Physical Therapy in Preventative Care

Remember needing to get your medical physical each year before playing sports or getting that exciting post card in the mail just to be disappointed that it was from the dentist saying it was time for your check up?

Rather than getting post cards in the mail most of us simply get e-mails or phone calls  reminding us that it's time for a visit to the physician or dentist. Even if you feel perfectly healthy and have no concerns these visits to health care professionals are highly advised, but why? Preventative care is a major goal of the health care field because it's way cheaper and easier to prevent a problem rather than fixing a problem. People also benefit from this focus on preventative care as well. Wouldn't you rather go to a yearly physical and find you are at risk for having a heart attack and have a discussion on ways to prevent it rather than just going to the hospital when you have a heart attack? What if the health care system worked that way? Imagine only being able to go see your dentist once a cavity is giving you problems and you can't eat without pain or only going to the physician only to find out you have an advanced stage of cancer that could have been stopped earlier with frequent check up visitis. This system would lead to a lot of unnecessary suffering and anxiety for the patients and even more money spent on health care. I feel safe saying that almost everyone out there agrees that preventative health care is important and are grateful that we have a health care system in place that encourages preventative care. A funny thing happens though when it comes to the physical therapist's role in the medical field because, for the most part, a physical therapist is really only seen when somebody has a problem that needs worked on. For most of health care we think preventative medicine is crucial but, physical therapists are under utilized when it comes to prevention. What can physical therapists even do in terms of prevention? While there are a lot of injuries and things that happen that no amount of prevention will avoid, there is still plenty of things that physical therapists can help prevent. Let's talk about one of the most common things that brings people in to see a physical therapist...low back pain. Did you know that around 80% of Americans will have some episode of low back pain in their lives? Did you also know that physical therapists can assist in preventing some of that low back pain? Physical therapists analyze posture, both standing and while moving, as well as potential areas of muscle weakness that could contribute to low back pain. Similar principles apply for people that have neck and shoulder pain. A lot of these individuals work behind a desk and on a computer all day. By having a physical therapist analyze posture and give ways to correct it there is a huge potential to decrease these issues before they become a problem. What about athletic injuries? With the early specialization in sports we are seeing a large increase in injuries at a younger age. People are going to be putting their kids in sports early and having them specialize even if they know the risks to it. By checking out motions of the athlete each year before a season starts a physical therapist has the ability to inform the person of their risks and what areas to address to try and prevent future injury. Those are just a few examples of how physical therapists can play a role in preventative medicine. We are so focused on preventing so many different diseases and problems in our bodies why not start trying to prevent musculoskeletal problems too. We find the idea of only seeing a dentist and physician when we have a problem ridiculous and yet that is exactly how we treat physical therapists. Do annual check ups to see your physical therapist sound impossible? Imagine if we could prevent just a small percent of conditions like low back pain. It would save billions of dollars each year and give people much higher quality of life. Do you think it's worth it to have an annual physical done by a physical therapist? Would you find it an important physical to go to each year?

How Much Is Your Quality of Life Worth?

How would you feel if you were told that your health was only worth a certain amount of money? Let's say you had a traumatic brain injury and needed rehabilitation but somebody told you that you were only worth about $2,000 before improving your quality of life just costs too much. This concept sounds ridiculous! Sadly, this is exactly what has been going on for the last 20 years for individuals with Medicare thanks to the Medicare Therapy Cap on the rehabilitation services of Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services. In 1997 Congress placed an annual cap on rehabilitation services for those on Medicare. This means that an individual on Medicare is only able to get rehabilitation services each year until they reach this arbitrary monetary amount that was set by congress. The worst part about this for those wanting to see a Physical Therapist is that this arbitrary cap has been set at $1,980, as of 2017, for physical therapy AND speech-language therapy combined. This cap set at $1,980 is just a random number and does not take into account the amount of clinical care needed by individual patients. This means that many people that are covered by Medicare following a stroke, spinal cord injury, Parkinson Disease, or any chronic  condition that lowers an individual's quality of life are not able to get the rehabilitation they need for a higher quality of life because they reach their cap each year before they can reach those functional goals. Some of these people need both physical therapy and speech therapy so with the combined cap they reach their limit rapidly severely limiting the care these patients receive. These individuals can try to extend their therapy cap to get more, but it has to be "medically necessary" which most of the time improving quality of life through outpatient therapy is not going to qualify them for that.  If you are thinking that this all sounds really bad for the patient and for rehabilitation services...then you are right! This is why the American Physical Therapy Association, APTA, believes that it's necessary for a full repeal of the Medicare Therapy Cap to occur. They have been taking action to work with congress to try and get this full repeal to occur. Now I am not just here to vent, I am posting this to inform everyone and give you some ways that you can get involved. The first is to get involved in the Flash Action Strategy occuring this year on September 12-13 which is an annual student led campaign that collaborates with the APTA. This year the campaign is completely focused on the full repeal of the Medicare Therapy Cap. To learn more about this and how to get involved check out this link:

