With specialized equipment, manual techniques and treatments like massage, physical therapy is often imagined as just that – physical. But as the public health crisis continues to put pressure on health care workers, PT, like nearly every other medical field, has had to adapt.
And though the transition has been anything but smooth, the pandemic’s push to change has shown hands-off PT is not only possible but sometimes preferable. In fact, Annick Lamb started exploring the option long before COVID-19 swept Santa Barbara.
Six months ago, the local physical therapist left her position at the Goleta-based PT clinic Hayashida and Associates to pursue something different – a telehealth practice. While virtual PT was just an emerging business model at the time, Ms. Lamb wanted to provide more access to those for whom in-person care is difficult, like pregnant and postpartum mothers.
“I was working with moms in the clinic, and I saw a high drop-off rate of women who wouldn’t find childcare and couldn’t schedule appointments in advance,” said Ms. Lamb. “I saw telehealth as a solution to bring therapy to them.”
Since then, Ms. Lamb has spent her time making sure the budding practice, known as Pregnancy to Performance, comes to life. Yet as the coronavirus prompted stay-at-home orders and made elective medical appointments a scary endeavor, her focus again shifted – this time unexpectedly.
“Telehealth has become a huge part of health care,” she said. “It’s the only way people can get access, so I’m expanding my telehealth practice and opening the doors to anyone.”
Now, Ms. Lamb is developing P2P to include Path to Performance, an associated practice open for all physical therapy needs. Both avenues to therapy will open for public access on April 21. By then, those interested can make an appointment at pathtoperformancept.com or pregnancytoperformance.com.
Virtual PT may seem like foreign territory, but Ms. Lamb urges potential patients to keep an open mind. So long as they have a computer, tablet or smartphone with a webcam and speakers, telehealth visits are as simple as they sound. After an appointment is booked, all that’s left to do is throw on some loose clothes, find a quiet space and follow an email link to the video call.
If patients are limited to their phones, they must download the “Telehealth by SimplePractice” app to access their appointments. SimplePractice, LLC is P2P’s practice management software for scheduling, case management video visits, and therapy notes.
The platform uses a HIPPA compliant software, so all patient information remains secure.
Likewise, P2P’s prices are designed to remove barriers. Similar to an in-person clinic, patients will pay per session. Initial visits are available for the price of $110 and will last 50 minutes to an hour. Follow up sessions are then $60 a piece and run for around 25 minutes. To put this in perspective, Ms. Lamb looked into the cost of visiting a physical therapist under her personal insurance plan, and even she was surprised to see such a large disparity.
“I was looking to see how much it would be to see a physical therapist if my insurance covered the session and the copay would be $75,” she said. “So my starting price is actually much cheaper than my copay would be to see a physical therapist. My goal is to provide access to people, and I hope my prices reflect that, too.”
Ease of access has been reflected by the government as well, with state and federal regulators agreeing to reimburse doctors who provide telemedicine services to patients on Medicare and MediCal. Likewise, California has also ordered all private insurance companies to reimburse doctors for telemedicine during the current state of emergency.
Still, though the coronavirus continues to pave the way towards telehealth services, Ms. Lamb has noticed a sluggish start to accept the mediated technique.
“It’s been slow to pick up to be honest,” she said. “People are confined to their homes right now, A lot of them are cancelling their appointments, but you don’t have to wait for the pandemic to be over. Telehealth is a great option for physical therapy.”
Evident from her change in career, Ms. Lamb believed in telehealth services and particularly virtual PT is a good option not just for convenience but for patients’ overall health and improvement as well. And now, PT in particular may be more essential than ever, with the coronavirus limiting activity and movement.
“I feel like the pandemic is stretching farther than some of us expected,” said Ms. Lamb. “I wonder if because people are sitting more they might get some new aches and pains. It might be a great time to have someone in their team checking on you to help with those new aches and pains.”
Luckily, Ms. Lamb is confident in P2P’s ability to care comparable to in-person clinics. She in part owes the simple transition to her focus prior approach to PT. Even when she worked at Hayashida and Associates and other facilities, Ms. Lamb preferred exercise and movement-based treatments to those more hands-on.
“People expect physical therapy to involve a lot of hands-on care, but there’s so much you can do with exercise and visual cues just watching someone do something,” she said. “That’s how I structured (sessions) in the clinic, focusing on activity and getting someone to move in a pain-free way.”
Through just an initial e-visit, Ms. Lamb can typically narrow down a patient’s condition to one of three diagnoses. By observing movements as simple as bending forward, patterns of pain start to become clear. Better yet, without the crutch of a physical therapist, the limitation in contact may even motivate patients to put more effort towards rehabilitation.
“I like exercise because it puts the ball in their court,” said Ms. Lamb. “That’s the most powerful thing with telehealth. It automatically sets the ball up in their court. I can give them advice through the screen, but it’s up to them to get better, as opposed to manual therapy where a patient is waiting for someone else to make them better.”
From there, if hands-on care is needed down the line, telehealth appointments give patients the information they need to be treated swiftly once in the doctor’s office. For now, as in-person visits remain limited, Ms. Lamb hopes people realize they aren’t being forced into a lesser option.
“I still think patients are thinking, ‘If I want PT, I have to do it this way,’” she said. “But I see it as a really powerful treatment tool to recover on your own doing the things you love.”
Ms. Lamb’s confidence is built on more than speculation. Operating on a soft opening of P2P, she has spent the past few months preparing for the big launch of her practice any way that she could. On top of taking additional extended learning classes to specialize in pregnant and postpartum care, this has meant networking to family and friends by word of mouth.
Ms. Lamb’s current patients include a woman who gave birth 15 months ago. After a few in-person PT visits, the woman decided to take a turn with Ms. Lamb. Five sessions together later, she has regained a level of movement she didn’t think possible with the telehealth realm. Another success story comes from a younger woman working through the impact of shoulder surgery, who now has full rotation of her arm.
With proven progress under her belt, Ms. Lamb knows once people give it a try, P2P can be an asset during and long after the current emergency.
“Ever since the pandemic, a lot has shifted and changed with helping the whole movement of telehealth work,” she said. “I hope it stays like that… I think that when people try it, it’ll stick. What I’ve experienced so far is that my clients have decided health care is a good option. I think it’s a matter of getting used to it.”
And once the dust settles, Ms. Lamb hopes every avenue of PT can work in tandem, a goal she believes will strengthen the discipline as a whole.
“What I will say is that telehealth shouldn’t take the place of clinic care,” she said. “There will always be a time and place to get hands-on care. There are certain conditions where that is the best choice. But a lot can be done in telehealth. They should work together.”