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Digital Health: Friend or Foe to Brick-and-Mortar PT

October 28, 2021 • Advocacy • Heidi Jannenga

If you ever wanted to see the survival of the fittest ideology play out in the business world in real-time, last year was the perfect time to watch the market. Brick and mortar businesses ran the gauntlet as they struggled to find enough customers (or in our case, patients), to buy their products or services given in-person interactions were banned in the interest of public health. In our industry, only the most financially viable and innovative practices stayed afloat—and that was largely thanks to digital healthcare services.

Virtual care exploded during the pandemic.

Whether it was via telehealth, e-visits, or phone visits, many brick-and-mortar practices began connecting with patients digitally for the first time ever. But more than that, fully digital (and generally non-PT-led health and wellness services) found their footing in the market, catering to patients who weren’t too keen on leaving their homes. These companies—which I’ll refer to as digital musculoskeletal (MSK) companies from here on out—boomed.

In fact, the digital health market closed the first quarter of 2021 with $6.7B in US funding, becoming the most-funded quarter in history.  And now, as we’re learning how to navigate this new, increasingly tech-centric world, many are left asking, “Should we be wary of these digital health upstarts?” “Could these newcomers devalue—and potentially displace—brick and mortar PT services over time?”

I recently had the opportunity to discuss this topic with some of the biggest leaders in the industry at the WebPT Ascend Executive Summit, and I came away believing even more strongly than I had previously that for PTs to have a clear path forward, we must embrace this surge of digital health—and learn how to use its innovations to our advantage.

In order to do so, however, we must be honest about our profession’s shortcomings, check our egos, and be unified in our efforts to turn these weaknesses into opportunities.

PTs have less-than-spectacular market penetration.

The PT profession has an enormous potential patient market. According to the World Health Organization, “approximately 1.71 billion people have musculoskeletal conditions worldwide”—and about 128 million of those individuals reside here, in the US. Yet even though PT is in higher demand than ever before, PTs are only servicing 10% of the patients who could actually benefit from care.

That’s 90%—or 116 million—adults with musculoskeletal pain who aren’t achieving their best health. So, to say we have some major issues surrounding patient access to our care is a huge understatement. However, brick and mortar PTs are not the only ones who know the potential that exists in this space.

If PTs don’t tap that market, someone else will.

Over the past two decades, private equity activity has been steadily climbing in the physical therapy space, in part because we have enormous potential for growth. In fact, it’s estimated that the PT industry will be worth $45.7 billion by 2023. While this is undoubtedly good news for our profession, the consumerization of healthcare and shift to value-based care has caught the eye of market disruptors (i.e., digital MSK companies), and they’re just as eager to get a slice of that private equity funding.

They’re pursuing consumers from our market, and they’re already finding success. For the first time in human history, digital MSK healthcare companies were among the top six funded clinical indications—and I personally believe that we’re going to see more of that moving forward.

Digital MSK companies are already thriving.

Let’s look at a case study: Hinge Health. Hinge Health is a fully digital healthcare service that provides complete musculoskeletal care to its consumers. It uses the latest tech (like motion tracking) to help its members improve their virtual care, and it has an all-in-one app that members can use to attend video calls and access their records. The company also prides itself in being “high-touch,” with employees frequently reaching out to members to assist them with their care or encourage them to begin a new care plan.

Digital MSK companies find success by offering convenience.

For all of physical therapy’s strengths and virtues, one area it often falls short is in regard to convenience. We ask patients to drive to our clinics one to three times a week—in addition to setting aside time to complete daily HEPs. Many clinics are still relatively “low-tech,” eschewing digital intake, automated appointment reminders, or digital scheduling solutions—equating to less convenience for patients.

This is exactly where digital MSK companies like Hinge Health thrive. They:

  • Reduce communication friction by allowing members to communicate directly with the leaders of their care;
  • Provide the convenience today’s patients crave; and
  • Reduce out-of-pocket expenses for patients and businesses alike.

