Physical Therapy transformed in the age of Coronavirus (COVID-19)

Several months ago, we had a few patients reach out to us from as far away as Texas and Virginia to inquire if we were able to somehow assess and treat them ‘virtually’ via Skype or Facetime or another means of tele-health communication. We were able to successfully accomplish this task with surprisingly wonderful results.

Through a very thorough medical intake, lengthy conversation regarding history of movement impairments, medical interventions, medications, etc., we were able to come up with a subjective history that was quite comprehensive. A virtual objective assessment was then conducted by having the patient move as directed on the other side of the screen. Gait analysis was conducted and a modified SFMA (selective functional movement assessment) was also conducted to screen for movement impairments as well as postural deviations and patterned movement faults. Trunk rotation, pelvic position, foot and knee mechanics during single limb stance and gait were also observed and documented. Other assessment modalities were used as well in conjunction with the above. In all, we were able to create a very thorough and complete picture of the patient objectively and come up with the accurate diagnosis and treatment protocols to put in place that did not involve manual intervention.

Over the course of 4-6 virtual/on-line sessions and through the use of cloud-based software, videos were created and shared with the patient as the sessions progressed. We were able to take our patients through a progression positions, movements, breathing patterns, anti-gravity to full gravity positions. Through a comprehensive treatment program that was walked through with each client and then videotaped and uploaded to our cloud-based video system, we then shared these videos with our patients who then were able to see themselves our us in the video moving the way they’re supposed to move in order to create amazing results with reductions in pain, increases in range of motion and strength. Progress was made and each client felt better by the end of each session. More importantly, they all had a plan that was 100% executable by themselves without us needing to manually intervene. Through constant communication and continued patient support, their ability to sustain a high level of compliance was a pleasant surprise and led to very successful outcomes.

That was then and this is now. THIS is the present-day Coronavirus (COVID-19) reality that is ‘Social Distancing.’ Appropriate government (local/state & federal) quarantine initiatives have (hopefully very temporarily) changed the landscape for every American citizen. Physical therapy services have had to close their doors due to the ease of community spread of the virus. Now physical therapists will need to adapt and pivot their services to the current situation and begin to offer ‘virtual’ or ‘tele-health’ services that I discussed above.

How successful or sustainable can this be on an ongoing basis? Will insurers reimburse for web-based/tele-health/virtual Physical Therapy services? What do the next 4 weeks or 4 months have in store for us with regard to the prognosis of COVID-19 virus containment with the US and worldwide. When will be able to go back to our business and lives as we lived them before this outbreak? None of us can honestly give you that answer today. Most small private practices (like ours) do not have deep bank accounts and ‘fall-back’ mechanisms in place to not be severely impacted from a financial standpoint. Being a service-based business means that if there is no service being performed, there is no income coming in. The formula is not complicated. The question remains simple as well: How long can each small private practice survive without income?

Total Physical Therapy has always offered tele-health services to their patients as an alternative for clients that cannot get to our offices. Now it is exactly these tele-health services that will become a necessity if we want some or most of our businesses to survive in the present-day environment. Through the use of social media, cloud-based services and the internet as a whole, our capacity to adapt to the current state of affairs is at a tipping point. By educating the public on the ability to offer virtual/tele-health physical therapy rehabilitation services that are successful in their end-product/outcome is going to be vital in the short term. We do have several patients that we are currently working with via virtual-PT and so far, so good. We will keep you updated as this evolving scenario unfolds. Please reach out if you have any questions/concerns regarding this post. We are always here for all of you and are more then willing to chat at length.

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