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6 Challenges Facing Physical Therapists in 2020

The challenge of keeping a physical therapy practice afloat has taken on new meaning in the wake of 2020’s COVID-19. If you’re a physical therapist and feeling stressed or concerned about the health of your practice, you’re not alone.

The pandemic has led to a substantial increase in stress and anxiety among physical therapists, as many of the challenges physical therapists face have only been amplified. These are the top 6 challenges that are affecting PT’s, as well as some suggestions on what you can do to overcome them:

1. Telehealth Adoption

Accelerated by the COVID-19 pandemic, telehealth uptake in physical therapy practices has increased this year. But the onboarding of telehealth technology, understandably, has not been straightforward. While most clients associate physical therapy with in-person visits to work on rehabilitation and mobility, the lock-down landscape has forced both clients and practitioners to revise their thinking and make changes to the way that they care for their clients.

In a recent article, we took an in-depth look at how physical therapists can use telehealth to treat their patients remotely across a range of sub-specialties including geriatric physical therapy, paediatrics, women’s health, sports medicine, neurological physical therapy, orthopaedic physical therapy and more.

So, what’s the solution?

It might not be easy, but you need to accept that the world has changed. While there will always be a need for in-person appointments, in order to compete with other practices, you need to have a slick, seamless telehealth offering. Rather than thinking of this as a challenge, you can think of it as an opportunity. For starters, it’s going to differentiate you from the competition, and it also offers a number of benefits for clients (think better access to care and better health outcomes) and your practice (think reduced no-shows and a healthier bottom line).

And how do you get started? It can be as simple as making use of the telehealth features that are integrated within your practice management software. At Power Diary, for example, we have built our telehealth service from the ground up and offer it as part of our software solution, free of charge.

With the technical component out the way, it gets simpler. You’ll need to brainstorm services that you can offer via video visits such as guiding clients through exercises remotely to help them recover from surgery or to address chronic conditions. These exercises can cover a range of potential outcomes including strengthening, balance, flexibility, and functional mobility exercises.

2. Educational Costs

COVID aside, one of the most pressing challenges physical therapists face is the education costs that many carry, often for many years after graduation. It’s not a concern that affects only physical therapists, but it’s worth noting that physical therapists usually have at least six years of college behind them before they start work, which brings with it large student loans and interest repayments. Trying to focus on your career while struggling with debt makes it more difficult to focus on offering the best levels of care to your clients. Research by the APTA showed that over 90% of physical therapy graduates have debt in excess of $153,000 (not including mortgage debt) and that the vast majority of the debt is education-related, at around $116,000 on average.

The situation is made even tougher by physical therapy graduates commonly starting at lower salaries than most other healthcare professionals. Then there is the ongoing challenge of staying up-to-date with developments in the industry, which necessitate further education and study, and more costs.

So, what’s the solution?

This is a less simple one and is a whole article on its own. But here are the main points:

  • Read through (and understand) the terms of your contract – depending on how the loan has been set-up, you might benefit from paying it off as quickly as possible, but in some cases, there is a penalty for early repayment.
  • Negotiate a good salary – your salary isn’t set in stone, so you need to do your research before accepting the first job offer that comes your way. It should be related to your level of experience, the value you offer, the job you are being employed to do, and the location that you will be practicing in.
  • Plan your repayments – you might not be able to change the amount that you owe in student loans, but you can review which of your loans should be paid off first, budget in your repayments for every month, and prioritise what you spend your salary on. This might mean owning an inexpensive car, renting a smaller apartment, and sticking to lower-cost holidays.
  • Pay off more than you need to (and refinance if possible) – if you have money left over at the end of the month, put those funds towards your student loans. It might also be possible to refinance your loans to get a lower interest rate, which will save you a lot of money over time.

3. Exemplary Client Care

As a physical therapist, you’re invested in the health and rehabilitation of your clients, and it might even feel that sometimes you care more about their health than they do. When clients struggle to make necessary lifestyle changes, continue to skip appointments, and are late paying their therapy bills, it makes keeping motivated to do your job much more difficult.

According to the Centre of Disease Control and Prevention, over 40% of US adults are obese, and even in the UK (25%) and Australia (30%), the numbers are climbing. Recovering from an injury or surgery is difficult without the added limitation of an obese client. This may make it more challenging for them to complete their at-home exercises, and an in-person session will be more physically demanding for you as the therapist. Also, in many cases, the client’s weight will make your sessions less effective, causing the client to attend therapy for longer, incur greater costs, and achieve a less positive outcome.

