Low-cost physio programs fill void ahead of health cuts

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This article was published 21/11/2017 (2888 days ago), so information in it may no longer be current.

Alternative options are popping up for Winnipeggers whose access to publicly funded outpatient physiotherapy services will be cut off this weekend.

Although they won’t be free, private providers at facilities, including the not-for-profit Reh-Fit Centre, are opening programs meant to emulate outpatient physiotherapy they plan to offer at more affordable prices than one-on-one sessions out of reach for many without insurance.

Just last week, Reh-Fit launched its total knee-replacement exercise class. The sessions cost $15 each and are offered three times a week, designed after physiotherapists Jasmine Thorsteinson and Kelly Small visited outpatient units at Winnipeg’s Concordia, Grace and Victoria hospitals.

The idea, Thorsteinson said, was to design a class that would pick up where the Winnipeg Regional Health ­Authority’s (WRHA) outpatient program gets cut off.

“We spoke to the therapists there to make sure that we had a continuance of care,” she said.

“We tried to make sure that the program we were offering was quite similar.”

So far it’s doing the trick, Keith Hildahl said Monday, still sweaty from his noon-hour session.

Hildahl had a total knee replacement last month at Concordia Hospital. His surgery coincided with publicity around the reduction of the WRHA’s programming, leaving him uncertain about his options for post-operative physiotherapy.

“If you’re going to have a good outcome after a knee replacement, you have to do physiotherapy classes,” he said. However, when he was in the hospital, “they were in chaos because the physiotherapist didn’t know.”

There was some confusion around when patients would not longer be ­­referred into the program, Hildahl said, so when he learned Reh-Fit was starting a class, he signed up.

To join the sessions, patients need to be first evaluated by a physiotherapist such as Thorsteinson. Once approved to join, they can choose to attend however many sessions they like each week.

Each class is capped at 12 participants with two physiotherapists overseeing. Exercises still need to be done at home.

“We have stations set up that help improve their range of motion and their strength post-op,” Thorsteinson said. “They’re basically going from station to station with a checklist of the exercises that they need to address throughout the program.”

Although Reh-Fit only offers the program for people who’ve had total knee replacements — there are five participants since it opened a week ago — she said the plan is to expand to total hip-replacement patients as well.

Reh-Fit picked total knee ­replacements as a starting point, Thorsteinson said, simply because the group of patients having the operation was quite large and rehabilitation after such surgery is “super essential.”

The fact private providers such as Reh-Fit are starting to initiate low-cost options is quite heartening, said Jim Hayes of the Manitoba Physiotherapy Association.

One of the major concerns after the WRHA announced in July it was shuttering the bulk of the programming was many patients without insurance would not get the therapy they need because they wouldn’t be able to afford it.

“The fact that it’s taught by a physiotherapist, we believe is important,” Hayes said, not just because they’re there to explain the exercises and make sure they’re done correctly, but also because they provide a “trained eye” on recovering patients.

“It’s not a treatment, but it’s an observation,” he said. “From our vantage point, that’s extremely important ­because while it’s not a thorough assessment, it is sufficient observation that if a patient post-operatively is experiencing difficulty (the physiotherapist) would trigger further assessment and treatment.”

Outpatient physiotherapy is set to close Friday at Concordia Hospital, Deer Lodge Centre, Grace Hospital, Misericordia Health Centre, St. Boniface Hospital, Seven Oaks General Hospital and Victoria General Hospital.

Smaller, consolidated services are scheduled to begin Nov. 27 at Health Sciences Centre, where patients will be admitted to the program if they meet clinical criteria outlined by the health authority last month. Those who don’t meet the criteria will be referred out to private physiotherapists.

The majority of the outpatient physiotherapists will lose their jobs, while a dozen or so will be kept to staff the HSC program.

jane.gerster@freepress.mb.ca