Improving Access to Musculoskeletal Physical Therapist Care

Only 24% to 50% of referred patients access physical therapist care for musculoskeletal conditions. Below are published papers describing my work to address access problems.

  • I am focused on users, which my work indicates, are one of the biggest drivers of care access

  • I use both qualitative and quantitative methods to fully understand how users interact with systems

  • At the core of developing products to increase user access is a cycle of collaborator and patient engagement with recurring data analysis, followed by modifications to the product.

    My work indicates that to increase care access we need to provide more information about physical therapy, including the possible benefits of treatment in both written and video mediums, a clear choice between a face-to-face or a telehealth appointment, and assistance with the scheduling process. Also, wait times should be reduced through same-day appointments and more convenient locations.

  • Linked here is a podcast where I describe my work. Check it out!

Identifying Patients Who Access Musculoskeletal Physical Therapy: A Retrospective Cohort Analysis

  • Patients are rarely referred (18%) and infrequently use physical therapy after referral (24%), Patient and system level factors influence patients use of physical therapy

  • The factors associated with increased physical therapy use are a referral from orthopaedics, using private insurance, white race, back pain diagnoses, non-obese diagnoses and living closer to a clinic

Effect of Patient Use of Physical Therapy After Referral for Musculoskeletal Conditions on Future Medical Utilization: A Retrospective Cohort Analysis

  • Physical therapy was associated with increased medical use

  • Back pain is associated with reduced use

  • Using physical therapy did not influence medical use outcomes when examined by diagnosis

Patients’ Use of Physical Therapy for Lower Back Pain: A Qualitative Study

  • Patients are seeking the best care they can receive from “highest qualified” providers while also considering a health system’s reputation

  • There is a disconnect between patients’ ideas about diagnosis and their belief about what treatment is the best for their back pain

  • Patient choices develop over time and are influenced by a variety of factors.

  • Addressing patient perceptions and knowledge about physical therapy will likely help address these barriers and increase access to physical therapy.

Patient Choice After Referral to Physical Therapy for Lower Back Pain and Knee Osteoarthritis

  • Access is challenging, even in a system with minimal out-of-pocket costs for most patients (Veterans Health Affairs)

  • The patient-level recommendations for improvements included: providing information about physical therapy, including the possible benefits of treatment, a clear choice between a face-to-face or a telehealth appointment, and assistance with the scheduling process.

  • System-level recommendations for improvements included: reducing wait times through same-day appointments, transportation support, and more convenient locations.

How is access improved?

My work indicates that to increase care access; we need to provide more information about physical therapy, including the possible benefits of treatment in both written and video mediums, a clear choice between a face-to-face or a telehealth appointment, and assistance with the scheduling process. Also, wait times should be reduced through same-day appointments and more convenient treatment options.