This time, I tried something new. I gave virtual physical therapy a try. What I learned is that there is a wonderful budding new tool for the musculoskeletal issues plaguing so many of us. Here is my story, with added implications for employers.
I have experienced physical therapy a couple of times in the past. Once was when I badly strained my right quadriceps after a determined run the day following a gluttonous Thanksgiving. “No holiday bulge for me,” I thought as I hit the pavement early that Black Friday. I ran through some excruciating pain and, by the time I made it back to my sister-in-law’s home, I could barely walk unassisted. I landed on a four-month recovery and physical therapy (PT) plan that included multiple PT visits…and no running. I bulged that holiday season.
On another occasion, I experienced significant pain in my shoulder. For nearly two months I made weekly trips for my physical therapy. There I would sign in, wait for my appointment, be treated, and then be assigned my exercises to do at home.
That was then. This is now.
A couple of months ago I went for a run that was a little further than I had anticipated. I misjudged the distance to where I would pick up my daughter’s car after repairs for a recall. About a mile and a half from the dealership my right knee began to hurt. I was much closer to the dealership than I was to my home, so turning back wasn’t an option. I didn’t want to call a ride-share in this season of COVID-19. So I did what any proud guy would do: I pressed on through the pain. Weeks later I still had an issue with my knee.
During this same time, I began working on a project to research musculoskeletal (MSK) solutions for our clients at The Benefit Company. Our team of advisors and account executives was more familiar with these services, but I wanted to learn more. I contacted various MSK vendors, and vetted and compared their solutions. Impressive. I was surprised to discover that there was truly something to online, digital, video physical therapy.
On my calls with one vendor, I mentioned the issue with my knee and asked if I could test-drive their services. Hoping not only for some free medical care and an opportunity to shorten my recovery, I also desired to better understand the service. This vendor readily agreed. I tried it. Like peanut butter meeting chocolate, PT had met telemedicine. It was beautiful.
Here are some of the highlights of what I learned through my experience, plus my continued research on MSK solutions:
- Effective intake. Not everyone who wants to use a virtual MSK solution is a good match. One vendor told me that 15% of those who call in for the first visit is not a good fit for the digital solution. About 5% need hands-on care or imaging and are referred to as in-person treatment. After the initial evaluation, another 10% don’t need any professional medical care. For my evaluation, the PT asked me a series of questions and then had me pose and move in front of the camera on my smartphone so that he could assess my pain and needs.
- Convenient. For my previous PT experiences, I had to take time off work, drive to the medical offices, sign-in, wait for my appointment, and then begin my PT treatment—often as the therapist moved back and forth between several patients during our exercises. This time, however, I had the full attention of the PT for the video calls, none of which lasted longer than 20 minutes. At the very minimum, the virtual visits saved me 1.5 hours per occurrence. Furthermore, I didn’t miss anytime from work, as I scheduled my visits for the early evening.
- The right care faster. In the typical in-person model, an employee with an MSK issue would first go to the ER, their primary care physician (PCP), a chiropractor, or to a clinic. These providers may then refer the person to PT, or they may prescribe pain killers and tell the patient to “rest a couple of weeks and come back to see me.” If the issue is not resolved during those two weeks, they may then refer the patient to PT. In this typical model, getting to the right care is delayed. With virtual services, however, employees will typically have their PT visits within 48 hours. In my case, the visit was scheduled for the next day. Faster to the right care. Faster to recovery.
- Technology. Not only does the employee have access to an online coach, PT, or physician, but the vendors also provide their solutions via mobile apps. There is a wide array of technology accompanying the apps. Varying among the solutions, the additional technology may include digital therapeutics, motion tracking, wearable sensors, and communication via video, email, phone, or chat.
- Less drug usage. In the typical model, the use of prescription pain killers is much more likely than with a virtual MSK solution. Not only does this save on the employer Rx costs, but it eliminates the unnecessary use of prescription drugs. I see this as one of the greatest advantages of using virtual MSK solutions.
- Costs. The pricing for these services will vary depending on the vendor and the type of services they offer. The pricing is typically per user and for the duration of treatment for the patient (including unlimited sessions with their coach or PT). A virtual solution is not only less likely to prescribe prescription drugs, but also less likely to order X-rays or other costly imaging. They may also prevent unnecessary surgeries. The cost of the programs — even those on the higher end — can mean significant savings for an employer versus traditional means of care for MSK issues. One vendor stated that the average participant in their services saves the employer more than $4,000.
Musculoskeletal Issues on the Job
MSK is the largest driver of disability claims, with knee, back, and shoulder pain leading the way. Furthermore, as many as 50% of today’s workforce members experience some form of MSK disorder each year. Couple this with more than 15% of the medical spend coming from MSK treatment, and these solutions are certainly worth considering.
When it comes to finding the right solution, however, not all MSK solutions are the same. In addition to different cost models, the capabilities and services also vary depending on the musculoskeletal conditions addressed. Some vendors may only treat back and neck pain, whereas others also include knee, hip, shoulder, foot, and other MSK disorders.
The qualifications and credentials of those providing care also vary among vendors. Some may use a combination of physicians and other clinicians. Others may tout that they use nurses, certified health coaches, or physical therapists.
When deciding which solution to use, smaller employers will have fewer options, as several of the most prominent vendors have a size threshold. However, as was the case with the solution I used, some vendors will work with an employer of any size.
My knee is near 100% back, so I will end this post now and go for a run. And if you think it is time to consider an MSK vendor for your organization, contact us at The Benefit Company. We will be happy to help you find the best solution for you and your organization.
Jack W. Bruce, SPHR, Director of Population Health & Wellbeing
- Population Health
- Employee Wellness & Wellbeing
- Human Resources