Making a Difference: A physical therapist assistant becomes a healthcare entrepreneur

Part II

Guest blogger: Mary Morgan Saalman

Mary Morgan Saalman

I returned from my first John F. Barnes’ Myofascial Release® seminar—taught by John Barnes himself—and began using the techniques I had learned right away. It was beyond amazing, and my life shifted forever, as my understanding of the body, all bodies—even those of our animal friends—was finally clearer. The first person I treated using MFR was a man who had been with our clinic for months. He suffered terrible neck pain from a vehicle accident. We were ready to plan his discharge because he had “plateaued,” which means he had improved about 25% but had shown no progress beyond that for two weeks. Therefore, insurance dictated that he be discharged from therapy. However, he still experienced terrible pain and could not turn his head very far, which was a problem for him considering he was a truck driver. 

I asked him if I could use MFR to treat him during his last visit. He agreed. I worked on him for only thirty-five minutes. I discovered the problem was not in his neck, but rather, due to restrictions in his pelvis and lower back that were pulling on his fascial “web” all the way up to his neck. He was amazed when we finished. His pain went from an 8/10 to a 2/10, and he had full cervical range of motion. He was stunned. So was I. He was incredibly thankful but couldn’t help but feel discouraged by the fact that he had spent over $1,500 on his therapy over eight weeks during which he had to meet his deductible. Now, here I had helped him significantly in just one visit. This was the day I knew I had to find a way to open my own clinic so that I could practice the work I knew would help people, especially those who could not afford insurance or traditional medical care, but how would I accomplish that?

I was a physical therapist assistant so was required to practice with a physical therapist under my current license. After an entire year of using MFR to treat my patients and watching people improve and get their lives back more fully and quicker than traditional therapy, I knew I had to make a change. So, I bit the bullet and went to school to receive my massage therapy license. I had no desire to practice massage, which is not what I do. However, I needed the license in order to open my own clinic to practice what I know to be a much needed and affordable healing modality.

I am strictly cash based. I do not accept insurance. I refuse to be a prisoner to insurance companies ever again. I know what my clients need to heal. Insurance companies do not. You might think that people would find it difficult to pay for medical services out of pocket, that it would be unaffordable. However, this is not true. I currently charge $70 per hour. That may seem like a lot of money, right? Well, it is to many of us. However, here is the difference. People do not have to see their physician to get a referral to visit me, unlike other forms of physical, occupational, or speech therapy. Furthermore, since MFR is a full body and mind treatment, my clients improve with fewer treatments than with traditional therapies, which saves them a lot of money over the long run that they would have otherwise had to pay toward their deductibles. Their outcomes are better with MFR than they had been with traditional therapies.

Many of my clients have told me that they were so excited to tell their doctors about me and myofascial release, how it has changed their lives, and helped them to understand that their body is a complete unit, not merely “areas of pain.” They tell me that their doctors “don’t buy it.” This is frustrating for me. Still, some physicians have asked their client to bring them more information on MFR and my clinic because they are shocked at the incredible improvements their patient has made [with me] since their last visit. It’s changing one mind at a time, right?

My dream came true last August. After much hard work and faith, I opened my clinic, Advanced Healing Myofascial Release & Wellness, in Angola, Indiana. I cannot express how wonderful it feels to be able to help people heal and learn more about their bodies. I also teach my clients how to treat themselves at home. My goal is to decrease the number of times they visit my office by hastening the healing process so that they are not returning to me forever and spending their precious dollars. Many talk to me about how much money I have saved them, keeping them out of the revolving-healthcare door by helping them to heal their bodies, teaching them how to keep their bodies healthy, and more importantly, feeling much better.

I do not turn anyone away. I do my best to work out a payment plan for anyone who needs help. A traditional therapy clinic will rarely do that. If you do not have insurance or the money up front, they will not treat you. I consider that barbaric. Many of my clients have very little, but they do have enough to see me for a few visits to feel better and learn how to maintain the improvements made during treatment, saving them money in the long run. 

Many of my clients come to me because their physicians are pushing them to have surgery for, pick your problem: carpal tunnel, frozen shoulder, back/neck pain, hip pain, etc. These patients are looking for an alternative to surgery to help them feel better and function without the pain and/or the cost of going under the knife. I get results. 75% of my clients no longer need surgery after working with me.

