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To all female athletes!

Posted on July 20, 2016 at 9:50 AM

Wearable Reduces ACL Injuries in Female Study Subjects

Published on July 11, 2016

http://www.dreamstime.com/royalty-free-stock-photo-uefa-female-soccer-championship-2009-italy-hungary-image10426435

Technology may offer a way to control the significantly higher occurrences of ACL injury among young women who play soccer. A new report shows that using a wearable neuromuscular (WNM) as part of a training protocol helped substantially reduce ACL injuries in recent testing.

 

According to the study, presented recently at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting in Colorado Springs, Colo, athletes who used the devices in combination with a regular training program showed functional improvements.

 

“Our study showed that training with a wearable neuromuscular (WNM) device improved postural control in athletes, without limiting performance,” says Michael John Decker, PhD, from the University of Denver in Denver, in a media release from AOSSM. “Moreover, no athletes in the study experienced an ACL injury during training or over the course of the following season.”

 

In the study involving 79 elite youth and collegiate female soccer players (ages 12 to 25), participants trained with a WNM device that applied bilateral, topical pressure to the medial quadriceps and hamstring muscles. The preseason training program with the device lasted 7 to 9 weeks, and consisted of strength and conditioning exercises and on-field team practices.

 

“Research has shown female soccer players have a three times greater risk of ACL injury compared to males, yet only a small portion of soccer coaches are currently utilizing ACL injury risk reduction programs,” Decker states in the release. “We hope these devices offer coaches a practical means to overcome participation barriers, opening the door for more organizations and teams to implement similar programs.”

 

[Source(s): American Orthopaedic Society for Sports Medicine, Science Daily]

Can't Sleep?? Come in and see us.

Posted on July 16, 2016 at 8:40 AM

In the past 10 years, computers and cellphones have become one of the most important factors in our lives, and one which has a tremendously negative impact on our muscles. Muscle tension may be one of the causes of sleep disturbance. Tension in the shoulders and neck can affect blood circulation to the muscles. This research uses a dry needling treatment to reduce muscle tension in order to determine if the strain in the head and shoulders can influence sleep duration. All 38 patients taking part in the testing suffered from tinnitus and have been experiencing disturbed sleep for at least one to five years. Even after undergoing drug therapy treatments and traditional acupuncture therapies, their sleep disturbances have not shown any improvement. After five to 10 dry needling treatments, 24 of the patients reported an improvement in their sleep duration. Five patients considered themselves to be completely recovered, while 12 patients experienced no improvement. This study investigated these pathogenic and therapeutic problems. The standard treatment for sleep disturbances is drug-based therapy; the results of most standard treatments are unfortunately negative. The result of this clinical research has demonstrated that: The possible cause of sleep disturbance for a lot of patients is the result of tensions in the neck and shoulder muscles. Blood circulation to those muscles is also influenced by the duration of sleep. Hypertonic neck and shoulder muscles are considered to impact sleeping patterns and lead to disturbed sleep. Poor posture, often adopted while speaking on the phone, is one of the main causes of hypertonic neck and shoulder muscle problems. The dry needling treatment specifically focuses on the release of muscle tension.



Check out the full article here! 

http://www.waset.org/publications/10004906

Replace CPR?

Posted on July 13, 2016 at 8:35 AM

Can new devices match Heimlich to stop choking?

Published July 13, 2016

The Wall Street Journal

The Ache: Nearly 5,000 people a year die from choking in the U.S., according to the nonprofit National Safety Council.

 

The Claim: Two new easy-to-use devices work like plungers to suck out obstructions in the airway, providing another option if standard treatment—such as abdominal thrusts developed in 1974 by Henry Heimlich—fail to clear the airway, say the companies who sell them.

 

The Verdict: A recently published laboratory study showed the LifeVac, from LifeVac LLC of Springfield Gardens, N.Y., dislodged simulated obstructions. So far there haven’t been any scientific publications detailing lives saved with the LifeVac or another device, from Dechoker LLC, of Salisbury, N.C.

 

More on this...

