Machines do not a Physiotherapy Treatment Make

If you have ever been for physiotherapy treatment, it likely went something like this. You saw the physiotherapist for about five to ten minutes, then an assistant put a bunch of machines and maybe an ice pack on you, gave you some exercises, and sent you on your way. As you were leaving you likely noticed that the physiotherapist had three or four other clients there at the same time as you.

Machines like ultrasound, TENS, and interferential current in the physiotherapy world are referred to as modalities. They have become a mainstay in most clinics, but here’s the kicker. There is actually very little clinical evidence to suggest that they work. So why do so many therapists still use them?

This article published by the Canadian Physiotherapy Association and written by an anonymous physiotherapist sheds some light on this question. When you read it you will understand why the author wanted to remain anonymous.

This therapist was working in a clinic where not only were modalities widely used, they were pretty much insisted upon. The physiotherapist, who was a new graduate, was made to feel incompetent for not using them. Over time the therapist discovered why.

“I gradually realized that an emphasis on modalities actually facilitates seeing, and therefore billing, more patients per hour, because of your ability to see multiple patients at once.”

Ah, the almighty buck. Seeing clients one-on-one is not conducive to making lots of money. Seeing a client for five minutes, though, doesn’t make people feel like they received very much for their money, so time is filled in with modalities despite their less than convincing track record.

“Modality-heavy sessions still may give patients the feeling of “getting their money’s worth” because the session is long, but patients may be unaware that seeing a physiotherapist one-on-one for less than five minutes may not represent good quality care.”  

 “I started to feel like I was being mentored in how to increase clinic revenue more than how to provide quality care. “

I believe that when someone goes to a physiotherapy clinic, they should expect to see a physiotherapist. What they are paying for is the physiotherapist’s expertise, and to only get five minutes’ worth doesn’t represent good value for the money, let alone quality care.

“As the months went on, it eventually became undeniable to me that the clinic was profit-driven, not quality-driven. I eventually decided to leave this clinic, in large part due to its profit-focused culture.”

Sadly this is extremely commonplace in my profession, and I believe it is at least partly driven by consumers who look only at the bottom line. When I speak to potential new clients and tell them our rates, I often get asked why we charge more than most clinics, and at worst I get hung up on by those who only hear the numbers.

The reason our rates are higher is quite simply because we treat people exclusively one-on-one for the entire treatment time, which is usually an hour. We do not use machines. We do not use assistants. We do not waste your time with ice packs that you can apply at home. You are paying for our clinical expertise and we are providing you with that expertise and only that expertise. No fluff. No window dressing. No abracadabra.

“I think that a clinic’s success should be based on its ability to improve the quality of life of its patients. I think our reputation as physiotherapists depends on this.”

I couldn’t agree more and I believe the only way to do this is to spend the time to look at the entire person and everything that is affecting their movement patterns. This requires patience, expertise, compassion, and above all time.

I will never make even a quarter of what some physiotherapists who see five clients at once do, but at the end of the day I can look at myself in the mirror and know that I provided the best quality care that I possibly could. Knowing this is certainly fulfilling for me. If this approach makes sense to you, then come and see us. We would be happy to show you what one-on-one personalized care can do for you.