Think about this on a larger scale. Any surgery is expensive. Now, think about the possibility that people receive alternative treatments, such as MFR, to address their health problems and the possibility that even 50% of these people no longer need surgery. Think about the cost savings to insurance companies, which in an alternative universe, would be put back in to the system to help lower insurance premiums and other healthcare costs. Think about the savings to people who no longer need surgery, considering that the average insurance deductible today is $3,000 with a 20% copay on charges above the deductible. Furthermore, most surgeries cost tens of thousands of dollars, depending on what needs to be done and if it is done on an inpatient or outpatient basis. My clients averaged paying $400 for my services. That seems like a deal to me.

The cash-based trend is growing in our country. Many therapists are slowly switching over to cash-based businesses, refusing insurance. It might seem that this would cost the client more, but it does not. There are also physicians who are experimenting with cash-based business models solely so that they can provide medical services to those who cannot afford insurance or to see a “traditional physician.” Those who have done so state that they now have time to care for their patients’ needs instead of tackling mounds of paperwork for insurance companies. Nor are they spending their time developing care plans based on insurance company requirements. They spend more time with their patients, better understanding their needs as opposed to adhering to the “conveyor belt” business model they were taught in medical school.

There are many ways to make healthcare more accessible for every person who needs it. Making healthcare affordable for every single American should be a priority. Most healthcare professionals sincerely care about their patients and want to help them heal. It is simply wrong to turn sick and hurt people away. The medical care professionals who are turning toward cash-based practices are at the forefront of a new business model that will make healthcare more accessible and affordable to all people. I am proud to be a part of that trend. 

Read Part I 

Disclaimer: The views, thoughts, and opinions expressed in this blog post belong solely to the author, and do not necessarily reflect those of A Better Tomorrow Media. 

Making a Difference: Fed up with the status quo, a physical therapist assistant discovers a better way to serve her patients

Part I
Guest blogger: Mary Morgan Saalman 

Mary Morgan Saalman

My life as a physical therapist was hectic. Like most healthcare practitioners, my patients came in for treatment and were out in no time, leaving little opportunity to discuss or understand their situation beyond the physical. Feelings and concerns were after-thoughts. They entered the room and the clock started ticking. Patients were seen usually for forty-five minutes—maybe an hour—during a typical physical-therapy session. As I treated a patient, I may have felt that we were making a break-through, but then time was up, and I had to usher them out because the next patient was waiting. 

I have become increasingly frustrated with this situation over the years. The insurance companies always seemed to be a dark cloud, looming overhead, dictating every move we made. Nothing could be done for my patients without insurance company approval. Almost always, patients would talk to me about how they could not afford therapy for very long, or that their insurance wouldn’t pay for it or other less invasive forms of treatment. The insurance companies, however, were all too happy to pay for extensive surgery, if the physician recommended it. 'Why?' I wondered. What was their justification for this and how did it save money, decrease the cost of insurance, or make healthcare more affordable and accessible?  And more importantly, was this best for the patient? Why was/is it so difficult to access high-quality, affordable health care?

The main reason people have difficulty accessing quality medical care is the lack of insurance or inadequate coverage with high deductibles. For many individuals and families, a $3,000 or $5,000 deductible feels as if they have no insurance at all. Many people live paycheck to paycheck and do not have the money to see a doctor, unless they are forced to because of an illness or an emergency.

Another road block to accessing quality medical care is the fact that our society has evolved into one that treats the illness while disregarding the overall well-being of the person. The bulk of our medical practitioners are taught to set up literal conveyor-belt type businesses that move patients efficiently in and out of the office, seeing as many people as time affords. Medical students are taught during their education to look at the body in parts with the mindset of alleviating patients' symptoms in order to make them feel better. Of course, this often means medication or too many unnecessary surgeries. Many healthcare practitioners feel that if the patient is not “feeling” their symptoms, well, that’s a good thing, and this is the outcome they and their patients want. Unfortunately, this has led our country down an ominous road to opioid addiction, unhealthy habits, and too many unnecessary surgeries.

Numerous medical practitioners schedule patients in fifteen- or thirty-minute increments, perpetuating the conveyor-belt business model, ensuring themselves a healthy bottom line. Healthcare professionals often limit the time with their patients, which leaves little time to talk and learn about the “whole” person, rather than just their sore back or headache. This perpetuates the dependence on pharmaceuticals, which “will fix everything.” I believe it is this mentality, inherent in our healthcare industry, that is preventing us from not only receiving quality medical care, but also from taking care of our mind and body in integrated ways, which would improve our health and save us money. The U.S. healthcare apparatus is driven by greed, making the status quo extremely difficult to change. 

