Saving People Time AND Money

I talk a lot with friends and other healthcare colleagues about how unique my business model is among physical therapy practices. We discuss small nuances that make big difference in my clinical decision making and the relationship I have with my clients. The reality is, often I'm 'preaching to the choir.' The most meaningful differences are often common sense. Other clinics would have made similar changes years ago, but have been limited in their ability to be flexible. 

Selling PT to the average person is like trying to get my kids to watch 'Cosmos' with me. They are excited to watch some TV about space, but it'll take some time before they can fully appreciate the details. Describing my practice to prospective patients creates a similar challenge. They have some baseline sense of the value I provide, but if they haven't experienced PT at another clinic, the differences may be hard to imagine. 

In this post, I'm going to describe five unique ways Impetus is set up to benefit patients in terms of time and money. I've also provided a graphic to further illiterate some difference between my place an others. 

1. A strong(er) emphasis on patient independence 

I've worked and continue to work in several settings where patients have difficulty achieving independence. PT with these patients requires additional time and sweat, often where I am helping patients do simple stretching or strengthening that they are simply unable to do alone, due to some level of physical limitation. Many patients in the outpatient setting do not require this level of physical assistance, yet often are not expected to participate significantly in their own rehab outside of the clinic. 

At Impetus, I see a different kind of patient, one who values taking an active role in their own rehabilitation. Many of these patients are motivated and able to complete the majority of their therapy at home on their own schedule. My interventions focus on activities that can be done in their living room, not with expensive equipment at a gym. I spend most of my time educating them, and teaching them to perform their home programs with precision.

This allows patients the ability to make the same amount of progress with significantly fewer visits to PT than the typical 2-3 times/week at other clinics. Together, we often achieve in 5 visits what other clinics will achieve in 12, and because of this, patients almost always end up saving some cash. 

2. quicker access to healthcare 

The saddest challenge in PT is how to make up for lost time: those patients who really should have started PT months or years sooner. Research consistently points to the fact that the more delayed treatment becomes, the more time it requires to fix the problem. PTs have been able to see patients directly in NC for a number of years, but most insurance companies continue to require a referral from a physician before they are willing to pay for therapy. This means almost everyone has to go to their physician first (if they want insurance to cover their rehab.)

If you hurt your back tomorrow, how long would it take to see your primary care doctor? Would you simply wait a week to see if it resolved on its own? Maybe you decide the Urgent Care would be faster. Either way, it can take between 1-3 weeks to get your foot in the door, meanwhile, you may miss work or be in worse pain. 

I chose to leave this hurdle out. Even if patients don't know it yet, PT is typically the first place you want to go with the onset of a new musculoskeletal pain or dysfunction. PTs are now educated to receive patients directly, getting a higher level of education to more accurately screen for serious medical problems, and refer out when appropriate. I don't contract with insurance companies because I know that the sooner a patient can start PT, the sooner they'll be back to square one.   

3. trimming the fat for The Weekend warriors

As a runner, even before I went to PT school, I often encountered random bouts of injury. These were often familiar, and I knew that PT was where I needed to go for a solution. I dreaded the fact that I had to go to my physician first and even sometimes pay for medical imaging that I didn't want, simply to get a PT referral. Today I realize that most physicians also dread this requirement.

Chuck Forsbrey from Greensboro, NC enjoys covering some serious mileage during his solo trek across Eastern North Carolina.  

Chuck Forsbrey from Greensboro, NC enjoys covering some serious mileage during his solo trek across Eastern North Carolina.  

Today, I can identify several groups of friends who spend their weekends cycling 100 mile 'century rides,' running 12-hour relays in Summerfield, or competing in CrossFit events. Even the avid gym goer can identify the difference between a reason to go to the physician, the ER, and the PT. I've made access to PT services at Impetus easy, hoping to keep these weekend warriors on their feet. The problems are usually not too complex, and often a quick solution can be found. 

4. Extended hours

This one was a no-brainer when I imagined opening up shop years ago. Having to miss work to go to therapy adds insult to injury. Many insurances have increased patient copays in the last 2-3 years, some as high as $85 per visit. Having to miss work to take care of yourself simply isn't an option for most hard working folks. 

I maintain treatment hours on evenings and weekends for my patients. I don't charge extra like some other clinics do. Some of my first clients took advantage those evening appointments simply to wait until the kids were in bed. So, don't miss work, and don't bail on your family. There's time to get the help you need. 

5. Proficient treatment without imaging

The use of medical imaging has exploded in the last 10-15 years. The mere mentioning of low back pain often results in an MRI 'just to be safe.' Consistently, research continues to show what a waste in resources this is becoming. Attempts to cut back on the overuse of imaging in hospitals has resulted in the use of statistically validated and published criteria that help determine whether the use of imaging is warranted or excessive. 

There are dozens and dozens of cases that simply don't warrant the use of these expensive tools. PTs in the US can't order imaging, and therefore utilize a combination of thorough hands-on examination, detailed history taking, and special tests and measures to develop accurate diagnosis and treatment programs.

This approach works extremely well, and in many cases, I often am able to help resolve my patients' complaints before they even make it to that scheduled MRI. In this case alone, trying PT first before that MRI is done results in dollars saved in the thousands. Read more about this here

6. ok...number six is a freebie

I've already mentioned this, but rising costs in healthcare have resulted in rising copays for many. As a clinician in a typical PT setting, I often see patients leave therapy before goals are met simply because they can't afford $85 per visit. Even worse, some patients will decide to forego therapy all together. This is more frequently becoming the origin story of many who fall into the rabbit hole of healthcare with chronic pain. Read here for a more clear picture. 

As my clinic bills one flat hourly rate, I am able to provide services at competitive rate for everyone, regardless of coverage. This doesn't always create significant savings for individuals with lower copays, but it helps maintain access to healthcare when others have financial hurdles. It also allows fair rate services to those who may not have PT coverage related to their specific diagnosis (cancer, heart disease, preventative services) or for those who have exhausted all of their covered visits.  

What does the big picture look like?

If you don't work in health care or have never been through PT, some of this may seem confusing, or perhaps not make much sense. I created a comparative timeline to help show an example of two potential paths: the typical PT path, and the alternative that my patients get to take advantage of. As you take a look at it, ask yourself: which of these makes the most sense to me? I'm in this to save my patients time and money; to get them back on their feet as soon as possible. 

I hope you found this post helpful. I continue to try to find ways to make access to good care simpler and more enjoyable. I'm finding that my patients tend to take more ownership of the rehab progress and their outcomes. At Impetus, I definitely function in this setting more as a guide and educator, which I find helps patient save some money and recovery quickly! 

For more information, visit or on Facebook at Feel free to contact us today via phone or set up your own appointment at our website. Thanks for reading and until next time, don't stop moving!