Implementing an annual physical therapy examination in both traditional and nontraditional physical therapy practice settings offers "tremendous opportunities" for physical therapists, according to Jennifer Gamboa, PT, DPT, OCS. "
Gamboa was 1 of 2 speakers at the June 12 session "Implementing the Annual Physical Therapy Examination Into Your Practice" at NEXT 2014.
The first speaker, David Taylor, PT, DPT, OCS, provided an introduction to and history of the annual physical therapy examination. He noted that the concept is not new. As early as 1993, APTA's House of Delegates adopted a position on the role of health promotion and wellness by physical therapists (PTs) and physical therapist assistants (PTAs). Subsequent APTA policies, House of Delegate motions, and positions have affirmed the role of PTs in providing annual examinations. The association's recently adopted vision—"transform society by optimizing movement to improve the human experience"—further supports the implementation of an annual physical therapy examination.
Gamboa explained that the economic burden of chronic disease in 2007 was estimated to be $80 billion annually. Of that, $20 billion was classified as avoidable. "That's where the annual physical therapy examination comes in," she said.
She advised PTs to look for opportunities beyond the traditional impairment and payment model. She described her own practice as offering a continuum of services, and explained that consumers may enter either through the rehabilitation "door" or through the health promotion and fitness "door." The goal, in any case, is to develop a base of long-term clients who ultimately will use both health and wellness and rehabilitation services.
In her practice, the rehabilitation "door" in 2009 accounted for 37% of her clients and 31% of her practice's revenues. The health promotion and fitness programs accounted for 41% of her clients and 21% of the revenues. The intersection—long-term clients—accounted for 22% of clients and 48% of revenues. Her goal is to raise the figure for long-term clients to 50%.
She advised those attending the session: "What you have to 'sell' must fill a genuine human need. And you will earn the loyalty of clients only if you sincerely care about satisfying their needs." Addressing the techniques to identify those genuine needs, she suggested answering the questions: "What are your patients asking you for? And what do your referral sources need?"
Gamboa also described activities to encourage employers to send their employees to practices for annual examinations and wellness programs. Those included both onsite employer-based programs and in-clinic programs. The benefits to the employers include cost-savings in terms of fewer time-loss hours due to injury, lower health insurance premiums, and a lower worker compensation case rate. She also offers a discounted rate on services offered by her practice.
Even in the traditional health care system, Gamboa said, plenty of opportunities exist for physical therapists. She provided 2 lists of ICD-9 codes, 1 of which she characterized as "tried and true" and the other consisting of codes—involving patients with high body mass indices or who are overweight or obese—that she said were "not well tested in physical therapy but very applicable." She also described opportunities to collaborate with physicians, accountable care organizations, and medical homes."