The throbbing ache in my pectoral muscle felt as if someone had mercilessly pounded the tissue with a hammer. Thankfully, the doctor’s diagnosis proved to be a strain. No serious treatment needed.
“I’ll just need to prescribe some anti-inflammatory medication,” the physician said, after inspecting the site of the pain. “And you’ll need some physical therapy.”
Breathing a sigh of relief, I knew this would not only be a small price to pay for recovery, it was also very ironic. Being in the middle of working on an article about the popular retail-style model of physical therapy, the doctor’s orders couldn’t be timed any better. I would soon find myself having a hands-on experience in the communal environment of contemporary outpatient physical therapy.
The interior of the Atlanta Rehabilitation & Performance Center in Decatur looks more like a gym than a medical facility. Exercise equipment —think stationary bikes and weightlifting machines— share space with elastic exercise bands, pilates balls, foam rollers and other aids.
As I pull a set of rubbery bands in a rowing motion, I scan the rest of the room, watching the therapists and fellow patients at work. Some sprawl on examining tables and do leg exercises, while another patient takes a spin on the stationary cycle.
When I ask my therapist, Katie Moise, if this type of setting has more equipment than the standard hospital environment, she replies, “Definitely.”
“We are at an advantage having a lot of props,” Moise said. “In a hospital, therapy mostly consists of getting up out of a chair or walking down a hallway and maybe a few bedside exercises. But the props and equipment you have is much more limited. That’s what fun about working in outpatient. You have a bunch of stuff at your disposal to work with.”
As the times change, so does healthcare. New approaches such as outpatient physical therapy come into play. Being able to adapt to those changes, Moise says, remains important. As more and more patients become aware of this option, Moise says they’ll likely notice the immediate benefits.
“We’ve seen a lot of patients who didn’t have access to a place like ours following an injury or surgery that took place maybe a year or two earlier,” Moise said. “They come in, and you can tell how far behind they are compared to other patients. They have to work harder to get back to where they want to be.”
Part of the issue is awareness. Although the Decatur location of Atlanta Rehabilitation & Performance Center is in an office park, other centers face the visibility issue head on by situating themselves in shopping plazas and strip malls.
Zach Walston, senior clinic director and national director of research for PT Solutions, often works out of the Duluth location tucked in the middle of a Kroger shopping center. If a patient wants to soothe an ailment with a sugar fix, a Dunkin’ Donuts is nearby. Walston says he shares a wall with a Chinese restaurant.
“The thing that I appreciate about the retail setting is the visibility for patients,” Walston said. “We get walk-ins. Someone might go to the restaurant next door and they see PT Solutions. We have a sign out front that offers free entry screens. It’s a way for us to be more accessible to the patients and the general population.”
While the proximity of certain outpatient clinics can benefit patients, the open setting of these facilities gives the employees better proximity to their coworkers. Ashely South, an occupational therapist at the Benchmark Physical Therapy location in Atlanta, says she reaps these benefits.
“I love the clinic’s dynamics,” South said, “as far as getting to be in a context where you have your peers right next to you and near you. You can feed off of them and their energy and collaborate.”
Moise agrees. She says she and her cohorts keep an upbeat and enjoyable vibe permeating the facility with popular music providing the soundtrack. This sets the tone for a lively environment where the employees bounce ideas off of each other in order to better help the patients.
The sense of community allows Moise to be inspired by her colleagues and get creative with her arsenal of exercises. According to Moise, when she graduated from physical therapy school, she had a toolbox of exercises that she had learned along the way. Once she arrived in the real world, Moise says she soon realized the exercises didn’t work for everyone. Collaborating with the rest of the Atlanta Rehabilitation & Performance Center staff has her thinking outside of the box.
“Our staff is really good about adapting exercises for different body types or certain injuries,” Moise said, “and just getting more creative. We see all ages. Something I would do for a 70-year-old patient would be different than what I would do with a 12-year-old. For example, they might both be being seen for knee injuries, but we use different equipment to make different exercises for them.”
While the employees galvanize each other, the same goes for the patients, Moise says. Without walls separating them, they’re able to witness each other performing their respective physical therapy.
“A lot of times if patients are in there with similar injuries,” she explained, “they can see the other person doing an exercise and feel more comfortable about giving that exercise a try. It’s great seeing patients inspiring one another.”
They gym-style retail setting of outpatient physical therapy proves to be a far cry from the hospital physical therapy scene. Walston says some patients feel uncomfortable doing physical therapy at hospitals with the often looming stigma of illness.
“Sometimes it can be great, but there are people who don’t respond as well to that locale,” Walston said. “Whereas the retail framework can be a little more comforting and just enjoyable for the patient when they’re there.”
At her Benchmark location, South says they take steps to break away from that stigma. Therapists bypass scrubs and opt for business professional attire to help bolster a more welcoming environment. In the process, South and her contemporaries strive for personal touches, including greeting regular patients by name.
“A big part of outpatient therapy is customer service,” South said. “That’s huge when it comes to making people feel welcome and not like just another patient at a medical institute.”
While keeping the setting attractive to customers, outpatient physical therapy can lure therapists who are unfamiliar with the environment. Just ask Moise. While attending physical therapy school, Moise says the outpatient model didn’t interest her at first. After doing rotations in a hospital, an acute care facility and an outpatient facility, she acquired a newfound appreciation for the latter.
“I just really enjoyed having the time with the patients and helping them for a full hour,” Moise said. “I like working with these types of injuries, because I’m really fascinated with anatomy. So those things kind of steered me into the direction of an outpatient context.”
As Moise steers me through another session, I tell her how much better I’m feeling. That pectoral pain has faded into oblivion and my range of motion has totally improved. Yet she quickly warns me not to jump back into my workout routine.
Making patient assessments and being a sort of PT detective keeps Moise excited about her work, she says.
“It’s great being able to look at somebody and address how they’re moving and what types of movement patterns they’ve developed,” she said. “Helping that patient work through it and become a more efficient mover is very enjoyable.”
