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Social Media Tips for Healthcare Professionals

In 2009, Google launched its Flu Tracker application to map the spread of infectious disease by monitoring search keywords by geography. More recently, researchers at Johns Hopkins claimed that they could track the spread of the flu using Twitter significantly faster than the CDC could predict. Its like the town crier amplified by a million. Individually, there have been examples of doctors learning more about their patients on social media that has lead to either diagnosis, or follow-up visits. In previous posts we explored how social media can play a role in recovery for patients. Now, we’ll take a look at social media for healthcare professionals.

Ways in which healthcare practitioners can benefit from social media:

icanhazpdf

icanhazpdf hashtag for finding research documents

  • Research. There is a ton of information being shared through social media, including studies that might be otherwise hard to find. Did you know there’s a Twitter hashtag where you can ask for a publication? If someone in your network has a copy that is allowed to be shared, you can usually find it. #icanhazpdf
  • Connect with your peers. There are people from all over the world participating in conversations about treatments and best practices.
  • Connect with your clients and potential clients. Social media is an easy, and inexpensive marketing and patient engagement tool.

A few simple Do’s and Don’ts for healthcare practitioners for engaging on social media:

Do

  • Do: Use social media to build your reputation and practice. Can patients and potential patients find you on Twitter, Facebook, LinkedIn? Can patients who love you easily recommend your services? The Mayo clinic offers a course in social media for healthcare practitioners. They also monitor which social media sites are used by healthcare organizations
  • Do: Use social media to research, connect with your peers, and spread best practices. Did you know that there’s a weekly Twitter chat where physical therapists discuss business issues related to their profession? Tune in to #solvePT at 9PM EST to see what it’s about.
  • Do: Take advantage of the immediacy of social media. Jointworks Chiropractics, for example, uses Twitter to fill last-minute cancellations.
  • Do: Start slowly. Managing social media can take a lot of time. Make sure you know how you want to participate. Start by watching what similar practices or people are doing.
  • Do: Keep learning. The methods of communication are changing constantly and are going to keep evolving.

Don’t

  • Don’t: Ever share patient identifiable information on social media. If you learn something helpful about a patient on social media, follow up privately. An individual can share whatever they like about their health, but you cannot, so even if they post something on your Facebook page, you still need to answer privately. Even email may not be private enough for HIPAA standards. All communication needs to be encrypted. 
  • Don’t: Share information about yourself on public networks that you wouldn’t want patients or colleagues to know
  • Don’t: Criticize patients on social media. Yes, they can rate you and criticize you, but it doesn’t go both ways.
  • Don’t: Be afraid to show some of your personality. It will help patients connect with you and you might have more effective visits.
  • Don’t:  Underestimate the impact that social media has and will have on health.

If you’re interested in this topic, here are a few additional articles you might want to take a look at.

Should Doctors and Patients Be Friends? from the Wall Street Journal

A survey of physicians last May by Epocrates inc., which develops medical reference apps for physicians, found that 82% were using social networks to engage with other physicians, while just 8% were doing so with patients.

Teenagers, Social Media, and Health Information Privacy from ihealthbeat.org

Teens “do not seem to associate their personal identity with their diagnosis. They identify who they are by their friends, school, interests, etc. It is in this context that some of them mentioned that they don’t talk about their diagnosis or treatment on Facebook because they don’t want to be perceived as ‘attention-seekers,

How Facebook is Transforming Science and Public Health from Wired

The logic is a simple one: Everyone on Facebook, all 1 billion-plus people, will have an illness at some point in their lives. And, as Facebook’s social creatures are in the habit of doing, that mass of people will share their experience battling disease, ask questions of their friends, and field advice from outsiders

 

Posted in: Healthcare Social Media, Uncategorized

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How To Become a Minimalist Runner

Last week I attended a free seminar at Sitka Physio & Wellness in Vancouver, BC, about how to avoid runner’s injuries with a focus on the mechanics of minimalist running. We also blogged about offering seminars like this as a best practice.

Physical Therapist Elisabeth Mclatchie

Physical Therapist Elisabeth Mclatchie. Source Sitka Physio & Wellness

The seminar by physical therapist Elizabeth McLatchie, started with an overview of why people get injured: repeated mechanical stress to tissues. She then talked about how the main goal of minimalist running and the new minimalist or barefoot shoes is to change the mechanics to avoid injury.  I’ve read a lot about minimalist shoes and have talked to a few runners about them, but this clinic really helped me understand what they are trying to accomplish and why: more efficient movement, and encouraging a mid-foot strike rather than a heel strike, with the long-term goal of avoiding injury.

Challenges with Traditional Shoes

Challenges with Traditional Shoes

When a runner heel strikes, his or her center of gravity is off, resulting in more force on the body and more energy spent. Heel striking also affects cadence (how quickly you can move from one foot to another) because you are spending more time transferring weight across the foot, rather than touching down and lifting off. While minimalist shoes attempt to change the way people run, people can be trained to run differently in any type of shoe. 90% of runners will heel strike in traditional shoes. Unfortunately there’s a group of about 10% of runners that will heel strike regardless of shoe.  Heel striking and overuse are key causes of injuries, and over 80% of runners will be injured during their running careers.

As an example, we were shown video of a runner who regularly runs 50K races running in shoes, barefoot, and at different cadences. Running barefoot (on a treadmill) helped her to increase her cadence to 180 beats with minimal effort. For more effective running, runners should strive to be light on their feet and run at a 180 cadence. (Note that this may take some working up to: recommendations for switching to a minimalist style and shoes suggest 9-12 months for the full transition.)

Elisabeth recommended a phased approach to switching to a minimalist style, and for those wanting to try barefoot shoes, to phase in the change over 9-12 months. She also stressed that you don’t necessarily need to move to minimalist shoes to change running styles, and that there are many types of shoes. Minimalist doesn’t equal no support and no padding, it just means less rise in the heel of the shoe. For those who had further questions, she recommended talking to either an expert at a dedicated running store or a physical therapist, who could also perform a gait analysis. Elizabeth finished off the talk by demonstrating some ABCD drills, which are recommended ‘active stretch’ warm-ups for runners and talked about the lack of consensus on stretching in general.

The most important takeaways from the talk were about how to avoid overuse injuries:

  • Avoid repeated mechanical stress: you can do this by varying terrain, speed, intensity, and distance
  • Improve efficiency: change your running style to mid-foot strike from heel strike
  • Find your cadence: running at 180 cadence and being light on feet will minimize reaction force from the ground and therefore energy loss.

