Key to PT decision: Know your company

Should your company have on-site PT services? That depends on what your company does, and on the nature of your employee population, says Dennis Isernhagen, PT, vice president of occupational health for Isernhagen Work Systems, a Duluth, MN-based international consulting firm for work injury management and prevention.

"When you look at companies from a therapeutic standpoint, you must look at the nature of the business," he explains. "For example, manufacturing companies are more of a prime target than non-manufacturing companies." His company’s data shows that 63% — 70% of all injuries are soft tissue injuries.

Size is not necessarily a critical determinant, Isernhagen says, because you can retain a PT firm for anywhere from a few hours a week to full time. "We will either work on an hourly rate, set a fee rate, or where there is (an) insurance, bill to the insurer," he explains.

What the employer must do to determine a need is look at what are his or her losses to date. "And you can’t just look at your PT bills," he emphasizes. "Rehab costs and medical costs alone could be very misleading. You must also look at lost days; loss in revenue per lost day [how much revenue that person would produce per day] and the cost of replacements."

Once you’ve decided to go the on-site route, check out potential providers carefully. "A firm’s previous experiences with other companies will give the employer a history," says Isernhagen. "You should ask each provider for their documented outcomes. Have they seen a decrease in the length of time employees are out of work? Have they produced a decrease in cost per episode of care? Did it take 20 visits or four to treat low back pain?"

You should also query the provider about his attitude towards disability. "You want someone who provides aggressive care, not passive care," Isernhagen advises. "Passive" care, he says, consists of heat packs, ultrasound, and other "feel-good" treatments. "You want a program that most accurately simulates the work situation of the employee, and gets him back to work as soon as possible – if not in his regular job, then at least in some job that has relevance. Having any time where the employee is totally away from work should not be tolerated, unless he really needs it."

Finally, once you have selected a provider, it’s important to lay a solid foundation for the program’s success. "It’s critical that the provider has the support of management," says Isernhagen. "He should also have a thorough knowledge of the company and of its culture. If there is a union, it’s extremely important to also engage that union and win its support."

[For more information, contact: Dennis Isernhagen, Isernhagen Work Systems, 1015 East Superior St., Duluth, MN 55802. Telephone: (218) 728-6455. E-mail: ddiiwin@aol.com.]