As physical therapists, you can think of patient discharge in two different ways:
1. A celebration! A time to praise for hard work, to reminiscence about how bad patients were when arrived but much better now, and a time to check off long term goals.
2. Termination! An ending of care, a hug to say we hope not to see you again (joking of course), a way to close out the account. Abolishing the ease for a patient to return to us if needed.
In all reality, we know that symptom reoccurrence is high. Up to 70% in most spinal conditions. Why do physical therapists make it harder for patients to return to us by discharging them? We all realize that coming to us first for spinal conditions reduces costs, improves out of work days and overall is more effective treatment of choice.
In this day and age, patients are still limited in how they can access a physical therapist. Some states do not have Direct Access and others are very restrained. In the state of VA, if I have seen a patient who was referred to me 90 days ago for, say back pain, then I cannot see them again without a referral. The patient knows the physical therapist is who they need to see, but is restricted in getting back in for relief and improved function.
So, the question comes to mind in that who can our duration of care be? I think this is a gray area, but why not put ‘4 weeks initially and then as needed’? We don’t need to discharge our patients, but have an open chart for them to return if the same condition arises again. You don’t see primary care physicians, chiropractors, or even massage therapists filling out discharge papers. Why do we?
Some food for thought. I would like to hear your feedback.