After an injury or surgery, physical therapy often plays an essential role in recovery. It can also improve fitness and function for people dealing with chronic pain. A personalized rehab program can do patients a world of good, but not all facilities provide the same type or level of care.
“Physical therapy centers are not all created equal, and many people don’t realize the importance of choosing the right therapist and facility for their needs,” says Zack Rogers, PT, DPT, OCS, CSCS, rehab site manager of the Hospital for Special Surgery Rehabilitation and Performance Center, which recently opened at HSS Long Island in Uniondale.
Some facilities may focus more on sports rehabilitation after an athletic injury or surgery. Others have physical therapists with advanced training and certification in treating orthopedic conditions such as back pain, arthritis, tendon issues or ligament sprains. Certified specialties range from pediatric to geriatric physical therapy.
Some centers, like the one at HSS, provide direct one-on-one care. “When a patient comes in, I work exclusively with that person during the entire session,” Rogers explains. “At other facilities, the therapist may give the patient exercises to do on their own, treating several people at the same time.”
While patients who have worked out in the past may be fine with doing exercises on their own, others may prefer the undivided attention of a physical therapist who works with them the entire time, Rogers says.
To find a physical therapy provider, people may receive a recommendation from their doctor or from a friend who had a positive experience. But it’s up to many individuals to find a rehab center on their own. The Internet may be a good place to start, as many practices list areas of special expertise and other pertinent information on their website, Rogers says. They often show photos and may offer a virtual tour of the facility.
People often begin by looking for a center in a convenient location that accepts their health insurance. Many states allow “direct access” to physical therapy services, which means people do not need a physician referral. The exception is when an individual has Medicare or a health insurance plan that requires a referral. Coverage may also be limited to facilities in the plan’s network.
Convenience should not be the only consideration, says James Wyss, MD, PT, a former physical therapist who went on to earn a medical degree and specialize in physical medicine and rehabilitation. Wyss, who sees patients at HSS Long Island and specializes in treating patients with sports injuries and other painful conditions, says physical therapy is a balance between science, art and experience. “Certain physical therapists have areas of special interest, with additional training and credentials, and the right therapist can make all the difference in a patient’s progress," says Dr. Wyss, who serves as head team physician for the Long Island Nets. "But patients should also understand that they are responsible for their recovery as well. They need to work together with their physical therapist, communicate openly, and follow their advice, as well as the advice of their physician."
Rogers agrees that it's important to find a physical therapist with whom one has a good rapport. "Communication is key. Physical therapy is a partnership, a team effort, and having that connection makes a big difference. I want people to feel comfortable enough to tell me what’s going on and how they are feeling, so I can best treat them,” says Rogers, who encourages his patients to call or email him with any questions or concerns.
The HSS experts developed a checklist for choosing a physical therapy facility:
Select the right practice for your needs. Call and ask questions to make sure there are physical therapists with expertise in treating your specific problem and request that therapist in advance.
Ask who will be treating you and how much experience the therapist has. Once you begin physical therapy, make sure you're receiving care from a licensed physical therapist or a licensed PT assistant. It is best to receive care from the same therapist at each visit.
Try to set up a time to take a tour of the facility before beginning therapy. Virtual tours may also be available online.
Check if the facility is clean and well-maintained. Are therapists washing their hands in between patients? Is equipment being disinfected after each patient?
If the coronavirus is a concern, check the facility’s safety policy in advance. Some practices also offer remote physical therapy. Hospital for Special Surgery, for example, offers virtual PT, as well as remote one-on-one training sessions and ergonomic assessments of one’s workspace.
Are you comfortable with the noise level? If loud music is blaring and therapists are shouting instructions, you may find that distracting. Some people like the gym-like atmosphere of loud music, while others may find it intolerable.
Consider the general atmosphere. Are therapists and therapy assistants actively working with patients, or are people standing around waiting to be treated?
Are people working there wearing a name badge with their job title? They are required to do so in many states, including New York.
Inquire about the cancellation policy. Some facilities charge a fee for cancelling an appointment.
Consider how quickly you can get an appointment. If you need to wait more than a week or two, you may be better off finding a facility where you can start sooner.
The experts also point out that you should be evaluated and treated by a licensed physical therapist who has completed many years of education and training to earn the doctorate degree required to practice. The physical therapist should develop a personalized plan to meet your specific needs and goals. PT assistants are also trained and licensed, and they may work with your therapist to provide care after you’ve been evaluated.
You should not be receiving treatment from an unlicensed physical therapy aide or technician, Rogers says. Aides help physical therapists with tasks such as basic administrative duties, getting treatment areas ready and escorting patients within the clinic, but they are not legally permitted to provide treatment or instruct patients in exercises. If you're not sure of the credentials of the person treating you, you have the right to ask.
You should also receive instruction on exercises to do at home. The therapist may provide handouts, a link to a video demonstrating the correct movements, or another form of instruction to ensure you are doing the exercises correctly.
The HSS experts say that if you ever feel uncomfortable or if an exercise or treatment is painful, you should speak up. If you feel the physical therapist is not spending enough time with you, appears distracted, or is bouncing back and forth between you and other patients, you may want to find someone who offers more personalized care and attention.(AS/Newswise)
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