An Educated Editorial:
Over the years of listening to patients who have had poor treatment elsewhere I have grown disgusted with what commonly passes to the unwitting public as "physical therapy". Hopefully your life has been healthy enough that you have had minimal, if any, need for therapy. If you have needed therapy, I sincerely hope that you have had the experience of meeting one of the growing numbers of dedicated and competent therapists who are building the profession in an appropriate way. These people I am proud to call colleagues. There is, unfortunately, a mass of substandard treatment in the market place.
I recently spent some time with a colleague who was going through the necessary planning stages of opening her own practice. When it came to the name of the practice she told me that she was so disillusioned with the practice level of her peers that she wanted to avoid using the phrase "physical therapy" in the name. She lamented that she is commonly told by potential patients that they have already tried PT only to learn that it was some internet driven "therapy" advice, an iPhone application or, even worse, some unethical, intellectually lethargic PT watching as they rode the bike or some other mindless passage of time that allowed a justification for billing. This was disturbing but very understandable. I agreed that, based on what we see the public subjected to, I should have named my practice Fearon Orthopaedic Manual Therapy.
In this current market place there is a great deal of driving economic force dictating what is offered as care. Don't be fooled by unscrupulous arrangements or haphazard care. Most insurance companies develop a list of preferred providers based on how little they can pay them, not on how effectively they treat patients. In other words preferred price structure for the insurance company, not preferred care for the patient. This, of course, pushes down to the clinic who tries to have the cost of delivering the care be as low as possible. Often the solution is that the therapist schedules more patients per hour, gives them less of their time and has ancillary personnel deliver the "care".
Many physician offices hide behind the veil of trust of their patients and have them see "their therapist" which they, in fact, employ and are profiting from the referral for your "care". The fact that they profit from the treatment delivered by "their therapist" is all too often the motive for the recommendation, not the effectiveness of their care. Remember that you have the right to choose your PT provider, no one can tell you that "you must go here."
Many corporate owned therapy facilities put high pressure on their clinics to have production numbers. In short, these practices focus on the business side of being in the rehabilitation business, not the clinical effectiveness. To be fair, some do so and deliver good care. You, the patient, should hold us all to the same standards.