96-year-old Heimlich uses namesake maneuver on choking woman

Autistic NYC boy says 'SpongeBob' taught him Heimlich

The ubiquitous choking poster gets a makeover

Both the Dechoker, $89.95, and the LifeVac, $69.95, have a plastic mask that provides a seal over the mouth and nose while suction is provided. The Dechoker looks like a large syringe, while the LifeVac’s plunger is shaped like a small accordion. In both devices, one-way valves allow air to only travel out of the mask and not into it, which avoids pushing the object deeper in, says LifeVac Chief Executive Arthur Lih.

What we do in the spine and extremities affects our brain.

Posted on July 7, 2016 at 9:35 AM

Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study


LINK: 

 

http://www.hindawi.com/journals/np/2016/3704964/



Above is a title of a new article looking at what happens we apply joint manipulation in the spine, on the brain. Amazing. Again, this is yet another article that shows interventions that are applied to the spine and extremitieis affect our BRAIN. This in time could induce neuroplastic changes. Good stuff! 

Wellness Programs

Posted on June 29, 2016 at 11:10 AM

Employee Satisfaction Linked to Wellness Programs

The prevalence of wellness programs in today’s work environment was examined in the 2012 Aflac WorkForces Report, an online survey of more than 1,800 benefits decision-makers and more than 6,100 U.S. workers. The study included findings about the impact of wellness programs on employee satisfaction, well-being and productivity. Compared to workers who are not offered wellness programs, employees who are offered wellness programs and participate in them are more likely to have a higher level of job satisfaction, feel happier with their employer, and be more satisfied with their overall benefits.  

The bottom line is that companies can help increase employee satisfaction by focusing on the well-being of their workforce. For example, 28 percent of workers said they would feel more satisfied and more loyal to their employer if their company offered more options to improve their health and lifestyle. Workers also recognize the fact that they need to take an active role in workplace wellness. Thirty-five percent of employees were willing to change their lifestyle habits if it meant they could lower their health insurance premiums.

 

Financial Benefits of Implementing Wellness Programs

While companies certainly care about the well-being of their employees, benefits decision-makers admit that a primary reason their company maintains a wellness program is to help curb health care costs, and 59 percent of companies agree that wellness programs can help reduce these costs.

 

Despite the benefits of wellness program, nearly a quarter (22 percent) of companies do not offer them for their workforce due to the difficulty in quantifying the return-on-investment (ROI). However, a comprehensive analysis of 42 published studies of worksite health promotion programs showed that companies that implemented an effective wellness program realized significant cost reductions and financial gains, including:

 

· An average of 28 percent reduction in sick days

· An average of 26 percent reduction in health costs

· An average of 30 percent reduction in workers’ compensation and disability management claims

· An average $5.93 to $1 savings-to-cost ratio.

 

The 2012 Aflac WorkForces Report found similar results. Nearly all (92 percent) of the companies with a wellness program in place agreed that these programs are effective, and 47 percent reported the programs are very or extremely effective. In addition, 44 percent of employers agree they are able to offer lower health insurance premiums as a result of their wellness program, and six in 10 (61 percent) agree they have a healthier workforce as a result of having a wellness program in place.

 

Recognizing the Role Financial Stress Plays in Overall Health

Creating a healthy workforce requires more than physical health. Financial security is another factor that influences overall wellness. Many American workers today are facing financial predicaments and high debt as a result of the current economy and a lack of education about financial principles. These situations can lead workers to enormous amounts of stress which in turn can lessen overall wellness.

 

For instance, only eight percent of workers strongly agree that their family will be financially prepared in the event of an unexpected emergency, while 51 percent are trying to reduce debt. Nearly six in 10 workers (58 percent) don’t have a financial plan in place to handle the unexpected, and the same amount either don’t consider health insurance a part of their financial plan or consider it a minor part. Clearly, many Americans are in a difficult financial position and that often means turning to their employer for help.

 

Workers facing debt and unstable financial situations reported their stress has caused occurrences of ulcers, digestive problems, migraines, anxiety and depression. Results even showed heart attacks occurred at rates between two and three times the national average for these overstressed workers.

