1. The Surgeon-Therapist Relationship Derek Cuff, M.D. Suncoast Orthopaedic Surgery and Sports Medicine

2. Goals Discuss the role therapy plays Discuss ways to improve communication Discuss ways to improve education Encourage you to document your value

3. Surgeon-Therapist Relationship Surgery is a team sport – Surgeon – Patient – Operating room personnel – Nursing – Therapists

4. Surgeon-Therapist Relationship Therapist are a critical part of the team – Multiple interactions post-op – Involved through duration of healing process

5. Surgeon-Therapist Relationship Best outcomes when both excel Bad surgery + great therapy = bad outcome Great surgery + bad therapy = bad outcome

8. Surgeon-Therapist Relationship Open line of communication is critical – Instructions should be detailed and clear – Interact with your surgeons beyond PT notes – Phone, email, text etc if needed – Alert us to compliance issues

9. Surgeon-Therapist Relationship Beware of “Eval and Treat Shoulder” – Hold the surgeon to a higher standard – Protect yourself by requiring more guidance

10. Surgeon-Therapist Relationship Expanding your education is key – Learn more about the procedures – Go watch a surgery – Incredible online access as well

11. Surgeon-Therapist Relationship Gives you a mental picture of the mechanics – How does the repair construct look? – How does that artificial joint move?

12. Surgeon-Therapist Relationship Document your value Changing era in healthcare Value = Quality / Cost

13. Surgeon-Therapist Relationship Going to be a fight for healthcare dollars Treatments deemed high cost but low results will be cut Those who demonstrate the value of their care get paid

14. Surgeon-Therapist Relationship Fee for service model- Compensated for the number of treatments irrespective of outcome Value base model- Compensated for the level of outcomes you produce

15. Surgeon-Therapist Relationship Illinois- Avg. 43 visits: Cost $8066 Florida- Avg. 32 visits: Cost $2343 California- Avg. 22 visits: Cost $1529

16. Surgeon-Therapists Relationship Journal of Shoulder and Elbow Surgery 2012 – Dipalo et al. – 36% reduction of PT visits via an independent home program = no difference in outcomes after RTC repair

17. Surgeon-Therapist Relationship “You are an endangered species in the coming health care environment if you do not prove your value.” – JP Warner-Harvard School of Medicine

18. Surgeon-Therapist Relationship Fee for service model is in jeopardy of fading A therapists value may be higher if you treat the patient 22 times vs 43 times depending on outcome We will be judged (and compensated) on our outcomes

19. Surgeon-Therapist Relationship If we are judged on outcomes then surgeons and therapists are linked Surgeon is = to therapist in this equation Collaboration is critical

20. Surgeon-Therapist Relationship My advice – Document your outcomes – Only way to show and track your value and show you are critical part of the team – Use validated outcome scores to show you make a difference

21. Conclusions Therapist are a critical part of the team Push for open communication Maximize your education Document your outcomes

22. Thank You