To me, this looks like a successful blueprint for happy patients: Why not put it to good use?

Digital care isn’t our enemy—and it’s time to give it the credit that’s due.

I believe that the digital changes around us are here to stay and that we cannot afford to be aloof and apathetic toward them. Considering our industry’s potential, we serve a relatively small patient sector, and frankly, I don’t think we’re in a good position to remain complacent with our current treatment practices. We must keep up with the times, embrace change, and revamp our profession with a digital environment in mind.

And instead of clamming up around these digital competitors and writing off their tactics offhand, I think we should study them. It’s in our best interest to understand the successful business models of other digital MSK companies, see what appeals most to consumers (or patients), and try to adopt those practices to our own clinics.

It’s time to commit to leveraging virtual care.

If we want to live up to the convenience of our digital MSK competitors, we need to commit to leveraging virtual care. During the height of the pandemic last year, an enormous number of physical therapists used virtual care to treat their patients, and that number has plummeted as states opened up and allowed patients to resume their outpatient care.

I believe this is a huge missed opportunity. We need to commit to offering telehealth, an enormously convenient treatment option, to our patients. We know it’s an excellent treatment option, and for some diagnoses and patients, it results in outcomes equivalent to in-person care.

Create a high-quality, high-touch patient experience.

We also desperately need to digitize our industry’s administrative processes—from scheduling to payment to HEP distribution—giving patients the high-quality care and easy convenience that they crave. Specifically, we must embrace technology and offer:

  • Telehealth options,
  • An HEP app for their phone,
  • Online scheduling and a payment portal,
  • Digital patient intake options, and
  • Digital review options.

Digital MSK companies also excel at keeping the conversation flowing with members. They reach out to past recipients of their services (even those who dropped out of care), creating an opportunity for those people to schedule more appointments. They also offer services based on the patient’s hobbies and level of activity (e.g., gait training for patients with fall risks and injury prevention for athletes).

We should absolutely adopt these practices in our care. Keeping in touch with patients is the best way to get them to recommend our services to their friends or return for our care if they, unfortunately, need it at a later time.

It’s time to reimagine the DPT school curriculum.

Modernizing our industry won’t be easy, however, as we’ll need to redesign our approach to digital care from the ground up—starting at DPT school. We need to evaluate how our DPT programs are exposing students to technology. Are they learning how to provide virtual care—or even how to navigate any of the digital solutions (like EMRs) that they’ll have to use daily? To prepare our profession for the future, we must immediately integrate telehealth processes, protocols, and interactions into the student curriculum—especially in this rapidly digitizing clinical climate.

Begin training staff now.

Of course, change takes time in our profession—but we can’t afford to twiddle our thumbs for 10 years while we wait to see widespread technology adoption. We reacted brilliantly in response to the pandemic and our patients’ evolving needs, and we have proven that virtual care can be effective—so why are so quick to fall back into the status quo? Payment is often cited as a reason for not evolving our care, but this is exactly where savvy clinic leaders can step up. By dedicating time to training staff on telehealth, clinic technology, and the digital patient experience, we can achieve an improved patient experience with reduced overhead costs—and potentially, increased patient volumes. We must start edging into the digital healthcare market today or risk becoming overshadowed by digital MSK companies that are highly funded and not hindered by antiquated predispositions.


I believe that PTs can make a huge positive impact on millions of more patients than we do today—if we set ourselves up for success. But it will require a focus on innovation, patient-centric long-term thinking, and razor-sharp business acumen—especially as our industry continues to attract digital disruptors. So, what do you think? I’d love to hear your thoughts on the “threats” to our profession.

Heidi Jannenga

Heidi Jannenga, PT, DPT, ATC, is the co-founder and Chief Clinical Officer of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi advises on WebPT’s product vision, company culture, branding efforts and internal operations, while advocating for the rehab therapy profession on a national and international scale. She’s an APTA member,...

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