 

As a result, employers are also feeling the effects of their employees’ anxiety, beyond higher health care costs. One in five (20 percent) workers have experienced a health issue that has affected their ability to get their work done, which can result in higher productivity losses for companies. Additionally, nearly half of companies (43 percent) surveyed estimated their average productivity loss stemming from employees’ concern over personal issues is between 11 and 30 percent, and productivity losses related to personal and family health problems cost U.S. employers $1,685 per employee, per year, or $225.8 billion annually.

 

These statistics show the negative impact companies face if their workers are not adequately protected by their current benefits coverage. Voluntary benefits options are beneficial because they allow businesses to add coverage options at no direct cost to their company and, at the same time, help protect workers.

By making voluntary plans available to workers, companies can help alleviate financial concern and help employees feel more protected in case of an unexpected health event. Workers have more positive feelings about their benefits options when they are offered or enrolled in voluntary plans. For instance, 70 percent of employees whose benefit packages include voluntary options feel that a comprehensive benefits package safeguards their health and wellness

Upper Traps role in headaches

Posted on May 15, 2016 at 7:20 PM







Upper trapezius and its referral sources

The trapezius commonly contains trigger points, and referred pain from these trigger points bring patients to the office more often than for any other problem. As you can see from the picture, the trapezius is a large kite-shaped muscle, covering much of the back and posterior neck.

There are three main parts to the muscle: the Upper, middle, and lower trapezius, and each part has its own actions and common symptoms.

Common Symptoms

 

Upper Trapezius

headaches on the temples / "tension" headaches

facial, temple, or jaw pain

pain behind the eye

dizziness or vertigo (in conjunction with the sternocleidomastoid muscle)

severe neck pain

a stiff neck

limited range-of-motion

intolerance to weight on your shoulders

Middle Trapezius

mid-back pain

headaches at the base of your skull

TrP5 refers superficial burning pain close to the spine

TrP6 refers aching pain to the top of the shoulder near the joint

Lower trapezius

mid-back, neck, and/or upper shoulder region pain

possibly referral on the back of the shoulder blade, down the inside of the arm, and into the ring and little fingers (TrP7), very similar to a serratus posterior superior referral pattern

headaches at the base of the skull 5

TrP3 can refer a deep ache and diffuse tenderness over the top of the shoulder 6

 

Causes and Perpetuation of Trigger Points

one leg shorter than the other

a hemipelvis that is smaller on one side (the part of the pelvis you sit on)

short upper arms (which causes you to lean to one side to use the armrests)

large breasts

fatigue

tensing your shoulders

cradling a phone between your ear and shoulder

a chair without armrests, or the armrests are too high

typing with a keyboard too high

sewing on your lap with your arms unsupported

jogging

sleeping on your front or back with your head rotated to the side for a long period

playing a violin

sports activities with sudden one-sided movements

sitting without a firm back support (sitting slumped)

backpacking

bike-riding

kayaking

any profession or activity that requires you to bend over for extended periods (i.e.. dentists/hygienists, architects/draftsmen, and secretaries/computer users)

bra straps that are too tight (either the shoulder straps or the torso strap)

a purse or daypack that is too heavy

a mis-fitting, heavy coat

carrying a day pack or purse over one shoulder -- even if you think you are not hiking up one shoulder, you are, no matter how light the item

whiplash (a car accident, falling on your head, or any sudden jerk of the head) 10

head-forward posture

walking with a cane that is too long

turning your head to one side for long periods to have a conversation

tight pectoralis major muscles

 

Often times, we can address these trigger points in 1-2 sessions and by eliminating these, patients see a drastic redution in neck, and headache pain as well as an immediate increase in AROM. Contact us today to set up an evaluation!!! 502-771-1774

 

 

 

How all your medical professionals get paid.

Posted on May 15, 2016 at 7:10 PM


Great post about our system in general. This is exactly why my employers are MY PATIENTS and I will continue to achieve greater results for THEM. 


Thanks to all my patients!!!!


Dr. B. 



