For me, a yoga mat and foam roller count as professional tools. They also represent my personal commitment to patient engagement. I’ve worked as a writer and editor for a long time and, most days, spend hours sitting at the computer. That and other things I sometimes overdo—gardening, dancing, life in general—lead to aches and pains, which I’ve been able to control with the help of a good physical therapist who includes me fully in the therapy process. The mat and roller are part of my active patient engagement, physical therapy routine.
My schedule and office space (in my home) usually make it easy for me to take breaks to lie atop the foam roller or on the mat, doing neck and shoulder exercises. My mission is to cause myself pain in a controlled way designed to eventually lessen pain, restore my range of motion, build strength, and prevent injury.
Mary Duffy Zupkus, principle of Physical Therapist Associates of Concord (Massachusetts), designs my treatment plans. We have worked together over the years to address my chronically creaky neck and a notable bout of shoulder pain. I also worked with Mary on a task force she chaired for the Massachusetts chapter of the American Physical Therapy Association. Mary is a past president of APTAMA, an accomplished health policy wonk (MPA, Kennedy School of Government, Harvard University), and tech-savvy innovator.
Mary is passionate about the role physical therapists can and should play in moving our health system toward care that is consumer-centric, coordinated, efficient, and effective. As a patient, I know she depends on me for honest, accurate descriptions of my symptoms in order to diagnose and treat my problems. I see her more often than I see my primary care physician. Through my appointments with Mary, I’ve learned a lot about my functional health and how important it is to my overall well-being. I’ve also developed a sense of responsibility for the work I do between our visits. If I don’t do my job, her work is less effective, which would not be good for either of us. At its best, physical therapy is an exemplar of participatory medicine, where the patient-provider relationship is grounded in honest communication and shared work.
Care Coordination Across the Continuum
PT also provides an example of the importance of consistent care across the continuum. Mary’s vision for coordinated care is characteristically ambitious. Speaking in May 2015 to the graduating class of Massachusetts General Hospital’s Institute of Health Professions, she used knee replacement surgery to illustrate an opportunity for PT leadership in our evolving healthcare system. In a bit of role reversal (as an engaged patient), Mary weighed options for her own knee surgery and stayed focused on her goal: improved function. Mary is a fan of innovation, and innovative implants were and option she considered, but she also knew that physical therapy provided pre- and post-operatively would be key to achieving her goal. Some of the high-tech options she considered skimped on the role of physical therapy. In her address, Mary called on the graduates and all physical therapists to take the lead in innovation, work with other healthcare professionals, and assure that treatment plans work for all patients across the continuum:
Cost-effective, patient-centric solutions…can only be achieved when unconventional teams of developers, engineers, surgeons and physical therapists share, learn, and work collaboratively to create better implants, improve surgical techniques, optimize pain management, and standardize the rehab process based on physical therapists’ best practice. Only then will we have produced a seamless solution that meets the expectations of the consumer and the value that the healthcare market demands. You can be agents of this change.
Given what I know about physical therapy, it didn’t surprise me to learn that e-Patient Dave deBronkart (author of a recent post for Engaging Patients) is a fan of PT. Reporting on his wife, Ginny’s, successful bilateral knee surgery in 2015, Dave emphasized the importance of physical therapy throughout her treatment, including pre-operative preparation. As we call for accelerating the advancement of patient engagement, we should make sure to include physical therapists as natural partners.