Physical therapists are uniquely positioned to look at the whole health of the patient, however, many are still just treating the injury. Health promotion needs to be a key evolution of the profession.
These were themes in a few sessions at APTA CSM 2013 last week in San Diego, particularly in “How Can We Integrate Wellness Into Orthopedic Physical Therapy?” and “Challenging PTs to Thrive in a Changing Healthcare Environment.”
Both sessions challenged physical therapists to think about how to expand their impact by focusing on whole wellness of the person, whether that is trying to understand other lifestyle factors that may affect their health, or how to keep people active after their treatment. When they only focus on the injury, physical therapists get the patient to a certain point of recovery and then discharge. The patients then don’t continue their exercises and are likely to re-injure. The idea of “patients for life” was introduced, not that we want patients to be injured for life, but that patients can continue to look to their physical therapist for prevention of injuries and support for their general well being.
Behavior change was cited as a key tool in helping patients manage their entire health. It’s not enough to get them to do their exercises, they may also have to change their behaviors if these are also impacting their recovery. For example, diet might need to change. Physical therapists are urged to look at one unhealthy behavior and figure out how to change it.
Understanding the full picture of wellness, will help understand the full patient. The University of California Riverside defines these 7 forms of wellness as:
Identifying whether any of these, besides physical, are inhibiting the patient from recovery is key. For example, a patient might be missing social support, like a friend who could go for walks with them, which could slow or impair overall recovery.
Although both talks were similar in their recommendation that physical therapists become more involved in helping the patient modify their behavior to get better, neither offered practical tips on how to do this in a clinical setting. As well, they both admitted that although physical therapists were uniquely suited to do this they didn’t have the right training or tools.
At Wellpepper, we’d say this is consistent with our experience during our research on patient exercise compliance. Some of the physical therapists we talked to had well-defined strategies for getting patients to do their exercises, for example, don’t assign too many exercises or get the patient to choose the time, while others just prescribed and hoped. Helping patients modify their behavior for positive outcomes is a key tenant of what we’re trying to do at Wellpepper, so we’d love help physical therapists take a more active role in this.
Both sessions also encouraged the profession to have a voice in public health on health promotion and wellness. Doing this could make health promotion a more systematic part of physical therapy practice, and give physical therapists a seat at the table in the larger health reform conversation. We’re all in favor of this, and hope we can help.