Efficient Physical Therapy: One Therapists’ Opinion

“The stupidest question, is the question that has not been asked, or there are no stupid questions” Albert Einstein.

A search of the internet using the term” speedy home repair” will turn up large number of businesses. Using the search term “speedy Physical Therapy” will result in zero listings. When it comes to Physical Therapy services, it seems the preponderance of attention is on effectiveness and less attention is paid to efficiency.

Effectiveness and efficiency are two different but related concepts. Effective therapy the intervention achieves the desired or intended results. Efficient therapy the intervention is achieving the desired results with minimum wasted efforts or expense.

Historically effective healthcare has assumed a higher level of perceived value, and most individuals are less concerned that their healthcare is efficient. The health insurance system has been set up to encourage more service. The standard healthcare model is the provider gets paid for service, not the results or outcome. The more units of service/procedures provided the more the healthcare provider makes. The more tests ordered, the greater the financial reward for the healthcare provider. The greater the number of follow up visits the greater the financial reward for the Physical Therapist. Physical Therapist makes more money the longer each physical therapy visit.

A problem is financial incentives in today’s health care industry is to provide more service not more efficient service. In current healthcare system more money can be made if you are not very good at the service provided. Withholding ineffective treatment is not profitable.

When I contract to have repairs on my home I am charged by the job/project. I am not eager to pay according to how many hours it takes to put new gutters on my house.

It is considered unethical for a Physical Therapist to participate in underutilization or overutilization of physical therapy services for personal or institutional financial gain. Truth be told when it comes to the implementation of ethical concepts the truth is often grey and not black and white. It is very difficult to determine when healthcare is underutilization or overutilization.

Being effective is about doing the right things, while being efficient is about doing things right.