What is Evidenced-Based Medicine and What Does it Mean to Me?

Evidenced-Based Medicine

Evidenced Based Practice has different meanings for medical clinicians vs for patients, that is probably beyond the scope of this blog post.   Regarding quality of healthcare, patients should be asking themselves "Am I receiving the best care, that is supported by evidence, that correctly diagnosed my symptoms and pain, that will lead me to the best outcome?"  For example, the treatment for low back pain (LBP) isn’t as easy as just being diagnosed as “low back pain”  Acute LBP has been shown to spontaneously resolve in 4-6 weeks, so if your treatment takes 4 weeks to get better, did the treatment really do anything?  So you can be treated with the standard care for your LBP with the normal 3x a week for 4 weeks with a (for example) $20 co-pay each visit, (and you may even better pay for the whole treatment if your insurance deductible is not met), receive exercise intervention only, slap on some E-stim that makes you feel good but does nothing to solve the problem, and at the end the treatment you received may not have even done anything. 

This is when evidence based practice comes in and can lead to a more accurate diagnosis, show better outcomes quicker, with less visits, and overall cost less money, getting you better in 4-6 visits instead of the standard 12.  Pursuit Physical Therapy offers one on one care, using evidenced based interventions, showing better outcomes than the standard.   Also Pursuit Physical Therapy is incentive based so if you only need a 30 minute treatment, that is what you get.  30-60 minute treatments for 4 visits and you are done.  The standard is insurance based and the longer you stay and the more times you are seen, the more productive they are.  The standard is usually 3 x a week for 4 weeks.   If a clinician has an intervention that can get you better quicker with better outcomes, don’t they owe it to you to provide this treatment? YES!   If you have pain that is stopping you from doing something you love to do, don’t wait for the pain to go away.  Call Pursuit Physical Therapy to see if physical therapy is appropriate for you, can get pain free sooner!

What is Wrong with Healthcare?

We could go on for hours about this, but recently TIME published two articles: High Cost of Healthcare and  Why Medical Bills are Killing Us that are great reads that show some of the problems with healthcare.  All of health care is going to be challenged to do things better by managing expenditures, maximizing cost effectiveness, improving access, decreasing practice variation, and ensuring that the care provided is implemented with the best interventions supported by evidence.  So how are private practices and small healthcare businesses going to stay in business in the future?  A Cash-based service.  Healthcare has been forced to the level of mediocrity due to the increased need in healthcare services, decreased reimbursement, and restricted insurance company guidelines.  Currently, working in the standard insurance-based PT clinic, I find myself not having enough time with each patient, double-booking patients who need one-on-one care, placing patients with assistants, and results are delayed and decreased due to the current system.  A cash-based service would allow one-on-one patient care for one hour, providing great outcomes, allowing patient needs to dictate treatment not insurance company guidelines, no grouping multiple patients together, not worrying about what services get reimbursed, and still being able to generate revenue for a business to be profitable.  Pursuit Physical Therapy will be a new brand of outpatient physical therapy that is cash-based, providing one-on-one patient care, by doctors of physical therapy, by board certified specialists, using evidence-based practice, thus showing better outcomes in a shorter number of visits.  Pursuit Physical Therapy care is based on treatment outcomes and what is best for the patient, and not guided by insurance companies or strict guidelines.  We will offer a high quality of healthcare that people need, showing better outcomes than the other standard area physical therapy clinic and will see valuable enough to pay cash for our services. 

Why is Pursuit Physical Therapy Cash Based?

There is no doubt that reimbursement for medical services regardless of whether the patient is insured by Medicare or other insurance companies will continue to decrease.  The needs for healthcare services will continue to increase, especially with the baby boomers coming through, but reimbursement will continue to decrease.  This presents a major problem that is quickly becoming reality for many private practices.  Healthcare providers will be forced to see more patients a day, double and triple booking patients, placing patients with assistants that are less qualified, having decreased one-on-one patient care, that all lead to poor outcomes and a decreased quality of care.  Many clinicians already find it difficult to provide the desired quality of care when treating multiple patients at once, and it is even harder with the constraints and guidelines placed on by insurance companies.  

The reason Pursuit Physical Therapy is a cash-based service is because there is no way to treat patients the way that we feel is most effective and accept insurance, without going bankrupt.  Insurance companies only reimburse about half what is billed.  In order to make a profit, clinics that handle insurance have their patients be seen by assistants and less qualified clinicians.  They are also forced to see multiple patients at the same time, so if you would go to an insurance based clinic, you will be double or triple booked with another patient.  We spend 30 or 60 minutes of one-on-one time with each one of my patients, primarily using manual therapy that has been shown to show superior outcomes and better results than standard care. No physician script is required so we can treat you now, and you do not have to wait weeks to be seen or treated.  While you are being treated here, you will not be charged for exercises that you can easily do at home on your own.  With this approach, we feel confident that we can get you better in less than half of the number of visits they would need at an insurance based clinic.  With the time savings of fewer clinic visits, and the value of feeling better sooner, most patients feel the out-of-pocket expense is more than worth it. We can also provide receipts with codes needed to send self claims to your insurance company.  Depending on your insurance plan, many of my patients receive some level of reimbursement or have the cost of their treatment applied to their deductible.