Unfortunately, it’s a common scenario…
- Busy physical therapist in an outpatient setting
- Multiple therapists at each location and between locations
- Patient arrives for their initial evaluation…sees “therapist A”
- On second visit, patient arrives and finds out they’re scheduled with “therapist B”
- On third visit, patient arrives and finds out they’re scheduled with “therapist C”
- Patient gets frustrated and stops attending physical therapy
In day to day practice, there are multiple times that we hear the question from patients “Are you going to be MY physical therapist?” It’s a question borne from frustration, and unfortunately, common experience that many patients have when referred to physical therapy. While there are many potential arguments that could be made for why this is occurring, the bottom-line question that should be asked is… what is the impact on the patient?
Intuitively, as physical therapists, we know that the patient seeing the same therapist at each visit improves outcomes and patient satisfaction. It just makes more sense. A recent study (1) attempts to objectify what we’ve likely known all this time. The aim of the study was to examine the impact of continuity of the physical therapy provider on health care use and costs in patients with low back pain referred from primary care. What the authors found was that continuity of care in physical therapy improved outcomes, in this case, lowering costs and reducing the need for surgery in patients with low back pain.
Is provider continuity the end-all, be-all to improve outcomes and reduce the need for surgery in patients with LBP? Of course not. Timing of referral to physical therapy (2) and the therapeutic alliance (3) between patient and PT are factors that must be taken into consideration as well. However, from personal experience, continuity of care does matter. As a patient, I personally know that my experience was better when I saw the same PT at each visit. I developed a relationship with him and developed trust over time. How can you develop a relationship (and subsequently trust) if you see a different provider at each visit?
As a therapist, I wanted to take ownership of my patients. It was important to me, as a physical therapist, to create the relationship with my patients so that they would trust me with their injury. I could feel the walls come down with my patients when they knew that I was going to be the only person in charge of their care. It was key to a patient-centered approach that was important to me as a PT. I got into this profession and have remained involved in this profession because of the difference we make in the lives of others, in large part because of the relationship we develop with patients over time.
We believe it’s an important conversation to have as physical therapy providers as we continue to advance as integral members of the healthcare team. Subtleties, such as a laser-focus on continuity of care, make a difference for the patient. This positively effects outcome, utilization and cost (1) and the patient experience, at least based upon the feedback from patients and NPS (net promoter score) feedback. And, in the end, consumers will make the ultimate choice based upon their expectations vs. their actual experience.
At Axes, we believe in continuity of care. Our experience, the opinions of others, and published research supports the idea that patients who attend outpatient physical therapy deserve the right to be seen by the same physical therapist. This maximizes the physical therapist – patient relationship which promotes trust, adherence, satisfaction, and the best possible outcome.
So, next time you attend physical therapy for an injury or following a surgery, have the conversation with your provider. Ask them…”are you going to be my physical therapist?” See what they say.
If you are in need of pre or post surgical care, general re-conditioning, or help returning to sport/daily activities in the wake of an injury, schedule your appointment at one of our 11 Greater St. Louis area locations or via a Telehealth injury screening.