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Physical Therapy Without a Doctor’s Referral

Greg Roskovensky • Jan 23, 2015

Did you know that as of January 1st of this year, you’re allowed to go see your physical therapist without having to go to the doctor first?  I bet you didn’t.  I also bet you didn’t know that current research shows that physical therapist are as good as diagnosing musculoskeletal issues as any physician out there with the only exception being orthopedic/sports medicine surgeons.

Michigan is one of the last states to allow this to happen.  Unfortunately, this is a process and most insurance companies aren’t going to cover these services without a physician referral.

Why is that good for you?  At Advantage Performance Therapy, we work on a cash based system so we don’t bill insurance.  We don’t accept insurance because I feel that working with the restrictions imposed by insurance doesn’t allow me to focus on you as a person, but forced me to look at you as an impairment.  Cash based therapy often times allows you to get out of my care in 2-5 sessions rather than 8-12 visits.  Also, if you had a high deductible you could be paying $400 dollars per hour until your deductible is met.  We are significantly cheaper than that and will only need a few visits.  Your information is also stored on a HIPAA protected server and is not at risk.

Let’s say you workout at Advantage Strength and Conditioning.  You have a nagging injury and you want to get it checked out.  Rather than go see your family physician, then potentially get imaging that is likely not going to affect any outcome of your treatment (some research shows that getting an MRI correlates with poor outcomes), then go see a specialist who will sit down with you for a few minutes and send you to physical therapy, you can stop in on a Thursday night and get evaluated without prescription.

At that point, it’s my job to determine whether you fit within the scope of my practice.  If I feel like I can help you, I have 10 visits or 21 days to give it my all to help you.  If your symptoms are not responding as standard, conservative treatment should, then we get you to your doctor.  If your symptoms seem strange or don’t quite add up, we can always get you to your doctor as well.

Early physical therapy interventions correlate well with better outcomes of therapy.  Many people experience pain and dysfunction for months before they get whatever is ailing them checked out.

Send me an email at: [email protected] and let’s talk about that nagging or brand new pain you have.

Not injured but want to get ready for baseball/track/spring football?  We can prepare a corrective and strength and conditioning program to get you ready for the season.

Already working with Brian or another coach?  Let’s get you fixed up and back to training with strength coach.

Want to swing by and talk about mid 90’s to mid 2000’s comedies?  I’m game with that as well 🙂

29 Mar, 2022
So far I’ve introduced a little about the “non-diet” approach , as well as the Diet Cycle , which many people find themselves stuck in when using a restrictive “diet” approach to food and health. For some of those people, the idea of eating what they love and “giving up” on diet or weight loss doesn’t seem like an option, understandably. We face a LOT of pressure, day after day, to eat “clean” and lose weight. That pressure may come from well-intentioned family, friends, and healthcare professionals who are concerned about our health (more on that later); or from fear-inducing headlines that compare sugar to poison; or from photo-shopped & face-tuned ads on Instagram of celebrities selling their flat tummy tea or shapewear. We are surrounded by Diet Culture, and are forced to engage with it- no matter if it’s coming from our loved ones, acquaintances, coworkers, or even strangers. What exactly is Diet Culture? You might have an idea just from the sound of it... Messaging that promotes diet & weight loss. Right? It’s actually more than that. Here’s a definition from Aubrey Gordon, author of “What We Don’t Talk About When We Talk About Fat”: Diet Culture: “A system of cultural beliefs and practices that equates thinness not just with health, but with moral virtue, and which advocates for weight loss at any cost. Diet culture isn’t just a matter of being on a diet, but of the social forces that make dieting (or lifestyle changes or wellness) culturally mandatory for so many of us.” The key phrases are “moral virtue” and “weight loss at any cost”. Diet culture doesn’t only convince us that weight loss is necessary (to be beautiful, to demonstrate our worth, or to be healthy); but it creates this pressure that we are MORALLY obligated to do so. In order to be perceived as good, responsible people, Diet Culture urges us to pursue weight loss at any cost- which could mean sacrificing our social life, a significant amount of money on supplements or meal replacements or programs, our emotional wellbeing, and even our physical wellbeing. Maybe diet and weight loss aren’t so healthy after all… And while this may not be everyone’s experience, we have research that demonstrates the following emotional impacts of restrictive dieting: Dieting is associated with higher anxiety levels (Kwasnicka, 2020) Dieting is associated with poorer emotional and mental quality of life (Burns etal, 2001) Dieting is linked with reduced life satisfaction (Esch and Zullig, 2013) Further, restrictive dieting has actually been found to cause weight GAIN. To be clear, weight gain is nothing to be ashamed about (bodies change!); but if the multibillion dollar diet industry is selling a diet plan for weight loss, they’re not exactly being honest about the likely outcomes. 1⁄3 to 2⁄3 regained weight within 1 year, with almost all weight regained within 5 years (1992 NIH Consensus) Most weight is gained back within 2 years and most gained back all the weight by 5 years (2013 Australian Research Council) A team of UCLA researchers reviewed 31 long term studies on the effectiveness of dieting and concluded that dieting is a consistent predictor of weight gain —up to two-thirds of the people regained more weight than they lost (Mann 2007) This quote from Weight Watchers former Finance Director sums it up pretty well:
07 Mar, 2022
Good morning! Thank you to everyone who came out to Break the Diet Cycle presentation. I hope you’re starting today feeling curious about Intuitive Eating and eager to rediscover your favorite foods in a fresh, positive way. I attached the PDFs of the presentation for you to reference, as well as the “HAES (Health at Every Size) Manifesto”, by Dr. Lindo Bacon, author of Health at Every Size. This provides a snapshot of the science behind the weight neutral approach, Health at Every Size, which Intuitive Eating is aligned with. For those of you who couldn’t attend, you may be wondering- what exactly is Intuitive Eating? As I mentioned in an earlier newsletter, Intuitive Eating is a non-diet approach to food and health. The framework consists of 10 principles to help you examine and reevaluate your beliefs & attitudes about your body, your food, physical activity, health, and more. While practicing Intuitive Eating, individuals relearn how to eat in accordance to their natural hunger and fullness cues; food cravings; energy needs, and so on. They begin to trust their body to tell them when to eat, what to eat, and how much to eat. The Ten Principles of Intuitive Eating are: 1. Reject the Diet Mentality 2. Honor Your Hunger 3. Make Peace with Food 4. Challenge the Food Police 5. Feel Your Fullness 6. Discover the Satisfaction actor 7. Cope with Your Feelings without Using Food 8. Respect Your Body 9. Exercise to Feel the Difference 10. Honor Your Health with Gentle Nutrition Intuitive Eating may seem like a straightforward concept, but in a culture that heavily promotes dieting and weight loss as a path to health, happiness, and even moral virtue, it can be hard to break out of the Diet Cycle (seen below). Also known as the “Restrict-Binge Cycle”, this eating pattern is typically kicked off by some diet thought, like “I need to lose weight” or “I need to start eating better”.
25 Jan, 2022
Snack Break with Mary Registered Dietitian-Nutritionist & Certified Intuitive Eating Counselor at Advantage Strength
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