anybody else having trouble getting their patients to actually go PT? id say a good 50% of my patients say that they cant afford it b/c of the copays. patient population is a mix of indigent and well-to-do, but fairly representative of the population as a whole.
expensive PT
- Thread starter SSdoc33
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$50 per session is not all that rare around here.... crazy. 2-3x/wk x 4 weeks just ain't gonna happen for most of those patients. Usually I'll convince them to go 1-2x be taught and practice a proper hep/core/etc program. That works fairly well for the motivated ones...... not so much for those who need a constant kick in the ***** to actively participate in their own care.
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The problem with the above (i.e. going once or twice) is that they may start with an entirely passive approach at the beginning, as pts will tend to feel better with this immediately.
I find it interesting to ask patients what is actually done in physio.
Without exception, the el-cheapos get exclusively passive modalities. Slap on a heat pad and TENS for a little while and they're good to go. This is the only way these jokers can work multiple rooms, and crank out lotsa patients.
I wonder if they even teach active modalities at some of these places...
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I work at a VA where the problem is no copays. The patients want to continue therapy indefinitely. Many of the patients are retired/disabled and enjoy the social interaction with the therapists and other patients.
What do you mean by active modalities? Stretching & Strengthening exercises? Home Exercise Program?
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Yes and yes.
Passive = no effort on part of pt = transient relief = you will not get better in the long term = not so great.
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Insurance companies are increasing these copays to recude expenditures via these disincentives. And it works well. This way, they sell a policy advertising that PT is covered, but then get out of paying for it because the out-of-pocket exenses are too much for John Q Public.
If all they are getting is passive modalities, I tell them they are wasting their time and money. I also steer my patients away from those therapists.
If all they are getting is passive modalities, I tell them they are wasting their time and money. I also steer my patients away from those therapists.
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If you know which places use these passive approaches, try to avoid sending your patients there at all costs.
Also, I find it's rarely justified to use passive modalities such as e-stim, ultrasound, etc even in the early stages of rehabilitation. There is quite a bit of evidence, particularly with LBP, that reliance on passive coping mechanisms (which US, e-stim, heating pads promote) results in a worse outcome. There is also some data that implicates use of passive treatments is associated with worse outcomes for some foot and ankle, and shoulder conditions.
Co-payments have been increasing for quite some time, primarily as a way for insurance companies to decrease utilization. The increases have accelerated since the economy went in the crapper, and more employers would looking for ways to decrease their costs, and were able to improve their bottom line by offering a cheaper insurance plan.