Another obstacle to accessing quality medical care is the fact that insurance companies dictate patient treatment. Every medical care professional who accepts insurance must adhere to the regulations of the insurance industry. Every physician’s plan of care for their patients takes in to account what the insurance companies will cover. For example, if you are diagnosed with a condition and have insurance, your ability to receive the treatments or therapies you need are completely and totally based on what your insurance company considers “necessary and reasonable.” Your physician might feel you need specific tests or medications. However, your insurance company may state they are not necessary. Therefore, unless you can afford to pay for expensive medications or tests out of pocket, you might not have access to the care that you need to improve, or sometimes, survive.

There are plenty of healthcare professionals, such as myself, who treat the entire person as opposed to a sick person who has a bad back, a sore leg, or cancer. However, we are the outliers in the medical community. Even when patients go back to their physicians and tell them that they went to a healthcare practitioner and received an alternative therapy and are feeling the best they have felt in a while, most physicians will immediately scoff and/or write this off, continuing with their business model of get them in, get them out, see more people, etc. This is not quality care. It limits people from finding other forms of healthcare that would not only help them feel better and many times quicker, but would also save them precious dollars because they would not be caught in the revolving door of traditional medicine. The rigid adherence to the traditional medicine model, in my opinion, is a defect in the medical programs in our universities, as many healthcare professionals will agree.

For the record, I am not saying that medications do not have a place in healing, because they most certainly do. There are medications that indisputably save and improve lives, and I am thankful that we have talented people who can create these medications and find cures for terrible diseases and conditions. On the other hand, if we would begin to pay more attention to and tend to our overall health—our bodies, minds, and spirits—maybe some of these diseases and afflictions would become less common.

It is for the reasons I have outlined above that my mindset about bodies and health have evolved over my twenty years in the healthcare field, as a practicing physical therapist assistant. I have practiced in every area: pediatrics, hippotherapy (using the horse as a therapy tool), outpatient clinic, long-term care, and home health. I have always loved what I do. I love helping people to feel better and regain their lives. However, as the years went by, I could not help but feel that something was missing; something just wasn’t right.

I also began to realize that although many of my patients recuperated almost 100%, most others would not. Most patients show improvement. Maybe they begin therapy with a pain level of 9/10 and they finish with one of 5/10 and improved, yet limited mobility. Many patients were returning several times a year for the same problem. Why? And why is this acceptable? Why can’t people improve more, sooner, and spend less time and money on therapy, physician visits, medications and/or surgeries? As physical therapists, most of us are taught in school to treat the “areas” of pain or the “conditions.” Someone comes in with a painful shoulder, so we treat only that shoulder, ignoring that there is an entire body and systems within the body that all communicate with one another. It was these feelings of inadequacy and frustration that led me to find, what I feel to be, one of the most important modalities/treatments for our bodies, the John Barnes Approach to Myofascial Release.

John Barnes is a physical therapist who developed his technique after experiencing his own dramatic injury in college over forty years ago. He focuses on treating the fascial system. He has trained over 150,000 therapists, nurses, chiropractors, and physicians worldwide. Myofascial release is a gentle, hands-on technique that releases restrictions in our fascia, or connective tissue. To learn more about fascia and how John F. Barnes’ Approach to Myofascial Release has helped to heal thousands of people, you can visit my website Advanced Healing Myofascial Release and Wellness, LLC and/or  MFR Treatment Centers & Seminars. You will find helpful information, articles, and book recommendations about the fascial system and the conditions and diagnoses that MFR can help. If you are interested in finding a therapist or attending a seminar, you can search for one in your area on Mr. Barnes' website.

After my first seminar, not only did my life change, but also the lives of many of my patients. It was beyond anything I could imagine and set me on a new path to healing others.

In Part II we learn about Mary’s transition in the medical field, trends in the industry, and  how she started her own business.

Mary Morgan Saalman is mother to Austin and Delaney and wife to Michael Deimen as well as 'mom' to three dogs and four cats. She recently relocated from Jasper, Indiana, to Northwestern Ohio, where she reestablished her business, Advanced Healing Myofascial Release & Wellness. She specializes in The John F. Barnes Approach to Myofascial Release. When not treating clients, she enjoys spending time with her family, hiking, kayaking, and is an avid reader. She also enjoys traveling, exploring new places, and meeting new people.

Disclaimer: The views, thoughts, and opinions expressed in this blog post belong solely to the author, and do not necessarily reflect those of A Better Tomorrow Media.