Why I Hate Physical Therapy

I started Restore/Thrive for a lot of reasons, but perhaps the biggest is the current state of the profession of physical therapy (PT). There’s a general lack of understanding by medical and non-medical folks alike about the differences between good and bad PT. There may be an even greater measure of apathy and lack of vision by many of my colleagues in the profession as it relates to its current state of being. There’s potential for greatness, but that’s about all it’s got-potential.

Here are my gripes, numbered so this post doesn’t look like one big run-on sentence rant, but in no particular order otherwise.

  1. PT is captive to a third party (third-party insurers) that has no idea or expertise related to what I do with my patients yet holds the right to tell me and my patients when they’ve had enough treatments.
  2. The profession (and medicine in general) is stuck in a reactive-model that too often is left to simply pick up the pieces of a broken human being who would have been better served if they had been educated 10 years earlier how to perform basic daily maintenance on their own bodies.
  3. Physical therapy kneels before referring physicians who perplexingly hold the privilege to decide who does and who doesn’t need physical therapy (and how much of it they’ll need), despite having little to no training in physical medicine and rehabilitation or exercise physiology.
  4. Culturally, physical therapists are seen as quasi-allied health professionals that specialize in “Pain & Torture”, or worse yet, copy machines that hand out pre-printed exercise protocols for your particular body part that hurts (more on that last part in a hot minute).
  5. Private practitioners of physical therapy, like me, are being squeezed more tightly as the years go by to make a choice between patient-centered care and business solvency. These are not mutually accommodating goals.Private practitioners are being choked to death by this current state of affairs. Someday soon, your insurance is only going to cover you for PT in a group setting with 3 to 5 other patients at the same time. Sound like fun?
  6. The patient that comes in to see me thinking I’m going to rub their leg for 30 minutes, exercise them for another 10, and then send them on their way to walk and sit with their crappy posture and less-than-zero motivation to move more than is absolutely necessary to survive, AND THEN gets an attitude with ME when they don’t notice a difference in how they feel.
  7. The other patient I hate-who comes to see me for the same problem year, after year, after year. I’m not your chiropractor-my job security doesn’t hinge on making you my dependent. My job is to help fix you, then teach you how to maintain your own body and take you to a higher level of human performance. Trauma is about 1% of the reason I see patients. “Inevitable incidents” caused by personal inattention account of the other 99%.
  8. The doctor or patient who sees no difference in the field of physical therapy from one clinic to another. Do you think a patient who is one of four patients seen at once by a therapist gets the same level of treatment as a patient who sees the a PT in a one-on-one environment? I don’t know if the doctor or the patient not recognizing this difference is more depressing to me.
  9. The clinic/PT who sees four patients at once and gives every patient the same shoulder/back/knee/ankle exercise handout while barely watching anyone who comes in their clinic so they can keep up with billing and paperwork. Amazingly this PT receives the greater financial reward than the PT who cares enough to see only one patient at a time and give true patient-centered care. If you’re a PT in a turn and churn clinic seeing more than one patient at a time, you’re part of the problem. You’re not helping. Stop it.
  10. The paperwork. To quote a favorite band “Wanna let it burn! Wanna, wanna let it BURN!” (Bonus points if you can name the band in the comments section without clicking on the link).
  11. PT has been so under-promoted in the U.S. that people will run to almost anything (hypnotists, icy hot patches, pain management treatment, copper bracelets) before considering that physical therapy might be worth a shot. Do you guys know we SPECIALIZE in treating muscular, skeletal, neurological, pediatric, geriatric, cardiovascular, and sports performance-related issues?
  12. Did I mention insurance? In what other consumer-provider-related transaction do you expect someone else to pay for what you need or want? Why is your insurance company getting paid for something they had no direct role in providing for you? You wonder why your health insurance premiums are so high? There’s somebody involved in the patient-practitioner transaction right now that doesn’t actually have any business being there beyond trying to turn a profit at your (and my) expense.

At Restore/Thrive our aim-our “mission”, if you’d like to call it that-is to rise above all of this. When you work with us we have a few standards:

  1. Don’t expect somebody else to pay for and make you feel better-own your problems.
  2. Our short term vision and purpose is to help fix you. Our long-term vision and purpose is to make you better than your were before.
  3. Your job is to restore and maintain your body. Our job is to guide you.
  4. We will not be a burden on the U.S. healthcare system-because we choose not to be a part of a system that waves a flag of “health” while it enables people to continue to make poor health choices and provides “easy” cover ups to enable them to deny their culpability in their current health predicament.
  5. You are a person, not a problem, and we will treat you, the whole person. We expect your full participation.

So when you come to see us, please don’t ask us to submit your claim to your insurance company. Or rub your leg.

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