how to choose a physical therapist (from a PT’s perspective)
What is a physical therapist (PT)? Many of us (including PTs themselves), have trouble defining our profession, which trickles down to our patients and leaves them confused with lots of questions. Are PTs specialists in one area of the body? Should I see the PT that works at my surgeon’s office? Why did my last PT have me work with an aide half the time, and another spent an hour with me? For what period of time should I see a PT, and when do I know when I’m “done?” Or should I ever be done?
These are all valid and pertinent questions, and, it’s true: there is a wide range of PTs and clinics out there. It’s important to educate yourself and know what to look for when choosing a PT to get the most of your time and money, and to ensure that your health and personal goals will be the priority.
Here are a few inside tips from a PT’s perspective:
1. Look for a PT who is a little like YOU.
Let’s be honest. If I’m a runner, I probably want to find a PT that is also into running and has worked with lots of runners. If I’m into Crossfit deadlifting or want to get ready for ski season without tweaking my knee again, same story. Read the staff bios, Google search, check out Instagram, and find someone with a niche similar to what interests you. Chances are they are just as passionate as you are about that activity or topic, and will know the language and what it takes to rehab or improve your performance more than a generalist who treats “everything.” Plus, you’ll have a lot more fun! INSIDER TIP: Ask if you can do a free consult first. Many clinics offer this, and you can often do it virtually. It’s a great way to see if you connect with the PT prior to making a commitment.
2. Choose someone that works one-on-one with you for the majority of the session.
PTs are movement specialists. We are Doctorate level health professionals and the best in the biz when it comes to analyzing, and improving functional movements and education to help you move better and keep doing activities you enjoy. Sure, we are manual therapists as well, and this is a highly valuable skill. HOWEVER, when the only time a DPT spends with you is during the manual therapy component, then you are passed off to an aide or exercise tech for the majority of your exercises, this is a MAJOR RED FLAG. Not watching you move and really getting into the essence of your movement patterns is a major disservice to you as a patient, and doesn’t allow the PT to fully utilize their skills to work in your favor.
3. Consider a clinic with a wellness and/or performance component.
More and more PTs are getting into the wellness side of things. This means that when you work with this provider, they will take a more holistic approach and be able to focus on factors other than the injury you came in with such as mindset, injury prevention, and improving performance over a longer duration. This often means that insurance will offer limited coverage for these services, because our current health system does not value preventive care. Think of the amount of money you could save and injuries you could avoid over time if you focus on your health on a regular basis, not only as a reaction to an acute injury. I challenge you to look beyond insurance coverage. I would argue that finding a practitioner who understands you and your wellness goals, that you can check in with on a regular basis could be your secret weapon to long lasting health and wellbeing, and highly worth your while in the long run.
4. Choose a PT who listens to you.
This goes without saying, but make sure your PT lets you tell your story. A good PT will cater your treatment plan specifically to you, and check in with you each session to see if the plan is working or if changes need to be made. You shouldn’t have to repeat the same story over and over until they catch on. Good communication skills and cultivating a plan that changes with the changing needs of the patient are invaluable skills to look for in a PT.
5. Consider a place that won’t kick you out when you’re “better.”
Would your dentist kick you out after you had a root canal because that problem has “resolved?” What about your primary care physician after you’ve had some blood work done and things look good? Your therapist after your anxiety has calmed down? A resounding “NO” is the obvious answer. Why, then, are PTs any different? Wouldn’t it be great to have a provider who is an expert in functional anatomy AND a movement specialist that you have a consistent and long term relationship with? Doesn’t it make a lot of sense to check in with a PT on a semi-regular basis (maybe monthly or quarterly) to make sure you are on track with your stretching, working on areas of imbalance, and addressing any pain points that come up vs. waiting until the pain is so bad that it requires surgery? Just some food for thought.
6. Look for a clinic with less than 5 locations.
In the PT world, there are typically two types of outpatient practices: the large franchise and the small, private practice. Having worked for two larger companies, I can honestly say that I would rarely choose to go there as a patient. These companies typically value quantity over quantity, and productivity is king. Sure, there are some awesome PTs within the system, but often they get caught up in the numbers game, and aren’t able to truly focus on quality patient care without feeling burned out. Smaller, stand alone clinics are typically more community oriented, have more experienced PTs and don’t have all the red tape (see: financial benchmarks) that large ones do. Plus, who doesn’t love supporting local businesses?
7. Choose somewhere you enjoy spending time (and is convenient!).
When you are rehabbing from an injury, you are often going to PT fairly often, typically on a weekly basis. You want to make sure you really click with your PT, and the clinic has a vibe that feels good for you. Maybe you like a place with fun music or weekly challenges with a community feel. Maybe you prefer a more calm, serene environment. Usually you’ll know on the first visit if the clinic is a good fit for you. ALSO, don’t make getting there a barrier. Typically, you should pick somewhere you shouldn’t have to drive more than 15 minutes for convenience sake.
8. Speaking of convenience, look for mobile and/or telehealth options.
These days, it’s good to have options. We don’t always have time to make it to the clinic. You could be a new mom with a baby at home, but want to safely get back into a fitness routine. Maybe you want to see how you can improve your desk setup since you are working from home and your back has been hurting. Maybe you just had surgery. Whatever the case may be, many PTs are opting in to offering mobile and telehealth services to make things easier for patients. This flexibility often helps with follow through and helps keep you on track. These innovative providers are at the forefront of our profession and worth taking a closer look.
9. Avoid clinics owned by a physician.
On the surface, I can see how this setup can look appealing. A one-stop-shop for surgery and PT, right?? What could be better? What you don’t realize is that often the physician has a financial relationship with the PT clinic, often in the physician’s favor. This is a big RED FLAG in the PT industry, and it should be for you too. What typically happens is the PTs typically follow protocols outlined by the surgeon, and that’s about it. It ends up being very cookie cutter with little room for creativity and autonomy by the PT. Many PTs in these situations end up more or less “going through the motions” and not using their problem solving skills.
10. Look for someone who knows when to refer you out.
Say you are in for your first appointment and nothing you or the PT does reproduces your symptoms. Or you’ve been seen for 12 visits and nothing has really changed. PTs are educated on differential diagnosis and screening for health red flags, which is part of our DPT education and key for self refer patients which are becoming more and more common. If something outside of our scope may be happening, we want you to get it checked out right away so you can either rule it out or get the treatment you need outside of the PT realm. Similarly, we don’t want you to keep coming back for more visits with little change. If the PT has tried everything in their toolkit and given the necessary time to see how this affects your symptoms, it’s probably time to see a specialist who can provide additional information such as imaging, nerve studies, or a pain specialist. A good PT will refer you to another practitioner they trust to get a better picture of what’s going on, and use a team approach to your care.
I’m happy to chat and answer any questions or comments you have about this post or any PT-related questions! Contact me at anna@upwardptseattle.com.