How do you know if the treatment you received in Physical Therapy is worth the effort and money you are paying? Are there things you can look at to determine this, especially when looking for specialized care like scoliosis treatment?
Contrary to popular belief, not all Physical Therapy is created equal. What you get at one clinic, may not be what you get down the road. So, how do you decide? (And please don’t just go by your insurance!)
My wife Dionne and I just returned from an anniversary trip to Puerto Rico, and while we were there, I noticed many things that added, or subtracted, value. I think some of those apply to Physical Therapy as well.
1. Convenience
As I write this blog post, I am sitting in an uncomfortable seat on Spirit Airlines. If you have flown with Spirit, you will know that if you want anything beyond a hard seat that doesn’t recline, you have to pay extra for it.
We wanted to spend our money on the things we did in Puerto Rico, so we didn’t spend as much money on the flight.
So, as we are sitting here flying back to Utah, Dionne sees something on their menu she wanted to try. It was a snack pack with a cheese tray, and included 2 drinks. $15…didn’t seem too bad.
As we get the items from the cart, we realize the choice was the snack pack OR the cheese tray. Not both. We chose the snack pack….which included a tiny container of spreadable cheese, bag of 8 almonds, a bag of 4 chocolate chip cookies the size of quarters, small fruit snack pack, and 4 crackers. Color me underwhelmed!
What we expected to be a good snack for our flight home became something that was a let down and didn’t meet expectations, just because of the cost of convenience.
How does this relate to Physical Therapy?
Convenience in scheduling PT is important, but not at the expense of getting what you need. The way a lot of PT clinics do it, because of reduced insurance reimbursement, is treating multiple patients at a time. This allows you to schedule an appointment sooner and most likely when you want, but this is because there are more times available.
I totally agree that we should make Physical Therapy as convenient as possible, but again, not at the expense of getting the highest value.
2. Specialization
In Puerto Rico, we stayed on a little island named Culebra. To get there, we had 2 choices…either take a ferry, or fly.
I knew I wanted to get to Culebra fast, but more importantly, that we could get back from Culebra on time to catch our flight home. I had heard that the ferry was unreliable, and pretty rough. In contrast, I had read great reviews about the little flights that head over multiple times each day.
When I considered what I wanted out of traveling to this little island, I decided to fly there with Air Flamenco instead of taking a chance on the ferry. The specialized way in which they made the trip happen was worth the extra cost because it brought value.
In Physical Therapy, and especially with spine specific treatment, make sure you are using a clinic that meets your goals. Are they specialized in a way that gets you to those goals in the best way possible?
Treatment for scoliosis is specifically on my mind with this one. We are out of network with some insurances in our area, and one large one in particular. When someone calls that insurance to ask if they can get the same type of treatment for scoliosis as they would get at my clinic, they give them a list of 5-10 PTs who “specialize” in scoliosis.
I have called that list multiple times, and EVERY time I talk to the PT, they say “well, no, I don’t specialize in scoliosis”.
The fact that the insurance company will send out a list, knowing full well those PTs ARE NOT specialists in this area makes me angry. It has taken me and my therapists YEARS and significant financial cost to get to the level where we feel like we are specialists in this area.
Sure, all PTs “can” treat scoliosis, but should they? The research is pretty clear that the most impact on scoliosis, especially adolescent idiopathic scoliosis, is with a PT who has been trained in a specific scoliosis treatment school (Schroth, SEAS, PSSE, etc).
Look for someone who specializes in your condition! This adds significant value.
3. Experience
If you have been to an island like Culebra, you probably know finding good food is sometimes a challenge…and it is ALWAYS expensive.
On our last day on the island, we decided to go to a “nicer” restaurant to celebrate our 20th Anniversary. With half of the restaurants in town closed because it was the off season, that left only one option…Mamacitas.
This place is situated on a little bay and canal where you sit right by the water. Sounds promising, right? And an added benefit…they have Tarpon that you can feed right from your table.
So, we get there and stand waiting to be seated for 10 minutes. Finally, someone came up and told us that we could just seat ourselves. We find a table next to the water and sit down, but notice the table hasn’t been cleaned off yet.
At this point I am pretty proud of our ability to get a table right by the water! Our waitress comes over, and I ask her if we can get the table cleaned before we order. Her reaction made it seem like I had just asked her to jump in with the Tarpon!
She took about 10 minutes to get a cloth to wipe the table down, and then had a horrible attitude when we ordered, and all the way till we left.
Now, the food was good, where our table was was great, and it was a warm, beautiful night…but the waitress really made a bad impression that evening.
What has your experience been in Physical Therapy? Are you just a number, or do they know your name and know YOU?
When it comes to working with people in pain, or with a spinal deformity that is progressing, or really anything health related, the experience goes a long way. It should be excellent and it should make you want to come back.
4. Results
One thing Puerto Rico is known for is having a few Bioluminescent bays. This is where algae release light when they are disturbed at night. It is a defense mechanism, and I won’t get into the specifics of it, but it is pretty cool to see.
I booked us a kayak tour at a bioluminescent bay in Fijardo because there aren’t very many of these in the world. It is the off season for this, but I thought we would still try to see something cool.
We arrived at the meeting place and after having some training in kayaking with a group of 20 people, we got in our kayaks, and headed through a river to the bay.
Now, the kayaking was pretty cool by itself and we started near sunset so the light started to fade as we went up stream into the bay.
In my mind, what I was going to see was like someone sprinkling glow sticks in the water. This turned out to not be the case.
Since it was the off season, they told us that we might not see anything, and that it was only about 20% of what it can be. So we paddled around, ran our hands through the water, and watched for something to shine.
The longer it took, the more disappointed we became. Were we even going to see something?
Then, we started to see little sparks and the darker it got we saw more and more sparks. Now, it wasn’t the light show I had envisioned, but it was something! To see lights in the water from these little creatures was pretty amazing, even if it was less than expected.
Without having this result, the trip would have been more of a let down.
You go to Physical Therapy to get results. Are you getting them? Are you confident you WILL get them?
Sometimes the results aren’t exactly what we expect, like when we see someone’s scoliosis progress, but we have to give it our best effort. That effort is how we get results.
5. Skilled
Now, this can be the most important one.
As we flew to Culebra and back to the mainland, it was important that the pilot was flying the plane. He didn’t hand over the controls to a passenger or bring in someone he was training…it was him flying the plane.
This may seem basic, but unfortunately, it is an all too common situation in Physical Therapy.
Many times, the PT does the initial evaluation, and then for the majority of treatment they pass the patient off to aides, techs, students, etc to carry out the treatment. This immediately decreases the value of that care.
You went to Physical Therapy to see a therapist, right? So, if you are handed off to someone with minimal to no training, that is not right. You would expect that your results wouldn’t be as good as if you saw a licensed therapist each and every time.
In my clinic, the only time someone is handed off is when it is to a PTA (physical therapist assistant), who is a licensed therapist and has been trained to provide care for that condition. You are never pushed to someone who is not licensed and who has not had training.
Are you seeing the therapist each time, and for the whole treatment? If not, you are not getting the value you could, and should, be getting.
You may notice that within these 5 things there is no mention of insurance coverage or being “in-network”. That is because I would hope that isn’t the main reason you are choosing a therapist…or any healthcare provider for that matter.
You should choose a Physical Therapist based on whether they are the best fit for you and what you have going on. This is how that treatment is valuable, and how you will get the results you need to get you back to what you want to do.
Don’t compromise your care, just because of convenience or because of insurance restrictions. Do what is best for you!
If you want to learn more about how we treat, please check out other blog posts, or browse our website for more information on specific conditions.
Dave
