Nestled in an unassuming business park in Goodyear, Arizona, this Empower Physical Therapy clinic location is quieter than you might expect—but it feels welcoming. One of the front desk workers waves hello, her smiling eyes crinkling each time someone walks through the tall glass entry doors. A subdued hum of conversation floats through the front room as therapists work with their patients. Warm, bright sunlight shines through the expansive windows lining one wall of the clinic, illuminating a gym space that’s packed with blue, beige, black, and copper-colored treatment tables of all heights and sizes; pristine arm bikes, elliptical machines, and inversion tables; and a set of metal parallel bars that are still shiny from a recent bout of cleaning.
Goniometers, resistance bands, and ankle weights hang from shelves and pegboards mounted next to clocks and framed photos of famous athletes. Everything seems to be in place, just as it should be—but there’s no hiding from what’s happening outside, and proof of the pandemic has silently eked into this clean, inviting space.
Only a small number of masked patients pad across the carpeted floors. Masked therapists allow their colleagues and all other patients a wide, six-foot berth as they navigate around the treatment area. Bottles of hand sanitizer polka-dot the tables and shelves found throughout the building, and—if you were to pull down your own mask—you’d detect the faint-but-familiar scent of the cleaning products that are pulled out, like clockwork, to sanitize equipment between uses.
But, even though it’s quiet, the mood is not tense. The front desk attendants are friendly and kind, and ever-patient PTs gently offer encouragement to patients as they labor through their exercises. There’s a sense of unity and camaraderie—even positivity—as everyone inside this Empower PT clinic learns to interact with a new and unfamiliar world.
The History of Empower Physical Therapy
The camaraderie that comes from a shared experience is strong, and it can create a near-unbreakable foundation for collaboration and teamwork. That’s the foundation that five enterprising private practice owners stood on when they created Empower Physical Therapy nearly two years ago.
When you work in rehabilitative therapy, it’s easy to meet other folks in the industry—if you’re open to it, of course, explains Mathew Figueroa, PT, DPT, Empower PT’s Chief Clinical Officer. Friendly communication and networking can open the door to some amazing opportunities—which is exactly what happened when a group of competing clinic owners realized that they upheld similar values in their individual clinics.
Their shared experience helped them relate to one another, and it wasn’t long before they started communicating frequently and openly. “We started treating ourselves as allies rather than competitors,” says Figueroa, explaining that it was nice to have allies who were experiencing similar challenges and obstacles. “We weren’t afraid to learn from one another,” he adds.
Eventually, the group decided to take that collaborative spirit one step further, and—on August 24, 2018—they officially merged their practices into one large organization: Empower. “We thought, ‘Let’s dream big, but, you know, let’s start small and see where we go with it,’” says Figeruoa. The goal? To grow an organization big enough to compete with PT giants—without losing the feeling and workflow of a small, private practice.
Figueroa believes it’s important to provide patients with attentive, individualized care. And the team at Empower PT has delivered exactly that: “The patients feel like they have somebody to listen to them—whether it’s their pain complaints, or their desires for the future, what they want to accomplish—somebody is listening to them,” Figueroa says.
The Impact of COVID-19
By the beginning of 2020, Empower PT’s future was looking bright. Its leaders were collaborating well, learning from each other, and growing their new organization—and the practice had a strong, defined culture and vision for the future.
Then COVID-19 turned the world upside down.
The novel coronavirus hit Empower PT hard, fast, and indiscriminately—the same way it hit the rest of the PT industry. Referrals plummeted, and elective surgeries came to a screeching halt. As Giovanni Leone, PTA, Empower PT’s Director of Clinical Quality and Compliance Officer, explains, fewer people were going to the doctor about their aches and pains, which meant fewer patients were finding their way to physical therapy. This resulted in reduced patient volume (and therefore, hours)—which ultimately led to a reduction in staffing.
But Empower PT wanted to continue serving the community, so the executive team got together to strategize. “We just kind of looked at—what were some other means of [providing] the kind of care that we wanted to still be able to provide our patients?” says Leone. One of their first considerations was telehealth.
Leone says the executive team started looking at platforms, payers, and state board rules, trying to parse out the logistics of providing telehealth. And while it was tough to keep up with the tidal wave of rapidly changing telehealth regulations, implementing the platform itself was surprisingly easy—thanks in part to the ample training employees received. “When we determined what platform we were going to use for telehealth, within a few days we had an entire write-up,” Leone says.
The Learning Process
As with anything new, telehealth has presented a bit of a learning curve for the team at Empower PT. Leone says he was constantly (and occasionally still is!) seeking out up-to-date information on telehealth regulations and payer coverage—by watching webinars, reading articles, and chatting with experts outside of the clinic.
