of this article held any additional information that would be benefit to you.

 

Excerpts taken from

Quatre T. WHY THEY BUY: Because They Can Calculate Your Value. Impact. July 2016: 11.

Author: Dr. Vince Gutierrez, PT, cert. MDT

After having dedicated 8 years to growing my knowledge regarding the profession of physical therapy, it seems only fitting that I join the social media world in order to spread a little of the knowledge that I have gained over the years. This by no means is meant to act in place of a one-one medical consultation, but only to supplement your baseline knowledge in which to choose a practitioner for your problem. Having completed a Master of Physical Therapy degree, the MDT (Mechanical Diagnosis and Therapy) certification and currently finishing a post-graduate doctorate degree, I have spent the previous 12 years in some sort of post-baccalalaureate study. Hopefully the reader finds the information insightful and uses the information in order to make more informed healthcare decisions. MISSION STATEMENT: My personal mission statement is as follows: As a professional, I will provide a thorough assessment of your clinical presentation and symptoms in order to determine both the provocative and relieving positions and movements. The assessment process and ensuing treatment will be based on current and relevant evidence. Furthermore, I will educate the patients regarding their symptoms and their likelihood of improving with either skilled therapy, an independent exercise program, spontaneous recovery or if the patient should be referred to a separate specialist to possibly provide a more rapid resolution of symptoms. Respecting the patient’s limited resources is important and I will provide an accurate overview of the prognosis within 7 visits, again based on current research. My goal is to empower the patient in order to take charge of both the symptomatic resolution and return to full function with as little dependence on the therapist as possible. Personally, I strive to be an example for family and friends. My goal is to demonstrate that success is not a byproduct of situations, but a series of choices and actions. I will mentor those, in any way possible, that are having difficulty with the choices and actions for success. I will continue to honor my family’s “blue-collar” roots by working to excel at my chosen career and life situations. I choose to be a leader of example, and not words, all the while reducing negativity in my life. I began working towards the professional aspect of the mission statement while still in physical therapy school. By choosing an internship that emphasized patient care and empowering the patient, instead of the internship that was either closest to home or where I knew that I would have the easiest road to graduation, I took the first step towards learning how to utilize the evidence to teach patients how to reduce their symptoms. I continued this process by completing Mechanical Diagnosis and Therapy courses A-D and passing the credentialing exam. I will continue to pursue my clinical education through CEU’s on MDT and my goal is to obtain the status of Diplomat of MDT. Returning back to school for the t-DPT was a major decision for me, as resources (i.e. time and money) are limited. My choice was between saving money for the Dip MDT course (about 15,000 dollars) and continuing on with the Fellowship of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT) (about 5,000 dollars), as these courses are paired through the MDT curriculum or returning to school to work towards a Doctorate of Physical Therapy degree. I initially planned on saving for the Dip MDT and FAAOMPT, but life changes forced me to re-evaluate my situation. The decision then changed to return for the tDPT, as my employer paid for a portion of the DPT program. My goal for applying to and finishing the Dip MDT and FAAOMPT is 10 years. This is how long I anticipate that it will take to finish paying student loans and save for both programs, based on the current rate of payment. I don’t know if I will ever accomplish what I set forth in the mission statement, but I do know that it will be a forever struggle to maintain this standard that I set for myself.

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