Imagine going to your favorite restaurant. You are greeted at the door by the hostess, who seats you and takes your drink order. You order through your favorite waiter, Andrew, who recommends the special of the day: prime rib with a dinner salad and a chocolate torte for dessert. Soon after, the food is brought out and it is delicious! You have time to enjoy your food. You then receive the bill and pay for your meal, returning to your home satisfied, all your dining needs met. Let’s say, for simplicity's sake, you paid $75 for this meal: $50 for the steak, $10 for the salad and $15 for the dessert.

 

A change then occurs in the restaurant industry. A new form of eating out has been adopted. Your favorite restaurant has now contracted with over 30 ”different restaurant insurance companies.”

 

Anticipating another pleasant dining experience, your return to the restaurant with your new “subscribers card.” You pay your $5 “copay.” You sit in the foyer of the restaurant. You wait an hour, even though you made reservations. A harried Andrew greets you and quickly takes your order after you briefly glance at the menu. The food arrives at your table. As you take your second bite, Andrew informs you that “your time is up” and the table is reserved for another party. You are escorted outside with your hastily boxed left-overs.

 

What has happened to the restaurant? Behind the scenes, the restaurant owner has learned some tough realities of the “new system.” During the first month of taking insurance, the owner sends a form to the insurance company requesting payment for the $75 steak dinner: $50 for the steak, $10 for the salad and $15 for the torte. The contract with the insurance company already states that they will only pay $45 for the $50 steak, but the owner decides that the extra customers brought to the restaurant by contracting with this insurance company will more than off-set this small loss.

 

The first attempt at collecting the $75 dollars for the full meal is returned unpaid with the note that it was rejected due to a “coding error.” The forms for payment from the insurance company require the owner to list the parts of the meal, not by name, but by the numerical codes. The owner had listed the salad by the wrong numerical code. No suggestions for the correct code are offered, so the restaurant owner purchases a series of books, at a cost of $500, to learn how to assign the correct code to the different parts of the meals. These books will need to be bought annually due to the constant changing of the code numbers. After 30 minutes of study, the owner realizes the dinner salad should be coded as a 723.13, not the723.1 the owner originally put on the form. The salad, it turns out, needed to have two digits after the decimal point, indicating that it was a dinner salad, and not a “main course” salad. The owner mails the corrected form.

 

In response to the second request for payment, the insurance company does not send a check, but a detailed questionnaire: Was garlic used in seasoning the steak? Was it necessary to use garlic for this particular recipe? Did the restaurant ask for permission to use garlic from the insurance company before serving the steak? Why was salt, a less expensive alternative, not used instead? The owner submits the answers, emphasizing that the garlic is part of a secret family recipe that made the restaurant famous.

 

The owner waits another week (it has now been 3 weeks since the dinner was served). The check arrives three and a half weeks after the meal was served. The check is for $20 and states that it is specifically for the steak. The check also comes with a letter stating that no billing of the patron may occur for the salad, but no other explanation is enclosed. No mention is made of the $15 dessert.

 

The now frustrated restaurant owner calls the provider service number listed in the contract. After five separate phone calls to five different numbers (The harried voice behind phone call number four explains that the insurance company has merged with another insurance company and the phone numbers had all changed last week, sorry for the inconvenience…), the owner gets to ask why, when the contract says the steak will be paid at $45, has the check only been written for $20? And what happened to the payment for the $10 salad and the $15 dessert?

 

As it turns out, this particular patron’s insurance contract only pays $45 when the patron has reached their deductible, which this patron has not at this time. The remaining portion of payment for the steak must now be billed by the restaurant to the patron directly.

 

The $10 for the salad would have been paid if the patron had ordered it on a different day, but, per page 35 in the contract, because it was billed on the same day as the steak, it is considered to be part of the payment for the steak and no extra money can be collected from the patron or the insurance company.

 

The dessert, the owner learns, should have had a “modifier” number put with its particular billing code when billed with the steak and the salad.

 

Realizing that the insurance billing is quite a bit harder than anticipated, the restaurant owner hires a company, who is paid 5% of any money collected to specifically make sure these coding errors do not occur again and follow up on payment rejections. For an additional $99 per month, the billing company will “scrub” the forms submitted for payment to make sure specific clerical errors will not cause future delays in payment.

