"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Friday, July 25, 2008

The Physical Therapy Value Proposition

I've received notice that my value proposition is not as clear and logical as I thought it was.

My thanks to Larry Benz, PT Selena Horner, PT and Mark Schwall, PT for commenting on several of my last posts.

I'll try again.

Physical therapists measure patients:

  • ROM
  • strength
  • extremity girth
  • difficulty with activities (OPTIMAL)
  • Fear-Avoidance Beliefs
  • isometric lumbar extension strength
  • the list goes on...

The measurements and the interpretation of these measurements is all that separates physical therapists from other professions that do many of the same interventions we do:

  • specialized exercise by personal trainers
  • massage by massage therapists
  • spinal manipulation by chiropractors and osteopaths
  • ultrasound and electric stimulation by athletic trainers
  • splint and orthotic fabrication by orthotists and occupational therapists

Going forward, my recommendation is that physical therapists hang their hats on simple physical therapy measurements as the value proposition to the consumer.

Consumers like value.

Consumers include the following:

  • Patients
  • Insurance companies
  • Medicare
  • Industrial work places
  • Schools
  • Military

The value created in the exchange between the patient and the physical therapist is information.

Simple measurements create information which is valuable.

I'll give one example...

You measure a weak external rotator muscle and advise the patient that overhead lifting or throwing sports are risky because the likelihood of impingement and eventual tear is increased.

You have created new information that did not exist prior to your exchange with the patient.

You have demonstrated the medical necessity for physical therapy.

You have demonstrated skilled physical therapy.

Physical therapists need to take more measurements of their patients in order to create additional value during the exchange.

Outcomes are one type of measurement. The OPTIMAL is an outcome measure.

But measurements are also predictive. Measurements taken during the evaluation help the physical therapist select interventions and set long term goals.

Measurements allow physical therapists to classify patients.

Measurements allow the physical therapist to make a physical therapy diagnosis and, ultimately, a prognosis.

Without measurement there is no value in physical therapy.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.