As an orthopedic surgeon, I perform about 900 hip and knee replacements each year. In an era of rapid discharge and outpatient surgery, patient education is of paramount importance. Nonetheless, besides the surgery itself, one of the most common areas of concern for patients is what comes after the procedure. The rehabilitation process after surgery is as important as what happens in the operating room itself, and each patient needs high-quality, easily accessible physical therapy to ensure they get the most effective care post-operatively. Unfortunately, too few people are getting the kind of care they need after a joint replacement, resulting in suboptimal outcomes and longer recovery time. The problem is twofold. First, too few people go to physical therapy frequently enough to ensure the best recovery possible. Many do not even complete their full treatment plan. For most of them, it’s a matter of convenience — people simply do not have the time to visit an outpatient clinic multiple times a week that may not be conveniently located. Second, there is no way to standardize the physical therapy care patients are receiving. The post-acute care system is fragmented, and some patients may stay within a health system for physical therapy, while others choose external providers. Each outpatient clinic may have different protocols and ways of delivering care. On an individual level, even ensuring patients see the same therapist each visit is not always easy. The reality is that in the current outpatient physical therapy model, these problems of access and fragmented care are the norm. To solve this problem, we need physical therapy that meets people where they are. Patients should be able to schedule physical therapy appointments as easily as they order dinner from DoorDash. It’s a win-win. The patient gets the care they need in their home, and surgeons can be sure their patients are getting standardized care and completing their care plans. The good news is solutions like this already exist. Technology is available to match patients with conveniently located therapists who will meet them in their homes and standardize the care they deliver. If we can do it for ordering restaurant delivery, ridesharing, and appliance repair, we can do it for physical therapy. And demand is high for receiving more health care in the home. A recent report showed that 65 percent of people prefer to get health care in the home if the alternative is visiting a clinic. The COVID-19 pandemic gave people a taste of the convenience of handling many health care interactions directly in their home. There is good reason to believe that we can deliver health care at home in a seamless and high-quality way. In my experience, when I began referring patients to Luna, which delivers on-demand physical therapy, I saw immediate improvement in outcomes. Luna reports increasing adherence rates by 50 percent compared to outpatient clinic visits and achieving 50 percent better pain improvement outcomes within 10 visits. I have seen the improved recoveries first-hand. I have also heard my patients express high satisfaction with the experience, as an alternative to visiting an outpatient PT clinic. This is a model we should consider replicating across health care. Rather than waiting for patients to come to clinics and placing the entire burden for an optimal recovery on them, we can make the process easy by meeting them where they are. It’s time for health care to evolve to truly put the patient first. Alexander Sah is an orthopedic surgeon. Source