 

The owner now must lay off the hostess and the bus boy to pay the billing company, so these duties are now added to the waiter’s other responsibilities.

 

In the meantime, the restaurant owner has also had the waiter take on the job of answering the phones due to the now high volume of phone calls from patrons questioning why they are receiving bills for meals they ate over two months ago, and why did their insurance company not pay for this portion of the meal? This extra work is now resulting in longer times patrons must wait to be seated, and grumblings from the waiters who “were not hired or trained to do this kind of work.”

 

 

The owner now realizes that, although the dinner originally cost $75 to make, only $25 has been paid. The remaining $30 billed to the patron is now in its third mailing, with the first two requests for payment going unanswered by the patron. The restaurant owner realizes a collection agency must be employed in order to have any hope of receiving any portion of payment from the patron.

 

Each meal served now costs at least an additional $20 due to the added overhead of the billing company, coding books, and the collection agency. These added expenses have nothing to do with cooking food or providing any direct service to the restaurant’s customers.

 

Service to the restaurant’s patrons has been compromised with these changes as well. The owner has now over-extended the waiter, who was an excellent waiter, but is now taking on the roles of host, phone answering and table bussing.

 

In order to even meet the costs of providing fine dining, the restaurant owner now must seat twice as many patrons in the same amount of time.

 

What was once an outstanding business that focused on fine dining and customer service has now been turned into a business in the business of trying to get paid.

 

Alas, I wish this were a fictional tale, but it is not. The only fictional portion is that this is not your favorite restaurant, but your favorite doctor’s office, which is responsible not for meeting your dining needs, but those of your health.

Summer is approaching!!!!

Posted on May 2, 2016 at 5:45 PM

With Summer around the corner, many people are taking up tennis, and even the relatively newer sport of pickleball. 


Here are a few common ailments that can sneak up on you if you dont keep things in check!!



 

 

1) The Infamous Tennis Elbow

What is it? Tennis Elbow is a condition where the outer forearm muscles become inflamed or have small tears which causes pain on the outer part of the elbow.

What are the symptoms? Pain and tenderness on the outside of the elbow, which may travel down towards your wrist. Pain when bending or lifting your arm, gripping your racket or twisting your forearm. Pain and stiffness when fully extending the elbow.

Why does tennis cause it? Players tend to overload the forearm muscles, particularly when new to the sport. Additional causes include a faulty backhand technique and a tendency to swing from the elbow, leading the racket.

How can you avoid it?

Check the string tension of your racket and reduce this if necessary, as less tension means less impact on your forearm muscles.

Talk to us about specific exercises to avoid having this sometimes complicated injruy. 

2) Tennis Shoulder (SAY WHHHAA???)

What is it? There are 4 rotator cuff muscles in the shoulder which help aid shoulder movement in all directions. Tennis shoulder (also known as rotator cuff tendinitis) occurs when the tendons of these muscles become inflamed and irritated.

Why does tennis cause it? Tennis shoulder is caused by the tremendous repetitive forces which occur when hitting the ball. Over time, this damages and inflames the tendons, causing tendinitis.

What are the symptoms? Weak shoulder movements, pain when putting your arm behind your back, pain when raising and lowering your arm, clicking or flicking sensation when raising your arm, swelling at front of your shoulder, stiff and restricted shoulder movement.

How can you avoid it?

Work on strengthening your shoulder muscles so they can cope with the repeated motion of swinging the racket to the ball.

Stretch your shoulders thoroughly before playing, Tight muscles restrict movement and are more likely to inflame due to friction.

If you need specifics please give us a call. 


3) Wrist Strain

What is it? A wrist strain occurs when the tendons of your wrist muscles become damaged.

What are the symptoms? Pain around the wrist, swelling and perhaps bruising in the area, spasms in your wrist muscles, some loss of movement and flexibility in the wrist.

Why does tennis cause it? A wrist strain is caused when tendons in the area are over stretched in a forceful nature. In tennis players often go to strike the ball with the racket and misses, they yank their wrist which damages the tendons. It can also be caused during return shots, when the ball travels with force and causes both your racket and wrist to bend backwards.

