When going to any medical
appointment, you are trading your time and money (copay or deductible) in the
belief that the interaction will help you to get better. Whether you have pain,
an illness, or loss of function, the medical appointment should lead you down
the right path towards recovery. This could be in the form of medication, a
surgery, a diagnostic test, or an exercise session. I have had a number of
patients tell me that they have “never seen Physical Therapy like this before”
when they come to 3DPT, which made me ask about what their previous experiences
were in Physical Therapy.
Below are 6 key questions to ask
when scheduling your first Physical Therapy visit and think about on each
follow up visit to make sure that you are trading your time and your money for
the best services to get you back to full function.
How many
visits do your Physical Therapists see per hour?
Each Physical Therapy visit may
overlap with another patient. When you have more than two patients per hour,
the PT is not able to effectively watch your form during exercise and make
recommendations to improve the effectiveness of the exercise. She or he is not
able to provide the hands on joint mobilizations, Graston, Active release, or
other manual techniques that are paramount to improving the tightness in
muscles and joints to make the exercises that much more effective. When you ask
this question, the answer should not be more than two patients per hour. If you
begin treatment and notice that the visits per hour is more than you were
initially told, question your PT for a different time of day that may work
better, or consider changing companies entirely.
Do you
work with the same PT each visit?
Your
physical therapy experience should be about your relationship with the
therapist and their knowledge about how the body works. All graduating
Physical Therapists have a Doctorate degree now. This requires an undergraduate
degree in addition to 2-3 years of schooling to obtain their Doctorate.
When you see a physician, you make a connection with that
physician. You believe that physician will
get you better, and you see the same physician on follow up visits because she
or he knows you, your case, and what they have tried before that has worked or
not worked. I believe this relationship is even more important with your
Physical Therapist. You will see your PT anywhere from 1-3 times per week, and
they should be doing some kind of hands on intervention each session. It is
imperative that they know you and you know them since it is a more intimate
relationship than you will have with the physician. If you are seeing a
different PT each visit, the hands on technique may be different, the treatment
philosophy may be different, and it may take longer or inhbit your recovery
because the person doesn’t know you. There is a difference between the PT
knowing your diagnosis and knowing you as an individual. There are some
treatment protocols out there for people after surgeries, but every individual
is different. It matters for your recovery if the therapist knows your goal is
to lift your grandchildren, run a 5K, or sit while at work without pain. The
same PT will get to you know and the “why” we are working with you.
Will my
session be with the PT or with an assistant or aide?
Physical Therapists know the body
and know movement inside and out, and they designed your treatment plan after
performing your initial evaluation. When you are doing your exercises in the
treatment sessions, the movements that the PT selected are for a reason. They
are designed to improve strength, flexibility, control, etc. It really matters
if your arm is at a 90 degree angle versus a 70 degree angle for activities,
and you want a Doctor of Physical Therapy or other movement expert to be the
one supervising your exercises to make sure the exercise is being performed the
correct way. Physical Therapist Assistants work closely with the PT and are
also experts in exercises and hands on interventions. There are excellent teams
of PTs and PTAs who work hand in hand to get their patients better.
In the State of New Jersey, a
Physical Therapy aide is not permitted to make recommendations on correcting
form and/or instructing patients in how to do an exercise. You are trading your
time and money for a PT visit, and you should ask that a movement specialist is
the one making sure you are maximizing your session.
What
continuing education has your PT taken?
Physical Therapists are required
to complete 30 hours of continuing education courses every two years. Some PTs
take the minimum just to remain licensed, and others shatter the required
amount year after year because of their thirst for knowledge. PTs can
specialize in treating different conditions based on their continuing
education. You want someone working with you who has completed advanced
coursework or certifications in a treatment that will help you, not someone who
passed their licensure exam years ago, and now just takes the minimum to get
by.
Click here to find a board certified Physical Therapy specialist in your area.
Is your
treatment being progressed towards your goals?
As I said before, each patient is
different. Two people with the same diagnosis may be trying to achieve two
different things and therefore should be treated two different ways. Every
treatment session should be making progress towards achieving YOUR goals with
an individualized home exercise program that you can perform in between
sessions. If you are performing the same exercises day in and day out for few
weeks and are not seeing progress, then you should question the PT on taking a
different approach to YOUR particular rehabilitation. It doesn’t take long to
know that a round peg will not fit into a square hole, and your PT should be
able to recommend different treatment options for you.
Is your
Physical Therapist teaching you?
The ultimate goal of PT is to
instruct and empower you, the patient. You will learn about your condition as
well as learn what exercises and/or stretches should be performed after your
graduation from PT to reduce the risk of the condition returning. You should
ask your PT why they are selecting certain exercises and what their hands on
interventions are trying to accomplish. This allows you to understand the
rationale behind treating your particular condition and helps with reinforcing
the importance of the home exercises they issued you.
There are a lot of excellent
Physical Therapists out there, and there are some Physical Therapists who are
not as good. There are a lot of excellent PT clinics, and some that are too
overcrowded to be able to offer you the care that you need. You have every
right to make sure you are with the right Physical Therapist in the right
environment and setting to get you better. Your Physician or your friends may
recommend a company that they like or refer to often or are financially vested
in, but make sure that the office works for you and will not load you into an overcrowded
office where you are working exclusively with an aide or a different PT each
session. By having the right team between the physician and the PT, you will
get better, faster, and with less of a risk of reinjury. The more you can find
out in advance or switch to the right clinic for you, the better you will reach
your goals.
Ken Guzzardo, PT, DPT, OCS, SCS
3 Dimensional Physical Therapy
kguzzardo@3dpt.com
