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Rehab for an Industry

By wmadministrator

Successful Kentucky physical therapy entrepreneur Larry Benz has decided to take his own industry on as a patient and is working to change the way more than 170,000 U.S. physical therapists are taught and how they approach treating clients.

“The inconsistent and highly variable way in which physical therapists treat patients is wrong,” said Benz, whose base is Louisville. “The method of delivering education to PTs is barbaric. The system of treating injured workers is set up for failure.”

Ouch!

Benz has perspective and experience from which to assess his profession.

He began his PT training in the military and augmented it extensively as a civilian. He holds an MBA from Ohio State and a physical therapy doctorate from the Massachusetts General Hospital Institute of Health Professionals in Boston – both considered Top 5 institutions – as well as a PT masters from Baylor and a biology degree from Bowling Green (Ohio) State. He is board-certified in orthopedic physical therapy and electrophysiologic physical therapy.

Benz is a doer.

He opened his first Kentucky Orthopedic Rehab Team (KORT) clinic in 1987 and with a strong service ethic, built it into the largest private PT chain in the state. Its 35 clinics are located for easy access from patients’ homes or offices. With  more than 200 employees and the largest number of board-certified PTs in the state, KORT has 180,000-plus patient encounters per year in Kentucky and Southern Indiana. Additionally, KORT athletic trainers work on site with many employers and at least two dozen high school, college and professional sports teams. KORT also has an oversight role with 34 clinics in Florida.

In early 2008, however, Benz handed off management of KORT so he could pursue other entrepreneurial opportunities he believes will improve care in the industry. Currently under the umbrella of his PT Development LLC entity are: Evidence in Motion, Fit for Work LLC and Texas Physical Therapy Specialists as well as management of clinics in Colorado and Minnesota.

Fit For Work (www.wellworkforce.com) provides workplace physical and occupational therapy for employers, including distribution companies, grocers and medium to large manufacturing companies.

Louisville-based Evidence in Motion is “an education and business-practice consultation company whose sole reason for existence is to create and promote a culture of evidence-based practice within the physical therapy profession.” EIM operates under the slogan “translating evidence into practice.” It is introducing new media and educating PTs online through various formats, including myphysicaltherapyspace.com, and through online fellowship and residency classes allowing practitioners to continue their education at their own pace.

Benz is on a mission to change the profession. Physical therapy – often referred to as “rehab” – is provided for accident, disease and stroke patients. It includes therapeutic exercise, joint mobilization and manipulation, massage, ultrasound, light and temperature therapy and electrical stimulation. Therapists teach patients to use crutches, prostheses and wheelchairs. They use their knowledge of biomechanics to analyze movement. And much more.

Benz is convinced, though, that most PT treatment can be delivered better. By keeping abreast of the latest developments and best practices, he envisions that “physical therapists will become the practitioners of choice in the management of musculoskeletal disorders.” He encourages the military’s model under which PTs are involved on the front end in assessing injury and intervening early on rather than seeing clients after everyone else.

Benz says 90 percent of what most medical PT clinicians do, regardless of how many years they have been practicing, remains what they learned in school or their clinical internship. And according to Benz, the majority of these day-to-day techniques aren’t validated by scientific research. Without the latest evidence-based techniques, he argues, therapists and providers are not applying current best practices to their patients.

As a physical therapist who went through training and internship in the 1980s, he noticed there were more than 200 PT programs in the country, but only 5,000 graduates. He has worked to develop a more effective way to train PTs and to deliver treatment to patients. His mission is to change the way all physical therapists in the United States practice by getting them to embrace and practice utilizing the best current evidence.

“We teach physical therapists how to access databases of information,”  Benz said of EIM. “Residency programs and therapists around the country are taught where to search and the best techniques to use. It’s hard to keep up with professional journals, so we’ve brought experts together to look at each diagnosis and decide on the best treatment using the latest, best and current evidence. I do Webinars and online training. The field of medicine is usually slow to adapt and lags behind business in terms of practices, (although) not in equipment.”