Flash Action Strategy
http://www.apta.org/FAS/

You should also follow the APTA Student Assembly on Twitter @APTASA and like them on Facebook at APTA Student Assembly to keep up with what they are doing during this Flash Action Strategy.

You can also share the Flash Action Strategy graphics, which can be found on the link provided above, on your social media accounts using the hashtag #StopTheCap

To learn more about the Medicare Therapy Cap and find more actions you can take visit the following link:

APTA Medical Therapy Cap Information
http://www.apta.org/FederalIssues/TherapyCap/

Just because something has been done for 20 years does not mean it is the right way and now is the time to get rid of these arbitrary caps that are limiting the outpatient rehabilitation individuals need. If you had to put a price tag on your quality of life...would $1,980 a year be enough?

Who Is Your Physical Therapist?

Since I have attended three different colleges while being a student my little family has had the opportunity to move to different cities quite a few times. From these moves I have learned that among all the things I hate about moving, one of my least favorite things is trying to find a new dentist or, for my wife, a new cosmotologist. When you have your dentist or your physician for a good amount of time there is a certain comfort and trust that you build with them that takes time to replace. For my wife, it's hard to replace her hair stylist because the person who she has been going to knows exactly what my wife wants and how to do it. When it comes to health care most people are able to tell you instantly who their physician, dentist, or optometrist is however, if you ask them who their physical therapist is most people will have no idea. Why does this happen? One reason is that if you want to go see a dentist or physician you can just go without a referral from another health care professional. This is not always the case for people that want to see a physical therapist. Based on the state or insurance company you have some people have to get a referral from a physician before they go see a physical therapist. Along with that is most insurance companies cover things like dental visits, vision, and physician appointments, but physical therapy visits are very limited for most insurance plans. Those two factors combined make people less likely to see a physical therapist as frequently for their movement impairments as they would go see an optometrist for their vision. Less frequent visits means people will not feel that attachment or need to have a person be their physical therapist because they only saw them for a one time problem.

 Another important thing to consider is the wording people use when they need to see a physical therapist. Most people are told that they should try physical therapy or go to physical therapy. You never hear people say things like "you should go try some dentistry for your aching tooth" or "you need to get some optometry done for your bad vision." Both of those sound silly but for some reason it sounds fine to say that a person should recieve physical therapy for their hurt ankle. It seems small, but there is a big difference between that and saying "I am going to see a physical therapist for my hurt ankle." It's not just the physical therapy that treats you, the physical therapist matters as well. Once we realize that we start to build more of a relationship with the physical therapist. When that occurs and people can say that person is my physical therapist people will utilize them for more. Rather than just going to the ER for a sprained ankle people are more likely to directly make an appointment with their physical therapist. This is beneficial for patients as well because your physical therapist will already know your health history, your previous treatments, and your personal preferences which means less time explaining that each time you have to go in for treatment and a better overall experiene for the individual. When a person has their physical therapist they will have another medical professional on their side that they can turn to. Physical Therapists can then be utilized more to their potential of treatment and prevention of problems because people will use them more as their own therapist. People have their dentist, physician, and even hair stylist...isn't it about time everybody has their Physical Therapist?