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The New Reality: Physiotherapy to come back as hybrid model in Nova Scotia

N.S. health services to begin reopening Friday
WATCH: In the last two months, many physiotherapists have found a new way to work with clients. As Alicia Draus reports, as they prepare to reopen, they’ll use what they’ve learned to improve the practice.

This is the ninth in a series of stories looking at the new reality of life during the COVID-19 pandemic in the Maritimes. You can find the full series here.

Physiotherapy is a hands-on practice. Physiotherapists often help patients by manipulating joints and guiding stretches, but when they were mandated to shut down in late March by the Nova Scotia Government, the industry decided to try something new — Telehealth.

“It’s honestly not something I’d ever thought about,” says physiotherapist and owner of Scotia Physiotherapy Alison Beaton.

“I work a fair bit with national athletes, and it would have been a great solution with working with some of them, but I hadn’t thought of it in the past.”

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Beaton acknowledges that at first many clients were apprehensive and her workload dropped from over 15 patients a day to only one or two. But as the word got out, her workload increased and she says while it took some learning for everybody, she considers it a success.

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“It’s been more effective than we thought,” said Beaton.

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The New Reality: Massage therapy in the wake of COVID-19

Still, many are anxious to get back into clinics for the more hands-on approach. That can start happening Friday, but like most businesses, the new normal will look a bit different.

Physical distancing will be a priority as much as possible, with many clinics like Beaton’s rearranging the reception area and limiting seating.

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New Brunswick lawmakers consider their new normal

Patients will be asked to not show up early to appointments and in some cases clinics may ask patients to wait in their car when possible, and a receptionist will call them when they can come in.

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Beaton says her practice will also have patients fill out a questionnaire prior to each appointment to ensure patients with COVID-19 symptoms stay home.

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Hand sanitizer will be available in many clinics, and hand washing will be encouraged when both entering and exiting any clinic.

“It’s definitely going to be different,” said Beaton, but she says people are good at adapting.

Many clinics have hand sanitizer available for clients to use upon entry.
Many clinics have hand sanitizer available for clients to use upon entry. Alicia Draus / Global News

Inside the examination room, though, things will largely be the same — except that both the patient and physiotherapist will be wearing a mask.

“We will be in direct contact with patients,” said Beaton.

The Physiotherapy Association of Nova Scotia says patients may notice some treatments could change, or be switched for alternative methods.

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“As far as treatment goes, I think clinicians will probably really evaluate the value of each treatment that we do,” said Stephen Richey, president of the association.

“Clinicians will evaluate the risk.”

Consent will also take priority. Richey says informed consent was always required during physiotherapy sessions even before COVID-19, but will be increasingly important to make sure everyone is comfortable.

“Patients will probably see a little bit more of what they’ve seen in the past, or being a little bit more explicit than in the past, just to make sure that everyone’s clear as to what is going on.”

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There will also be extra measures taken behind the scenes that patients may not witness themselves, like increased cleaning.

Beaton says they will change the length of time they schedule appointments for to ensure there is time to clean spaces before and after a patient comes in.

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The clothing worn by staff is also being taken into consideration. While Richey says the science is still not clear on how clothes can carry the virus, they are encouraging their members to be mindful of what they wear into the clinic from outside.

“I think something most clinicians will want to consider is having clinic clothes, or some form of change of clothes or covering if that’s not always feasible.”

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Telehealth to stay

As clinics adjust to the new normal, Telehealth won’t be abandoned. Beaton estimates that her practice will likely see a 50/50 split of in-patient versus Telehealth appointments for the rest of year.

“I do have a number of clients that as we’re talking about reopening and planning for that reopening have requested to continue by Telehealth,” said Beaton.

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It will also be something that’s encouraged for anyone who is at higher risk of severe illness from COVID-19.

Physiotherapist Alison Beaton conducts a telehealth appointment with a patient.
Physiotherapist Alison Beaton conducts a telehealth appointment with a patient. Alicia Draus / Global News

And while COVID-19 forced many clinics to adopt Telehealth, it will likely continue on even after the pandemic, and can be something to help physiotherapists when their clients are sick or away, or even to expand their customer base.

“I’ve had some patients from other areas of Nova Scotia and from other provinces that I’ve connected with that I wouldn’t have before,” said Beaton.

And even patients who return to clinics will be able to benefit from what’s been learned through the Telehealth experience.

“It’s challenged physios to improve how they educate people, and how they explain things, and to problem solve a little bit more,” said Beaton.

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“I think it’s really also taught clients to be a bit more self-empowered and that they can change their pain, and can change their injury with some guidance, doing it themselves.”