According to Sir Francis Bacon, knowledge itself is power—and we couldn’t agree more. However, there’s a lot happening in the healthcare industry right now, and staying knowledgeable about everything can certainly feel like a daunting task. That’s why we’ve curated seven of the most thought-provoking facts about physical therapy and put them together in one quick-read post. Without further ado, here are some bite-sized bits of knowledge. Just remember, with great knowledge, comes great responsibility.

(Please note: Any fact that doesn’t link to an outside source is based on statistical analysis Strive Labs  conducted on more than 30,000 pieces of insurance data from claims processed in 2012 that were submitted by privately owned outpatient physical therapy clinics in a specific geographical area.)

1. Each year, half of all Americans over the age of 18 will develop a musculoskeletal injury that lasts longer than three months (according to this resource). That’s more than a hundred million people who could benefit from seeing a physical therapist. This is great information, We are underutilized in the medical community. We should be one of the first lines of defense for patients. We should be able to guide patients to the direct provider for their care. 

2. In 2011, only about 11.7 million adults took advantage of outpatient physical therapy services (according to this resource), which means only 9.58% of the people who could have benefited from our services ever received them. Even if these numbers have positively shifted over the past several years, it’s still safe to say that we have a ways to go before we realize our potential as the practitioner of choice for patients with musculoskeletal injuries. We must continue (and dare I say, double down) our efforts to increase consumer adoption—and that means we have to expand our marketing efforts to target potential patients directly. Totally agree. We need better marketing in our clinics. Our professional groups need to support us in a more positive way, But we also need to advocate for ourselves. Our best marketing is our treatment and care we provide to our patients. 

3. The average outpatient course of care is only seven to 10 sessions, and reimbursement rates—as well as the number of payer-approved visits for physical therapy services—are remaining largely stagnant and, in some cases, decreasing (according to this resource and this one). This fact may trigger anger or frustration, but read on, because even if insurance companies don’t increase their number of PT visits—or their reimbursement rates—there are things we can do to help our patients and our revenue streams. We are a cost effective treatment for patients, costing thousands less than an often un needed Xray or MRI. Diagnostics are important, but not for the vast majority of our patients. 

4. Only 30% of patients who receive outpatient physical therapy services attend all the visits their insurance company authorizes. That means that the majority of patients aren’t completing their course of care, which means we may not be effectively communicating the value of doing so. After all, when our patients are in a lot of pain at the onset of care, they’re much more likely to prioritize PT over just about anything else. However, once they start to feel better—even if they haven’t met their functional goals and could still benefit from receiving physical therapy—attending sessions becomes less of a priority, and things like missing work and hiring a babysitter may not seem as worthwhile as they once did. But, that’s where we come in. It is up to us as PTs to articulate the value of finishing care, decrease patients’ perceived barriers to continuing treatment, and help them reach their goals. This is a real issue here as it show we are usually not able to convert or create a buy in without our patient population. Because of this, we do have some negative outcomes that unjust. We combat the mill clinics are large corporation clinics by being better, selling our services and treating our patients better than. the big companies to earn their trust. We create our marketing by being better. 

5. As a result of patients not completing their courses of care, the average outpatient physical therapy practice loses out on approximately $250,000 of revenue per year. (Note: For this calculation, we set the average rate of reimbursement per visit at $100, which we based on the 2012 annual report by US Physical Therapy, Inc.) A clinic’s revenue is directly tied to reimbursement, so if a patient is authorized to receive ten visits, but only attends eight, then the clinic only accrues 80% of the potential revenue and leaves 20% on the table. As a business owner, this is a real issue. We need to make sure our doctors are aware of this statistic. We need to treat appropriately, we need to convince the patient we are worth it. We struggle with this as a profession as often we aren’t worth it, we aren’t selling our services enough. Yes, some therapists aren’t very good. I would argue that 80pct of the work force in our profession is inadequate because we allow them to be. Quality control in health care is just as important as any other field or business. Quality works, and it provides return business, trust, and referrals. 

6. Only 35% of physical therapy patients fully adhere to their plans of care (according to this resource).While we tend to think of compliance as binary—either a patient is or is not compliant—it’s actually multifactorial and largely correlated with the concepts of behavior change theory. It’s no coincidence that most Americans don’t get enough exercise and most patients don’t fully adhere to their plans of care. After all, it’s exponentially harder to do something than to do nothing. But, we can help by ensuring our patients have the support, tools, and encouragement they need to complete their home exercise programs outside of the clinic and thus, adhere to those programs. Again, this is primarily our fault, We need to explain the how, the why , the what and the when. We are the issue here. this number should be greater than 80% if we are doing our jobs at the highest level of clinical competency. If your disagree with me you are wrong.  At CORE we are consistently fixing and continuing failed care from big health care companies that didn’t care enough to educate their patients. We take the time to provide full spectrum care, is your physical therapist doing that?

7. Many PTs report not feeling confident in their ability to apply the concepts of behavioral change theory in clinical practice (according to this resource). If the terms “self-efficacy,” “transtheoretical model,” and “decisional balance” aren’t ringing any bells, it’s time to hit the books—or at least the Internet—because we have a unique opportunity to provide positive and lasting outcomes to our patients in a cost-effective manner. But, in order for these outcomes to be sticky (i.e., long lasting), we need to help our patients adopt healthy habits. After all, helping our patients feel better—and stay that way—is where our goals intersect with the patient’s and the payer’s. That’s where we can differentiate ourselves. That’s where we can win. But we won’t be able to get very far unless we can understand and implement the steps necessary to affect behavior change. The mental aspect of recovery is one of the most important. We need buy in from the patient, which means we need to earn their trust. We need more training in the issues they are dealing with. Paid training for our doctors of physical therapy is important for competency. It important for patient and clinician inter relation. More training. More reflection. More time built in for reflection. It remains the most forgotten and neglected part of the job. 

Reaction by Dr. Mark T. Rathjen PT DPT CSCS in RED