Our Role in Regenerative Medicine

The tug of war between profit and loss.

By Bill PFister Jr, PT, MPT, CLT

Decreasing payment and increasing administrative burdens—placed on physical therapists by insurers—have created a tug of war between profit and loss, which has ultimately become an endurance exercise that only those most fit will overcome. As physical therapists and business owners, we constantly look for ways to increase our prospective markets as well as develop new markets. During the recent evolution of health care, regenerative medicine is on the rise, offering promising results for patients in this conservative care spectrum.

Throughout the past decade, regenerative medicine has made significant advances. As a result, we have new conservative treatment options to help accelerate the healing process for many different types of pathologies. Platelet-Rich Plasma (PRP) and Bone Marrow Cell Concentrate (BMCC) injections are just two types of treatments. These injections typically treat conditions such as joint pain, strains/sprains, and repetitive stress disorders. Currently, these procedures are considered experimental by the FDA and are not covered by insurance—and therefore are a cash pay service. The cost to patients varies from $500 for a PRP injection to $4,000 for a BMCC injection. Despite the cost, an expanding number of people are willing to pay out-of-pocket for regenerative procedures to avoid a possible surgery for the same problem.

Due to the promise of these treatments, many physicians use regenerative medicine as an adjunctive service to their existing practice. Dr. Kathy Wang, DO, an interventional pain management specialist at NeoSpine in Puyallup, Washington, is among the physicians to recently begin performing regenerative medicine interventions. Dr. Wang uses physical therapist consultation as part of her inclusion/exclusion criteria for patients who may or may not benefit from these procedures. Dr. Wang reports she wants to better understand if the patient’s problem is because of a mechanical dysfunction, such as hypermobility, joint laxity, restricted ROM, flexibility, or impaired strength, prior to considering performing any procedure. Dr. Wang further reports that having an intimate understanding of the patient’s problem allows her to choose the most appropriate intervention to achieve the best outcome possible for the patient.

Regenerative medicine offers an opportunity for physical therapists to corner their own prospective markets or further develop a new market by demonstrating their value to the physician community that is performing these interventions. To develop this market in your practice(s), consider the following three tasks:

1. Create a regenerative physical therapist evaluation. The great thing about this evaluation is that it is not anything different than what we already do for all our patients. Educate your clinicians on the current regenerative medicine interventions that are available and share the studies that highlight their significance. Develop a fundamental understanding of regenerative medicine and the benefits of having a physical therapist involved on some level of treatment prior to the patient receiving these procedures. Advertise that you perform physical therapy evaluations for regenerative medicine intervention on your materials and website.
2. Identify your market. Find out who is performing these regenerative procedures in your area. Identify if you have existing referral sources that perform these interventions. If your current referral sources are not performing these procedures, develop new referral sources who are performing them. The bottom line is to find out who in your area is implementing regenerative procedures and who else may be interested in adding these procedures to their practice in the future.
3. Educate referral sources as to how you can partner with them and their regenerative medicine program. Communicate to them how valuable your help can be in identifying good and bad candidates alike. Educate them on your abilities to identify mechanical dysfunction and impairments that are contributing factors to the patient’s pain and functional limitations. By demonstrating your value to these providers, you may have success in changing the behavior patterns of these physicians, and to use your expertise more frequently when dealing with all patients seeking treatment for pain due to a musculoskeletal or neuromuscular pathology.

Our health care system continually evolves, creating a time of uncertainty for many private practice owners. Despite these changes in health care, the science of medicine and the art of healing continue to trailblaze new interventions and treatments for patients, thus creating new opportunities for physical therapists to continue to thrive and offer value to patients, providers, and payors. We just need to look for the opportunities that may be right in front of us.

Bill Pfister Jr, PT, MPT, CLT, is an Impact editorial board member and partner with RET Physical Therapy Group. He is the director of Meridian Physical Therapy in Puyallup, Washington. He can be reached at billp@retpt.com.