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Why you need an Out-of-Network Physical Therapist

Hey guys!


Happy Friday and for many of you the end of the work week! For those of you who don’t know me, I’m Alli! I own Empowered Physical Therapy and have been fortunate enough over the last 2 years to no longer classify my weeks by my work.


See, I love what I do for a living. Helping those who are struggling with pain to move and feel better allows them to enjoy their lives as active, physical beings. Pretty cool job right?! Now, the term “job” should be used cautiously as many in the workforce view this as something they HAVE to do. “I have to go to work today”. “I have to go to a meeting.” “I have to work late again tonight.”


Sound familiar?


Yea, me too.


I worked as a staff physical therapist for an in-network physical therapy clinic for almost 3 years. During which I felt myself begin to fall into the stereotypical in-network ways. I was seeing 2-3 patients at a time, I would defer treatment to an assistant if possible, utilizing multiple modalities (ice, heat, e-stim, ultrasound) at each visit was considered the standard of care, and I would see everyone at least twice a week.


As you can imagine this turned a very ambitious Dr. Alli straight out of PT school into an in-network zombie by year one. I was exhausted both physically and mentally. I was trying so hard to treat people the way I WANTED to treat them but still maintain a predetermined level of productivity that was expected of me. Summer 2018 I hit my breaking point and realized this was not the model made for me. It was time to take my “job” back and stop “working” so hard.


When I opened Empowered Physical Therapy in early 2019 I knew I wanted to operate under a different model. I wanted to provide my patients not only with the best care, but the most enjoyable experience as possible, because let’s face it – pain sucks. No one wants to go to physical therapy. That’s because we have all had a poor experience in an in-network setting.


At Empowered we have CHOSEN to be an out-of-network clinic. I have CHOSEN to do so because to me physical therapy should be so much more. My core values line up best with the out-of-network model because I believe in the following:

- I believe every manual technique, corrective exercise, and drill given requires the eyes and mind of a doctorally trained therapist.

- I believe that if patients are put into the right setting to work on themselves both body and mind 2-3 appointments a week can be overkill and unnecessary.

- I believe that having shoulder pain in an overhand tennis serve or low back pain in the bottom of a squat are major problems when it comes to quality of life.

- I believe in getting people better quickly and educating them on taking care of their own bodies.


So, I’ve given you my perspective as a health care provider and now you may be saying “yea, sure Alli – but how different can the two models really be?” Let’s compare the same path to recovery for two 35-year-old men recovering from a torn rotator cuff. Mike chooses to go the private-pay route with Empowered PT, while Tim sticks with the traditional third-party reimbursement track. Before we dive into the breakdown, we will assume one crucial thing: both Iron Mike and Tiny Tim have met their annual deductible and have chosen conservative over surgery (which has better long-term outcomes according to the latest medical research) so Tim qualifies for reimbursement from his insurance, which typically looks like 20% out-of-pocket or $30 co-pays per session. If we take the “standard” protocol in an insurance-based model for a torn rotator cuff in a healthy individual (25-35), the patient will typically need 4-6 months of rehab requiring passive and active PT (~2 times per week) according to the US National Library of Medicine. In our model we typically see the patient 1x a week and give them an extensive home program so he or she can begin working on this stuff at home. We also see our patient on overage 6-10 times during a plan of care and quickly go from rehabilitation to working on performance and prevention.



MIKE TIM



At the end of 6-months, Mike has spent $480 more out of pocket than his buddy Tim. Although both men were recovering from similar injuries, Mike invests less than a third of the time (10.6 vs 32 hours) for a fuller recovery that got him back to the lifestyle he loved sooner. This outcome also doesn’t account for the intangibles around enjoying a dynamic, individualized care plan and relationship built with his Empowered PT. Furthermore, had Tim NOT met his deductible, this care path through traditional PT would have cost him $1,688 ($101 for the initial evaluation + 23 sessions at $69/ea) out of pocket, which would have him spending $488 more in less-effective care than if he had gone through Empowered PT. Now, you may be thinking this is crazy and your head may be spinning. You pay for health insurance and feel that you should be able to use it.


Let’s change our perspective a bit. Let’s try to look at your health insurance like your car insurance. Your car insurance won’t pay for new tires, or brakes, and if you need an oil change or gas you don’t look for a service station or mechanic that works with your insurance company. Your car insurance is for major accidents, and really unfortunate situations. Your health insurance should be viewed the same way. At Empowered Physical Therapy we make a conscious decision to not work with any insurance companies because they are not looking out for your health and wellbeing. Instead, they are looking out for their bottom line.


Like parachutes, physical therapy is not something you should get for a bargain. You get what you pay for. Other clinics might be cheaper. But they’re also not as good. If cost is what you value most – more so than who treats you or how long it takes to get better – let’s cut to the chase and save each other valuable time: we’re probably aren’t the right provider for you.


But, instead of saying “its too expensive” say “my health is just not worth the investment” and see how that sounds…




At Empowered Physical Therapy we choose to do REHAB DIFFERENTLY. Which path will you choose?

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