Are you Reactive or Proactive in your Health Care?
Reactive care can be defined as care or treatment that is provided after an adverse health event such as an injury or disease occurs. A simple example would be you are diagnosed with high blood pressure and then react by taking a drug to lower your blood pressure. Proactive care, on the other hand, is taking action before disease or an adverse health event occurs.
Shifting health care focus from being primarily reactive to more proactive has recently been a hot topic of discussion amongst health organizations, economists and politicians. It can be argued that proactive and preventative health care could not only be one of the most cost-effective ways to improve general health and wellness in our communities, but “indeed, preventing disease, rather than interventions that interrupt the progression of established disease, is more effective from the perspective of providing the greatest health benefits to the greatest number of people” (Waldman, 2019).
As stated in a Centers for Disease Control and Prevention (CDC) article, “The Power of Prevention”, more than 75% of our health care spending in the United States is on people with chronic conditions such as heart and lung disease, stroke, obesity, diabetes and cancer. What does the CDC propose as a solution to decrease incidence of chronic disease? Address four modifiable health risk behaviors including physical inactivity, poor nutrition, smoking and excessive alcohol intake. In fact, the WHO estimates that “if the major risk factors for chronic disease were eliminated, at least 80% of all heart disease, stroke, and type 2 diabetes would be prevented, and more than 40% of cancer cases would be prevented.”
As a physical therapist in a cash-based setting, I am uniquely, and conceivably better, positioned to address at least one of the four modifiable health risk behaviors, physical inactivity, than any other healthcare provider. Physical therapists are movement experts who know the anatomy and biomechanics of movement well. When physical barriers to activity occur whether that be injury, surgery or disease, it is our job to either rehabilitate the patient to their prior level of function pre-injury or pre-surgery, or keep them moving to the best of their ability throughout disease progression. But note, that rehab after injury and physical therapy after the onset of disease progression are both reactive healthcare approaches. These reactive approaches are also the only type of physical therapy care that your health insurance is likely to pay for. Health insurance companies will typically only pay for physical therapy services that they (as non-medical providers) deem “medically necessary”. As stated in a recent Freakonomics podcast How to Fix the Hot Mess of U.S. Healthcare “Incentives in our healthcare system encourage procedures more than prevention.” In this case, the incentive is payment in the form of reimbursement for services… but only those services that are reactive to an adverse medical event.
What your health insurance is NOT likely to pay for is proactive, preventative movement-based services that physical therapists are uniquely skilled at providing. It is unfortunately not well known that rehabilitation from injury and disease is just one aspect of a physical therapist’s scope of practice. But when you google “What is physical therapy?” definitions include “Physical therapy (PT) is care that aims to ease pain and help you function, move, and live better.”- WebMD. WebMD follows this definition with a laundry list of things besides rehabilitation that a physical therapist can help you with including preventing a sports injury, preventing disability or surgery and preventing a slip or fall. Yet, rarely any of these preventative services are covered by health insurance UNLESS a sports injury, a disability or a slip or fall has already occurred. The American Physical Therapy Association says, “Physical therapists are movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education.” Again, general exercise and wellness programs and health education classes are not covered by your health insurance. Therefore, they are not widely offered within many medical institutions that work directly with health insurance companies because those institutions won’t be reimbursed by health insurance companies for those preventative services.
At Home Team Physical Therapy, we feel fortunate that we are not only able to provide excellent rehabilitation services to those who have been injured, but we are also able to serve our community with proactive, preventative health services such as individualized skilled exercise programs, group education classes, and movement-based sports performance and injury prevention services. The way we are able to do this is by NOT accepting health insurance—- they won’t pay for those preventative physical therapy services anyways.
Instead, we offer competitive cash prices for hour long physical therapy appointments that are 1:1 with a doctor of physical therapy for the entirety of the session. Because we do not accept health insurance and are not incentivized by insurance reimbursement, we have the time freedom to be able to do that. Also, considering it is now the beginning of the New Year, many overall healthy people will not meet their high insurance deductibles for quite some time (if ever this year). Upfront payments for cash-based health services are likely to save them money and time and will be something for many to consider.
So as you make your New Year’s Resolutions and delve into your fitness and health related goals, I challenge you to also think about whether you are being reactive or proactive with your own healthcare. Are you participating in proactive health and wellness programs in your community? Attending health education classes when available? Do you have a health professional who is keeping you accountable toward your physical activity goals? Do you have a licensed provider available at all times to answer your movement and fitness-based questions and address your aches and pains as they arise, before they become a debilitating injury? If not, Home Team Physical Therapy would love to work with you this year, proactively. Call us for a free phone consultation to discuss your New Year’s activity-related goals and how we can help you stay on track to achieving them. Happy New Year!!!!
References
American Physical Therapy Association. “What Physical Therapists Do.” https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt
Bernstein, Susan. “What is Physical Therapy?” WebMD. July 31, 2021. https://www.webmd.com/pain-management/what-is-physical-therapy
ChoosePT. “Understanding Payment for Physical Therapy Services.” American Physical Therapy Association. 2021. https://www.choosept.com/health-tips/understanding-payment-physical-therapy-services
Dubner, Stephen J. How to Fix the Hot Mess of U.S. Healthcare. Freakonomics Radio. March 21, 2021. https://podcasts.apple.com/us/podcast/freakonomics-radio/id354668519?i=1000515271391.
“The Power of Prevention.” Centers for Disease Control and Prevention. 2009. https://www.cdc.gov/chronicdisease/pdf/2009-power-of-prevention.pdf
Waldman, Scott A, and Andre Terzic. “Health Care Evolves From Reactive to Proactive.” Clinical pharmacology and therapeutics vol. 105,1 (2019): 10-13. doi:10.1002/cpt.1295