How to Maximize the Value of Physical and Occupational Therapy

By Michelle Hopkins | 12/18/2018

Employers want assurance that their injured employees are getting the right treatment to return to work and function as soon as possible. When a referral is made to physical therapy or occupational therapy, some employers may have questions about why therapy was recommended. By staying in touch with the clinician, therapist, and the injured employee and using the following tips, employers can maximize the value of physical or occupational therapy. 

Tip #1. Get the employee into physical or occupational therapy early.

Many physicians continue to recommend passive treatment, such as bed rest and the application of ice or heat for days or weeks before beginning active treatment. However, this method misses a critical treatment window. Damaged tissues undergo changes within the first 24 to 48 hours after injury. Because of this, delaying treatment or taking a passive approach can make the injury worse or prolong the recovery period.

“Concentra’s model of physical therapy differs from competitors by intervening early (within 24 hours of an injury, if possible) and using an active approach. We begin exercises on the very first day and teach patients exercises to do at home,” says Shelby Mendez, FAAOMPT, PT, Concentra® director of therapy operations for Florida.

Early intervention therapy produces more favorable outcomes.1 This can mean fewer physician visits with fewer restricted workdays, fewer days away from work, and shorter case durations.

Tip #2. Ask the clinician why physical or occupational therapy is prescribed.

If a clinician refers all (or most) physically injured individuals for physical or occupational therapy, that may be a red flag. Concentra clinicians know judicious use of therapy is what is needed for positive outcomes and faster return to work. They use objective criteria to refer only about 35 percent of patients to therapy. When patients are referred, they complete treatment in significantly fewer visits than the national average.

While Concentra is precise in using physical or occupational therapy only when needed, sometimes a third-party review prior to authorization of treatment is required. “By partnering with physicians, Concentra therapists can leverage their visits with the patient to have the physician give the patient exercises to do before therapy formally begins,” says Mike Morgan, DPT, OCS, PT, Concentra associate director of therapy operations for Arizona and physical therapy director for the Peoria clinic. “In this way, we help keep the patient a step ahead in his or her recovery.”

 Tip #3. Seek therapists with interpersonal skills.

A therapist’s interpersonal skills are important because quickly completing therapy depends on motivating the patient to do exercises regularly at home.

It can be difficult to know a therapist’s level of interpersonal skills until treatment is well underway. However, an employer may be able to get an indication by talking to a therapy director or visiting the local medical center.

“Concentra therapists are outgoing and people-oriented. They like to get to know their patients,” says Jen Klose, APTA, DPT, PT, Concentra director of therapy operations for western Pennsylvania and eastern Ohio. “It’s important to find a connection with a patient, to dive into their expectations and learn what’s important for them. This type of therapeutic alliance is key.”

Morgan agrees. “I coordinate treatment goals with what the patient wants and needs to do. Putting a patient in charge of the healing process in this way is empowering. I check in with the patient at each visit on their percentage of functionality and that’s very motivating for them.”

Occupational therapist Lexy Kauska, MS, in Dallas knows how important it is to keep injured employees engaged. “I see post-operative patients three times a week and others two to three times a week for 45 minutes to an hour each time. Healing can’t happen in three hours a week. It’s essential they do the homework,” she says.

Tip #4. Ask how the clinician and the therapist deal with pain.

Many physical and occupational therapists continue to use the traditional pain scale, asking injured employees to rate the severity of their pain at each visit. However, modern scientific research shows that pain can be an unreliable indicator of healing. This is because the brain can increase the perception of pain, even when tissues heal and function has been improved. Repeatedly asking about pain causes the brain to become more entrenched in a pain response.

Because of this new research, Concentra therapists use an alternative approach to treatment that emphasizes function, rather than pain. This focus on function accelerates recovery but requires a skilled therapist. “Injured employees come into therapy after seeing the doctor. They’re in pain; they’re tired and just want to go home and relax,” adds Mendez. “I have to find out what motivates him or her. It may not be getting back to work. It may be getting down on the floor to play with the grandchildren.”

“With each exercise, we teach them how the exercise will produce a beneficial effect for their recovery,” explains Klose. “Taking the time to talk on that level helps the patient understand and makes him or her more committed.” 

 

Tip #5. Inquire if and how the clinician and therapist collaborate on care.

Concentra clinicians and therapists collaborate closely on an ongoing basis; in contrast, third-party therapists used by competitors often don’t report back to the referring clinician until after the full course of treatment is completed.

“We provide physical therapy under the same roof as the prescribing clinician. We don’t send patients to a third-party therapy provider. That means we can control the treatment plan and costs better than our competitors,” Mendez says.

“Being under the same roof is a tremendous advantage. By working closely with the physician, we can identify instances when treatment is not working the way we would like and get specialists involved or make adjustments in treatment,” Morgan explains.

“We have two customers – the injured employee and the employer,” notes Mendez. “Sometimes, an injured individual may tell a doctor one thing, but in physical therapy we see something different. The clinician and therapist compare notes and provide a service to employers by staying focused on objective measures of function, not perceptions that can give an inaccurate snapshot of healing.”

Another advantage of close clinician-therapist collaboration is the feeling of partnership created between the medical team, the injured employee and the employer. “Everyone understands the treatment targets and all work in tandem,” says Klose. “This is good not just for case management; it’s also good for the patient. He or she gets a strong sense that everyone is on the same team, working toward recovery.”

Find out how Concentra physical and occupational therapy can restore function and accelerate return to work for your injured employees. Talk to an expert.

Digging Deeper: Understanding the Difference Between Physical and Occupational Therapy

Physical therapy treats impairments in mobility and physical function that are caused either by injury or illness. A physical therapist may use manual therapy (hands-on mobilization of joints, nervous system, and soft tissues), individualized exercise prescription, electrical stimulation, or traction. At Concentra®, physical therapists also help prevent injury or re-injury through workplace inspections, ergonomic consultations, and pre-placement function tests to assess the capacity of individuals to perform the physical demands of a job.

Occupational therapy, by its name, sounds like it targets the workplace exclusively, but “occupational” is something of a misnomer. In therapy, the word “occupation” refers not to a vocation but to any activities people engage in to sustain themselves and make life meaningful.

“Occupations” addressed by occupational therapy include:

  • Showering, dressing, and eating
  • Caring for family or pets
  • Driving and using equipment
  • Rest, sleep, and leisure activities
  • Learning and applying new skills
  • Social activities and interaction
  • Engaging in hobbies and work

In workplace settings, occupational therapists address functional impairments of the upper extremities (shoulder, arm, wrist, and hand). Concentra’s use of occupational therapists largely involves certified hand therapists and post-operative therapy for surgical patients.

At times, physical therapy and occupational therapy may both have a role in the treatment plan for a single patient. An example would be a construction employee who has a heat stroke and falls from a scaffolding. Physical therapy would be used to restore mobility and overall function. Occupational therapy may be used for custom splinting and to restore function to the upper extremities.

Now that you know the difference between these treatment approaches, contract Concentra to see how physical and occupational therapy can support your company’s health and safety initiatives.

1. Dudek D, Morgan M, Studebaker C, Stultz S, and Warner S, Physical Therapy Early Intervention in the Work Place, Orthopaedic Practice, Vol. 28; 2:16 (2016), Retrieved from https://www.orthopt.org/uploads/content_files/files/OHSIG28.2.pdf