Elizabeth was an engaging and enthusiastic speaker who truly cared about imparting her knowledge. Her passion for her profession shone through in the presentation.

For more on the topic of ‘barefoot’ or minimalist running:

Posted in: Exercise Physiology, Rehabilitation Business

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Five Best Practices For Community Outreach for Physical Therapy Clinics

In our recent study, we found that 96% of physical therapy clinics offer additional services beyond physical therapy. The most popular were the following:

Popular Services

One clinic owner we spoke to said that his business didn’t become profitable until he started offering additional services. While this is definitely not true for everyone, we’ve seen a promising trend with physical therapists talking about how they can help manage the whole health of the individual, and this includes offering additional services. When we saw a post on Twitter advertising a minimalist running clinic at Sitka Physio & Wellness in Vancouver, BC, we thought we’d check it out, both for our own education, we’re all runners at Wellpepper and love learning how to improve, and of course for the blog.

Sitka Physio & Wellness

Sitka Physio & Wellness Reception

Sitka Physio & Wellness is located in the Fairmont Hotel Vancouver, which isn’t a typical location for a rehab center, but makes perfect sense for a wellness clinic, where hotel patrons and local business people might stop in. The clinic itself is beautiful: clean and airy, it definitely connotes health and wellness. We were positively greeted as soon as we came in. We’ve visited our fair share of clinics since starting Wellpepper, and this is definitely one you’d want to visit even if you weren’t injured.

The seminar itself, by physical therapist Elizabeth McLatchie, focused on basic education minimalist running. It was so full of great information that we’ve covered the content in a separate blog post. Many of the attendees were already familiar with Sitka Physio & Wellness from their weekly running club that Elizabeth mentioned. (Interestingly, and reflecting the demographics of runners, the audience was predominantly female.)

Selection of minimalist shoes

Selection of minimalist shoes

I talked to both Elizabeth and clinic owner Helen Ries after the session and learned that they offer these type of community outreach classes monthly. Elizabeth said that the physios all volunteer to do the sessions and she had to wait 8 months to get on the calendar because their were so many other sessions booked. She said she loves sharing her knowledge and would definitely volunteer to do more sessions. Upcoming sessions include Pilates for pelvic floor control and golf swing analysis.

Some of the best practices we noted in the session:

  1. Elizabeth did a great job of providing examples and breaking down more complex concepts into something we could understand.
  2. The session was focused on preventing injuries, which changes the conversation that someone might have with their physical therapist, and enables the clinic to emphasize their wellness services.
  3. She engaged with the broader running community. The clinic featured shoes from local businesses that focus on the running community. This provides a potential symbiotic relationship: if a runner is looking for new shoes because of an injury or issue the store could refer this person back to Sitka, and of course, Sitka referred to these stores, as experts in shoe fitting.
  4. The session targeted an audience that needed to engage with physical therapy. Over 80% of serious runners will face injury at some point. Why not establish a relationship with them before they “need” you?
  5. Suggestions of how to further engage with your physical therapist, for example, for a gait analysis were presented within the context of the overall session. Elizabeth also recommended that if people were interested in what type of shoes might work for their running style that they consult their physical therapist. Both of these services furthered the idea that physical therapists are there to help you stay well, not just for episodic treatment.

Offering sessions like this are a great way to market your clinic and services, first you get people into the clinic, second you help educate them on the importance of proper movement, and third you can educate them on other services you might be able to offer them. We’d love to see more clinics offering these types of services, and you can bet that we’ll be back for more sessions at Sitka Physio and Wellness. Jacquie needs to fix her golf swing. 😉

Posted in: Exercise Physiology, Rehabilitation Business

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Film review: Extraordinary Measures

“The football coach makes more than my annual research budget,” Harrison Ford as Dr. Tom Stonehill in Extraordinary Measures.

We recently attended a screening of the film Extraordinary Measures sponsored by the Washington Biotech Association (WBBA). The film is a semi-fictional account of the real life story of John Crowley’s determination to speed a new drug to market to help manage his childrens’ rare chronic disease. The film, released in 2010, was produced by Harrison Ford, and stars him as “Dr. Tom Stonehill”, an amalgamation of a number of doctors that John Crowley worked with in real life. John Crowley is played by Brendan Fraser. Keri Russell plays his wife Aileen Crowley, and we have no doubt that the real Aileen had a lot more to do in real life than poor Keri in this film who has to deliver unfortunate lines like “the medicines are working. “

Film critique aside, the true story is quite fascinating, and you can find out more on the Crowley family’s website and in the book by Pulitzer-prize winning journalist, Geeta Anand, The Cure. Two of the three Crowley family children, Megs and Patrick have Pompe disease, a rare condition that is related to muscular dystrophy. At the time the film starts, life expectancy for children with this disease is 9 years, and as Megs approaches her 8th birthday, John becomes driven to find a cure. Poring over research late at night, he finds some interesting theories by Dr. Tom Stonehill, and on impulse flies to Nebraska to try to meet the doctor, who turns out to be ornery and eccentric. Also on impulse John promises Dr. Stonehill that he will find funding. He does, and the two manage to set out building a company. However it becomes pretty clear that while Dr. Stonehill most likely has the right solution to manage Pompe, he knows nothing about bringing a drug to market, and while John understands the business side, like how much revenue a Pompe patient will generate over a lifetime, his experience usually takes over after all the manufacturing problems are solved.

The solution comes in the form of a large drug company that buys them out, mostly for Dr. Stonehill’s experience. John and Dr. Stonehill are now rich, and John buys a gigantic house but Dr. Stonehill doesn’t cash his check because he doesn’t believe has earned the money. It’s a bit disconcerting to see the Crowley’s in a multi-million dollar home when earlier in the film they mention that they have $40,000 monthly medical bills, and when earlier they were calling all their friends to fundraise for their foundation. It seems like there might be better uses for the money, and Aileen doesn’t seem all that comfortable with the home that John justifies as “the kids love it.” However, at this point he doesn’t know that a way to manage the disease will be found, so the rationale is probably that they should be happy in their short lives.

John and Dr. Stonehill both try to shake things up a bit at the drug company. John out of desperation to save his children’s lives, and Dr. Stonehill because he’s a maverick. What’s interesting about this segment is that while some of the drug company executives seem cold and clinical, they are trying to follow procedures for the safety of the general public, and John, while driven by love for his family and others like his does face some ethical issues with his close involvement in the drug trials.