Benz has assembled his companies and a team of like-minded “evangelists” to rehab the profession – to change the way workers in physically demanding jobs are treated and alter new physical therapists’ education and professional training. They advocate placing students in a clinical network they have developed using their own standards. He describes these placements as the equivalent of medical school “matching” that has been successful for years.
Anthony Delitto, PT, Ph.D, FAPTA, is an associate professor and chair in the Department of Physical Therapy at the University of Pittsburgh, with 32 years in the physical therapy field and has known Benz five years. Delitto and his colleagues constantly seek ways to make therapists more efficient and have incorporated ideas Benz shared with them.

“I believe that Larry represents what is truly good about the profession of physical therapy,” said Delitto, who is vice president for education and research at Centers for Rehab Services, one of the largest PT providers in western Pennsylvania. “He is committed to the best possible care and delivering this care in the most efficient manner. He is very long-term oriented, and his ideas are refreshing. The notion of using physical therapists in the primary management of musculoskeletal disorders is both effective from the patient’s perspective and cost-conscious from the payer’s perspective.”

Kim Maddox, who has been in the field of physical therapy since 1988 and known Benz almost as long, agrees.

“Larry’s an innovator and a visionary,” Maddox said. “Those words are overused these days, but he’s creative and inventive, never content with the status quo and always pushing for the next best thing. He’s passionate about his craft, works hard to promote the discipline and tirelessly helps to develop those around him.”

Maddox lauds Benz for setting up a work atmosphere that’s trusting, fun, and energetic: Therapists act proactively based on what’s best for the client rather than always worrying about what will happen if something fails.

Maddox credits Benz for establishing an online presence to pursue his goals. He developed the largest social networking site and the most subscribed-to blog in the industry.

“Larry and his partners have rocked the PT world with Evidence in Motion. EIM has constructed ways for PTs to stay current with their treatment approach, which is extraordinarily helpful to PTs and the profession as a whole,” Maddox said. “When you think about it, it’s hugely difficult for PTs – or physicians for that matter – to keep up with the most current evidence. Each year, there are 460,000 articles added to Medline. And we as patients expect our PTs and our docs to be knowledgeable about all this, and the truth is they aren’t keeping up.”

EIM presents the means to keep up with musculoskeletal disorders via a blog, daily e-mails that link PTs to evidence within categories of their choice, professional/social e-networking groups, online courses, a residency and fellowship program and other resources.

PT professionals who previously had to relocate and study under an approved clinician to perform a residency now can continue their education from home without having to uproot their lives. Professionals can take up to 90 percent of EIM’s certified programs online. The remaining components require a PT to complete four weekends of hands-on training at approved partner clinics over a 12-month period.

Dr. John D. Childs is part of the executive team for Evidence in Motion. He’s an assistant professor and director of research for U.S. Army-Baylor University Doctoral Program in Physical Therapy and an assistant professor in the Army-Baylor Post-Professional Doctoral Program in orthopedic and manual physical therapy.

“Larry is a visionary in the physical therapy profession who understands the value of providing high-quality care based on the latest research, combined with the personal touches of great customer service,” Childs said. “He would probably argue that physical therapists are vastly underutilized. … Drugs, imaging and surgery consume the vast proportion of health-care costs when it comes to managing patients with musculoskeletal conditions, and patients frequently don’t encounter a physical therapist until the biggest ‘window of opportunity’ (early in an episode) has been lost.”

Childs said Benz is advocating “improving the brand” for the physical therapy profession. The recent momentum in the profession to focus on presenting physical therapists as experts in managing patients is something Childs believes Benz has been influential in creating.

In 2006, Benz received the New York-based Gallup Healthcare Group’s annual Excellence Award, which honors best-practice innovators for ingenuity, improvement and accomplishment from which the rest of the industry may learn. Benz also was the 2006 Regional Ernst & Young Entrepreneur of the Year for the South Central Ohio and Kentucky region.

What plans does Benz have for the future?

“Practice management is a weakness, so an executive management course in the physical therapy field is needed,” said Benz. “I want to expand clinics in western Kentucky under the Pro Rehab name, create a network of clinical sites around the country that have embraced EIM to contract with physical therapy programs, and make Evidence in Motion one of the largest orthopedic physical therapy residencies in the country.”

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