Finding a Physiotherapist for ME!

[lehughes]

I'm posting this for a member:

Hi Laurie,
I'm not sure if this is the best way to write you or if I should go through the website somehow. I just read today's post and my question is, HOW does one find a PT (for oneself) that, as you recommend, has a lot of manual therapy experience? I"ve been sent to PT many times over the years, for bad back,for post op knee surgeries, and they never do much (or any) manual -- a little ultrasound, and little heat/cold, a little TENS, but mostly they are just into me doing exercises. Also, for those of us participating in the wonderful US "managed care"health care system who are constrained to one physical therapy company-- is this even possible,finding someone to do manual work? I have a back problem again -- just went through a week of being unable to walk due to extreme pain, my doctor diagnosed SI luxation but I am pretty sure she is wrong since the pain is mostly cranial thigh which to me means femoral N means L2-4 disc.Chiropractor agrees with me. But I'd love a PT who can do for me what yours did for you
Pam Mueller

[lehughes]

Hi Pam,

You know I get this question a lot!! Especially from American's. I could tell you exactly what I'd I'd look for up here... but let me take a stab at this. And I AM going to post this onto the forum - so hopefully we can get more ideas / answer!

I'm afraid that 'crappy care' is pervasive across all healthcare sectors, and it's hard to navigate the different systems. I feel sorry for people with zero medical background!

So, some key things to look for (not a guarantee, but a somewhere to start):

• Letters behind their name... if there's more than just their PT degree, you at least know that they are an education junkie. In the US, you might look for OCS (Orthopaedic Clinical Specialist), or SCS (Sports Clinical Therapist). Other manual therapy certifications include FAAOMPT MTC, COMT
  Ask about their years of experience. If you know your issue to be complicated (i.e. perhaps involving spinal joints or radiating pain), then choose someone that has been out of school for 5 years or longer. Chances are that those therapists have consumed more continuing education courses than others.
  Ask if any of the therapists have a special interest in or special training in your type of issue. (If you're told 'all of our therapists are equal', then you may need to look elsewhere. Yes, many receptionists may do this, but a great clinic receptionist will ask questions about what's going on and tell you if there is one or two therapists in a clinic who really 'enjoy' treating a particular condition. Unfortunately, you may need to grill the receptionist to get this info.)
  Go online and read the therapists' bios. Read about their special interests (look for ones that say they have additional training in an area, or a special interest in an area.) As well, see what their hobbies are, are they a runner, a coach, a yogi, etc? Do they themselves have a healthy lifestyle? Do they enjoy the sport / past-times that you enjoy? (Even being able to make a connection can lead to better care... crazy at it sounds, if they understand what your pain is taking you away from they might have more ideas for solutions to your particular problems.)
  Look for key words in the bios, or ask the receptionist about 'Manual Therapy'. This is the physio & PT-code for the hands-on care that may encompass mobilization, manipulation, myofascial release, etc. Also 'dry needling' could be something to look for (depending on whether PTs are allowed to use it in your state).

Now, the other component that gives you 'secret clues' into the attention you will receive from your therapist would be:

• How many patients does the therapist see at one time (or within an hour)? (one on one care is ideal... but likely more costly. Some therapists will see 2 an hour. 3 or more patients an hours means that you will only get 15 - 20 minutes of one-on-one time. You do the math!)
  Will I see the same therapist every time? The best answer is "yes" or "you will see 'Jane' for your assessment, but if she feels it's necessary, she may get one of the other therapists to consult on your case or transfer you to one of the other therapists." You want to be able to develop a rapport with your therapist, and I know when I see patients, I establish a timeline of ideas for what to do, or differential diagnoses if need be.
  Will my care be provided by a physical therapy assistant or aide? In big clinics, having plenty of assistants (and aides) mean more patients can be seen. (An 'Assistant' is a licensed professional that assists the physical therapist, an Aide is more of a clinic helper and should not be doing any direct patient care.) If you are looking for a manual therapist, they may have an assistant that helps lead you in exercise, or deliver the modalities, but the manual therapy needs to be done by the physical therapist.
  And because you're American, you likely need to ask upfront about whether or not that particular clinic accepts your type of insurance. To be honest, I don't know how you get around that one! You may need to shop the clinics that do accept your insurance and then ask the questions above.

And lastly, ASK AROUND! Ask your friends, ask your clients, ask you co-workers for a good recommendation. People that are happy and enthusiastic about the professional they see or have seen will be delighted to tell you the name of the person they see. For example, I have an AMAZING massage therapist that I go to as well! If anyone asks me, I gush about how she is 'hands down' the best massage therapist I have EVER been to. Great practitioners tend to get glowing reviews.

Okay... so that's my 2 cents! Good luck to you!
(And my SIJ refers to my anterior thigh as well... for what that's worth!)

Cheers,

Laurie

[Stella]

I could never imagine treating a client without doing any manual therapy. Almost all my clients get manual therapy However, I hear all the time of PT clinics that won't do manual therapy on WSIB clients because WSIB 'doesn't pay enough'. Makes me so angry, its not the clients fault they got injured at work! They deserve the same treatment as any of your other clients!