If you have an interest in the pharma business or how drugs are brought to market, this is an interesting and enjoyable film. Unlike a similar film also based on true life adventures in big pharma, Love and Other Drugs, this one is suitable for the whole family and children will probably really enjoy it both because it’s based on a real life drama and for the bubbly and determined Megs Crowley who gets some of the best lines, like “My hobbies are video games and penguins.”

Definitely check out this short video featuring the real Crowleys that fills in some of the background details and shows how extraordinary the achievement really is.

If you do watch the film, be on the lookout for a cameo from the real John Crowley in one of the early fundraising meetings.

Posted in: Healthcare Disruption, Managing Chronic Disease

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How To Score Big With Your Next Big (Physical Therapy) Marketing Idea

“You guys need to spend more money on a PR campaign” said speaker Adele Cehrs, CEO of Epic PR Group, addressing a crowd of physical therapy business owners at the American Physical Therapy Association conference in Salt Lake City last week. The Public Relations veteran pulled no punches when encouraging the audience to think differently about how they market themselves.

Adele Cehrs, CEO, Epic PR Group, source: EPIC PR

“Consumers don’t understand ‘musculo-skeletal’. They know something went pop.” At this point one of the audience members said that a ‘pop’ isn’t an indication of a problem. Adele pointed out that consumers don’t know this, and it’s about speaking their language.

Adele’s PR firm represents the Private Practice section of the APTA, whose members own some of the 57,000 independent physical therapy clinics in the United States. She told the audience that she has a really hard time finding clinic owners willing to speak to the press when she has a story, and was extremely surprised that people weren’t coming forward to take advantage of this membership benefit of the Private Practice Section of APTA.

When she wasn’t encouraging the audience to be more proactive with marketing and understanding what their potential customers care about, Adele led the group through a number of exercises to develop creative solutions to real-world marketing challenges. She started by dividing the audience into groups of 3, and requiring that each person spin a wheel to determine what role or ‘hat’ they would represent in the group. The roles consisted of common archetypes in either in business and group work, and each person was responsible for approaching the problem from the perspective of that person. In our group we had a future visionary, a bean counter, and an analyst. The role of the visionary was to evaluate the ideas had sticking power in the long run. The bean counter was responsible for ROI, and the analyst was to question the viability of the solution. I was the analyst in our group, which is my natural behavior, so it wasn’t much of a stretch. The idea of this role playing is actually to see things from another perspective, so I didn’t have that benefit. However, not actually being a physical therapy clinic owner did enable me to stretch my viewpoint significantly.

In our small groups we worked on two business problems, the first was to determine how to capitalize on new research that showed 33% better performance from patients that didn’t receive overly positive encouragement (“you’ve got this”) from their physical therapists. With my analyst hat on, I questioned whether everyone liked the same type of motivation and also wanted to see the actual study. Our group decided that some groups, for example, seniors might actually like friendly encouragement, so our recommendation was to screen patients and match them with the type of physical therapist who would be most compatible for their personality. Another group recommended using the patients phones or clinic iPads and filming them, and said that when patients are engaged everyone wins. (At Wellpepper we concur, but also think you can go further in extending your reach outside the clinic and also warn you to make sure your mobile patient communications are HIPAA-compliant.)

Another exercise involved ways to increase the number of clients at the clinic. Solutions to this included examining where most referrals came from and trying to duplicate this with another segment of users. Other ideas included offering free screenings or volunteering to provide services for a local team. Adele pushed people to go further, both in sharing the data around why physical therapy works and sharing patient stories for additional human interest.

Adele also mentioned that people trust their own data more than yours, which is why her company offers an online quiz to access your PR readiness. She explained that when people see their own PR readiness, it’s a much more powerful change agent than her firm telling them what their gaps are. She asked the group to consider how to apply this theory to marketing physical therapy. Our group decided that an online falls quiz might be helpful for attracting the attention of people whose parents were aging and at risk. Adult children and caregivers could do it together, and it would be an opportunity to educate on how physical therapy can aid in falls prevention.

We didn’t actually get to finish all the content in the 90-minute session because of the interactive nature of the talk and the great stories told by Adele. If you’re a member of APTA’s Private Practice section, we recommend joining her newsletter for additional tips and PR opportunities, and if you’re not a member, having a resource like this available to you might be reason to consider joining.

Posted in: Rehabilitation Business

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Innovative Care Models for Prevention, Health Promotion, Fitness and Disease Management

Standing room only at the APTA 2013 Conference

Standing room only at the APTA 2013 Conference

It was a packed house for an excellent session on Innovative Care models at the American Physical Therapy association annual conference in Salt Lake City last week. Any of the 5 presenters could have held their own for the entire session. Together, they provided a powerhouse of enthusiasm, ideas, and motivation to change healthcare practice.

A common theme across all the presenters was that the time is now right for the types of innovative programs they were espousing. Many commented on how they are seeing a lot more acceptance of new ideas and new models of care than when they first embarked on this path. Another common theme was that the data doesn’t lie. Healthcare is in crisis due to the declining health of the American public. Our favorite quote of the session was from Mike Eisenhart from Pro-activity who said “Chronic disease is simply the accumulation of years of bad behavior.” Sad but true that most chronic disease in the United States is entirely preventable. Each presenter showed saddening statistics that supported this view.

Karen Kemmis kicked off the session by reviewing the triple aim of healthcare reform developed by the Institute for Healthcare Improvement:

Triple Aim for Healthcare Improvement

Triple Aim for Healthcare Improvement

She also described changes that are making new care models possible including:

  • Integrated care models, like Accountable Care Organizations
  • Expansion in coverage
  • Changing payment mechanisms
  • Outcome and quality based payments
  • Program integrity

Next up was Jennifer Gamboa, founder and President of Body Dynamics, Inc – a multi-disciplinary physical therapy and wellness center in Falls Church, Virginia. Dr. Gamboa outlined their consistent and unique approach to treating clients, where each healthcare professional applies the same rigorous screening process to access overall health and wellness. This approach recognized that clients choose their treatments, for example, many lower back-pain patients see a registered massage therapist first although they might be better helped by a physical therapist. Rather than bemoaning the lack of consumer awareness, Body Dynamics works with the consumer to access overall health and willingness to change regardless of how they found the clinic. It was a refreshing approach that creates a health team that includes a physical therapist, nutritionist, massage therapist, personal trainer, and counselor, and screens patients based on their movement quality, disease risk factors, fitness, and willingness to change. Body Dynamics is incubating the process now, so Dr Gamboa was not able to share outcomes or recommend how others might use her methodology yet but this is definitely a development to watch.