“You really have to make sure that you’re reaching out to these payers and finding out what’s going on,” Leone says. “We’ve put a process in place with our verifications team to actually call those payers based on who’s going to telehealth and individually verify what they’ll cover—what kind of codes, things like that.” It’s a little time-intensive, yes, but Leone knows it’s critical to the financial viability of the program. “You really need to put in the work…behind the scenes,” he says. “Otherwise, you really don’t know what you’re getting into from a reimbursement standpoint.”
But learning the telehealth billing and compliance ropes was only half the battle. The leadership at Empower PT also had to foster buy-in from therapists and patients alike. “I think it’s been a little bit of a learning curve for some therapists,” says Figueroa. “Some therapists have been like ‘Yes! Let’s do it!’ and they just jump right in and go for it…And others have been like ‘Well, how do you do this? How do you deliver a physical therapy visit over an electronic medium like that?’”
But the therapists who’ve seen the most success with telehealth are the ones who’ve embraced it with open arms—like Kylie Collins PT, DPT. “I wanted to provide the best quality care that I can to my patients,” says Collins. “And a lot of the population that I see fall into that high-risk category. And, you know, they were doing so well; I don’t want them to not have care. So, I was like, ‘Okay. This is my new normal. Let’s do it; let’s figure it out together.’”
Collins knew she would also have to earn patient buy-in—and she found that the best solution (and the key to telehealth in general) was open, honest communication. When patients seem reluctant to try telehealth, she acknowledges their concerns and asks them to give it a shot—just once. She tells them,“Let’s just try it. If you don’t like it, you don’t have to do it.”
And usually, Collins says, once patients try telehealth, they love the experience and respond really well. After all, a telehealth visit isn’t all that different from a regular in-clinic visit. “During the appointment, I’ll treat it just like I would a normal session—as if the patient was in front of me. [I’ll] ask…how they’re doing, if they have any questions,” she says. “And then…I’ll modify my daily treatment based on that.”
So far, Empower PT’s foray into the world of telehealth has yielded encouraging results. The first week the organization offered telehealth, the team scheduled a mere 13 remote visits. Two and a half weeks later, they had collectively scheduled more than 200 telehealth visits for the week—and that number is still climbing. “There was a little bit of hesitancy, I think, at first—but so far, as I’ve talked to therapists about it, patients are loving it,” says Leone. “They’re seeing that the quality of care can still be the exact same thing that they were getting when they were coming in-clinic.”
The team has also been fairly successful with marketing these new services. According to Leone, it was just a matter of getting the word out. The team had to get intentional and carve out time to call and email physician offices and patients—in addition to updating the clinic’s website and social media profiles.
“Telehealth is a great option to make people feel safe, to be able to keep the doors open and continue to provide care for these people,” says Sean Miller, PT, Empower PT’s Chief Operating Officer. It has also helped the organization remain financially viable. “Our facilities that are championing telehealth—them doing 15–20% more of their volume through telehealth is helping us keep that facility open,” he says.
As for the future, the leadership team at Empower PT believes telehealth is poised to shake up the industry in a big—and permanent—way. Miller says, “I think this is actually a tipping point for telehealth within the physical therapy profession—meaning that it’s not something that’s going to go away.”
And he may be right—telehealth may just stick around for the long haul. Although many of the latest telehealth regulations are time-gated to the COVID-19 pandemic, therapists and patients are finding real success with this type of service delivery. And those results could be the push that payers and state governments need to improve access to remote care—even beyond the crisis.
In the meantime, the Empower team encourages hesitant clinics to, at the very least, give telehealth a try. “Don’t wait on it! You kind of have to jump into the fire,” says Leone. “It’s kind of a trial and error process when you first go about it, but there’s a lot of people doing it now. There’s a lot of resources out there. So, there’s people who can help.”
On the clinical side, Collins says the easiest way to get into the swing of telehealth is to act like you’re providing a normal daily visit: prepare beforehand, get an idea of what you want to accomplish, and give patients as much communication as they need. “Communication,” she says with a smile, “and lots of hand-holding.”
The Empower Physical Therapy clinic that stands on the western side of the Valley of the Sun is quiet—but it’s a quiet that’s laden with mutual understanding and a hope that life will get back to normal, eventually. “The atmosphere in the clinics is one of positivity…Most people understand that we’re sort of all in this together,” Figueroa says. Times are tough, but he sees this bad hand as an opportunity: “I think as we come out of this, hopefully we all are a little bit more resilient and a little bit more creative. And that’s what I’m counting on for Empower—that we grow through this.”
Interested in giving telehealth a try in your clinic? Getting started is easy, and WebPT can help. Check out this page to learn more about WebPT’s telehealth offerings.