PT First Protocol Design
- Define the conditions covered: Low back pain, knee pain, hip pain, shoulder pain
- Define the PT requirement: Typically 6–12 sessions over 6–8 weeks
- Define exceptions: Emergency surgery, fractures, infections, and other urgent conditions
- Define the approval process: PT completion triggers automatic surgery approval
- Define the PT provider network: High-quality PT providers with good outcomes data
- Define the communication plan: Explain the protocol to employees before they need it
Avoiding Delays in Necessary Surgery
PT first protocols must be designed carefully to avoid delaying necessary surgery. Conditions that require urgent surgery — fractures, infections, tumors, severe neurological compromise — should be exempted from the PT requirement. The protocol should include a clear exception process for cases where PT is not appropriate.
PT First Communication
Pro Tip
Employee communication is critical for PT first protocol success. Employees who receive a PT first requirement without explanation may feel their care is being denied. Frame the communication positively: "We require physical therapy first because it is often more effective than surgery — and avoids the risks and recovery time of surgery. Most patients who complete PT are glad they tried it first." This framing reduces resistance and improves compliance.