Jennifer was followed by Margaret O’Neil from Drexel University, who talked about health promotion strategies for children and their caregivers. Dr. O’Neil stressed the importance of motivational interviewing to support behavior change. Motivational interviewing includes expressing empathy, supporting self-efficicacy, accepting resistance, and avoiding argumentation. Open questions and active listening are tools in motivational interviewing. The point of the process is to determine where someone is in their willingness to change, and therefore, the type of intervention that is appropriate. Interventions might need to be psychological before physical. As well, the entire family needs to be involved and parents need to model healthy eating and activity. Dr. O’Neil mentioned that parents often believe that being overweight is inevitable, using the excuse “we’re just a big-boned family.”

Next up was Mike Eisenhart from Pro-Activity, who was the most provocative  and tweetable (hashtag #apta2013) of the group. He graduated as a physical therapist and immediately stopped calling himself one because he was told that physical therapists could only treat problems not help prevent them. Instead, Mike built a business around wellness and prevention, specifically in the workplace and now helps to manage the health of over 20,000 people. Pro-Activity provides health assessments and helps employees manage change, resulting in lower insurance costs for employers. Mike is really happy that he’s starting to see other physical therapists take proactive roles in health and wellness.

The final presenter was Cheryl Resnik who quipped that you should find out how funny the other presenters are before agreeing to a panel. She didn’t need to worry, as the story of the USC Fit Families program was extremely compelling. The program, which provides exercise programs and a free physical therapy clinic to low-income families, is located near USC campus in a neighborhood known for a gang with ties to the Mexican mafia and that is a “food desert”. A food desert is defined as an area where it is not possible to buy fresh food. Fast food is often the only or definitely the cheapest option. Resnik recounts needing to buy a scale that measured up to 1,000 pounds to weigh some of her participants, who were mostly teenagers! Fit Families provides individualized and group exercise programs, nutrition counselling, and assessments. It’s funded by grants and volunteer physical therapy students from USC. Students become so engaged in the program they often continue volunteering after they’ve received their credits.

This was one of the best sessions we attended at American Physical Therapy Conference in Salt Lake City. It was amazing to see so many people focused on prevention and wellness both in for-profit and not-for-profit scenarios. At the end of the session, Margaret O’Neil asked the audience how many were inspired to try their own programs, and a number of people who reported previously being discouraged said they were ready to give it a go. We can’t wait!

Posted in: Healthcare Disruption, Healthcare motivation, Managing Chronic Disease, Rehabilitation Business

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Abreast In A Boat

This weekend marks the 25th anniversary of the Vancouver Dragon Boat festival, the biggest festival of its type in North America. Over 100,000 people will watch 180 teams racing to the finish. Dragon boating started over 2000 years ago in China as a fertility ritual held during summer solstice. Today there are dragon boat races across the globe, including North America, Europe, and of course Asia. Dragon boating promotes team work and discipline as the crew typically consists of 22 people: 10 pairs of paddlers, a caller at the front of the boat and a steerer at the rear.

Dragon Boat Racing from Wikimedia.org

In Vancouver, one of the most colorful and long-paddling teams, A Breast In A Boat, is made up of breast cancer survivors. In 1996 Dr. Don Mackenzie, professor of Kineseology at the University of British Columbia, posted an ad looking for breast cancer survivors to participate in an exercise study. At the time, the common understanding was that women who had treatment for breast cancer should refrain from upper body exercise to avoid the risk of developing chronic lymphedema  which is a permanent and sometimes incapacitating swelling of the arm that can be caused by damage to or removal of the lymph nodes, which often occurs in cancer treatment. Although this was the wisdom of the time, there was actually no research to support the fear. Dr. Mackenzie’s studies in the area of exercise rehabilitation led him to believe that the current thinking might be wrong. Dragon boating is mainly a core and upper body workout, so it provided the perfect way to test the theory. Dr. Mackenzie formed a team in February 1996, and the team named itself Abreast in a Boat.

In 1998, Dr Mackenzie was able to publish a research study on the project in the Canadian Medical Association Journal on the success of the project, observing:

How important is the Abreast in a Boat project? It is an approach to promoting health and raising breast cancer awareness that is driven by women with the disease. It reaches out to other women and offers them a message of hope and support. It is helping to change attitudes toward “life after breast cancer,” and it encourages women to lead full and active lives. It is making a difference.

Breast cancer survivors dragon boat teams

Breast cancer survivors dragon boat teams

What’s interesting about this study is that 15 years later, there is still not enough widespread evidence for the value of physical therapy after cancer treatment, in particular for recovery of muscle weakness from radiation. A lot more could be done to educate on both the value and the necessity for physical therapy to help patients gain back strength, abilities, and hope.

Today there are more than 116 breast cancer survivor dragon boat teams worldwide including 41 in Canada, 29 in Australia, and 24 in the United States. So, if you’re out watching in Vancouver or the rest of the globe this weekend, cheer a bit harder for the ladies in pink. They have paddled farther than you’ll know.

To read more:

Abreast in a Boat

Machestic Dragons

Rio Tinto Vancouver Dragon Boat Festival

Wikipedia

Posted in: Exercise Physiology, Healthcare Disruption, Healthcare motivation

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How much for that appendix? In Russia?

The recent news about the cost of healthcare in the United States has gotten me thinking. While critics say that transparency will not lower costs, it’s hard to imagine how hospitals will be able to continue to justify dramatic differences in costs for procedures between organizations or between countries. With numbers like this, is it any wonder that medical tourism is on the increase?

According to the Atlantic magazine, “getting your appendix out can cost between $2,000 and $180,000Hip replacements run from $10,000 to more than $100,000″.

The New York Times shows comparative pricing between the US and other countries, in the article “The 2.7 Trillion Dollar Medical Bill

Comparative Procedure Costs

Comparative Procedure Costs from the NY Times

“In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. “But it is a very weird market, riddled with market failures.”

One of the things that makes this such a weird market is that healthcare can be one of the biggest household expenses and yet people have no idea of the costs. This is true in both socialized medicine and an insurance-based system like the US. A number of years ago, my friend Bob tore his Achilles and needed surgery. As Bob, our friend Henry, and I were chatting about the procedure, Henry asked how much it would cost. Bob had no idea: the thought had never crossed his mind. We all worked at Microsoft HQ in Washington state and at the time, Microsoft had bar-none the best healthcare plan in the United States. (Microsoft has since changed their plan from this all-you-can-eat service.) The surgery was probably in the $25K range but Bob had absolutely no idea because he knew his insurance would cover it.

