Getting the Right Level of Care in Postpartum

There’s this argument in physical therapy right now comparing the access to care in the United States and the access to care in other parts of the world. 

I hear a lot of misinformation getting thrown back and forth, but at the end of the day, what we really need to focus on is WHO gets to make the decisions.

Who decides you need care?

Here’s my theory…

1/3 of women will do just fine postpartum

1/3 of women would benefit from basic postpartum care

1/3 if women need high level expertise for complex issues or won’t respond to basic care

That’s why it’s been challenging for me to hop on the “everybody needs care” train. 

We have to acknowledge not every single person who gets injured needs rehab. Not every person who has a baby needs the highest level of PT care.

But what every person does need is better screening, to determine which bucket they belong in.

It gets confusing because you would assume therapy is therapy. But think about any other job. Think about where you work. There are people who do fine and just get by. But there are people you go to when you have a complex problem that has a complex solution, right? 

Physical therapy is the same!

Now, when we bring insurance into the mix (and this is where we all get a headache.)

Most people start with “Do they accept my insurance?’ when REALLY we need to start with “What bucket do I fall into?” 

Most of the time this idea of “physical therapy doesn’t work” stems from a complex problem getting put in the wrong bucket. 

Many large practices are productivity oriented. They focus on revenue generation (ahem, churn & burn) They are busy negotiating contracts with insurance companies. Because the focus is productivity, you usually get the basic stuff that doesn’t work for everyone in every bucket.

We need to be better at triaging up front. That’s why I am so adamant on putting out resources for everyone to access. I’m only one person (still  haven’t figured out cloning technology) and my time is a finite resource. And many people are limited by geography. But many people (moms and Pros alike) can learn outside of a one-on-one visit. 

All of the stuff I put out is to make sure all the buckets are addressed. But if you’re in that third bucket and you spend 6 months doing that basic stuff, you can get really frustrated.

As patients, we need to be aware there are different levels of care. 

In the case you might be in that third bucket and you’ve tried to DIY and you’ve tried the clinic down the street, please know it isn’t your fault. You were just put in the wrong bucket. 

The last thing we need to be doing is guiliting more moms. 

As medical professionals, we have to step up. If someone isn’t getting better and you don’t have the capabilities to help, you need to know someone who does. 

Being able to identify your strengths and where you may be lacking, and then having resources to help in those areas, that’s crucial.

 Tell me what you think about this.

If you’re a mom, and you’ve done all you’re supposed to do and still didn’t get better, where did the blame go? 

If you’re a pro, where is your wheelhouse? Which bucket do you help most?