Nomad Therapies has been delivering in-home physiotherapy (also known as mobile physiotherapy) for almost 10 years. Over this time, we have learned a lot about how to deliver this extremely important and valuable service. Clients tend to be more compromised, more complicated, and more vulnerable so when you require in-home physiotherapy finding the right support team for yourself or a loved one is critical.
Here's what we have learned:
The therapy team’s experience and credentials are hugely important
In-home physiotherapists are trained and mentored in dealing with the medically compromised and complex clients commonly encountered in the environment in which they work. Making the right choices for this client require experience and access to a supportive knowledgeable team. Sometimes “it takes a village”. Different therapists have different areas of specialization and interest and these need to be aligned with the needs of the client specifically. For example, going into a client’s home to assist with an episode of acute back pain versus a stroke requires two different skill sets.
Commitment from the provider
As in many service provider scenarios, choosing a provider who delivers home physiotherapy regularly rather than occasionally will significantly increase your chances of finding an experienced, appropriate provider with a strong support team.
Look For Flexibility
In some health care situations, a patient must wait weeks, months or even years for an appointment. And when it is offered they may not even be able to negotiate the day or time. For home physiotherapy this is NOT the case. When selecting your provider you can be selective of time and date, although most offer less weekend options.
Ease of Integration Between Services
Sometimes you will need access to other private health care services such as occupational therapy, foot care, kinesiology, mental health services, private nursing, etc. You may also need to access services within the public healthcare system, such as home care or CPAS, or you may need to assess what is out there such as personal care homes or rehab equipment. Whatever your need, your home physiotherapist should be able to facilitate almost anything related to healthcare. And in many cases they can advocate for you to get what you need. Make sure you hook up with a provider with these capacities.
Time
Generally speaking follow-up appointment times in physiotherapy clinics are set at about 30 minutes, sometimes 20. For home physiotherapy, the appointment is usually set at 60 minutes. This usually includes travel time which is generally accepted as 10—20 minutes. Some providers allow 30 minute home PT sessions in cases where the direct client care time is minimal and no travel time is required. Having said that, as previously mentioned, home care physiotherapists typically see clients who are medically complicated, at least moderately functionally compromised, and require an hour booking. Be wary of providers that promise minimal time (e.g., in-clinic times and rates) – this may not be what you want with the complex client. Look for a provider that provides a one hour baseline appointment including travel, but will offer flexibility when appropriate.
Direct Billing, No Referral Required
Some home physiotherapy companies will direct bill your insurance provider if you have coverage in place. A physician’s referral is not required for treatment and is typically not required for insurance coverage—you should confirm this with your insurer or have the home physiotherapy provider check for you.
Strong Administrative Support
As mentioned, there is a large percentage of higher need clients in the home physiotherapy client population and providers that do this work require administrators that can manage a more advocative role than your typical physio clinic. For example, the home physiotherapy provider is constantly in contact with family and other health care providers as well as care home administrators, equipment agencies, the list goes on. So the administrators in these organizations must play a key role in managing the client and are, in essence, a critical part of the health care team.
Advocacy
Advocacy is a key skill for physiotherapists in general and it is integral to the home physiotherapy service. This may include phone calls to your physician, pushing for a specialist assessment, coordinating an occupational therapy visit or addressing conflicts with a facility or an employer. The advocate role of the in-home physiotherapist often requires a team effort from the provider. So if you are a client seeking home physiotherapy, the advocacy capacity of the provider should be considered.
We at Nomad Therapies take great pride in having evolved into an organization that can deliver on most if not all of the points discussed above. We aspire to continue our learning indefinitely as the learning curve on this clientele has no end. And the need and value is large for this very important service.
