• A safe, efficient and cost-effective solution for home exercises
  • Upgrade the business metrics. New opportunities
  • The quality of the physiotherapist’s service
  • More trust from the insurance companies
  • How can these things change and physiotherapy to gain more trust?

There are 1.71 billion people suffering from musculoskeletal conditions worldwide, according to WHO. In fact, musculoskeletal conditions are the leading contributor to disability. Because the population is increasing dramatically, with around 1% every year and life expectancy as well, the number of people with musculoskeletal conditions is rapidly increasing as well. We tend to do less physical activity and early retirement is a serious problem which puts a lot of pressure on governments and the workforce, which affects the private sector as well.

Physiotherapy is particularly relevant in this context because it can both prevent musculoskeletal conditions but also treat them in a natural way, unlocking the secret regenerative powers of the human body.  In terms of business development, the physical therapy sector has a lot of space to grow. But the way things are working right now in the industry, it makes sustainable growth very hard to achieve. A physical therapy business is among the hardest you can do. In the past we’ve written down some of the reasons why here.

What is clear is that the business challenges are not alone. Being a physiotherapist is a big challenge as well. You need to find your way into building enough expertise in your field, which will improve your overall outcomes in order to grow the number of patients and earn more.

The physiotherapist’s job is hard because more and more people need his help and the tools he has are mostly centered around the clinic.
A physiotherapy clinic is among the hardest medical businesses to scale, and very few entrepreneurs manage to do this efficiently. It’s enough to do a quick search and look how many chains of physiotherapy clinics you can find worldwide. There are a few dozen. Now compare with how many gyms you see out there. The gap between those two can be the opportunity if you look at the broader fundamental reasons.
Clinic owners are connected to both the opportunity and struggle, and so as public and private insurance companies, which see physical therapy as a black box. Why? There are many aspects here, but one which is among the most important ones is the little amount of data available in the clinical space.

But the technological revolution can touch on some of the key areas described. What re.flex and us as a team are aiming is to improve the physiotherapy space through the use of innovative technologies.

1) A safe, efficient and cost-effective solution for home exercises

Studies showed that 70% of the patients quit physiotherapy when the pain disappears and they achieve what they consider a good range of motion. The reasons are multiple, and we can mention a few:
-Cost of treatment
In both the private and public sector, the cost of physical therapy is consistent.
The public sector can’t offer enough sessions for a full rehabilitation so patients end up buying more.
In the private sector, costs of physical therapy are usually higher.
-The urgency of returning to work
If we have an injury or a surgery, we will go on a sick leave. But most probably the pay check won’t stay unaffected for as long as rehabilitation lasts. So people usually accept a partial recovery just to get back to work.
-Lack of motivation to continue
Rehabilitation progress is usually slow and requires a lot of physical effort and financial resources. During the different stages of the recovery, progress might stagnate or become less perceptible from one training to another. These periods with no or less progress are impacting people’s motivation to continue.
-Absence of pain
Very often people quit physiotherapy when the pain is gone and they consider they have good mobility. The problem is that absence of pain doesn’t necessarily signal the end of the recovery. In fact, getting rid of the pain is just the first step. Without supervision and physiotherapist’s input, rehabilitation should continue according to the relevant medical protocols.

-Lack of efficient and cost-effective tools for home exercise prescription
Medical protocols tend to last long. Even the easiest conditions require a minimum 6 months of treatment in the clinic. However….

after the in-clinical sessions of physical therapy, where the patient is monitored by a physiotherapist, there comes the last stage of the rehab which usually translates into a home recovery routine. One which is often prescribed via mail, paper, or video application, and without feedback from the patient.
Some clinics started to charge for home exercise prescriptions, but over time this proved to be totally not sustainable. Training physiotherapists to deliver video-based sessions while managing the patients visiting the clinic is close to impossible without the use of technology.

By creating a safe environment at home using technology, we are able to support patients in achieving a complete recovery from the comfort of their homes. We do this by empowering physiotherapists and orthopaedic doctors with the right set of tools which are able to turn their weak points into opportunities of growth. Healthcare providers are able to use technology in a renting model, without paying costly subscription fees. On the other hand, payers end up paying for the actual results. And in the end, patients rent a hardware solution, with all necessary training and assistance included in order to efficiently self manage their musculoskeletal condition at home. Activation of a specific code which corresponds to their medical health records makes the onboarding process efficient and the remote monitoring service a scalable one.

