Choosing the right Physical Therapy Clinic

Five indicators for success

When I was a kid, I hated shopping with my parents because they never just bought anything. They researched and compared and pondered and weighed pros and cons until I thought we were going to have to have our mail forwarded to the store. Now, though, I’m glad they did that because they made me an educated consumer and I (usually) make smart purchases.

When it comes to physical therapy, you need to be like my parents. Don’t just choose the first clinic with a nice-looking gym and friendly staff. Whether you are paying with cash or using your insurance benefits, eventually those resources will run out, and you want to have your problem resolved before that happens. Choosing the right physical therapy clinic determines how fast you will recover and if you will even recover at all.

The good news is there are five factors which will tell you if you are in a good clinic. The better news is that these factors are super-easy to spot when you know what you are looking for.

Let’s start out with a story about my friend Bob. Bob’s not real. That’s good because he won’t mind me sharing his private medical information with thousands of strangers, and I won’t have my physical therapy license revoked for doing so. It’s pretty much a win-win.

Bob loves pickleball. Like, really, really loves it. He’s struggled with his weight ever since college, and pickleball is the first activity he’s been able to stick with. He’s shedding weight, looking good for the ladies, and feeling amazing. Or at least he was until his left foot started hurting after his recent match against his arch-rival, the bad-boy of Saint-Augustine pickleball, Frankie “Two-Paddles” Patone (also not real). He went to his doctor and got the bad news: plantar fasciitis. The cure: physical therapy.

Bob chooses a local physical therapy clinic with a modern-looking website and catchy slogan. During his first appointment, his physical therapist, Patty, spends thirty minutes looking him over, shows him some exercises to do on the machines then sends him home with a photocopied exercise program.

On his subsequent visits, he starts out his therapy session with fifteen minutes on the exercise bike. Then Patty, or Rick, or Steve, or one of the other therapists in the clinic spend a few minutes talking to him to see how things are going, then it’s off to the machines to do his exercise program. He doesn’t really get much better and after six weeks, his insurance benefits are used up, his therapy prescription is finished, and so is his pickleball career.

This is a worst-case scenario, but anyone who has had physical therapy can probably relate to at least part of the above story. The bottom line is, all physical therapy clinics are different. As with everything, there are excellent ones, average ones, and ones you wouldn’t send your neighbor’s cat to.

So how do you know if you got an excellent one or a neighbor’s-cat one?

Glad you asked, because I’ve got the answer.

I’ve been a physical therapist for fifteen years and have practiced in all types of clinics. I started out in a clinic where I was expected to see anywhere from three to six patients at a time.  Nightmare status. I left after only 3 months. Nowadays, I run my own practice and only see one person at a time and spend an hour with each patient.

That brings me to my first indicator of a physical therapy clinic that will be right for you.
1) One on one treatment.
Physical therapy is every bit as complex and challenging as any other medical profession, sometimes more so. A therapist must correct pain and dysfunction using nothing but his or her hands, knowledge, and limited equipment. That requires deductive reasoning, attention to detail, and time. Lots of time. Because of this, you should choose physical therapy clinics where you are one-on-one with your therapist for the entire visit. No sharing. Forget what you learned in kindergarten, when it comes to your physical therapist, you have to be selfish.
2) You see your therapist every visit.
Physical therapy is the art of evaluation, treatment, and reassessment. This happens constantly, even after the first “evaluation” visit. A good therapist is always in evaluation mode—determining efficacy of treatment and looking for additional clues that will get you better. Shuffling between even two therapists totally disrupts the evaluation-treatment-reassessment flow. Of course, emergencies happen. Cars break down, and kids get sick. If your therapist is unavailable once or twice, it’s not the end of the world, but if you notice a pattern of getting shuffled between physical therapists, that’s a red flag that you need to consider.
3) Are you getting better?
It’s a common misconception that physical therapy has to take weeks and weeks to really work. In a vast majority of cases this just isn’t true. With  95% of my clients, if they aren’t showing improvement after the second or third visit, I’m not happy, because that means I’m on the wrong track. You should start noticing positive changes in the first 3 visits. If not, you need to talk to your therapist about it. This doesn’t have to be confrontational. Believe me, if your therapist is a good one, they already know you aren’t getting better and it is bugging them probably almost as much as it is bugging you. This indicator might require some leeway. Some conditions really do take a while before they start to improve. But if you aren’t getting better, and you notice some of the other warning signs described in this article, then you might want to switch therapists.
4) Experience is King. Or Queen.
The difference between a therapist with 1-3 years of experience and one with 10+ years of experience cannot be overstated. Physical therapy is an incredibly complex discipline that takes years and years to master. When you are choosing a physical therapist, don’t be shy about asking how much experience they have and requesting a more experienced therapist. Believe me, I wouldn’t have wanted me as a physical therapist when I only had a year or two of experience. There’s just so much I didn’t know. You might feel that choosing a more experienced therapist is unfair to the new ones, but don’t worry. There are tons of other patients and those new therapists will get seasoned in no time. You don’t want to be one of those patients they learn on. You want to see the therapist who has seen everything and knows how to treat it all.
5) Who owns the clinic?
I always recommend people start with physical-therapist-owned clinics. In the vast majority of cases, a physical therapist opens his or her own clinic because they care about the art and getting patients better. Usually, these clinics are the ones where you will get consistent, one-on-one treatment from the same therapist. Often, the therapists that open their own clinic have the experience needed to get you better. Are there exceptions? Sure. But usually, you are going to have a better chance at quality treatment going with a smaller, locally-based, physical-therapist owned clinic versus a big corporate name.

Don’t be like Bob. Choose a right physical therapy clinic where you will get consistent, insightful, one-on-one care that gets you better and back in action as soon as possible.

Matthew Rieder, DPT
Owner, Renew Physical Therapy and Wellness LLC.