During the course of patient care, the recognition of the need for referral for outpatient physical therapy frequently arises. The nature of this referral could be for a condition as common as chronic low back pain, or more involved like post surgical rehabilitation or a chronic disease process. Whatever the condition or illness, it is important to remember that there are a number of options for outpatient physical therapy services and that qualifications and credentials are an important factor in determining what may be the best clinic partner for your patient’s care.
The American Physical Therapy Association (APTA) has an advanced certification program with specialization areas for a number of advanced areas of study/focus. An APTA certified specialist must have a minimum of 2,000 hours of experience in their clinical practice area and demonstrate advanced knowledge with coursework and testing. APTA certified specialists may be in one of 8 clinical practice specializations: Orthopedics, Geriatric, Cardiopulmonary, Neurological, Pediatric, Sports, Women’s Health, and Clinical Electrophysiology. The APTA website has a link to allow a search in your patient’s geographic area to help find the closest APTA certified specialist in the specific area of medical focus for the prospective patient.
Other criteria for partnering with a given physical therapy office may be of a more practical nature and include issues such as “Can the clinic get my patients seen in a timely manner?”
If a clinic is so busy that it can’t schedule a new patient for three to four weeks out, it presents difficulty for a patient obtaining the necessary care in a timely manner. Physicians should consider the timeliness with which the prospective physical therapy partner clinic is able to see their patients.
Additionally, the referring Physician should consider the experience they have had with the physical therapy clinic’s services in the past. Are the patients satisfied with their care? Have the patients had a lot of different therapists or have they been seen by a consistent provider? Sometimes this is important for certain types of conditions, other times it is less so. What is the “word of mouth” about the office? Is it a clinic which takes time with their patients and spends the effort to tailor the therapy to the patient’s individual conditions or injury, or is it more of a “cookie cutter” approach, where patients experience a more generic protocol of techniques and exercises for a given condition? Would a physician feel comfortable sending a family member to that office? If no, then partnering with that clinic may not be an advisable proposition.
Is the physical therapy clinic’s communication timely with the physician’s office? Does the office send timely evaluation reports, progress notes, and discharge summaries? Is there a good impression that care is occurring in an appropriate manner? Is the clinic requesting multiple referrals for continued care without appropriate progress notes or rechecks with the physician’s office? A typical referral cycle can be anywhere from 4-8 weeks and up to 2-3 visits/week. Anything longer than that without a progress note/update may be indicative that care is occurring without adequate updates and reassessments.
Is the clinic conveniently located near the patient’s home or work? Do they have convenient hours? Is the support staff available for assisting with scheduling and going the extra mile to make sure that the patients are seen in a consistent manner and with the appropriate therapist? Is the billing office efficient and effective at answering patient’s questions and dealing with insurance billing issues? These are questions which on the surface seem obvious, but have a huge impact on the quality of care that occurs in a given physical therapy care cycle.
Finally, it is important to remember that the care the patient receives in the physical therapist’s office is a reflection of the physician who made the referral. You want your patients to feel like they have received appropriate care with a physical therapist that is capable, talented, skilled, possibly with advanced specialist certification from the APTA, and most importantly professional. This reflects well in the patient’s outcome to physical therapy, as well as on the physician who made the referral. A professional partner relationship with a quality clinic can prove to be a win-win-win for patient, physician, and the partner clinic providing the valuable and necessary service.
By: Alan Finston P.T., OCS
Alan received an MPT from the University of Puget Sound in 1993 and a BA from Whitman College in 1987. Alan is Board Certified Orthopedic Specialist (OSC) American Physical Therapy Association, 6/01, Level II Orthopedic Certification in North American Institute of Manual Therapy. Alan has extensive training in Orthotic Fabrication (Custom Arch Supports), Gait Analysis, and Vestibular Rehab. He has a strong manual therapy component (joint mobilization techniques, manual stretches) emphasized in clinical practice. Alan recently became an Ritm Certified Scenar Therapist. Scenar Therapy is cutting edge Russian biofeedback technology designed to expedite the bodies own healing process and improve neural communications between body systems. It is especially helpful in the healing of chronic injuries, including Fibromyalgia, chronic pain, and Migraines.