Like me, Henry had been raised in Canada with socialized medicine and before anyone got smug about the problems in the US system, he pointed out that neither system held people accountable for costs or decisions. We had no idea how much the surgery would cost in Canada either. This was the first time I really thought about healthcare costs, the amount of money changing hands, and how the beneficiary of the service had no idea what was being paid.

A few years later, my friend Diana, held a wonderful party in Seattle to celebrate overcoming breast cancer. One of the activities at the party was a contest to guess how much her breast cancer had cost. Diana and her husband are teachers, and while their salaries may not be particularly high, they do have good insurance. Total bill: $250,000, or 5 times the average annual salary for a Washington state teacher.

As I mentioned, I grew up in Canada, where thanks to Tommy Douglas, there is universal healthcare. Canadians do not need to worry about going bankrupt if they get sick. Canadians also do not get the kind premium service that the best insurance plans in the United States offer, and if you look you’ll find plenty of skeletons in the closet about wait times for procedures and so on. Although the individual does not know the costs of treatments, the healthcare system as a whole does a good job of ingraining the need to “not overburden the system.”  What this means is that people often second guess whether they are sick enough to go to the doctor or hospital, often because there is guilt associated with using the system unnecessarily. My friend Harriet describes this perfectly this in her blog post about her son’s asthma.

“This really isn’t right;  I should take him to the hospital.” But I hushed my inner voice thinking that once daylight hit, things would improve. And besides, I didn’t want to waste the taxpayer’s money on an unnecessary ER visit.” http://seetheorun.com/2012/09/12/trust-your-gut/

Canadians are often smug about our healthcare, and I suppose considering that the entire country receives free healthcare at a cost lower than what the US spends, maybe there is some justification. However, in 2001 when I moved to the US and experienced the “Cadillac of healthcare programs” while working for Microsoft, I have to admit it was pretty amazing. Unexplained coughing? Let’s see a lung specialist for airway testing. Psoriasis? Here’s an appointment with an expert at University of Washington. Contrast that to Canada where specialist referrals need to be renewed every 6 months by your GP. When I finally saw a dermatologist, we talked about how ridiculous it was that he couldn’t continue to treat me for a chronic skin condition without a note from my GP. Now who’s wasting taxpayer dollars?

Like Harriet, I have also internalized the “you’re okay, don’t see a doctor” mentality, exemplified when I experienced severe abdominal pain while living in Russia in early 2010. I moved to Moscow in 2008 for a 3-year posting with Microsoft, and was still supported by the best healthcare a corporation can buy. At 3am, with 12 hours of severe abdominal pain, I was still second guessing whether there was really a problem. It took an instant messaging chat with a friend in San Francisco to convince me to go to the hospital.

Again, thinking it couldn’t be that bad, I didn’t call an ambulance, but drove myself to the European Medical Center, a private clinic catering to expats and wealthy Russians. To put things in perspective, the healthcare plan that my Russian Microsoft colleagues had did not enable them to go this clinic; it was out of reach for their coverage. Within half an hour, I had an EKG, blood tests, CT scan, and a differential diagnosis of appendicitis. By noon the next day, I was minus one appendix.

The author and her Russian team in Moscow

Now here’s where the story might start to seem a bit ridiculous to you. Once my appendix was out, the rest of my hospital stay was so pleasant I didn’t want to leave. It was quiet, clean, with attentive staff, and a extremely comfortable bed with a down duvet.  I had a shared room with a Swedish woman who said the food was some of the best she’d had. (I wasn’t allowed to eat sadly.)

The final bill? $3500 Euro ($4900 at that time). Seems pretty reasonable doesn’t it? For comparison, my follow up visit with the surgeon was $90 Euro which is not cheap for a 15-minute consultation. This was one of the best facilities in Moscow, out of reach for most of the population including my affluent colleagues, and yet the costs of my surgery were not outrageous. It wasn’t as cheap as the $2000 lowest price cited by the Atlantic article but nowhere near their high-end of $180,000 plus I had CT scan (which can start at $1200 in the US), general anesthesia, laparoscopic surgery,  time in the ICU, an overnight stay, and some pretty amazing pain drugs.

Where does this leave us? Socialized medicine isn’t perfect but the free market isn’t working either. Prices can’t vary so widely. People need to understand their options and the costs of those options. Price transparency will help stop the gouging that happens at the high-end. The Obamacare mandate to cover more people will require less expensive solutions. Prevention and less expensive ways to manage health are key. New ways of paying for outcomes rather than diagnosis and procedures could help too.

At Wellpepper we’re passionate about improving the value of healthcare delivery while decreasing costs by extending the reach of the healthcare professional outside the clinic. We believe that technology, used by caring healthcare professionals can provide some solutions to these problems and we’re hoping to be part of the solution.

Author’s Note June 4th: Maybe Harriet and her family are stoic, or maybe we have some more problems in the system. Today after finally demanding x-rays her husband found out he’d been walking on a broken ankle for a month. The first doctor gave him painkillers and sent him on his way.

Posted in: Healthcare Disruption, Healthcare Technology

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The Case for M-Health

M-Health has been touted as the next-big thing in healthcare. We believe it’s more than a big thing, we believe that it’s where people want to interact, and mobile provides the opportunity to influence people much more than simply e-health. It makes sense right? Even if you sit at a computer all day, your mobile device travels with you and is always on. Some people are even sleeping with their devices.

Don’t take our word for it though, we’ve compiled some really interesting information and statistics on the growth of mobile and why it’s so important for healthcare.

Mobile Usage and Demographics

Starting from usage, The Harvard Business Review has an interesting take on the Rise of the Mobile User.

“55 percent of Americans said they’d used a mobile device to access the internet in 2012. A surprisingly large number — 31 percent — of these mobile internet users say that’s the primary way they access the web.”

What’s interesting about this, is that it crosses income lines. When we first started Wellpepper, one of the common objections we heard to our mobile focus was that “poor or old people don’t have smartphones” so we couldn’t reach enough of the population. That’s proving not to be true, in particularly because of the types of offers that the carriers provide. People who are accessing the Internet only through their cell phones may have never owned a personal computer.

Tablet technology has also opened up computing to a larger group of people. The ubiquitous iPad is used by babies and grandparents alike. Mobile Marketing Watch reports that 53% of seniors are online, 33% use social media and 70% have a cell phone. Over 50% of people in the US have a smartphone and we know that number is going to keep growing.

