While fears of COVID-19 heighten, non-essential personnel are being asked to stay home and practice social distancing to flatten the curve. Despite this, the number of cases and deaths are increasing exponentially just showing how contagious and deadly this virus really is.
In the midst of all this, one of the conversations stirring among my colleagues is whether physical therapists are really essential or are we doing more harm than good?
For those in the rehab world, you can imagine that most of the discussion centers around PTs working in the outpatient setting.
When trying to understand our role in this mess, there are always going to be those that put us down but don’t mind them. There’s usually a rational voice to make some counterpoints. In this case, a few:
Where do I stand?
If you haven’t learned about me yet, I’m a little bit of a workaholic and I enjoy getting paid to help people move better. Even after I paid off my 6-figure student loan, I got used to bouncing between two jobs even on those 12 hour days. It kept me busy, but all good things don’t last forever.
My work in outpatient PT has already come to a halt. Even after we survive this pandemic, I suspect it will take the clinic some time to ramp up before needing my help again. Thankfully, I still have my full-time position working in the home-care setting, but I don’t see it lasting too long either.
With this being the case, I needed to ask myself whether my work is really essential at least during a global pandemic.
I think most people would agree that PT in hospitals and rehab facilities are more “essential” since they work with sicker patients, but what about PT in other settings?
Is Outpatient Physical Therapy Essential?
While PTs are generally recognized as essential personnel by the organizations that govern us, it is clear that the majority of outpatient PT services can wait. Yet, outpatient therapists are left wondering why they’re still at work placing bets on whether or not their next patient will show up.
Outpatient PT clinics are seeing caseloads dwindle and many are finding creative ways to stay open such as transitioning to providing “outpatient” services in their patients’ homes. Some outpatient clinics have taken the initiative to close to protect the public, while others have chosen to keep their lights on until they can no longer do so.
PT may be essential on paper, but in the outpatient setting the supply-demand curve would suggest otherwise.
Is Home Health Care Physical Therapy Essential?
The question of whether outpatient PT being an essential service has already been answered by empty schedule books. Now, I’m beginning to see something similar happening to the home care setting as well. My caseload is gradually shrinking as I have decided to postpone treatment or modify care plans to minimize in-person contact.
Another reason that I may no longer be needed is that my company is receiving 30-40% fewer referrals. From what I heard, this is happening to many home health care agencies. This is because elective surgeries have been postponed. Physicians are being more selective about who they send to the ER. People are generally moving around less meaning fewer chances for accidents and altercations. Lastly, patients returning from home are saying no to home care. If you could help it right now, wouldn’t you refuse to?
Of course, this means the patients I am seeing now are the sickest of the sick. They are at high risk for hospitalization and I am finding myself spending a lot of time case managing. For the few I am serving, I do believe home health care is essential in minimizing rehospitalizations and PTs play a role. However, we have to modify our approach to care as suggested by a statement released by the American Physical Therapy Association.
If you are treating patients and you just feel like you’re not serving yourself or your patients, you’re probably not and you need to make a change.
As the death toll rises, the question of who and what is essential will continue to shift towards who and what is urgent. Until then, I believe the way we should proceed is to use professional judgment while weighing the risks and benefits of our interventions as we have always done.
After all, We are essentially part of a team
Whatever your job is, you are essential. Essential in the sense that you are important in keeping the public safe even if that means not going into work.
Even if the powers that be have deemed your work “non-essential,” you are still essential. Again, essential in the sense that you’re trying to do the right thing.
For me, the right thing means trying to keep patients out of the hospital. It also means longer sessions and telephone calls between more spread out visits. It means no cutting corners and making sure my patients understand that they’re not out of the woods yet. It means I have to make weekly unpaid drives to my main office to restock on PPE and sanitation supplies. All this extra work does not come with extra compensation. The extra stress and risks I take by being out there do not lead to any awards, but neither does kicking back and doing nothing. One this is for sure, we all have to stick together even if it means we’re further apart.