In an era in which budgetary considerations and productivity concerns can influence clinical practice, physical therapists (PTs) aren't accustomed to being directed to increase their time with patients. But what might seem like a good problem to have can have a downside. Consider the following scenario.

Travel Bane

Luke is a PT at a Veterans Administration (VA) facility in a rural area that serves a large geographic region. Luke enjoys the work—especially the satisfaction of helping individuals who have served their country to be as mobile and active as possible.

Getting to the VA center is a hardship for many of Luke's patients. They often must travel great distances, which may impose a physical burden if they drive themselves, or a financial or logistical burden to those who drive them.

Luke's solution has been, in some cases, to reduce visit frequency from 3 times a week to 2. He has studied the literature and has determined that, for the musculoskeletal issues that bring some of his patients to the facility, there's no significant benefit to a third weekly visit as long as he has maximized the other visits and has provided the patient with a strong home exercise program.