When you’re in physical therapy school, the professors fill you with pride. “You’re a Doctor of Physical Therapy,” they said. They encourage continuing education and research so you can deliver the most innovative, evidence-based care possible.
“Never tell your patients to do 3 sets of 10,” they instructed. A physical therapist should appropriately dose each exercise to maximize strength gains and minimize recovery time.
“Write detailed, objective notes and evaluations,” they said. Good documentation allows you or another physical therapist to exactly reproduce a treatment session. It also helps you better understand why you chose a specific intervention and how the patient responded to it. Your notes should validate your outcomes.
Then I graduated and took a job at a typical, high-volume clinic and reality quickly set in. So much of what I learned in school became impractical, if not impossible. As badly as I wanted to practice physical therapy the right way, I was forced into survival mode.
NUMBERS, NUMBERS, NUMBERS
I worked with one other physical therapist at this clinic. Our primary goal was to meet our weekly census count. We were expected to hit on average 160-200 patient visits per week between the two of us. In a 40-hour week, that’s an average of 2-3 patients per hour per therapist.
On the surface, that might not seem too bad. But patients aren’t scheduled in perfect intervals. During the busy after-work hours, for example, we would often double book them into 20-minute time slots. So that’s 4 patients in 40 minutes!
I tried spending as much time as possible with each person. But, just when I would start getting to the source of their pain and dysfunction, I would have to say “we’ll pick this up next visit” because other patients were waiting in line to see me.
HAVING TO RESORT TO 3 SETS OF 10
It’s not that my patients weren’t getting better in this type of treatment environment. For the most part they did over time. I just knew that if I could spend more undivided time with each person, they could get the same results in far fewer visits. It would save them time, money and suffering. And it wouldn’t waste any insurance benefits.
Furthermore, having to document up to 100 notes per week consumed my life. I would spend countless hours before work, after work, and on weekends writing my evaluations, daily notes, and insurance letters. It was really important for me to thoroughly document each session, just like I was taught by my school professors. Although as time went on, my reporting became more subjective than objective. I even began to sacrifice valuable treatment time just to get my notes done during the work day. After all, I had to have some sort of life outside of work.
I took continuing education when I could fit it into my busy schedule. I would always leave those courses feeling motivated and inspired to incorporate what we had learned into my treatment sessions. However, spending only 10-15 minutes with each patient made it too difficult to fully implement, practice and refine any new skills.
FOCUSING ON MY CLIENTS AND MYSELF
I became a physical therapist to help people get back to their active, pain-free lifestyles as quickly as possible. The conventional in-network practice model simply didn’t give me this opportunity to shine.
Something had to change. So, in early 2016, I went outside the box and joined Activcore.
I finally got to treat clients on a one-on-one basis. I had time to ask questions, attentively listen, and thoroughly assess each person. My sessions naturally became more holistic, more productive, and more fun than conventional PT.
I had better work-life balance. I could easily keep up with my documentation and study the latest research and trends in the industry. I could develop professionally as both a clinician and entrepreneur.
RESULTS ARE JUDGED BY MY OUTCOMES, NOT VOLUME
To produce more results in fewer visits is an exhilarating experience. Clients value my time and are willing to pay cash upfront to see me.
I’m out of survival mode and into an environment that provides so many opportunities to do exactly what I was taught in school. I no longer feel like a technician. I no longer have to resort to 3 sets of 10. Now I truly feel like a Doctor of Physical Therapy.
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.