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Why the future of PT requires efficient therapists

Our mantra at Clinicient is: Rewarding Great Care. We believe providing your patients the great care they deserve should be personally fulfilling and compensated fairly. We also believe that great care is efficient care.

Why do we say that? The reality is that more care doesn’t always equal better care. In fact, it can be quite the opposite. Longer patient visits, more visits, and more procedures per visit are often an indicator that the care provided is not very effective. Shorter patient visits, fewer visits, and fewer procedures per visit usually indicate that the care provided is effective and efficient. Think about it from a patient’s point of view. Can you imagine making time in your schedule to visit a PT three times a week for weeks on end? It’s a bigger time commitment than many patients who need our help can afford.

But, in our perversely incentivized fee for service world, the less effective therapist providing more procedures and more visits for a longer period of time is financially rewarded while the master clinician providing fewer, more efficient visits, resulting in better service, is financially penalized. Sounds backwards, doesn’t it?

That will not be the case in coming years as we continue the slow transition from fee for service to value-based care payment models. Successful therapists will innovate to provide even better care that is provided much more efficiently. To provide this effective and efficient care, we need to change some habits we have developed because of fee for service incentives.

Success in this brave new world will require a greater emphasis on soft skills, a system for patient engagement, and providing the right care with the right intensity by the right clinicians:

Soft Skills: Coaching, teaching, mentoring, problem solving, motivating, and monitoring patient compliance will become much more important than hands-on treatment.

A Patient Engagement System: Our EMR and claims systems today are designed to serve our fee for service system, not to deliver great care. An effective patient engagement system will help us manage populations of people, not just caseloads of active patients.

An EMR designed for therapists: To be truly efficient and demonstrate you deliver great care, you need an EMR system that is designed to make it fast and easy for therapists to document at the point of care and stay connected and engaged with patients. By being able to quickly document your care and share this with patients, physicians and payers, you are able to prove you deliver better service.

The right care: Evidence based clinical guidelines have been available for years, but multiple studies across multiple healthcare specialties indicate that there is very little adherence to these guidelines. I believe it is because the guidelines either tend to be too rigid, complex, or simply impractical. In addition, they are often not well integrated into EMR systems. Simple, practical, evidence based clinical guidelines that are supported by integrated EMR and patient engagement systems will be critical to success.

The right amount of care: The highly motivated, well-educated patient often needs less hands-on care than the less educated, less motivated patient. But, we all know who receives more care today. Early assessment of patient motivation and the ability to follow directions independently will become as important as assessing physical impairments.

Provided by the right skill level: There is already a shortage of PTs, OTs, and SLPs. As value-based payment models evolve, the number of patients being managed by a single therapist will increase. Our caseloads will require us to manage populations, not just patients. We will need to get better at delegating tasks and hands-on treatment that do not require the skills of a more highly trained therapist to assistants and technicians.

All of this will require a change in our collective mindset as well as new processes and tools to increase our efficiency. I am looking forward to the day when we no longer measure therapists on the basis of the volume of services they provide, but by their great care.

Author

Jerry Henderson, PT

VP of Clinical Strategy

Jerry is a physical therapist and one of the founders of Clinicient and currently serves as the VP of Clinical Strategy. Prior to Clinicient, Jerry was a founding partner in a series of successful physical therapy clinics in the Seattle Area: Integrated Rehabilitation Group, Physical Therapy Clinics, Inc. PS, and Physiocare Corporation. He has a BS in Physical Therapy from the University of Utah.

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