I love me some physical therapy. it has helped me come back from orthopedic surgery, injury, accident, wear and tear and repetitive motion-induced pains.
One of the things I love the most about PT (physio in Canada) is how much I learn about my body through interacting with my physical therapist, adjusting and changing exercises over time. We always talk about what’s become easier, what is still difficult, how different body parts and functions are changing over time, and how that affects my health and fitness goals and practices.
Last year, I spent 5 months in PT for sciatica that had gotten to the point where climbing stairs was painful, hip pain woke me up at night, and even walking right after driving hurt. Yes, I know, driving is the one of the worst things for our musculoskeletal systems. Whatcha gonna do…
By the end of that rehab period, I felt so much stronger and happier and functional and knowledgeable about my vulnerabilities, needs and resources. Yay! Thanks Julian and Louis!
Here’s the thing: PT/physio seems like exactly the kind of healthcare that needs to be in person, with two bodies present: patient and physical therapist. Recovery trajectories aren’t linear. They involve dips and surges, all of which require on-the-spot adjustments to exercise regimens.
So you wouldn’t think that anyone would even consider outsourcing PT/physio to something like AN APP.
But guess what? They have. Yes, I’m aware of the We’ve-got-an-app-for-that approach to healthcare, but I just got a most unwelcome update when my state employee healthcare overseers, MassGIC, started hawking a new app (this one is called Hinge Health), with the promise of ease, flexibility and no copays. They also included this on their website:
To be sure, not all apps for all uses for all healthcare are ill-concieved. In a 2024 qualitative study of use of exercise apps for people managing osteoarthritis at home, both patients and therapists report convenience of the app over paper copies of exercises, increased accountability through digital reminders and ease of recording at-home exercise sessions. However, patients also reported problems with the quality of the apps, technical problems and security concerns about their personal data. Therapists reported concerns over compensation for interacting with patients over apps (that is, they frequently weren’t reimbursed for time spent with them) and overall a preference for paper exercises over app use.
For this company, I did a little sleuthing, and found that 37% of reviewers on TrustPilot, an independent reviewer site, gave it one star (i.e. bad bad bad). They cited aggressive marketing practices and also billing the patients when the service was explicitly covered by their insurance. Recall that having no copays was the primary appeal for patients. Sigh.
Technology continues to transform the way healthcare is delivered. I know this. And there are lots of advantages: increased access for those in less-resourced areas, ease and flexibility of access to information, tracking and accountability, and sometimes even cost.
One one size does not fit all. Some of us want and need in-person interactions with qualified health professionals for our care.
Also, when technology is poorly handled, those qualified professionals are either forced to do less or uncompensated work (e.g. emails, app chats, etc) or entirely supplanted by unqualified workers who must rely on canned materials to try to answer the complex questions of patients.
Which gets us to a bigger problem: trust.
I want healthcare that I can trust. And in order to trust it, I need to trust the healthcare providers. And in order to trust them, I personally need to see them in person, at least most of the time. Which sometimes can include telehealth, and sometimes may include email or patient portal messaging, and sometimes maybe even an app. But I need to know that my healthcare providers will provide me the access I need. Arguing with my phone is not how I want to spend my recovery.
