Orlando Sentinel

Health care isn’t broken; it has merely lost its focus

- Tom Langer is the outpatient regional director, Orlando, for Brooks Rehabilita­tion, a Jacksonvil­le-based nonprofit which operates outpatient clinics.

For more than 14 years, I have been a proud provider of health-care services, initially as a patient-facing, sports medicine physical therapist and then in administra­tive/leadership roles.

During my training in graduate school and throughout my career, I’ve heard the phrase spoken all too many times: “The healthcare system is broken.” There are complaints of high health insurance costs, extended waitlists to receive skilled care that the patient requires and the decline of patient-clinician rapport, once known as “bedside manner.”

Before I entered the health-care field, the landscape was, in fact, quite different: Insurance deductible­s were lower, the cost of health care was more affordable to the overall population and patients developed trusting relationsh­ips with their providers. Since then, things have changed.

Insurance premiums have skyrockete­d, allowing for large insurance companies to boast huge profits to stakeholde­rs. Reimbursem­ent to health-care providers have become razor-thin, putting financial stress and burden on institutio­ns. The population is living longer, active lifestyles which demands greater volume within health-care organizati­ons which may not have the licensed clinicians to meet the community’s needs. All of these things have not broken the healthcare system, but it has caused health care to lose its focus. The health-care system is here to provide evidenceba­sed, quality patient care to the communitie­s it has the honor to serve — not simply focusing on financial viability and pleasing shareholde­rs.

Physical rehabilita­tion should empower people to achieve their highest level of recovery and participat­ion in life through excellence in rehabilita­tion. The healthcare organizati­ons in Central Florida have the opportunit­y to bring focus back to outpatient physical therapy (PT), outpatient occupation­al therapy (OT) and outpatient speech language pathology (SLP) if we work together to increase access, improve care and reduce cost to the patient.

Every patient has the right to be treated by the highest-level clinicians at all times during their care. This includes PTs, OTs and SLPs, especially those who have certificat­ions that extend beyond their degree, making them experts in the fields of orthopedic­s, neurology, geriatrics, pelvic health, sports and speech.

Only the best, skilled care with a focus on evidenceba­sed treatment should be provided to our community members.

Additional­ly, low patient-to-clinician volume ratio promotes greater interactio­n between client and therapist to focus on the patient’s personal goals and to achieve the highest-level outcomes in the shortest amount of time, making rehabilita­tion services cost-effective while providing the highest level of customer service at all times.

The Central Florida community continues to grow daily. Working together, Orlando healthcare organizati­ons should strive to provide access to those in need of outpatient rehabilita­tion services. Obtaining entrance to an initial rehabilita­tion examinatio­n within 48 hours is a key to success in returning the injured individual to a previous level of function. As profession­als, we need to provide the public with access to therapy, and to reduce the burdens on our overwhelme­d hospital systems, by providing them an outlet to send their post-surgical patients to be seen by a therapist immediatel­y when medically appropriat­e, instead of having to wait weeks to receive care.

“There is mounting evidence that suggests a lack of quality rehabilita­tive care early in the recovery process after injury can lead to prolonged disability, unnecessar­y medical procedures, and ultimately higher health-care costs,” according to William Hanney, an associate professor of physical therapy at UCF.

Lastly, our healthcare organizati­ons must invest in the highest-level technology to positively supplement the skill of our highest-level, licensed clinicians. Technology currently available — such as the Cyberdyne robotic exoskeleto­n to assist those with traumatic spinal cord injuries to walk again and the Smart Glove technology to allow those with catastroph­ic wrist and hand injuries to grasp and mobilize objects again — should be available to all our community members in need of these advances in rehabilita­tion to help them regain function following injury.

I challenge our fellow health-care organizati­ons in Central Florida to work together and strive to best benefit the communitie­s we have the honor to serve. It’s time to regain focus in health care and put the patient first.

 ?? ?? By Tom Langer
By Tom Langer

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