Slowly across the country a new idea is spreading. As we have evolved in our ideas of Healthcare and what is appropriate, there has been a push for years now of preventative medicine. Gradually as the prevention idea of medicine has started working it’s way through the Physician boards and advocates, insurance companies have began to cover prevention of disease rather than just treatment of disease.
As more and more prevention concepts and programs have been developed, more and more research and data shows the cost savings of either full prevention or early intervention when looking at chronic disease.
“An ounce of prevention…..”
There are definitely significant cost benefits, as well as health benefits to prevention of chronic diseases like diabetes, heart disease, and cancer. Through education programs and monitoring of risk factors, these chronic diseases can be minimized or even be completely prevented.
Physical Therapy as prevention?
There has been a continued push across the country to emphasize the benefits of Physical Therapy to prevent injuries and chronic illness. Some easy examples are fall prevention and pain intervention to prevent chronic pain and/or opioid use.
Through a thourough evaluation in Physical Therapy, subtle issues that can be seen in muscle weaknesses, postural issues, balance issues, and muscle imbalances, can be addressed. These early interventions can prevent future issues like a fall or injury.
These early interventions can save significant money as compared to the cost of surgery and rehab from a fall and broken hip.
Is this only true for outpatient?
Unfortunately the concept of preventative medicine by Physical Therapy has not fully entered other settings. When looking at skilled nursing facilities, most focus is on fixing a problem. This problem could have been a fall or a decline in ability to function with caregivers.
For decades therapists in skilled nursing have been pushed into being the “fixers”. It is apparent in how our documentation is developed, our referrals from nursing are worded, and our mindset from being so focused on short term rehabilitation.
We have been unable to fully evolve and establish preventative programs and develop the documentation skills to establish the medical necessity of our services when looking at prevention. Many therapists forget that maintaining function is a covered and medically necessary service covered by Medicare.
Not just Physical Therapy
This phenomenon is not only true for Physical Therapy. This is also a valid point for both Occupational Therapy as well as Speech Therapy. Prevention and maintaining function not only preserves a level of function but also preserves a more positive mental level by encouraging and maintaining quality of life and independence.
Just a change in thinking
All it takes is a change in thinking for the therapists that are working with long term residents of a skilled nursing facility. They need to overcome the fallacy of the need to have improvement to continue care instead of the establishment of maintaining and habit forming. Often it is hard to be able to shift gears in the same day between short term rehabilitation thinking and long term rehabilitation thinking. Unfortunately as similar as it is, there is a different thought processing in establishing goals and documentation of the need for our continued intervention and justification of continuous care.
Hopefully with the continual change in other settings, more and more school programs will help with teaching these skills more before graduation into the real world of rehab. We need to take full advantage of the skills and knowledge we possess to help our residents live the best life possible with what they have left. We owe it to them.
