Is Manual Therapy Critical Care?

Practitioners have been fighting for essential care status in health care for many years. This is often what permits us to bill insurance companies for treating our clients who have traumatic injuries and health conditions where we can help ameliorate the symptoms.

In the COVID-19 era, we find ourselves stuck between a rock and a hard place. The Centers for Medicare & Medicaid Services has said that essential care providers are allowed to work, but nonessential care should be suspended. Elective surgeries and preventive care should be postponed. Any care that can be delivered online should be.

This guidance was well intended but has not been well executed.

For one, some practitioners across the country continue to work, even when testing is still unavailable for practitioners and personal protective equipment is scarce. In Washington state, where practitioners have been billing insurance since the 1980's, the guidelines allow practitioners to continue working with acute injuries and conditions. My clients in those situations have comorbidities, making the risk grave. I choose not to see them.

I know people need massage, but is massage lifesaving?

Will postponing massage worsen a life-threatening or debilitating prognosis?

The orthopedic surgeons decided that even though joint replacements will significantly improve the quality of a patient's life, their prognosis is still good if they wait three to four more months. Oncologists have a more difficult decision to make. Tumors will continue to grow without surgery. Even so, many were postponed.

If you're struggling to decide whether to see patients or not, consider the kinds of questions physicians have to ask.

If you do decide to see patients, I encourage you to watch the video conversation I posted with Ruth Werner, Melanie Hayden and myself. This will help you to at least know the risks and the best ways to protect yourself and your clients.

And remember, nothing is without risk with this disease.

In health,

Arthur L. Caplan, Shailin A. Thomas. A Better Way to Prioritize 'Essential' vs 'Elective' Care During COVID-19 - Medscape - Apr 15, 2020.