Last week we asked our readers, “Why do you think telerehab is not more prevalent?” Here’s what you said.
- It takes 17 years. Even when the evidence supports a change, it can take up to 17 years to adopt a new practice. (See the article by Morris et al. below).
- It’s easier to do what we’ve always done. You know the old sayings, “Change is hard.” “If it ain’t broke, don’t fix it.”
- We value touch, and we’re a little fearful. What if we miss something or fail to help you recover because we are not in the room with you providing hands-on care?
- Our patients may be fearful, too. What if I get inferior care because my therapist is not with me one-on-one? What if she misses something?
- We’re afraid that others may encroach on our territory. What if someone without the clinical space and equipment I’ve invested in can do this just as well over a laptop?
- We’re concerned about slipshod care. What if someone sets up a phone bank and runs a therapy mill with poorly trained staff? Might we dilute our value or esteem in the health care arena? Could telerehab lead to fraud and abuse?
- We are not sure about the laws around telehealth and reimbursement rates.
Thanks to all who responded. I have to confess, many of these responses were not what I expected. The literature often cites technical barriers, like no internet and lack of familiarity with video conferencing. Maybe these barriers went the way of the dodo with COVID-19. You tell me. If you’d like to add to the list, take issue with its content, or otherwise engage in the conversation, post a comment on the site. Meanwhile, if you want to learn more, checkout the resources below.
To learn more:
On the issue of 17 years, see The answer is 17 years, what is the question: understanding time lags in translational research by Zoë Slote Morris, Steven Wooding, and Jonathan Grant in JR Soc Med. 2011 Dec; 104(12): 510–520. It’s free on PubMed Central. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241518/
The APTA assembled some nice resources addressing telehealth in the US. If you are a member of the APTA, you can access that information here: https://www.apta.org/your-practice/practice-models-and-settings/telehealth-practice. If not, consider joining at https://www.apta.org/apta-and-you/explore-apta-membership/join-renew.
Here’s a recent review article by Cottrell and Russell. It’s also free on PubMed Central. Telehealth for musculoskeletal physiotherapy. Cottrell MA, Russell TG. Musculoskelet Sci Pract. 2020 Aug;48:102193. doi: 10.1016/j.msksp.2020.102193. Epub 2020 May 30. https://pubmed.ncbi.nlm.nih.gov/32560876/.
The Evidence Workshop, LLC
April 19, 2021
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