This morning, I was listening to a pod cast from a Physical Therapist that is promoting a cash based practice model for Physical Therapists. The title of the podcast was “Do Physical Therapists under value their own services?” Physical Therapists were invited to comment on the unvalued nature of the service that they have trained with years of schooling to provide. The purpose of Physical Therapy is to help people achieve their highest level of physical function. Imagine a grandmother not being able to lift up their grandchild or an office worker not being able to sit at their desk without pain. Pain limits function and affects people on not only a physical level, but an emotional level as well. Physical Therapists go to school and spend years studying anatomy, physiology and healing modalities with the intention of helping people rehab injuries and restore their bodies to optimal function. In reality, our health care model is having today’s Physical Therapist treat 3 people every 30 minutes in busy gym like settings. They may get to spend 10 minutes with a patient with little to no hands on treatment. How effective can that type of treatment be? In contrast, most Massage Therapy programs take 6 months from start to finish. Those therapists do not get the in-depth training contained in the Physical Therapy programs. However, these therapists actually spend one on one time with their clients. Even without the advanced knowledge that the Physical Therapists have, Massage Therapists can often have a better outcome with pain relief for their clients because they actually touch and spend time with their clients.
I was very lucky coming out of Physical Therapy school. I had an interest in Pediatric therapy and pursued that clientele right out of school. It required that I immediately seek additional continuing education as I did not have those skills from my Physical Therapy education. Myofascial Release was one of the first classes that I took. You can’t learn Myofascial Release effectively from a book. It requires hands on training and personal involvement in order to gain the skill beyond a mechanical level. Although I have to admit that even Myofascial Release at a mechanical level can be more effective then many other hands on techniques. I fell in love with this very effective treatment modality because I could feel the effectiveness in my own body. I was a new mom with two young children. I had started Physical Therapy school shortly after the birth of my first child and had my second child in my last semester of Physical Therapy school. Being a new mom and a student was all I had time for so needless to say, healing my body after two C-sections was not a priority for me. Within 1 year after the birth of my second child, I had started having typical pelvic floor issues such as pain, recurrent bladder infections and bladder urgency and frequency. True to form, I was like most women and ignored all the obvious symptoms. The Myofascial Release treatments that I received from beginning students in my classes not only began to alleviate the symptoms but brought my awareness to the problems that were slowly developing and becoming chronic. At that point, I decided that I could never do “mill therapy”. I dedicated my career to learning as much as I could about effective hands on healing modalities. I eventually opened my own private practice which utilized Myofascial Release as the core of our treatment. Hands On-Austin is now in it’s 20th year and has helped thousands of people eliminate pain and restore their function.
Do Physical Therapist under value their worth? Well let’s consider what most Physical Therapists do? How much are you willing to pay to go into a gym like setting, get put on heat, be treated with an electrical device and then put in a gym and have someone count your repetitions? How much is that really worth? Especially when the physical problem is never really addressed and the strengthening leads to more pain because you are strengthening a dysfunctional pattern. It’s unfortunate that this is the system that all Physical Therapists are being judged with. A typical private practice Physical Therapist will usually have a more specialized practice with better treatment outcomes. Most of these therapists are not in big clinics and do not file third party insurance. People have to pay out of pocket for these services and file insurance themselves. Their reimbursement from their insurance provider will generally not be as good, if they are reimbursed at all, as if they went to one of the “mill therapists” who are in-network. Austin, TX now has a Doctorate of Physical Therapy program where Physical Therapy students can graduate with a manual therapy certification. The problem is, they won’t have the ability to practice any of those skills as new graduates in the typical Physical Therapy department at any hospital or clinic. Insurance companies do not reimburse appropriately for this service as reimbursement is based on the model of minimal hands on.
So, if you are in pain, should you go to the Physical Therapist that is designed to remediate pain and restore function and has years of training to get the professional license? Or, should you go to a Massage Therapist trained and utilizing effective hands on skills, such as Myofascial Release? It’s obviously not a clear cut answer as Physical Therapists do have more training and understanding of the anatomy and physiology of the musculoskeletal system. It’s unfortunate that many of them are just not able to use or expand their knowledge base in our current health care model. My advice would be to seek the most qualified professional based on their ability to use hands on skills. Pain relief and restoration of pain of a musculoskeletal origin requires hands on techniques and an understanding of body mechanics to find the source of the problem. Don’t let the cheaper co-pay and insurance reimbursement make the full decision of where you go to take care of a potentially life limiting injury and pain. Based on what’s happening with our health insurance, our quality of life is going to depend on our ability to put our health care and wellness as a priority and pay out of pocket if needed.
Hands On-Austin and Verde Valley Myofascial Release are staffed with Physical Therapists, Occupational Therapists and Massage Therapists who utilize expert level manual therapy treatments, including Myofascial Release for the restoration of function and acute and chronic pain relief. They have advanced their knowledge base in some specialized areas which include: Women’s and Men’s Health,TMJ, Recreation and Sport Performance. You will get value for the service that you are seeking from professionals who have trained extensively beyond the level of their initial license.
I do realize that some Physical Therapists may take offense to my opinion of what has become standardized care within the Physical Therapy clinics. As a therapist who has never worked in a high volume clinic, I have a hard time identifying with that role. If you have an opinion, either from the patient or therapist stand point, please leave a comment.
Jody Hendryx, PT, LMT