After an injury or surgery, rehabilitation is often a critical factor on the road to recovery. Since physical therapy is usually a weekly commitment and may be for an extended period of time, convenience is an important consideration, according to JeMe Cioppa-Mosca, vice president of Rehabilitation at Hospital for Special Surgery in New York City. "However, many other factors should also be taken into account when deciding where to go," she says. "Not all facilities provide the same type or level of care."
"It's important for people to do their homework before choosing a facility," says Robin Benick, clinical supervisor of the Hospital for Special Surgery Rehabilitation Network. The network, which marked its 20th anniversary this year, is a resource for individuals looking for a facility in their community that meets high standards of care. Information about PT practices in New York, New Jersey, Connecticut and Florida that belong to the network is available at www.hss.edu/rehab-network.asp.
"Many people don't realize the importance of choosing the right therapist and the right facility for their needs," Cioppa-Mosca says. "Recovery from an injury is hard work. Although most physical therapists are well-trained and provide good care, practices are not all the same. Falling into the wrong hands can do more harm than good."
"Physical therapy is a balance between science, art and experience. Certain physical therapists have special areas of interest and additional training in certain techniques," explained James Wyss, M.D., a physiatrist at Hospital for Special Surgery and at the hospital's Physician Office on Long Island. A physiatrist is a medical doctor specializing in nonsurgical treatment of muscle and joint problems.
"The right therapist can make all the difference between failure and success," he says. "But patients also need to understand that they are responsible for their recovery, as well. They need to work together with their physical therapist, communicate openly, and follow their advice, as well as the advice of their physician."
It's important to find a physical therapist with whom you have a good rapport, according to Benick. "Communication is key. It's a partnership," she says.
People may receive a recommendation from their doctor or from a friend who had a positive experience. But it's up to many individuals to find a rehab center on their own. Practices may have areas of special expertise, and some physical therapists have additional credentials. Some may focus more on sports medicine, while others may specialize in rehabilitation for neck and back problems or after joint replacement. Certified specialties range from pediatric to geriatric physical therapy
Cioppa-Mosca and Benick offer the following tips when choosing a physical therapy practice:
• Choose the right practice for your needs. Call the facility and ask questions to make sure there are physical therapists with expertise in treating your particular problem.
• Ask who will be treating you and how much experience the therapist has. Once you begin physical therapy, make sure you're receiving care from a licensed physical therapist or a licensed physical therapy assistant.
• Choose a location that is convenient to where you live or work.
• Try to set up a time to take a tour of the facility before beginning therapy. A reputable practice should have no problem arranging a quick visit.
• Note if the facility is clean and well-maintained. Are therapists washing their hands between patients?
• Consider what the atmosphere is like. Are therapists and therapy assistants actively working with patients, or are people standing around waiting to be treated?
• Are people working there wearing a name badge with their job title? They are required to do so in many states, including New York.
• Inquire about the cancellation policy. Some facilities charge a fee for cancelling an appointment.
• Consider how quickly you can get an appointment. If you need to wait more than a week or two, you may be better off finding a facility where you can start sooner, especially if you've had recent surgery.
• If health insurance is an important consideration for you, make sure the practice accepts your insurance.
• If you require special equipment, such as a pool, make sure it is available at the facility.
Once you begin physical therapy, the experts stress that you'll do best with someone with whom you get along well. They also point out that you should be evaluated and treated by a licensed physical therapist. Physical therapy assistants are also trained, licensed professionals, and your therapist may work with an assistant to provide your care.
You should not be receiving treatment from an unlicensed physical therapy aide or technician, according to Benick. Aides help physical therapists with tasks such as basic administrative duties, getting treatment areas ready and escorting patients within the clinic, but they are not legally permitted to provide treatment or instruct patients in exercises. If you're not sure of the credentials of the person treating you, you have the right to ask.
If you feel the physical therapist is not spending enough time with you, appears distracted, or is bouncing back and forth between you and other patients, you may want to find someone who offers more personalized care and attention. The experts say that if you ever feel uncomfortable or if an exercise or treatment is painful, you should speak up.
You should also receive instruction on exercises to do at home. The therapist may provide handouts, a link to a video demonstrating the correct movements, or another form of instruction to ensure you are performing the exercise correctly.
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