“78 Million baby boomers use technology to stay in touch with loved ones, connect online and improve health.” Not really surprising is it?

Mobile for Health

Patient preferences for e-health communications

Patient preferences for e-health communications

According to an Accenture study of 1,100 people, 90% want to use digital to manage their healthcare. However, they see this as a way to augment in-person visits. 85% of those surveyed also want to communicate in-person with their doctors.

Consumers already understand the value of electronic and mobile communications to improve their healthcare: 63% of respondents to the Accenture study want to receive reminders for preventative or follow-up care on their mobile devices.

Research2Guidance reports that 500M people will be using healthcare mobile apps by 2015. Ralf-Gordon Jahns, Head of Research at research2guidance, points out “Our findings indicate that the long-expected mobile revolution in healthcare is set to happen. Both healthcare providers and consumers are embracing smartphones as a means to improving healthcare.”

The Pew Internet Foundation’s recent study looked at people who track health indicators. Tracking indicators is a positive way to improve health outcomes. They found that while up to 60% of people track some health indicator, only 21% of those who do this are using some form of technology to do so. Most people are keeping track in their head or on paper. Given the benefits of recording the information, like seeing progress overtime and being able to share that information with a loved one or healthcare professional, again, we think this is a trend that will only increase.

References

Is Healthcare Self-Service Enough to Satisfy Patients? Accenture

The Rise of the Mobile Only User Harvard Business Review

Tracking for Health Pew Internet Research

500M People to Use Mobile Apps for Tracking Health FastCompany summary

Mobile Health Report Research2Guidance

 

 

Posted in: Healthcare Disruption, Healthcare motivation, Healthcare Technology, M-health

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About our Bloggers

Amar Brar

Amar is a 4th year student of Kinesiology at Simon Fraser University in Vancouver, Canada. He leads an active lifestyle and hopes to continue to pursue his education to become a physical therapist. He is interested in how the body works and blogs on fitness and exercise physiology.

 

Anne Weiler

Anne Weiler

Anne is the CEO and co-founder of Wellpepper. She runs, plays Ultimate Frisbee, does yoga, skis and more. She is passionate about the ability of technology to disrupt and provide better experiences in Healthcare.

 

Jacquie Scarlett

Jacquie Scarlett

Jacquie is the Director of Customer Experience at Wellpepper. She is a former NCAA athlete who spent her fair share of time in physical therapy. She loves technology, data, self-tracking, and helping customers see real benefits from using Wellpepper.

 

 

Kaila Holtz

Kaila Holtz

Kaila is a resident in Physical Medicine and Rehabilitation. Prior to medical school she completed a Master’s degree in Kinesiology and represented Canada in softball at the 2004 Summer Olympics. She is passionate about helping others optimize their lifestyle through goal setting, making informed choices and tracking meaningful progress in new and innovative ways.

 

Lynda Bennet and Carey

Lynda Bennett and Carey

Lynda has become an expert in healthcare and a patient advocate, through her own experiences as a user of healthcare services. A long career in technology has made her passionate about technology’s ability to drive change.

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Film Review: Escape Fire-The Fight to Rescue American Healthcare

We recently attended a screening of the documentary “Escape Fire: The Fight to Rescue American Healthcare”. The 2012 film shines a light on major issues with the US healthcare system, and positions that the only way to fix it is to build an “escape fire.” The literal definition of escape fire is a fire intentionally set to provide shelter from a larger uncontrolled blaze. Figuratively, it is an improvised, effective solution to a problem that can’t be solved by traditional methods.

The film makes a strong argument that US healthcare is beyond traditional methods of repair. Some of the damning evidence of this comes in stories of unsustainable or questionable practices:

  • The woman who by her mid-30s had 57 stents in her heart
  • The soldier on a bagful of painkillers
  • The mid-40s man whose only healthcare is the emergency room after he suffers another heart attack

On the macro level the statistics are worse:

  • The US spends almost as much on pharmaceuticals as the rest of the world combined. (Is there any correlation between this and the fact that the US is one of only two countries where drug companies can market directly to consumers?)
  • 65% of Americans are overweight
  • 75% of health costs are spent on preventable diseases

The film makes a very strong case that the solutions will not be found in the traditional models where the incentives are currently not aligned with keeping people healthy, and where doctors are surprised that patients react well when they are listened to. Solutions come in preventative healthcare measures, team based medicine, and alternative therapies. Again the film does a great job of showing surprising solutions to the problems presented in the first half.

  • The woman with the stents will have them forever, but she now works with a healthcare team from Cleveland Clinic who monitor her whole health to prevent future episodes. One way they do this is that they are paid on salary not per procedure so incentives are aligned with what’s best for the patient.
  • The soldier with the bag full of drugs is taught meditation and receives acupuncture. He goes home with only these tools to manage post traumatic stress and pain and says he’s a changed man.
  • One of the most surprising solutions came from Safeway. Since in the US employers share in much of the burden in rising healthcare costs, it’s in their best interest to try to lower them. The CEO of Safeway realized this a number of years ago and the transformations in employee wellness and Safeway’s health insurance costs are tremendous.

Overall the film was thought-provoking with some incredibly powerful personal stories that represented the larger issues. Our only criticism would be that it failed to even mention models of care in other countries. Yes, it was about the problems in the US, and yes there are some large problems but there are interesting models worldwide that could also serve as potential lessons for how to evolve healthcare. If you are interested in healthcare disruption, though, we would recommend seeing this documentary and exploring some of the resources on the Escape Fire website.

Posted in: Healthcare Disruption, Healthcare motivation

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Encouraging Exercise for Injury Prevention

Washington Physical Therapy Conference Spring 2013Last weekend Wellpepper attended two conferences, the Washington Physical Therapy Association Conference in Spokane, Washington and the Physical Therapy Association of British Columbia Annual General Meeting in Vancouver, BC. It was amazing to introduce Wellpepper to so many new faces and to hear feedback. We were too busy at both conferences to take advantage of the information and other activities however, we did manage to attend one talk  “Recreational and Elite Athletes:  Can we really prevent injuries?”  by Rick Celebrini. Dr Celebrini is the head of sports medicine and science for the Vancouver Whitecaps MLS team, and former physiotherapist for the Canadian Olympic Ski Team. He became interested in physiotherapy after breaking his food during his teen years as a high-level soccer player.