The technology comes with a technical or medical support assistance, adding that glimpse of human touch and you get the recipe for a good overall adherence to treatment. Keeping patients engaged in the recovery creates positive medical outcomes which can be measured collectively when needed. 

2) Upgrade the business metrics. New opportunities

Talking with many managers, we understood how hard it is for the physiotherapy clinics to scale. For instance, raising the number of patients per physiotherapist ratio (thus making an employee more profitable), without impacting the clinical outcomes or the service quality is a very hard task. Hiring physiotherapists is also a hard thing to do sometimes. The junior physiotherapists need a lot of time to be trained. They need to get their at least their bachelor’s degree, pass some local exams and build strong clinical experience along the way. And they will still not be completely ready for what is coming. There is a multitude of affections and very specific protocols for each one. Being able to fulfill daily tasks and learning new treatment pathways along the way is quite challenging at the beginning. As a physiotherapist you need to invest in courses and accreditations in order to use different types of treatments. As you learn more and more from each case, from a beginner physiotherapy one can evolve into a senior role. Senior physiotherapists are rare gems in the market. They are hard to find, they get a good salary because every physiotherapy clinic needs at least one, if not many.

In order to grow a business like these, you must first ensure you are able to provide the same high quality experience to all of your customers, disregarding location. This needs to be reflected in very strict clinical protocols, with tools that can provide clear KPI’s for the new team members. Metrics on how those protocols are being followed also help business owners in managing the quality.

The use of technology has a without a doubt many benefits and can now improve the efficiency of the physiotherapy clinics, help managers implement certain protocols or just manage patient’s workload in a more efficient matter. Surprisingly or not, best clinics in the world do this. Being well organised and ensuring that a particular protocol and/or workflow are pursued by all the physiotherapists, give you all you need to be able to deliver the same amount of quality and have happy patients. Happy patients will raise awareness and more recommendations will come.

3) The quality of the physiotherapist’s service

There are cases when the physiotherapist is working with more than one patient at a time, so it’s very hard for them to stay continuously focused on the correct movement for each of the patient’s exercises and repetitions. They need to explain every move more than once, give important details during sessions and also create motivation for the patients.

Physiotherapists today need to improve their conversational and psychological skills in order to create and maintain a close relationship with the patient. And this is a big challenge for some of them.

By relying on technology, the physiotherapist can easily monitor the patients during their training and provide them a visualization of the correct movement. To make an efficient motivation with the help of technology he can show the patient his recovery progress.


4) More trust from the insurance companies

We couldn’t find a country where the amount of physical therapy reimbursed by public insurance is in accordance with the medical protocols. This is simply not possible because in-clinical physiotherapy is expensive. As a trend, the costs are increasing every year and the amount of clinical data is which they are able to get is limited. Certain private insurance found themselves in a position where they can’t reimbuse these services. Remote monitorization and a standardization of treatment was an idea which was emphasized for many years as a solution to bring more transparency into the reimbursement processes. And help payers shift to a success based reimbursement model. However it is agreed that this implementation simply couldn’t work without the use of technology.

The numbers speaking for the urgency of solving this problem are from US, where 25 out of every 100 patients who do not achieve complete recovery status, end up needing surgery. This means more money from the insurance companies are drained down an infinite string of challenges and weak links in the musculoskeletal patient’s pathway.

How can technology reshape the physiotherapy industry, and help it gain more trust?

A point of inflection would be in all physio clinics would start handing out activity reports, so that everybody along the pathway (doctor, payer, physio manager, patient etc) would visualize based on real data metrics like for example rehab progress, adherence and costs for every insured patient.

Providing this kind of transparency and reports over the billing and claims process will help payers, managers and universities develop improved medical protocols, efficiently allocate resources and improve business models.

This will benefit everybody. Patients will become more motivated in finishing recovery as they will do this is a more convenient way, and get everything reimbursed. The clinics will have more patients because their will be able to scale the public. The physiotherapist will treat more patients and have a bigger income.

Feedback from partner to partner

You are a physiotherapist or a clinic owner/manager and you believe that technology can revolutionize physiotherapy? Reach out to us at and let’s talk. You can be part of a research that will identify the needs of the physiotherapy industry and find solutions to the most common problems. In return, you will get the chance of becoming our clinical test partner, who will receive free sensors and free solution personalization. Act as a research partner with us and you will get the exclusivity in using our solution.

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re.flex team

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