Physical therapy without referral eases process

Published March 31, 2011
By Chris McCann
JBER PAO

JOINT BASE ELMENDORF-RICHARDSON, Alaska -- Emergency medical technicians often refer to the "golden hour" - the time immediately after a traumatic injury, in which the treatment a patient receives can make a life-or-death difference and even drastically alter the amount of recovery time needed.

Ankle sprains, on the other hand, often get a shrug and a wait-and-see attitude. Waiting a week or two for an appointment with a primary care physician doesn't matter - right? Wrong.

On Joint Base Elmendorf-Richardson, there's no need to wait and see, and physical therapist Air Force Maj. Troy McGill said immediate treatment can dramatically speed healing time for everything from a strained back to a sprung knee.

The direct-access Acute Care Physical and Occupational Therapy Clinic is currently open to all active-duty service members from 7 until 9 a.m. Mondays, Tuesdays and Thursdays at the JBER hospital.

"Direct access" means there's no need for a referral from a primary care provider.

Injured service members can simply walk into the clinic, and while there may be a bit of a wait, it's same-day service, McGill said.

Importantly, the walk-in treatment idea is exactly how the doctors operate in a deployed environment.

"(Doing it this way) keeps us ready to deploy, and it also pulls a load off the family practice clinic and the emergency room," McGill said.

"If the patient has an acute ankle sprain, for example, we're going to see them anyway, so why make them go through a referral process? It's worked out well so far."

The direct-access idea is the standard in the private sector, and Army facilities have largely done it for years. But at the JBER hospital, it's new; McGill only started the clinic about eight months ago, he said.

In a military environment, the goal of treatment is to get a service member back to duty as quickly as possible, while still ensuring wellness.

The usual treatment for strains, sprains and the like was to immobilize the joint if possible and manage swelling.

But that can be less than ideal, McGill explained; the injured tissue heals as if that immobile position is permanent, since it's not being moved, and recovering range of motion takes a long time.

"It can mean the difference between a patient being on a limited-duty profile for two weeks, then two weeks of reduced running and walking, and then being returned to duty, or being on a limited-duty profile for six weeks," McGill said.

On an average morning, between six and 10 patients come into the clinic.

A little more than half are Air Force service members, since the Army has a small physical therapy clinic on Fort Richardson.

"It's really convenient to have the clinic right here on base," said Air Force Staff Sgt. Stanley Manning of the 673d Medical Operations Squadron.

He visits the clinic to improve the stability of his ankles. "I live right here on base, so it's nice."

Physical therapists and technicians assist with exercises and meet with service members to help them achieve their recovery goals.

If the service member has problems that the staff can't treat, they can be referred to another physician within the hospital.

For outside referrals, patients still have to go through their primary care provider.

However, the ability to walk in and get an injured knee or elbow moving without waiting for a referral is the clinic's draw.

McGill explained they hope to expand the clinic's hours and even open it to family members, since the physical therapists have the credentials to do that.

"It's good that people can get in right away, without the need for a referral," said Air Force Staff Sgt. Antone Schiefelbein, a physical therapy technician at the clinic.

"They can get in and get out, and often they only need to visit a few times."

For information or to make an appointment, call 580-1701.