Dr Celebrini started his talk with some statistics about injuries. Injuries cost the MLS $7M in 2012. Considering that MLS players are not the highest paid professional athletes, you can only imagine what this might be in other sports. He also shared that sport and recreational injuries can cause osteoarthritis later in life. Then he focused on one of the most common sport injuries: ACL tear. The ACL tear will take an athlete out of commission for 8-12 months and is estimated to cost the US healthcare system $2B a year. Women are 4-6 times more likely to have an ACL tear and have a greater risk of osteoarthritis. The major cause of ACL tear is changing direction. 70% of injuries are non-contact, that is they are incurred by the athlete him or her self by changing direction or landing incorrectly: if the knee is close to extension, and the foot moves outside the center mass, this becomes a perfect situation for an ACL tear. This situation of imbalance can result from extrinsic or intrinsic factors. Extrinsic factors are things like weather, footwear, equipment. Intrinsic factors are related to things about the person: How does the person move? Is the person tired? What is their mood? When Dr. Celebrini had his injuries, he remembers that he was tired and felt he shouldn’t have been playing. These types of factors change on a daily basis.

It turns out however, that a study in 1986 proved how to prevent ACL tears. In particular changing how deceleration happens and making rounded turns instead of sharp changes of direction are two key factors. However, in all this time, there has been no change in the number of ACL injuries. The reason for this: human nature. He cited a study where physical therapists were brought in to help professional athletes with preventative techniques and exercises for ACL. As soon as the PTs left, and the coaches and players were on their own, only 50% had compliance with the program. Physiotherapy Association of British Columbia

Dr. Celebrini believes that we don’t need to do any more research into how to prevent ACL tears. What he’d like to see is the translation of the research into a practical application for people. That is, focusing on how to motivate them to change their behaviors for the better. He thinks there’s a gap between academic research and practical application. Even the Whitecaps, who rely on their bodies being healthy and functional for their careers, don’t do their preventative exercises.

Dr. Celebrini had some suggestions for this:

  • How do you fit preventative exercises into the schedule? He gave the example that the Whitecaps players would not want to spend 30 minutes pre-game doing preventative exercises, they would want to be warming up for key skills they’d need in the game.  Can you include exercises in the warm-up without detracting from other exercises they need to do? 
  • What is the player’s motivation? Can you tap into their desire to have a long career?
  • How do you make it sport specific? Can the exercises be adapted to have relevance to the specific sports?
  • Make sure that the decision makers are bought off. In the study he mentioned, the coaches weren’t on board and didn’t continue the program after the physical therapists left.

Finally he stressed the need for the research to include implementation. Researchers should collaborate with athletes, sports psychologists, and coaches, to translate the research into practice. At Wellpepper we’re working with physical therapists, behavior researchers, and patients to try to solve these challenges in getting people to do what’s good for them, so we were really happy to hear this message!

 

Posted in: Exercise Physiology, Rehabilitation Business

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Integrating Wellpepper Into Your Practice

At Wellpepper we’re focused on motivating behavior change and encouraging people to do their exercises and get better. We’ve learned that we are also asking you, the professionals to change your behavior. While we’ve developed Wellpepper to be extremely easy to learn and use, integrating any new technology into your practice requires some change.

A few things to think about as you are adopting Wellpepper:

    Wellpepper Clinic

    Wellpepper Clinic

  • Some clients may be better candidates than others for using Wellpepper. You might want to find out in advance who has an iPhone, iPad, or iPod touch and make sure they bring it to their first session. You could do this when confirming appointments.
  • Try it out first and practice recording videos and assigning exercises. Also check out what the client will see so you can answer any questions they may have. It’s easy to use, but you want to be a pro when you’re using it in practice.
  • Get help. We know you don’t have a lot of time with your clients. We recommend you set up their program before they even install. When you invite a client to use Wellpepper, their exercises will be waiting for them when they download the app and login. Maybe have your receptionist help the client download and login to Wellpepper before they leave your clinic. It will give them a chance to build a greater connection with the client and offer an increased level of service.
  • Determine your “SLA”. An SLA is a service level agreement: what is your commitment to your clients for their Wellpepper results? Will you look at them daily? Weekly? At the beginning of their next session? It’s your business, and it’s up to you but you need to set expectations with your clients.
  • Integrate Wellpepper into your sessions. At the point when you are getting clients to practice their exercises, just start recording them. Avoid the temptation to reach for pen and paper and your clients will thank you.
  • Create special programs or offerings that incorporate using Wellpepper, for example, get ready for tennis or golf season. Wellpepper can be used as part of the program as a lightweight communication tool for patients, to show them the exercises, and to hold clients accountable to reaching their goals.
  • Remember your iPad. This may seem obvious, but at the start it sometimes takes time to get used to remembering a new tool. Remember when you got your first cell phone? Did you always have it with you like you do now?

Our blog posts on choosing the right clients to use Wellpepper and best practices for recording video can also help you get started. We promise though, that once you make the change it will be as easy as drawing stick figures.

We design Wellpepper by testing and getting feedback from our users. Our development process enables us to continually improve and innovate.  If there’s anything you’d like to see us add to make Wellpepper even easier for you to adopt, we’d love to hear about it.

 

Posted in: Rehabilitation Business, Using Wellpepper

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Choosing the Best Clients to use Wellpepper

We’d like you to use Wellpepper with all your clients, however, we know that is not possible. Here are some things we know about clients that are good candidates for Wellpepper:

Technology Profile

Wellpepper Clinic Dashboard

  • Patients need access to a smart device. Either iOS or Android.
  • People who are already tracking things on their phones are often very excited to use Wellpepper

Age

  • Honestly, we haven’t seen any differences in age. Wellpepper users range from late teens to over 85. Familiarity and usage of technology seems to be a bigger factor than age although we have had users that are completely new to technology.

Time

  • The very best time to introduce Wellpepper is with new clients. Your long-term clients often already know their exercises. You’ll find that if you introduce Wellpepper as part of your overall treatment plan, you’ll get better client compliance. If your clients know you will be tracking them, they will do what you prescribe.
  • Another reason to introduce early is that in the first few weeks of a treatment or exercise program, clients often have more questions about whether they following the program correctly. Wellpepper enables them to be in touch with you for feedback and corrections without waiting for their next appointment to find out they’d been doing an exercise incorrectly.

Distance

  • Wellpepper is a great way to keep in touch with remote clients who can’t get to see you in person as often as you both would like. You can use it to check in with patients between visits.

Communication style

  • Have you noticed that some clients want to be in constant contact with you? Wellpepper lets them do that, but puts the control to respond in your own hands and doesn’t require you to give your clients your personal contact information.
  • For public health organizations, using Wellpepper is a great way to “discharge” patients from an active treatment program. They can still have contact but without in-person visits.

