Is your PT making a difference?
Cape Cod Hospital physical therapist Johnathan Corsino thinks physical therapists could and should play a larger role in the nation’s healthcare systems. He put his thoughts into an opinion piece published in the March 2018 issue of PT in Motion, the official journal of the American Physical Therapy Association.
“The article is a call for action to engage, to be utilized effectively,” said Corsino, who works in Cape Cod Hospital’s Department of Rehabilitation Services. “I think all physical therapists want to do it – help the most people as much as you can.”
According to Corsino, physical therapists and other healthcare professionals have a responsibility to continually check if they are being used fully and efficiently. In his piece, he argues that physical therapists can improve the existing healthcare model by:
- Emphasizing prevention and rehabilitation
- Assisting lifestyle changes in patients with chronic illnesses, such as diabetes and obesity
- Being more cost-effective and conservative than surgery and other treatments for back pain and other musculoskeletal ills
Healthcare is moving away from a “fee for service” model toward one based upon the value provided, Corsino said.
“Because of a fee-for-service payment structure, healthcare has relegated to a lower tier of importance conservative treatments that help the whole person,” he wrote in his piece in PT in Motion. “Physical therapy and lifestyle intervention can produce major benefits at low cost.”
Things that are better for patients, such as proactive, preventive care, are also better for healthcare because they are also cost effective, according to Corsino.
“All parties’ interests would be aligned, if we operated under a different reimbursement structure,” he said.
Physical therapy is great as a healthcare specialty because patients’ results are so directly related to how engaged and committed they are, according to Corsino. That goes a long way toward solving a problem of unclear responsibility between patients and the healthcare system.
“Physical therapy is dependent upon active involvement” of patients, who do better because they participate in their own care, Corsino said. “Physical therapists empower people to solve their own problems.”
Physical therapists can also play a role outside the outpatient setting, he claims in the letter. Early intervention in the intensive care unit, and helping diagnose movement disorders before a fall or other functional limitation are two examples he cites.
The growing popularity and acceptance of alternative medicine shows that many patients want to take a more active approach to their own healthcare, Corsino said.
He shares the American Physical Therapy Association’s pursuit of greater autonomy for physical therapists, who can set up their own practices, but are unlikely to have their treatments covered by insurance unless the patient is referred to them by a physician.
New physical therapists coming into the field are now required to earn a doctorate degree, making them a bargain in the healthcare field, Corsino claimed.
As lifespans increase, so will the demand for treatment of musculoskeletal problems, as well as chronic conditions. Physical therapists are well-positioned to help meet this need, Corsino said. Some of this can be done through prevention and lifestyle education via community efforts, he said, such as the Healthy Parks, Healthy People program, Cape Cod Healthcare’s partnership effort with the Cape Cod National Seashore.
Innovative Care Locally
Julie Drake, director of Cape Cod Hospital’s department of rehabilitation services, is thrilled that Corsino’s letter was published.
“John has been outstanding,” she said. “He gets incensed about inefficiency.”
Drake praised Corsino for arguing that healthcare shift to a more “value-based” system in which physical therapists would have greater autonomy and be more actively involved in determining a patient’s care.
“We (physical therapists) don’t get reimbursed for prevention,” she said, adding that she believes insurance companies are starting to see that preventive care saves money in the long-run.
Cape Cod Hospital has already seen the light, she said, and has initiated innovative wellness and exercise programs for employees and patients.
Healthcare will become more effective and less expensive “the more we can be preventative, rather than being reactive,” she said.
Corsino agreed that the hospital and Cape Cod Healthcare, in general, is on the cutting edge of good care.
“I love being at a community hospital that’s doing incredible things,” Corsino said. “It’s really fun to be in on it.”
In the conclusion of his letter in PT in Motion, Corsino claims physical therapists can play a big role in the future healthcare environment.
“PTs aren’t going to solve healthcare problems alone, but we are poised to contribute meaningfully to the solutions.”