Making a Difference: Fed up with the status quo, a physical therapist assistant discovers a better way to serve her patients

Part I
Guest blogger: Mary Morgan Saalman 

Mary Morgan Saalman

My life as a physical therapist was hectic. Like most healthcare practitioners, my patients came in for treatment and were out in no time, leaving little opportunity to discuss or understand their situation beyond the physical. Feelings and concerns were after-thoughts. They entered the room and the clock started ticking. Patients were seen usually for forty-five minutes—maybe an hour—during a typical physical-therapy session. As I treated a patient, I may have felt that we were making a break-through, but then time was up, and I had to usher them out because the next patient was waiting. 

I have become increasingly frustrated with this situation over the years. The insurance companies always seemed to be a dark cloud, looming overhead, dictating every move we made. Nothing could be done for my patients without insurance company approval. Almost always, patients would talk to me about how they could not afford therapy for very long, or that their insurance wouldn’t pay for it or other less invasive forms of treatment. The insurance companies, however, were all too happy to pay for extensive surgery, if the physician recommended it. 'Why?' I wondered. What was their justification for this and how did it save money, decrease the cost of insurance, or make healthcare more affordable and accessible?  And more importantly, was this best for the patient? Why was/is it so difficult to access high-quality, affordable health care?

The main reason people have difficulty accessing quality medical care is the lack of insurance or inadequate coverage with high deductibles. For many individuals and families, a $3,000 or $5,000 deductible feels as if they have no insurance at all. Many people live paycheck to paycheck and do not have the money to see a doctor, unless they are forced to because of an illness or an emergency.

Another road block to accessing quality medical care is the fact that our society has evolved into one that treats the illness while disregarding the overall well-being of the person. The bulk of our medical practitioners are taught to set up literal conveyor-belt type businesses that move patients efficiently in and out of the office, seeing as many people as time affords. Medical students are taught during their education to look at the body in parts with the mindset of alleviating patients' symptoms in order to make them feel better. Of course, this often means medication or too many unnecessary surgeries. Many healthcare practitioners feel that if the patient is not “feeling” their symptoms, well, that’s a good thing, and this is the outcome they and their patients want. Unfortunately, this has led our country down an ominous road to opioid addiction, unhealthy habits, and too many unnecessary surgeries.

Numerous medical practitioners schedule patients in fifteen- or thirty-minute increments, perpetuating the conveyor-belt business model, ensuring themselves a healthy bottom line. Healthcare professionals often limit the time with their patients, which leaves little time to talk and learn about the “whole” person, rather than just their sore back or headache. This perpetuates the dependence on pharmaceuticals, which “will fix everything.” I believe it is this mentality, inherent in our healthcare industry, that is preventing us from not only receiving quality medical care, but also from taking care of our mind and body in integrated ways, which would improve our health and save us money. The U.S. healthcare apparatus is driven by greed, making the status quo extremely difficult to change. 

Another obstacle to accessing quality medical care is the fact that insurance companies dictate patient treatment. Every medical care professional who accepts insurance must adhere to the regulations of the insurance industry. Every physician’s plan of care for their patients takes in to account what the insurance companies will cover. For example, if you are diagnosed with a condition and have insurance, your ability to receive the treatments or therapies you need are completely and totally based on what your insurance company considers “necessary and reasonable.” Your physician might feel you need specific tests or medications. However, your insurance company may state they are not necessary. Therefore, unless you can afford to pay for expensive medications or tests out of pocket, you might not have access to the care that you need to improve, or sometimes, survive.

There are plenty of healthcare professionals, such as myself, who treat the entire person as opposed to a sick person who has a bad back, a sore leg, or cancer. However, we are the outliers in the medical community. Even when patients go back to their physicians and tell them that they went to a healthcare practitioner and received an alternative therapy and are feeling the best they have felt in a while, most physicians will immediately scoff and/or write this off, continuing with their business model of get them in, get them out, see more people, etc. This is not quality care. It limits people from finding other forms of healthcare that would not only help them feel better and many times quicker, but would also save them precious dollars because they would not be caught in the revolving door of traditional medicine. The rigid adherence to the traditional medicine model, in my opinion, is a defect in the medical programs in our universities, as many healthcare professionals will agree.

For the record, I am not saying that medications do not have a place in healing, because they most certainly do. There are medications that indisputably save and improve lives, and I am thankful that we have talented people who can create these medications and find cures for terrible diseases and conditions. On the other hand, if we would begin to pay more attention to and tend to our overall health—our bodies, minds, and spirits—maybe some of these diseases and afflictions would become less common.

It is for the reasons I have outlined above that my mindset about bodies and health have evolved over my twenty years in the healthcare field, as a practicing physical therapist assistant. I have practiced in every area: pediatrics, hippotherapy (using the horse as a therapy tool), outpatient clinic, long-term care, and home health. I have always loved what I do. I love helping people to feel better and regain their lives. However, as the years went by, I could not help but feel that something was missing; something just wasn’t right.

I also began to realize that although many of my patients recuperated almost 100%, most others would not. Most patients show improvement. Maybe they begin therapy with a pain level of 9/10 and they finish with one of 5/10 and improved, yet limited mobility. Many patients were returning several times a year for the same problem. Why? And why is this acceptable? Why can’t people improve more, sooner, and spend less time and money on therapy, physician visits, medications and/or surgeries? As physical therapists, most of us are taught in school to treat the “areas” of pain or the “conditions.” Someone comes in with a painful shoulder, so we treat only that shoulder, ignoring that there is an entire body and systems within the body that all communicate with one another. It was these feelings of inadequacy and frustration that led me to find, what I feel to be, one of the most important modalities/treatments for our bodies, the John Barnes Approach to Myofascial Release.

John Barnes is a physical therapist who developed his technique after experiencing his own dramatic injury in college over forty years ago. He focuses on treating the fascial system. He has trained over 150,000 therapists, nurses, chiropractors, and physicians worldwide. Myofascial release is a gentle, hands-on technique that releases restrictions in our fascia, or connective tissue. To learn more about fascia and how John F. Barnes’ Approach to Myofascial Release has helped to heal thousands of people, you can visit my website Advanced Healing Myofascial Release and Wellness, LLC and/or  MFR Treatment Centers & Seminars. You will find helpful information, articles, and book recommendations about the fascial system and the conditions and diagnoses that MFR can help. If you are interested in finding a therapist or attending a seminar, you can search for one in your area on Mr. Barnes' website.

After my first seminar, not only did my life change, but also the lives of many of my patients. It was beyond anything I could imagine and set me on a new path to healing others.

In Part II we learn about Mary’s transition in the medical field, trends in the industry, and  how she started her own business.

Mary Morgan Saalman is mother to Austin and Delaney and wife to Michael Deimen as well as 'mom' to three dogs and four cats. She recently relocated from Jasper, Indiana, to Northwestern Ohio, where she reestablished her business, Advanced Healing Myofascial Release & Wellness. She specializes in The John F. Barnes Approach to Myofascial Release. When not treating clients, she enjoys spending time with her family, hiking, kayaking, and is an avid reader. She also enjoys traveling, exploring new places, and meeting new people.

Disclaimer: The views, thoughts, and opinions expressed in this blog post belong solely to the author, and do not necessarily reflect those of A Better Tomorrow Media.