This October, we celebrate National Physical Therapy Month, an annual opportunity to raise awareness around the importance and impact of physical therapy. As of 2021, there are 484,540 people employed in the Physical Therapists industry in the United States alone. Here’s what PT facilities need to do in order to ensure the success of their clients’ recoveries, while also mitigating the risk of potential lawsuits.
It is well known in the world of physical therapy that improperly treating a patient is the biggest, and likely the most obvious risk. Of course it is highly unlikely that malpractice is intentional, but it carries unimaginable consequences. Beyond the seemingly obvious risk of improper treatment, there are quite a few overlooked risks to consider.
1. Financial incentives can lead to overtreatment.
According to marketresearch.com, there are currently 38,800 clinics in America providing physical therapy, occupational therapy, speech therapy and audiology and no standardized method of compensation in the field which can lead to care related issues when compensation is based on patient time. OmniSure’s Carol Marshall explains how “often…physical therapists want to work a full 8 hours today, so they end up treating people they really shouldn’t. There are 7 hours of treatment they can bill to Medicare, but they receive an 8 hour a day paycheck.”
This can be particularly concerning in facilities that provide bonuses to therapists based on productivity. Unfortunately, this is a common practice in physical therapy facilities and it leads to incorrectly reporting time. It is easy for a problem to go unnoticed due to a therapist’s schedule being packed full. Individualized attention to detail must always be managed over possible financial incentives within clinics.
2. Shortage of therapists can lead to billing errors.
Marshall explains how OmniSure repeatedly sees a shortage of therapists across all settings. “Often we find that a PT is working at an acute care hospital and they have 12 or so people to see in 8 hours. Each patient would have one hour of treatment ordered.” The possible result? Patient care gets shortened. This is an extremely tough predicament, because in some cases there are simply not enough therapists to give patients the time prescribed by their doctors. Beyond the disadvantages this creates for a patient, a shortage of time can lead to accusations of payor fraud. Patient health plans might get billed an entire hour, though they were only seen for a 45 minute session (or less).
3. The lack of clear and thorough instructions for the Patient Home Regimen can put recovery at risk.
Physical Therapists must provide clear and thorough instructions to their patients. If a patient doesn’t adhere to the treatment plan established by the therapist and approved by the physician, this puts their recovery at risk. According to physical therapist Jenni Ribbens, “…attending physical therapy 2-3 times a week but failing to do exercises at home is a common reason patients do not achieve the results they hoped for.” This prolongs the healing process and does not help the patient nor therapist achieve their goals. Along with clear instructions regarding the exercises themselves, there must be instructions administered or communicated to the participant.
Accountability and trust are key components in the relationship between physical therapists and participants. Even if the patient is adhering to the exercises but not performing them as often as prescribed, they are not adhering to the treatment plan. This is easily avoided if the instructions provided are clear and thorough.
4. Physical Therapy Assistants practicing outside their scope of practice can put patients at risk.
Many physical therapy clinics have assistants who are in the residency phase of their programs. While these assistants are there to shadow a therapist, there are times when they’re given a task or assignment they’re under qualified to administer, and they do it regardless. Carol Marshall explains how this happens because “perhaps the student doesn’t want to look like they don’t know what they’re doing, so they go ahead with what they think is right.”
This is particularly dangerous in a care setting, because this could lead to further injury. A patient needs to know who’s treating them, and additionally, their therapist must have the skills in order to do so. Certified physical therapists need to practice certain protocols to ensure they are not leaving a patient unattended. Routine training and/or assessments are sometimes delegated to mitigate the risk of malpractice with PT assistants.
5. Equipment and devices used improperly or poorly maintained can result in harm.
The luxury of technology in a physical therapy setting has revolutionized the way therapists can take care of their patients. While there are a myriad of benefits that come from medical gear, this equipment also requires close attention. Like a medical device in any setting, employees must establish a routine maintenance check on all gear.
OmniSure’s Carol Marshall explains this using equipment with electronic stimulation as an example of a risk: “how often are those machines calibrated is a risk… if you have a shortage in that piece of equipment or voltage hasn’t been regulated or gone through regular maintenance this can result in malfunction.” Another example of this are hot packs, which could potentially harm anyone with a skin condition or an elderly patient on certain medications. It is essential that every physical therapist knows exactly what and how the tools they are using work, and the potential risks involved in using them.
Closely adhering to a patient safety, risk reduction and harm prevention strategy is vital for any PT clinic. There is always a potential for injury if employees are not paying close attention to detail. Clear communication between the providers and patients is always the greatest way to ensure positive outcomes throughout the recovery process. If you are looking for patient safety or risk mitigation advice, OmniSure is here to provide you with the insight you need. Contact us today.