How can you avoid it?

Make sure your racket is the correct weight with the correct handle size to suit your individual grip and swing, and use the “hand shake grip” with the arm in an L shape position.

It’s also a good idea to invest in wrist supports and shoes with strong grip, to prevent unnecessary injuries when tripping over.

4) Lower Back Pain

What is it? Lower back pain is a very common tennis ailment and the pain can come in all different forms, from sharp sudden pains to dull and long lasting aches.

What are the symptoms? Sudden, sharp persistent pain that may be worse after prolonged standing, sitting or running, muscle spasms in the area, pain that radiates down to your glutes and even hamstrings.

Why does tennis cause it? During service strokes, players exaggerate the arch in their back to increase power, which puts pressure on the tissues and joints of the spine. Overuse is a frequent cause, due to repeatedly rotating, flexing and extending the spine when serving.

How can you avoid it?

Wear shoes with plenty of cushioning to help absorb the impact caused by running around the court when playing tennis.

Strengthen your abdominal and lower back muscles so they are as prepared as possible, also remembering to stretch your lower back and hamstrings thoroughly.

Lower back mobility exercises are also important, so rotate from side to side before a match.

5) Ankle Sprains

What is it? An ankle sprain, also known as a twisted ankle, occurs when the ligaments within the ankle become overstretched and damage.

What are the symptoms? Swelling, bruising, tenderness, pain in the area, stiffness and trouble weight bearing.

Why does tennis cause it? The most common cause of an ankle sprain in tennis is twisting, rolling over on the ankle or landing on the outside part of the ankle. Most injuries occur towards the end of the match when the player is tired and less alert.

How can you avoid it?

Ensure your shoes are supportive and consider wearing an ankle support. It’s worth taping your ankle if you’ve sprained it before, to help avoid a repeat injury.

Focus on conditioning and stamina when working out off the court, so that you don’t get tired towards the end of matches.

Use balance and coordination exercises to improve the proprioception of the ankles. One legged exercises and wobble board programs are ideal for this. Don't forget those glute strengthening exercises!!!!!!


Remember, have a great safe and FUN summer!!!!





Simple preparation can also help, so remove all balls from the court to avoid tripping hazards!


Direct Care Lowers Health Costs

Posted on March 25, 2016 at 7:40 PM

Direct Physical Therapy Access Could Reduce Healthcare Costs

 

 

A policy brief from the Health Care Cost Institute reports that Individuals with lower back pain who received physical therapy had reduced healthcare costs.

When it comes to healthcare costs, the federal government, medical providers, and payers are attempting to reduce rising spending and adopt value-based care reimbursement.  A number of different strategies have been implemented including bundled payment models and accountable care organizations. In the realm of physical therapy, patients with lower back pain could benefit from reduced healthcare costs.

 

A policy brief from the Health Care Cost Institute reports that Individuals with lower back pain who received physical therapy had reduced healthcare costs when compared to patients who visited with another provider first. Patients who visited a physical therapist at the beginning of their treatment were less likely to end up in an emergency room. A lower likelihood of emergency department visits also produces hospitalization costs.

 

Since low back pain is a very common occurrence in the healthcare setting and a likely contribution to disability, these findings are key to reducing medical spending across the industry. In fact, $90.6 billion in direct healthcare costs are spent on treating back pain throughout the United States.

The study authors focused on analyzing beneficiary claims data from six states including Oregon, Washington, Wyoming, Alaska, Idaho, and Montana. The researchers  looked at claims data  showing three different groups of people including those who never saw a physical therapist, those who saw a physical therapist later in their treatment, and those who immediately received physical therapy.

 

The study found that patients who saw a physical therapist first were also less likely to be prescribed a painkiller when compared to others who saw a different type of clinician. The policy brief emphasizes that visiting with a physical therapist first will reduce the use of costly healthcare services and thereby cut spending across the board.

Researchers from the University of Washington and the George Washington University also found that taking away state restrictions on physical therapy could improve health outcomes among those on opioid prescriptions as well as enhance imaging. Individual states should consider addressing restrictions on direct physical therapy access, according to the policy brief.

