I’ve never been a big fan of medical dramas—even television blood makes me feel ill—but there was something particularly interesting about the show Private Practice, which ran from the late 2000s to the early 2010s. And it wasn’t the characters—or the plot (it was a Grey’s Anatomy spin-off, after all). Rather, it was the practice itself. Located in Los Angeles, the show’s co-op private practice was home to an OB/GYN; a fertility specialist and endocrinologist; an internist and cardiothoracic surgeon; a psychiatrist; an alternative medicine and infectious disease specialist; and a midwife trainee. And the the providers worked together to treat their patients. This benefited their practice—more money stayed within their walls—and their patients, who received the unique perspectives of not one specialist, but several. While the concept of such a holistic medical practice seemed novel ten years ago, it’s certainly becoming more common now—especially as healthcare reform continues to favor collaborative, patient-centric models of care.
We’ve written a lot about how physical therapists can—and should—incorporate wellness services in their physical therapy practices (for their patients’ sake as well as their bottom lines). But, we haven’t spent a whole lot of time discussing the possibility of bringing on other specialists to provide care that complements your own—à la Private Practice. (Although WebPT President Heidi Jannenga did mention it in this Founder Letter.) Given how well physical therapy plays with other specialties, this could be a very successful endeavor that not only improves your patients’ outcomes and satisfaction levels, but also sets your practice apart from the rest. So, which specialities would be good to consider? Here are just a few of the options available to you, partially adapted from this resource (and in no particular order):
Teachers and Trainers
According to this article, Pilates “is one of the fastest growing exercises in the world.” In fact, people rave about the benefits of a regular Pilates practice—benefits such as “added strength, length, and agility.” It can also assist patients with their recovery from injury caused by muscular imbalances. Pilates can be done on mats or using a special piece of equipment known as an apparatus.
As the author of this article points out, yoga has become “especially popular for musculoskeletal issues like lower and upper back pain, sciatica, and shoulder, neck, and hip pain.” According to Janice Gates—author and president of the International Association of Yoga Therapists—“Yoga therapy is very much about the whole person. It is complementary to physical therapy, but we take into account that back pain may be related to an emotional element, or it may be from lifestyle, some pattern that is not serving them, physical movement patterns or other patterns.”
A personal or athletic trainer can be a wonderful addition to a physical therapy practice, as many post-rehabilitation patients can benefit from a supervised exercise program before either transitioning back to their previous exercise regimen or starting a new one. As Ann Wendel writes in this post, offering “wellness services as a continuation of care for patients whom you’ve discharged from formal physical therapy…is a nice way to transition your existing patients who want to continue to develop strength and endurance but who don’t feel comfortable attending a commercial gym.”
Therapists and Counselors
According to this article, massage “has been growing at a double digit pace for most of this decade,” making bringing on a massage therapist a particularly appealing prospect. Plus, “patients love massage and it’s easy to refer patients to a therapist.” While that article talks about the cross-referral potential for a chiropractic/massage partnership, the same holds true for a physical therapist/massage therapist duo. There are plenty of opportunities for collaboration.
Developed by John E. Upledger—osteopathic physician and professor of biomechanics at Michigan State University—CranioSacral Therapy (CST) “is a gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance.” According to this provider, though, “well-trained CSTs are…challenging to find as opposed to a massage therapist who simply took a course on CST and now calls [him/herself] a practitioner.”
More and more research is connecting quality nutrition with overall health and wellbeing. As such, it may make sense to partner with a nutritional counselor who can offer complementary advice—in terms of diet and supplements—to patients who are recovering from an injury or wanting to make a positive lifestyle change.
According to this resource, Reiki is a “subtle and effective form of energy work using spiritually guided life force energy.” While some providers use hands-on touch, others hold their hands slightly above the client’s body while performing standard Reiki hand positions. Reiki sessions have been known to “help ease tension and stress and can help support the body to facilitate an environment for healing on all levels—physical, mental, and emotional.”
According to this physical therapy clinic that also offers Ayurvedic consultations, “Ayurveda is a natural system of medicine that originated in India and evolved there for more than 3,000 years. The prescription provided by these ancient doctors was simple: Make choices that support your individual balance and wellbeing.” Today, Ayurvedic practitioners use this ancient philosophy to identify and treat mind-body imbalances in order to “create optimal health and fulfillment.”
Traditional Chinese Medicine / Acupuncturist
Dating back to 2000 BC—and based in part “on the Daoist belief that we live in a universe in which everything is interconnected”—traditional Chinese medicine (TCM) is one of the “oldest continuous systems of medicine in history.” TCM incorporates many different modalities, including acupuncture, acupressure, moxibustion, massage, herbal remedies, diet and lifestyle alterations, meditation, and exercise (e.g., qigong or tai chi). Acupuncture is becoming quite popular—with Americans attending “12 million visits per year” and spending “upwards of half a billion dollars on acupuncture treatments.”
Other Medical Professionals
According to this resource, a “patient’s overall mental well-being plays a vital role in injury recovery, but is often ignored or overlooked.” That’s why “it is important to identify the psychological effects of injury to ensure that the patient receives the most comprehensive care.” With that in mind, it may make sense to partner with a psychologist who specializes in an area relevant to your patient population—for example, if you treat a lot of athletes, then bringing on a sports psychologist may make sense. If you treat many children or elderly patients, then you may want to consider teaming up with a child or geriatric psychologist, respectively.
According to the chiropractor who wrote this article, partnering with an MD “can vastly increase the scope of services rendered in your practice and, in turn, create a boost in billing as well.” However, providers must be very careful about structuring this type of a practice in a way that ensures compliance with the Stark Law and other regulations. It’s also worth noting that physician-owned physical therapy services (POPTS) aren’t well-liked in the industry.
While many PTs and chiropractors don’t see eye to eye, those who do may benefit from teaming up to offer a combination of services to their patients. After all, PTs and chiropractors often share a holistic approach to patient care.
According to this resource, “naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process.” If this healing modality resonates with you, then bringing in a naturopath could enable you to expand your service offerings and better care for your patients.
Before you jump into a new partnership with both feet, though, there are a few things to consider. For one, Wendel suggests making “sure you choose someone with the appropriate certifications and experience” to work with your clients. “You should feel confident that your clients are receiving the best possible instruction so they’re safely progressing toward their…goals,” she said. Second, you should “contact your state board and review your professional liability insurance (PLI) policy—perhaps with an attorney—before introducing a new wellness program.” And finally—as the author of this article emphasizes repeatedly—regardless of which non-therapy provider you decide to partner with, make sure that you have similar practice philosophies. It’s incredibly important—to your business, your staff, and your patients—that you bring in someone who shares your perspective on everything from patient care to billing. As Jannenga says in this Founder Letter, when hiring someone new, “culture comes first.” For more great strategies on bringing on the right person, check out her full post on hiring strategy here.