Chronic disease management

  • If you have clients who are trying to manage a chronic disease like Parkinson’s, multiple sclerosis, arthritis, or diabetes, you know the best way to keep them well is to keep them moving. Wellpepper motivates them to complete their exercise programs through notifications and reminders and by always having their program with them.

We strongly believe that applications like Wellpepper represent the future of patient and client engagement, and will eventually be used with every type of person. For now, these are some ideas to get you started.

Posted in: Uncategorized, Using Wellpepper

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How and Why to Record Personalized Client Exercise Video with Wellpepper

Smartphones and Instagram have made many of us into amateur or semi-professional photographers. Of course, one of the reasons is that we can instantly hone our skills by taking photograph after photograph, adding fancy filters, and only choosing to publish the very best ones.

While everyone’s skills might have improved dramatically as photographers and videographers, we thought we would offer a few tips to help you capture the best client photos and video when using Wellpepper. We know that fitting Wellpepper into your practice requires doing some things differently, and we want to help make this as easy as possible. Also, unlike the amateur photographer, you don’t have time to shoot and reshoot video when you’re working with a client. We designed Wellpepper to be as easy as drawing stick figures, and we want to help make recording video as natural to you as picking up a pencil.

A few things to consider to improve your client videos and photos

    • Practice first. Try recording yourself or your colleagues. You may also want to use these videos to assign to your clients if you think they best represent how to do the exercise.
    • Get the client to practice a few times before recording. In the same way you might have them do an exercise a few times and adjust them, or show them first, you’ll want to do that with video. When they have it perfect, ask them to do it once and capture it.
    • Try to keep your video to 30-60 seconds. Longer than that and clients probably won’t watch the whole thing anyway. You can record up to 2 minutes with Wellpepper, but that is usually overkill for one exercise.
    • Give verbal instructions while you are filming. You can even instruct on simple corrections, which helps them remember later the right way to do it. Take a look at this video, where the client doesn’t quite have her abdomen tucked in properly for the pelvic tilt. See how effective her correction is when she hears the instructions. Imagine how much this will help when she views it at home.

Pelvic tilt from Wellpepper on Vimeo.

  • Try to hold the iPad horizontally. We know this might not always be possible, given the type of exercise, and space constraints, but wide videos generally look better than tall ones. See what we mean? Because video players are horizontal, the vertical video is smaller than the horizontal one. However, for standing exercises, it’s not always possible to have a horizontal video.
Vertical and Horizontal Video Comparison in Wellpepper

Vertical and Horizontal Video Comparison in Wellpepper

What if your client doesn’t want to be recorded? First, we recommend that you try to convince them. Assure them that the only people who can see this video is them and you. It cannot be shared outside of Wellpepper. It’s not even stored on your iPad or their iPhone.  Second, tell them that it will be helpful to their treatment: physical therapists and personal trainers have told us that people remember and understand better when they review videos of themselves doing the exercises. We think there are a few reasons for this: first they have the visual representation of what their body remembers doing, and second, if they have a modified version of a standard exercise due to functional limitations they will see them doing it to their own abilities. This is a lot more motivating than seeing a perfectly fit model demonstrate an exercise.

If you really can’t convince them, or if you’re short on time, we recommend either having pre-recorded video of yourself or your colleagues doing the exercise that you can assign to them, or having the client record you doing the exercise during their session with you. (Yes, it’s easy enough that you can just hand them the iPad.)

Well, what are you waiting for? Download the Wellpepper Clinic app and try it out with up to 2 clients.

Posted in: Using Wellpepper

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The Value of Physical Therapy

We’ve participated in quite a few #solvePT tweetchats, and a recurring theme is the need for the physical therapy profession to better market the profession both to consumers and within healthcare as a whole. What’s interesting is that within our experience, everyone we know has seen a physical therapist at one point or another, and seen benefit. Of course, we are active ourselves and so are our friends. We also fall into that category of people who want to remain fit and active as we age.

Once, people did not see a doctor until they could barely get around. “Now patients will say: ‘I can’t exercise. I can’t ride my stationary bike or regular bike or go for walks of one or two or three miles,’ ” said Dr. Mark W. Pagnano, an orthopedist at the Mayo Clinic in Minnesota. NY Times

However, keeping in mind that everyone is not like us, we thought we’d explore the concept of the value of physical therapy and exercise in a few blog posts. Recently, we met with an MD who on the one hand was a huge proponent of preventative medicine, and on the other hand was a bit dismissive of physical therapy. However, he swore by his personal trainer so he definitely sees the value of exercise.

Search for “the value of physical therapy” and the fifth result is:

It may be stated with little fear of contradiction that there is no field of therapeutics less understood and less frequently employed by internists than physical therapy. There are several reasons that account for this unfortunate state of affairs which has its inception in our medical schools. http://jama.jamanetwork.com/article.aspx?articleid=252288

It’s from 1941, so hopefully sentiments have changed a bit, but the fact that it’s in the top search results is a bit disturbing. A much better resource has been developed by the Canadian Physiotherapy Association, where they outline the types of conditions and interventions where physical therapy can help.

Here’s the list, with links to evidence on how physical therapy can help in each one of these cases.

Tracking exercises in Wellpepper

Tracking exercises in Wellpepper

If you’re like us, accidents and sports injuries are the first areas that come to mind. However, where physical therapy can really shine is in preventative treatments for things like falls and low back pain. Did you know that low back pain causes almost as many work absences as the common cold? Management of chronic disease is also an area where physical therapy can add value. Diseases like arthritis, multiple sclerosis, and Parkinson’s can all be managed through regular movement and exercise. Keeping people moving is key to keeping them from getting worse. We’re working with researchers using Wellpepper for Parkinson’s management and we are hoping the findings can be applied more broadly to chronic disease management.

Recovery from disease is another area, stroke, heart disease, and cancer all need physical therapy to help regain quality of life. The first two are obvious. Healthcare professionals are just starting to realize the toll that cancer treatments take, and are prescribing physical therapy as part of a recovery program. Often people are so weakened that they need help to get muscles back to where they were.

In our experience, people who have been helped by exercise prescription understand the value. The challenge seems to be not enough people know about the possibilities. Direct access, which enables people to see a physical therapist without a doctor’s referral, can help this tremendously. However, in order for people and the profession to see the benefits of direct access, there needs to be more awareness of when it could help.

Posted in: Exercise Physiology, Managing Chronic Disease, Rehabilitation Business

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