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  • Writer's picturePiotr Solowiej

One on one

Not all physical therapy is created equal. There are myriad ways to operate a physical therapy practice, and unfortunately the dominating style in Chicago is the churn and burn, mill style clinic. This is not a dig at any particular company, but rather the healthcare business culture in the area as, off the top of my head, I can think of 8 major companies and systems operating their outpatient rehabilitation services in exactly this manner.

Patients are not seen as people, but as units counting towards productivity demands. Each therapist is set a target of productivity rendering them effectively powerless in vital decision making and resource management.

Now you may think being productive is analogous to getting (many) good outcomes. Nothing could be further from the truth. Productivity goals are time based. Meaning the longer you are in the office, the more units can be billed to your insurance. By stacking patient appointments at the same time you can run an incredibly lucrative business.

Here I want to highlight a keystone point: these companies are in the business of making money, and not making people better. Do people get better by going to these companies? Yes, of course, but in spite of their values. Picture overworked therapists, seeing multiple patients simultaneously, and disgruntled patients getting a minimum of individualized attention from the actual supervising physical therapist. No one is happy in this situation, except for the big fish with the big bank accounts. No matter what they say their priority is revenue and not your well being, plain and simple.


Yesterday I was working with a client, and he said something to the effect of, "I'm going to miss how nice it is having all this attention once the pandemic situation calms down and this place is full of 20+ people at the same time."

My immediate response was, "that will never happen."

We didn't practice that way before the pandemic, we don't practice that way during the pandemic, and we won't be practicing that way after.

Our one on one appointments are not a reaction to current public health concerns of COVID-19. Injuries, pain, functional limitations and disability...people...are not a commodity under our roof. In our value system, people rank higher than profits. It will always be this way. We started Team Sapiens because we craved a different healthcare culture. A better one, focused both on the well being of the person seeking help as well as the treating therapist.

In a profit over people system, therapists are pressured to operate under standards driven into them by the higher ups. Decisions are made by financial incentives for the betterment of the company. Therefore, therapy means going 3x/week for 6 weeks no matter the issue. If you don't get better with lackluster attention and high frequency visitation, well then time to try something more invasive and expensive.

In a people over profit system, therapy means making decisions based on history, goals, financial situation, and other resources available (or unavailable) to that individual. This means room for nuance and customization to unique needs, and no cookie cutter standards. And no ridiculous productivity quotas testing your ethical boundaries as a provider.

I know which system I would trust my healthcare and well-being in. What about you?

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