Shop Talk

Telerehab Q&A

Last week we asked our readers, “Why do you think telerehab is not more prevalent?” Here’s what you said. 

  1. It takes 17 years. Even when the evidence supports a change, it can take up to 17 years to adopt a new practice. (See the article by Morris et al. below). 
  2. It’s easier to do what we’ve always done. You know the old sayings,                  “Change is hard.”                                                                                                  “If it ain’t broke, don’t fix it.” 
  3. We value touch, and we’re a little fearful. What if we miss something or fail  to help you recover because we are not in the room with you providing hands-on care?
  4. Our patients may be fearful, too. What if I get inferior care because my therapist is not with me one-on-one? What if she misses something? 
  5. We’re afraid that others may encroach on our territory. What if someone without the clinical space and equipment I’ve invested in can do this just as well over a laptop? 
  6. We’re concerned about slipshod care. What if someone sets up a phone bank and runs a therapy mill with poorly trained staff? Might we dilute our value or esteem in the health care arena? Could telerehab lead to fraud and abuse? 
  7. We are not sure about the laws around telehealth and reimbursement rates. 

Thanks to all who responded. I have to confess, many of these responses were not what I expected. The literature often cites technical barriers, like no internet and lack of familiarity with video conferencing. Maybe these barriers went the way of the dodo with COVID-19. You tell me. If you’d like to add to the list, take issue with its content, or otherwise engage in the conversation, post a comment on the site. Meanwhile, if you want to learn more, checkout the resources below.

To learn more: 

On the issue of 17 years, see The answer is 17 years, what is the question: understanding time lags in translational research by Zoë Slote Morris, Steven Wooding, and Jonathan Grant in JR Soc Med. 2011 Dec; 104(12): 510–520. It’s free on PubMed Central.

The APTA assembled some nice resources addressing telehealth in the US. If you are a member of the APTA, you can access that information here: If not, consider joining at 

Here’s a recent review article by Cottrell and Russell. It’s also free on PubMed Central. Telehealth for musculoskeletal physiotherapy. Cottrell MA, Russell TG. Musculoskelet Sci Pract. 2020 Aug;48:102193. doi: 10.1016/j.msksp.2020.102193. Epub 2020 May 30.

The Evidence Workshop, LLC

April 19, 2021 

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