The Clinic Within

Offering physical therapy services at the worksite is a win-win for patients and employers

My career in physical therapy added a new twist in 2010. A physical therapist with whom I'd first teamed almost 20 years earlier urged me to come work with her on a part-time basis at a worksite-based health clinic operated by the Employer Solutions arm of Take Care Health Systems, which is part of the Walgreens Health and Wellness Division.

I was already a busy tenured professor at Butler County Community College in Butler, Pa., in the school's physical therapist assistant program. I was also working part-time as a PTA in a private practice outpatient setting.

But I decided I owed it to myself and my students to investigate firsthand an up-and-coming practice model that may hold future employment opportunities for some of them.

Onsite health centers are an avenue some employers are exploring to rein in costs. They offer employees ready access to an array of services, potentially resulting in a healthier workforce, reduced absenteeism, lower healthcare costs, higher productivity, and increased morale. The facility where I began work is located within the Pittsburgh headquarters of a large company that employs more than 2,000 people in that building alone.

It's been an interesting and satisfying three-plus years for me at the Take Care Health Clinic, which is one of more than 370 such Walgreens-owned facilities located on employer campuses across the country.

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Just Steps Away

The health center offers medical and physical therapy services, and a pharmacy. We feature orthopedic and neurological treatment, work hardening and return-to-work, post-injury prevention and pain management, personalized exercise and sports conditioning, pre- and post-op therapy and rehabilitation, health management awareness and education, and on-the-job injury prevention that includes ergonomic evaluation.

There's also a small physical therapy gym where we emphasize patient education, therapeutic principles, and compliance. We may direct patients, while they are under our care, to go to their employer's onsite wellness center and work with trainers, perform home exercises, or take an exercise class.

Upon discharge from physical therapy, we encourage and expect patients to transfer from our gym to the wellness center. We complete a "prescription for wellness" form to help trainers design programs for each patient.

The physical therapist and I each work 12 hours per week. We overlap on Mondays, per indirect supervision requirements in the state of Pennsylvania. We see nonsurgical and postsurgical patients twice per week - an interval facilitated by the emphasis we place on patient education and by the wellness center's onsite proximity. As a result, we can meet patients' needs yet maintain a flexible schedule. It's a win-win situation.

We work with an in-house physician to coordinate care, so employees who've been prescribed physical therapy can come immediately to us. They love the convenience, and we appreciate the interdisciplinary dialogue. Employees ask their outside physicians to refer to us as well - again, for the convenience of on-site therapy.

We get to know patients well. One woman who was struggling with chronic pain came to the clinic using a cane. Over time, we helped her progress to not needing an assistive device, and she eventually moved on to the wellness center where she could exercise regularly with minimal guidance from staff. Coworkers and supervisors soon noted improvement in her function, work habits and attitude.

Even after discharge from physical therapy, she often stopped by to proudly show us her pedometer progression. We appreciated being able to view and acknowledge her success.

Many patients return to us after subsequent injuries or surgeries, and patients praise us to their coworkers. Although the clinic's presence in the building is advertised, most of the referrals we receive are via word of mouth.

Certain individuals, such as postsurgical patients, may be seen for up to an hour three times per week, but the emphasis is on shorter physical therapy sessions - generally 30 minutes - with a strong focus on patient education. While this can be challenging, it's fun for us to serve highly motivated patients who want and need to get right back to work.

And working in this environment forces us to be efficient and creative in response to patients' needs, as we encourage them to play an active role in their own well-being.


The following are a few reasons I tell students in they should consider exploring the worksite-based clinic environment.

Resume enhancement. "In how many outpatient jobs," I sometimes ask my students, "might you speak with patients about their diet and exercise habits while you're coordinating physical therapy with their weight-reduction program, or with the counsel of their onsite dietician?" This environment offers practical experience and interdisciplinary communication not found in other settings.

Also, with healthcare models changing along with economic and societal trends, experience working within a corporate setting can prove valuable to job seekers.

Skills development. At worksite-based clinics, you encounter patients who present with a variety of conditions, and gain valuable experience honing your time-management, patient-education, and home exercise-prescription skills. The goal is to return patients quickly to their duties while ensuring that they're armed with exercises to complete on and off the job. This serves patients well and holds PTAs in good stead in the marketplace.

Job satisfaction. We chose our profession because we want to help people. While every practice setting provides these opportunities, in the worksite-based setting, we witness daily progress that continues even after the patients leave physical therapy. And when supervisors and coworkers of former patients attest to the difference you've made, it's a wonderful feeling.

Eyes on the future. My Take Care Health Clinic works closely with a wellness center - as do other worksite-based facilities around the country. More Americans are seeking wellness services, and this is a ripe niche area for PTs and PTAs. The more experience PTAs have in connecting clients with the wellness services they want and need, the better equipped they'll be to avail themselves of these opportunities.

Shadow of a Doubt?

I tell my students that before they accept their first job, they should spend a day shadowing someone at their prospective worksite. I tell them to ask questions so they're comfortable taking the job. That's good advice for all PTs and PTAs who are considering a job change.

No employment setting is perfect. Working at a clinic that's administered by a big organization and serves another big organization - as is my case at Take Care - involves bureaucracy that can slow communication, and that can be frustrating at times.

Still, I've truly enjoyed this experience and working again with my friend. We joke that we work so well together we could win television's "Amazing Race."

Ashlee Esplen is a tenured professor at Butler County Community College in Butler, Pa., and part-time PTA at Anchor Physical Therapy and at a worksite-based clinic.

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I am sorry I do not. I would recommend you contact your Chapter's remibursement Chair/committee.

Ashlee EsplenNovember 07, 2014
Pittsburgh, PA

Do you know of a cpt code used for PT onsite ergonomic evaluations in CA?

Jill November 06, 2014


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