PT and Telehealth Part 2
A while back, I wrote about a new practice here in the UK where patients are referred for therapy and receive a phone call from the physio. The physio asks a series of questions and then sends out advice and/or exercises in the post. I had some misgivings about it then. I have been able to see it in action for the first time now.
One of our health care assistants (the equivalent of a CNA or rehab assistant) had developed a painful shoulder. She went to her general practitioner, who referred her to physiotherapy. She received the phone call and reports that she was asked a lot of questions, after which the physio said, "I don't need to see you. I'll send you some exercises in the post. If you're not better in six weeks, then we'll bring you in."
She came to me to show me her exercise sheet so I could clarify how to do them correctly. I was not impressed. The exercises consisted of isometrics of internal and external shoulder rotation, followed by active motion using the equivalent of a therapy band (not included). She didn't understand how to perform the exercises and had no idea where to find the exercise band.
It's been a long time since I worked outpatient orthopedics, but I took a look at her shoulder. The supraspinatus and subscapularis as well as biceps heads were prominent and very tender to palpation. The muscles were strong and the movement painful. I initiated cross-friction massage and instructed the woman to perform it on herself, then apply ice. We began pendulums and some active-resistance motions with the weight of a soup can.
Now the woman is better and I'm strongly against tele-health in this fashion.