Physical therapy is one of the medical practices that would seem to demand in-person office visits. So how did Carol Krehel, a doctor of physical therapy and owner of Valley Physical Therapy in Munnsville, respond to closing her own office due to the coronavirus?
She set up telehealth sessions to continue her services virtually.
“In March as the pandemic began to become a new part of our reality, I intended to stay open as long as I could,” she recalled. “Unfortunately, I had a patient with an exposure and felt that morally and ethically the only decision to make was to close the office for the safety and welfare of everyone.”
Krehel said she immediately began contacting her professional associates to check out her options. She joined a national network of physical therapists to stay up to date. They met every day in the beginning due to the daily – and even hourly – changes. Now, they are meeting less frequently and from time to time also receive input from the CDC and infectious disease physicians, as well as insurance companies.
She also reached out to her patients for their own input.
“I continued contact with all of my patients and began looking into a possible new option: telehealth,” Krehel said. “I was skeptical and couldn’t imagine how it would work. I began taking classes and learned quickly that I could still measure range of motion and functional strength and assess pain levels, limitations, etc. And so began telehealth PT at Valley Physical Therapy.”
Patient Linda McLyman just had rotator cuff surgery as COVID-19 forced New York State to pause back in March. She recalled she knew she would need physical therapy afterwards and was dismayed to hear Krehel could not see her personally. McLyman admitted she was “skeptical” about the prospects of telehealth therapy sessions – but that skepticism soon faded, as she was pleasantly surprised at the excellent progress she was making under Krehel’s guidance.
“Dr. Krehel never tried to sell me on the idea of working with her remotely,” McLyman said. “She did, however, present an optimism and willingness to try something new that was refreshing and exactly what I needed to hear.”
After finishing her final remote tele physical therapy session, McLyman reported she was “thrilled with my full progress.”
Some insurance companies require a referral for physical therapy, while many do not. Patients should contact their insurance company or call Valley Physical Therapy and they will usually be able to provide the information. As an added benefit, most of the insurance companies are waiving copays for telehealth PT at this time. If a referral is needed, the patient’s physician, physician’s assistant or nurse practitioner can assist in providing one.
Once an appointment is scheduled and paperwork completed, Krehel meets remotely with the patients at their scheduled time. She has found the telehealth sessions have been well received.
“Most of the patients doing tele-PT love it; the satisfaction rate has been 98-99 percent,” she said. “It is convenient, easier to schedule in their day, safe and they get full attention. The online process is very easy. You simply go online, type in an address and are taken into a waiting room were you will be clicked in for your appointment.”
Krehel said a typical telehealth appointment begins with a brief reassessment of how the patient is doing in general, including their current status, successes and challenges. They discuss strategies and future exercise programs and care throughout the session. Models and demonstrations are used and some patients will exercise along with Krehel.
Starting the treatments from home actually makes it that much easier to plan in-home work from then on.
“An added benefit to telehealth is the ease of figuring out how to accomplish your program in your home; at times we can are able to assess and address home challenges,” she explained.
At the end of the appointment, the patients will receive a plan that often contains notes, videos and exercises. Some materials like elastic bands are also mailed or delivered. Patients have access by phone or email in between visits if questions or issues should arise, Krehel added.
But possibly the one who misses patients coming to the office the most is Murphy the therapy dog.
“Many of my former patients have enjoyed my therapy dog,” Krehel said. “He misses the patient contact which is not possible right now but he is happy to give patients a virtual wave online as we sign off. Murphy brings lots of smiles and last year was even awarded a golden retriever award called ‘Heart of Gold.’”
Unfortunately, Krehel said that due to the pandemic her business is one of so many negatively affected by the shutdowns. Due to the many restrictive guidelines designed to insure safety for all, her normal practices have been limited. Coupled with some increasing expenses, Krehel had to make a heartbreaking decision to sell her building, she said.
“This is certainly not what I had planned; I thought that I would be there for many more years,” she admitted. “It has been a time of sadness after 20 years filled with joy at my practice in Munnsville. COVID-19 has changed the future of healthcare.”
But once the property has sold, depending on where the pandemic is at the time, she plans to rent a smaller space to continue in-person services. Telehealth, however, is likely to be a part of her outreach from now on.
“The current wisdom is that tele-PT will be permanent and I plan to continue these services as well,” she promised. “In addition, I may be doing some online teaching as well. I love what I do and plan to continue for many years. I will continue to work with my patients and help each one discover their potential.”
Krehel is a licensed physical therapist and residency trained doctor of physical therapy with specialty certifications in orthopedics and sports as well as several other certifications. She was trained at the University of St. Augustine and also has Masters degrees from Colgate and California Universities and a Bachelors from Dickinson College.
Patients can call 315-495-2100 or email [email protected] if they are interested in scheduling an appointment or receiving more information.