Add this to a no-show rate of at least 10% and the financial costs, as well as the emotional burden of caring for clients, it can become overwhelming.

So, what’s the solution?

Take control over what you can influence. You can’t make your client lose weight, nor can you make them do their at-home exercises or attend the sessions that they book with you, but you can focus on:

  • Your own physical health – make sure that you’re looking after your body to prevent injuries when working with overweight clients.
  • Your mental health – if you are finding the burden of caring for your patients overwhelming, get support from a mental health professional, speak with other physical therapists, and remember to take time for yourself. This may mean doing things that you love outside of the work context to remind yourself that, although you’re an excellent physical therapist, that’s not all you are.
  • Reducing no-shows – this may mean offering visits via telehealth (which has been proven to reduce no-shows), using appointment reminder software, and implementing a cancellation policy if you have clients who routinely miss their appointments.
  • Managing payments – billing software will reduce the burden on you as you know that appointments can be accurately invoiced and have the best chance of prompt and full remuneration (either by the client or a third-party payer).

4. Changing Healthcare Legislation

There is a seemingly unending stream of regulatory changes that continue to trickle down to physical therapy practices, from Electronic Health Records to ICD-10 code changes and reimbursement schedules. This makes it harder for a practice to stay afloat as they are held back by red tape, as well as making it more difficult to get reimbursed by third-party payers, as the goalposts keep moving.

So, what’s the solution?

Read, then implement. Our feature article on Medicare Billing Guidelines for Physical Therapy (American Edition), covers the steps you need to take to bill accurately in order to improve your remuneration rates. The American Physical Therapy Association also has a number of resources related to Medicare coding and billing, and telehealth requirements to support your practice.

5. Stress Management

As a physical therapist, you know how important it is to stay fit and active, both for your physical and mental well-being, as well as to be able to do your job well. But long hours on the job are standard for physical therapists, with a constant stream of clients to see during the day, then admin and paperwork to catch up with in the evenings. These demands make it difficult to schedule time for yourself and your needs, and the ongoing physical exertion of your job leaves you exhausted by the evening and definitely not in the mood to pull on your trainers and take a run around the block. This becomes more noticeable as you get older, where the physical requirements of doing your job begin to take a heavier toll on your health and fitness.

And it’s not just exercise; work-life balance is essential for preventing burnout and reducing stress. Physical therapists, along with most other health professionals, are at risk of burnout and other stress-related conditions. You are charged with the care of patients who often have traumatic injuries, debilitating illnesses, and a negative long-term outlook on a daily basis. Full rehabilitation may not be possible in many cases, and so it becomes more about managing quality of life and measuring positive changes in small milestones and minor improvements.

So, what’s the solution?

Being a physical therapist is physically and emotionally difficult for many – even if you do have a positive attitude to life and your profession. Part of dealing with this challenge is to ensure a good work-life balance, prioritise exercise, seek counselling if needed and take time to look after yourself.

It’s also important to set up an exercise routine early on in your career when you have fewer responsibilities and more energy to do so. You can experiment to find the best time of day for you to exercise, as well as the type of exercise most suited to your lifestyle and needs. That way, as you progress, you’ll have a routine and discipline in place that you can fall back on when you’re running on empty but still need to take care of yourself.

6. New Referral Sources

As technology becomes further entrenched in society, health professionals, including physical therapists, need to adapt. While referral partners continue to be an important source of new clients, the potential of online client sources cannot be ignored. One of the big challenges physical therapists face in 2020 is deciding which technologies and channels to make use of in order to generate new client leads for their practice.

So, what’s the solution?

The issue for many physical therapy practices is where to begin. It’s all fair and well to say that Facebook Ads are the way forward, but how do you actually get started? If this is all sounding a bit too familiar, our complete guide to physical therapy marketing can help you with the broad brushstrokes, while resources such as this guide and this one can help you with honing your Facebook Ads strategy.

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Physical therapy continues to be one of the most rewarding health professions and makes for a satisfying career. You have the opportunity to help people overcome their physical difficulties and re-integrate into their lives following an injury or chronic condition, and that should serve as powerful motivation. But it’s not all sunshine and roses. Physical therapy is not without its challenges, and if they aren’t carefully and strategically addressed, they can lead to serious professional and personal consequences. Luckily, many of those can be addressed with careful, methodical planning. Any issues that remain can often be put into perspective when the broader context of the life-changing work that you do is taken into account. You play a role in hundreds, if not thousands, of patient success stories and most physical therapists will agree that, in the longer-run, the positives count for more than the challenges physical therapists face.


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