Value of a Pain Relief Clinic with Physiotherapists in a General Outpatient Clinic

By Dr. J. Gnanaraj, H.Charles Richard M.P.T., and S. Jebaseelan Joisingh, M.P.T.

Introduction

Dr G Therapy 1 picPain experienced by patients can vary from very mild to extreme, and it can be localized or widespread, depending on the cause. The word “pain” itself is derived from the Latin word “poena,” which means a fine or penalty (1).

Pain is the most common reason for physician consultation in most countries (2, 3). It is a major symptom in many medical conditions, and it can significantly interfere with a person’s quality of life and general functioning (4).

Here, we present how a pain clinic run by physiotherapists could help in a general outpatient clinic.

Method

We reviewed the records of patients who attended the outpatient clinic at the SEESHA Karunya community hospital at Karunyanagar for a one-year period from October 1, 2013 to September 30, 2014. We also reviewed the data from the physiotherapy department, as well as data from a peripheral clinic (SEESHA Medical Center) for the same period.

Results

The income from the physiotherapy department, excluding the medicines, forms about 15% of the total outpatient department income. The physiotherapy income from the smaller unit was about 10% of the total OPD income. The items sold for physiotherapy are from surgical stores, and unlike the medicines, they have a higher profit margin. Hence, the physiotherapy items from pharmacy sales constitute about 18% profit from the pharmacy.

Table 1 lists the five most commonly treated conditions at the physiotherapy unit.

Value of pain T1
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The approximate cost of setting up the physiotherapy department was INR 4,00,000 including the equipment and the plywood partitions that we had. They were set up in a space of about 700 square feet. The treatment modalities that we had were:

  • Ultrasound
  • TENS (Transcutaneous Electrical Nerve Stimulation)
  • IFT Interferential Therapy
  • Cryotherapy
  • Hot Packs
  • Traction Unit
  • Short Wave Diathermy

Dr G Therapy 2 picThe investment of Rs. 4,00,000 was recovered in less than a year, despite the low cost of treatment, which was only Rs. 50 per session. This, however, did not include the salaries of the physiotherapists.

Discussion

Pain management or pain medicine is intended to improve the quality of life of patients who have pain, by easing their distress using a variety of methods [5]. Physiotherapists’ techniques can be generally classified as passive or active therapy. Passive therapy includes heat and ice packs, TENS units, and ultrasound. Active therapy is comprised of various exercises, such as stretching, strength building, and low-impact aerobics.

The standard equipment necessary for setting up a physiotherapy unit at a hospital is not expensive. The total cost would be about Rs. 4,00,000.

Take-Home Message

Physiotherapy departments are a profitable addition to any outpatient department, whether at a hospital or a small peripheral clinic. They add great value to the treatment offered and are highly appreciated by the patients.

Gnanaraj-64 Dr. J. Gnanaraj MS, MCh [Urology], FICS, FARSI, FIAGES is a urologist and laparoscopic surgeon trained at CMC Vellore. He has been appointed as a Professor in the Electronics and Instrumentation Engineering Department of Karunya University and is the Director of Medical Services of the charitable organization SEESHA. He has a special interest in rural surgery and has trained many surgeons in remote rural areas while working in the mission hospitals in rural India. He has helped 21 rural hospitals start minimally invasive surgeries. He has more than 150 publications in national and international journals, most of which are related to modifications necessary for rural surgical practice. He received the Barker Memorial award from the Tropical Doctor for the work regarding surgical camps in rural areas. He is also the recipient of the Innovations award of Emmanuel Hospital Association for health insurance programs in remote areas and the Antia Finseth innovation award for Single incision Gas less laparoscopic surgeries. During the past year, he has been training surgeons in innovative gas less single incision laparoscopic surgeries.
charles passport H.Charles Richard M.P.T. (ORTHO), M.I.A.P
Physiotherapist at the SEESHA Karunya rural community hospital in the Karunya University campus, Coimbatore: The department specializes in treating a variety of sports injuries and has weight reduction programs.
joisingh passport S. Jebaseelan Joisingh, M.P.T. (Neuro), MIAP.
Physiotherapist at the SEESHA Karunya rural community hospital in the Karunya University campus, Coimbatore: The department specializes in treating a variety of sports injuries and has weight reduction programs.

References (click to show/hide)

  1. Definition of Pain. Medicinenet.com. (Accessed on October 9, 2014 at http://www.medicinenet.com/script/main/art.asp?articlekey=4723)
  2. Debono, DJ; Hoeksema, LJ; Hobbs, RD (August 2013). Caring for Patients with Chronic Pain: Pearls and Pitfalls. Journal of the American Osteopathic Association 113 (8): 620–627. doi:10.7556/jaoa.2013.023. PMID 23918913. http://www.jaoa.osteopathic.org/content/113/8/620.long
  3. Turk DC, Dworkin RH. What should be the core outcomes in chronic pain clinical trials?. Arthritis Res. Ther. 2004;6(4):151–4. doi:10.1186/ar1196. PMID 15225358. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC464897/
  4. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, Kvarstein G, Stubhaug A. Assessment of Pain. Br J Anaesth. 2008;101(1):17–24.doi:10.1093/bja/aen103. PMID 18487245. http://bja.oxfordjournals.org/content/101/1/17.full
  5. Hardy, Paul A. J. (1997). Chronic pain management: the essentials. U.K.: Greenwich Medical Media. ISBN 1-900151-85-5.


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