Advancing the Profession: Early Intervention for Injured Workers

Timing is everything—especially when it comes to accessing physical therapy treatment. Dr. Tim Phillips, a 2008 Transitional Doctor of Physical Therapy (tDPT) and 2006 Manual Therapy Certification (MTC) graduate, has done the research to prove it.

Improving Healthcare Management for Work Injuries

Dr. Phillips’ tDPT capstone project focused on improving healthcare management for injured workers. It was inspired by a Wall Street Journal article on healthcare cost reduction that Dr. Wanda Nitsch, then USAHS’ president and chief academic officer, shared with him. Dr. Phillips’ capstone thesis sparked the interest of his boss at Spectrum Health, a not-for-profit managed care organization that employs 31,000 people in western Michigan. Spectrum supported Dr. Phillips in running a pilot study testing early therapy intervention for its employees who were receiving worker’s compensation.

Dr. Phillips, who is the service line lead for his department of 700 rehabilitation employees, served as principal investigator for the study, leading a team of six physical therapists and three occupational therapists. He tracked 75 Spectrum Health employees with musculoskeletal injuries who attended one of Spectrum Health’s occupational medicine clinics between January 2012 and June 2013. In the pilot program, each patient was examined by both the occupational medicine physician and the physical therapist. Rather than having patients wait an average of 35 days to start physical therapy, the research team provided them with education, treatment, and a home exercise program during their first visit.

“The wait time for worker’s compensation cases can be terrible. Patients get increasingly frustrated when they have not been able to get answers to their problems and have to wait weeks to see a specialist,” says Phillips. “Our first interaction set the tone for the continuum of care for patients. We found that patients were making forward progress by their second and third physical therapy visits.”

When compared to 2009 data, the study demonstrated significant reductions in the duration (24%) and cost of care (46%–70%) when physical therapy evaluation and treatment became part of the initial visit for musculoskeletal injuries.

Dr. Phillips notes that the study also dealt with two hot-button issues. “Patients who saw early results from physical therapy were not banging down the doors for prescription painkillers or for additional imaging tests, which often is the case for patients who do not receive immediate attention and remain in pain.”

An Impactful tDPT Capstone Project

Dr. Phillips’ research paper, “Early Access to Physical Therapy and Specialty Care Management for American Workers with Musculoskeletal Injuries,” was published in April 2017 in the Journal of Occupational and Environmental Medicine. It has helped raise the stature of physical therapy to the executive level at Spectrum Health, says Dr. Phillips, who credits his doctoral training with helping him develop strong critical thinking and reasoning skills. “We are now viewed as a critical part of a cost-saving team that is giving customers what they want.”

Dr. Phillips, who never envisioned himself as a researcher, now sees research as a path to promote change in healthcare. “You do not need an elaborate study design. Find a good mentor, and if you have a hunch about a promising research project, particularly where waste is evident, pursue it.”

The University of St. Augustine for Health Sciences (USAHS) offers an online Transitional Doctor of Physical Therapy (tDPT) program* designed for working clinicians, with optional on-campus immersions (currently postponed due to COVID-19). Specializations include Manual Therapy, Primary Care, Craniofacial, Teaching & Learning, and Executive Leadership. Complete coursework when and where you want and earn your advanced degree while keeping your work and life in balance.

*The Transitional Doctor of Physical Therapy program is not subject to accreditation by CAPTE.