Top Docs: Let's get physical (therapy)

Dr. Adam B. Stein is the chairman, Dept. Dr. Adam B. Stein is the chairman, Dept. of Physical Medicine and Rehabilitation, Hofstra North Shore-Long Island Jewish School of Medicine, the North Shore-Long Island Jewish Health System, Great Neck. (August 19, 2011) Photo Credit: Steve Pfost

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Physical therapy can do wonders for all sorts of patients, from those recovering from strokes or car accidents to people who simply strained their backs and need pain relief. "It's a way to reverse decreased function as a result of injury or surgery and try to get people back to where they were as much as possible," said pain specialist Dr. Steven Litman, director of pain management at St. Charles Hospital in Port Jefferson.

Here's a look at five things you should know about physical therapy.

1. INSURERS DON'T ALWAYS COVER PHYSICAL THERAPY

Physical therapy typically requires 2-4 sessions a week over 4-6 weeks, although it may last longer, Litman said.

The cost varies widely, depending on whether a patient has insurance, said Dr. Adam B. Stein, chairman of the Department of Physical Medicine and Rehabilitation at Hofstra North Shore-Long Island Jewish School of Medicine. "A ballpark estimate is $80-$100 for 60 minutes of treatment when Medicare is the payer," he said.

"Generally, if a person's insurance policy allows for physical therapy, and the individual being treated is making progress toward the goals of treatment, it will be covered," Stein said.

Still, Litman said, insured people may pay more in out-of-pocket co-pays than in the past. And, he said, insurers are restricting inpatient physical therapy -- in which patients live in a facility -- in severe cases. "It's hard to get access to high-quality physical therapy for really sick patients," he said.

2. CERTAIN PATIENTS MAY AVOID CO-PAY HASSLES

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Even if you have insurance, you may have to pay more in out-of-pocket costs than some other patients. That's because the cause of your injury may make a big difference, Litman said. "I've seen patients that have relatively minor motor-vehicle accidents who get thousands of dollars of physical therapy with no co-pays or deductibles, and then I've seen HMOs that make patients pay $50 for every session they have, so the patient doesn't get treatment."

3. YOU MIGHT NEED INJECTIONS TO HELP YOU DO PHYSICAL THERAPY

Physical therapy doesn't do any good if you're in too much pain to tolerate it. If pain is limiting your improvement, pain specialists can try to block the pain through injections so you can accomplish more, Litman said. Injections can also quicken recovery by reducing inflammation, he said.

4. YOU MAY FIND PHYSICAL THERAPY QUITE STIMULATING

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Within the last few years, physicians and physical therapists have embraced the use of technology to electrically stimulate the muscles of patients as they engage in an activity like walking. The electricity works the muscles, allowing them to grow stronger.

For example, "several devices stimulate a nerve in the leg at precisely the right time during walking to allow a person with ankle weakness to no longer require a cumbersome ankle brace," Stein said.

5. TAKE ACTION IF YOUR SYMPTOMS GET WORSE

"If you're getting worse numbness or weakness with the therapy, back off and speak with your therapist," Litman said. "Sometimes you may need to have further diagnostic studies such as an MRI or need to be evaluated by a pain medicine specialist to figure out what's happening."

In general, you should feel relief. While physical therapy may not lead to complete recovery, Stein said, "people do feel better."

 

Occupational medicine

 

This is the 10th installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.

Dr. Sara Mendelsohn

800 Woodbury Rd.

Suite K

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Woodbury

516-682-9142

PHYSICAL MEDICINE & REHABILITATION

Dr. Jason Lipetz

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LI Spine Rehab. Medicine

801 Merrick Ave.

East Meadow

516-393-8941

Dr. Barry Root

North Shore Univ. Hospital at Glen Cove

Dept. Physical Med. & Rehab.

101 St. Andrews Lane

516-674-7501

Dr. Craig Rosenberg

Southside Hosp. -- Health Inst.

301 E. Main St.

Bay Shore

631-675-4550

Dr. Adam Stein

825 Northern Blvd.

Great Neck

516-465-8609

SPORTS MEDICINE

Dr. Stephen Kottmeier

14 Technology Dr.

East Setauket

631-444-4233

Dr. Eric Putterman

1800 Walt Whitman Rd.

Melville

631-293-9540

HAND SURGERY

Dr. Lawrence Hurst

14 Technology Dr.

East Setauket

631-444-3145

Dr. Kenneth Kamler

410 Lakeville Rd.

New Hyde Park

516-326-2266

Dr. Lewis Lane

600 Northern Blvd.

Great Neck

516-627-8717

Dr. Thomas Palmieri

1901 New Hyde Park Rd.

New Hyde Park

516-822-4843

Dr. Glenn Teplitz

Winthrop Orthopaedic Assoc.

1300 Franklin Ave.

Garden City

516-747-8900

PAIN MEDICINE

Dr. Carole Agin

Pain Management Center

Stony Brook Univ. Med. Center

3 Edmund D. Pellegrino Rd.

Stony Brook

631-638-0800

Dr. Juan Gargiulo

365 County Rd. 39A

Southampton

631-702-2300

Dr. Steven Litman

All Island Pain Consultants

387 E. Main St.

Bay Shore

631-665-0075

Dr. Steven Pinsky

176 N. Village Ave.

Rockville Centre

516-764-4875

Dr. Philippe Vaillancourt

877 E. Main St.

Riverhead

631-727-0660

 

How they were picked

 

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

 

To see the whole list . . .

 

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.

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