A Season for Disclosure

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Patients often ask if my work varies during certain times of the year. The truth is that I've been unable to observe consistent seasonal patterns in the number or type of injuries treated in my office.

January rarely brings an immediate influx of people suffering strains from skiing and snow shoveling. Knee pains born of a New Year's fitness resolution may not reach maturity until July. The spring and fall are quite similar in terms of shoulder pain related to activities like pitching (baseball) and cleaning windows.

These issues are my typical labor and may be rooted in seasonal interests. But many factors obscure the effects of latitude on the yield of injuries, such as individual pain tolerance, patience (or stubbornness), job status, insurance deductibles, and backlogs in the schedules of orthopedic surgeons.

Whatever the season, people with various aches and issues continue to trickle into the office, and I'm thankful for that.

[Wait. Did he just compare pain to a crop and say he's grateful for injuries?]

What I mean is that gratitude through all seasons is critical to my work. This certainly applies to other professions and may seem obvious given a physical therapists calling and place in the entire realm of health care. But in my experience, some models of outpatient rehabilitation serve patients and therapists better than others.

Of course it's rewarding for a physical therapist to help clients regain a portion of their lives, their ability to work, play, or simply care for themselves. But quite honestly, those rewards do have their limits, especially during busy seasons. While all health care providers want to be busy, the art of providing excellent care during busy seasons is not for rookies.

If you or someone you know is in need of outpatient rehabilitation, there are a few things you should know.

It is good when a physical therapists livelihood depends primarily upon the quality of work that they do, and not upon affiliations with health care networks, contractual obligations, or creative lease arrangements.

It is good when the natural checks and balances of free enterprise can quickly dry up the trickle of patients where a therapist fails to deliver outstanding care.

It is good when important business concerns like medical necessity, proficiency, scheduling, and balancing efficiency with quality of care have the chance to take care of themselves instead of being mandated by out of touch administrators.

To list these strengths of small, independent physical therapy practice is not to say that other models cannot provide high quality care. But I've worked in settings where a constant swell of patients presses against you whether or not you take the time to pay attention to the details. I know what it is like to be busy on a beautiful Thursday afternoon when someone needs a lot of reassurance and a little specific guidance beyond the general exercise protocol for their diagnosis.

While there are no substitutes for clinical competency, I’m sure that both patients and providers could stand to benefit from an honest appraisal and disclosure of the season they are in.

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