State restrictions on physical therapy access could affect overall healthcare costs by impacting the use of differing medical services. Essentially, in order to reduce healthcare costs, state policymakers should allow patients direct access to physical therapy without physician referral, according to the study.

“The findings from this study suggest that seeing a physical therapist as the first point of care compared to seeing a physical therapist at a later point in time (or not seeing a PT) reduces utilization of potentially costly services,” the study from the Health Care Cost Institute stated.

“Of particular interest was the significant decrease in opioid prescription, ED visits, and imaging for those patients receiving PT first. The potential reduction in opioid prescriptions is notable given the increasing awareness on the overprescription of opioids and the high risk of substance abuse. These findings suggest that having access to PT could have an impact on healthcare costs including out-of-pocket costs across all settings.”

While reducing healthcare costs is an imperative within the medical industry, quality care and patient needs come first. However, a study from the American Physical Therapy Association shows that patient needs may not come first in a referral-for-profit environment.

The study illustrates that patients who obtained physical therapy services from a clinic owned by their original physician received twice as many PT visits as compared to patients who were referred to physical therapy not affiliated with the referring surgeon. The therapy was also less customized and less intensive, the researchers found.

“When there is referral-for-profit, and from this data as related to group therapy and an extended number of visits, it stands to reason there is increased risk that the patient’s individual needs are of secondary importance to revenue. This has long been the concern here at the American Physical Therapy Association (APTA) and it is why we have fought so hard, alongside our partners in the AIM Coalition, against physician-owned physical therapy services (POPTS),” American Physical Therapy Association President Sharon Dunn, PT, PhD, OCS, stated in a press release.

“This study provides further evidence that when the bottom line takes precedence in healthcare, the patient loses. A patient’s welfare and recovery should always be the primary focus of treatment.”

The researchers looked at more than 3,000 patients who underwent total knee replacement surgery. Out of all of these, nearly 19 percent were found to be completed through a physician self-referral process while 72.3 percent of cases did not have a doctor who had “ownership interest in physical therapy services.”

The findings show that treatment in a physician-owned physical therapy setting lasted a week longer than services not affiliated with the referring physician. About twice as many visits were seen in physical therapy offices in which the referring doctor had a financial stake.

The issue seems to be that, in physician self-referral cases, patients were more likely to receive group therapy instead of individual, one-on-one care, which tends to extend the amount of visits needed to complete treatment.

This type of physician self-referral practice may improve revenue for an individual physical therapy clinic, but it only increases overall healthcare spending and negatively impacts patient care, the researchers wrote. In order to meet the Triple Aim of Healthcare, providers will need to look beyond their own revenue cycle and consider patient needs first.

When to Choose PT over Opioids

Posted on March 25, 2016 at 7:30 PM



Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management

 

 

According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though "there has not been an overall change in the amount of pain that Americans report."

 

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed.

 

But for other pain management, the CDC recommends nonopioid approaches including physical therapy.

 

Patients should choose physical therapy when ...

 

... Patients are concerned about the risks of opioid use.

"Given the substantial evidence gaps on opioids, uncertain benefits of long-term use, and potential for serious harms, patient education and discussion before starting opioid therapy are critical so that patient preferences and values can be understood and used to inform clinical decisions," the CDC states. Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids. As the CDC guidelines note, even in cases when evidence on the long-term benefits of nonopioid therapies is limited, "risks are much lower" with nonopioid treatment plans.

... Pain or function problems are related to low back pain, hip or knee osteoarthritis, or fibromyalgia.

The CDC cited "high-quality evidence" supporting exercise as part of a physical therapy treatment plan for those familiar conditions.

... Opioids are prescribed for pain.

Even in situations when opioids are prescribed, the CDC recommends that patients should receive "the lowest effective dosage," and opioids "should be combined" with nonopioid therapies, such as physical therapy.

... Pain lasts 90 days.

At this point, the pain is considered "chronic," and the risks for continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are "preferred" for chronic pain and that "clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient."

Before you agree to a prescription for opioids, consult with a physical therapist to discuss options for nonopioid treatment.

 

 


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