Effectiveness and efficiency of patient care while enrolled in an orthopedic physical therapy fellowship program

Abstract

Rationale: Post-professional orthopedic manual physical therapy education programs have proliferated, in part due to increasing therapist demand. Despite the time, effort, and money required to complete these programs, there is scant research addressing their impact.

We investigated whether physical therapists enrolled in an accredited manual physical therapy fellowship program achieved better outcomes, determined by patient changes in function, number of physical therapy visits, and episode of care duration while enrolled in the program. We also examined whether outcomes varied by clinician demographics, clinician life circumstances, and clinic characteristics.

Methods: Forty-two therapists contributed patient data addressing functional status, number of visits, and episode of care duration. We compared data from the first 30 patients with data from the last 30 patients seen by each therapist while enrolled in the program. We also surveyed therapists regarding their demographics, life circumstances, and clinic characteristics.

Results: There were no clinically meaningful or statistically significant differences in change in functional status when comparing results from the first 30 patients with the last 30 patients seen by therapists. However, there was a significant reduction in the number of visits and episode of care duration. Outcomes were influenced by entry-level degree and the presence of children at home.

Conclusion: In our study, enrollment in a physical therapy fellowship program did not improve patient functional status but did reduce the number of visits and episode of care duration. Outcomes were influenced by some clinician life circumstances and clinic characteristics.