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PT and the Greater Good

England's General Election

Published May 5, 2010 10:35 AM by Dean Metz

The election will take place on May 6. What does that mean for the NHS? The London Times writes that it will mean dramatic cuts in service and possibly shuttering some hospitals: www.timesonline.co.uk/tol/life_and_style/health/article7115199.ece

All of the major candidates for Prime Minister; Gordon Brown, Nick Clegg and David Cameron have pledged to preserve funding for the NHS. The public is very vocal about not cutting health care services. It would make the new P.M. very unpopular if service levels were cut and if the nurses union became angry at job losses. Nurses are still the most visible allied health professionals here in the UK and have the most political clout.

Only at the very end of the article mentioned above does the idea of providing care at home get mentioned. The people of the UK seem to still have a mindset that if one is unwell, then one must go to a hospital. The community-based team that I work on has been in existence for a decade but people are still shocked, and pleased, to learn about the services they can get at home. It would appear that forward-thinking trusts, like the one I work for, are positioning themselves to be more community-based and rely less upon hospital institutions for providing care. This could have a huge cost savings and reduce the likelihood of additional hospital-acquired complications, as well as improve patient perception of care.

A very similar thing is happening back in my hometown of New York City, which just last week saw the closing of St. Vincent's Hospital, one of the largest hospitals with a designated trauma center. They were a billion dollars in debt. However, the Visiting Nurse Service of New York's CHOICE program continues to grow as they maintain the frail elderly in their own homes. A decade ago when people were talking about health care moving away from hospital-centric into the communities and the probable closure of many institutions, I didn't believe it. Now I'm embracing it.

3 comments

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May 6, 2010 1:33 PM

@ Jason, I've heard the argument that outpatient PT "gets them out of the house" as well. Sometimes people genuinely need the environment of a clinic/practice to progress such as needing parallel bars, modalities, or other equipment. Most times I find it is because they have had 10 visits under Medicare and home care companies don't want to cut their profit by providing an 11th visit.  However, there is day care, family and friends, or any other option to address the social issue of "getting out of the house". I don't buy it as a stand alone reason for  outpatient treatment.  

Just because something is difficult, like reaching rural patients, doesn't mean it isn't worth doing. I wonder how many of those rural patients could even get to a clinic? Are people losing out on PT because they are inconvenient?

Dean Metz May 6, 2010 12:34 PM

In rural regions of the country home health is lacking.  Partly due to the drives one has to take on back ruts in the road and the cost to send a skilled provider more than 30 minutes away.  

I have known some PT providers who completely discount HH and favor having patients come to the clinic to get out of the house.  The adage of aging in place is important. What a better, more comfortable environment than your own home.  

For cost savings, companies want to see immediate results not in 5-10 years.  Like mentioned before, very short sighted.  

jason marketti May 6, 2010 10:44 AM

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About this Blog


    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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