Contributed by Mark Callanen, PT, DPT, OCS
Most health care providers do not like addressing the topic of money with patients, especially when it is related to the services they are providing. That being said, the topic of value with regard to a patient’s healthcare dollar is becoming more and more relevant as deductibles and co-pays rise each year.
Laser therapy is normally presented to patients as an overall cost saver when looking at total healthcare dollars spent, despite the fact that it is often not covered by insurance. For those practitioners utilizing Tendon Dry Needling (TDN), the discussion on how laser therapy can benefit a patient should be very similar. Like TDN, laser therapy is a procedure that helps patients heal quicker and can make dramatic impacts on a patient’s pain in a very small amount of time.
Laser therapy works through a process called photobiomodulation, which works to restore normal cellular function in damaged cells.1 Repeated sessions in a smaller timeframe will help stimulate cells regularly and allow for the repeated influence of afferent nerves to control pain generated from peripheral nocioceptors.2 Infrequent application of the laser will not allow for an ideal “push” of the system.
Accordingly, appropriate plans of care normally require multiple treatments within a set time period to maximize benefit. Common deep tissue laser therapy protocols call for 6-8 treatments over the course of 3 weeks for most problems. This can vary depending on multiple factors such as the size and scope of the injury, chronicity of the problem, and the tissue type(s) involved, to name a few. Subjective and objective patient feedback will help determine the best prescription.
If the patient is not interested in the additional cost of laser therapy, it’s not a problem. For those patients that resist being treated by the laser initially, don’t be surprised if they come back to their next visit wanting to try it out. Sometimes patients need time to think it over and do their own research before they try something that is perceived as “new”. Having some brief literature on photobiomodulation to hand out, as well as dedicated website page with testimonial and educational videos, can go a long way.
After your initial consult with the patient, hopefully you can agree upon the specific plan of care that best meets their needs and proceed accordingly. As the healthcare provider, you are only making your recommendation as to what you feel will get the patient better as quickly as possible. It is ultimately the patient’s decision on how they would like to proceed.
1. Chris E. Stout, Matt Kruger and Jeffrey Rogers, (Eds)- © 2011 Bentham Science Publishers Ltd. Current Perspectives in Clinical Treatment & Management in Workers’ Compensation Cases, 2011, 15: 191-2. 2. Kawatani, M, Matsumoto, I, Sato, T, Takeshige, C, Tsuchiya K 1993, ‘Diode laser irradiation selectively diminishes slow component of axonal volleys to dorsal roots from the saphenous nerve’, Neuroscience Letters, vol. 161, no. 1, pp. 65-68.