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How COVID-19 is Affecting Outpatient Physical Therapy

With cases of COVID-19 increasing rapidly throughout the world, physical therapists in outpatient facilities have had to adapt quickly to changes in healthcare.

While the definition of “essential” varies state by state, and doesn’t often specially mention physical therapy, many outpatient clinics are including themselves as essential “healthcare services.” The Cybersecurity and Infrastructure Security Agency does deem physical therapists “essential,” however, there is no differentiation made between those working in hospitals and long-term care facilities versus those treating in outpatient clinics.

There is a call for most nonessential physical therapy sessions to be canceled, rescheduled, or switched online. The APTA recommends “rescheduling nonurgent care,” without going so far as to make specific recommendations beyond following the guidelines from the Centers for Disease Control and Preventions.

The CDC urges the cancelation of elective procedures and the use of telemedicine whenever possible. According to the CDC, to safely treat patients who are suspected of having COVID-19 (and in many locations, all patients can be suspected of having the virus), personal protective equipment is needed. This PPE can include masks, gloves, and gowns. However, if clinics have this equipment, many are recommending they donate it to hospitals who are facing shortages, and are in dire need of these supplies.

“At least one physical therapy clinic in Alaska was found to have been connected to 15 cases of COVID-19.”

While some clinics have reduced their caseloads to allow for social distancing and increased cleaning in their clinics, this is likely not enough to decrease the virus’s spread and flatten the curve. With some people able to carry and spread the virus asymptomatically, and a number of less vulnerable patients ending up with severe cases of the virus, it is impossible to adequately screen patients to determine who should be allowed to attend physical therapy. At least one physical therapy clinic in Alaska was found to have been connected to 15 cases of COVID-19.

New graduate physical therapists, who are often the most recent hires in clinics, are often the first therapists to be affected as clinics close their doors or see decreasing caseloads.

Dr. Joe Lipsky, PT, DPT, CSCS

Dr. Joe Lipsky, PT, DPT, CSCS of Reload Physical Therapy in New York, notes that taking treatments online hasn’t been as big of a challenge since his company has always “prioritized education and exercise programming as the main intervention we provide.”

Others, have been less fortunate. With the switch from in-person visits to online physical therapy, they are less busy, and seeing their salaries decrease.

Dr. Alyssa Dickens, PT, DPT

Dr. Alyssa Dickens, PT, DPT, works at a practice private pediatric clinic in South Florida. Her clinic has been offering online treatments since mid-March, which was a relief to Dr. Dickens because as the virus began to spread, she says she “felt so conflicted about whether or not I should even be treating and being hands-on with these [children].”

She notes that so far, she has had several productive sessions with patients and their parents online. However, she notes not all patients have been able to continue with their therapy virtually, either due to a lack of access to the proper technology, or because their parents are too busy. The result is she is treating fewer patients and working significantly fewer hours.

“Does this scare me? Absolutely! But I have been doing my best to put my extra [energy to] shift my focus on what I can [do at] home.”

In her spare time, she notes the silver lining is being able to share more content online: “This brings me so much happiness, and I know parents and other therapists are grateful for the content I’m able to put out … Despite this being a scary time for job security and finances, I think that we all can use it for growth either personally, professionally, or both.”

Anonymous

Another new grad therapist, who did not want to be named, works at an outpatient orthopedic facility in the Midwest. She filed for unemployment since her facility has split its therapists into A and B groups who work every other week. She says her clinic has not yet implemented telehealth, and is instead relying on increased cleaning methods, gloves, and cloth masks. She is among many who wish for stronger leadership from the APTA: “I also wish the APTA would come out with solid guidelines for clinicians in outpatient clinics.”

Still others have lost their jobs, for what they hope is only a temporary period. Many physical therapists have been either furloughed or laid off. Although there are several ways to differentiate these terms, in general, being furloughed is temporary, whereas being laid off is usually permanent.

Gabrielle, PT, DPT

Gabrielle is a new graduate physical therapist who works at an outpatient orthopedic clinic in New York City. He declined to give his full name for privacy reasons. He recalls that as the virus spread, his caseload plummeted from 12-20 patients per day to 2-6. Although Gabrielle’s employer was doing what it could to sanitize the clinic, and the therapists were provided with masks and gloves, due to the declining number of patients, he was one of many physical therapists furloughed: “I understand the company's decision in doing so because the volume was just too little to keep all of us working.”

He notes that he is trying to use his time off productively by taking online continuing education courses.

In Addition

There are also ways for out-of-work physical therapists with extra time on their hands to help the fight against COVID-19. States such as New York and California are looking for healthcare workers to volunteer to treat those affected by the virus. Many of the volunteers will be paid for their efforts.

Tune in for our next articles on how students and DPT programs are handling the Covid - 19 pandemic

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