Independent physical therapist makes house calls

An appointment with a physical therapist can feel like another trip to the doctor, but Jay Shaver is trying to change the typical therapy experience for his patients.

Shaver, owner of Northern Physical Therapy, practices outpatient physical therapy not in a clinic, but in his patients’ homes or location of their choosing. He is one of just a few independent physical therapists in Montana who do home visits, and to his knowledge, he is the only one in the Flathead Valley.

Shaver pointed out that his practice is separate from home-health agencies that send physical therapists into homes for Medicare patients if they meet the definition of homebound.

“I can’t legally see patients if they’re seen by a home-health agency,” Shaver explained. “I’m the rest of the world.”

Shaver thinks his business model has many advantages, both for him and the patients. “It’s a much more casual relationship with my patients ... in some ways I’m able to provide better care,” Shaver said, speaking to the Inter Lake from his home north of Whitefish.

“My sense is the compliancy with the home-exercise program is significantly higher than when I set up home-exercise programs with people in my clinic,” he said, “simply because they’re able to see how it was done and they know we’re going to come back and check them at their house and see how they’re doing.”

For the therapist, seeing the patient’s home environment can make a big difference. Shaver said he can be more realistic about how people are going to perform rehab exercises. For instance, he can find “the perfect chair for patients to do sit-to-stand exercises or strengthening exercises” instead of setting up the exercises in a clinic and putting the burden on the patient to figure out how to perform the exercise at home.

“When you’re in a home, and you’re setting it up for them in their facility, they get it,” he said.

He also said it’s become “standard operating procedure” to check on the safety of the homes – especially for older patients – such as watching out for cluttered hallways or slick floors. He can meet with family members and have them assist in helping patients stick with an exercise regime.

But Shaver’s clients have not just been older people.

“It’s turned into a broader population than I had initially envisioned,” Shaver said.

“I have people who have jobs that only have a small slot of time during their day for physical therapy and don’t want to drive to treatment, so I come to their place of business. I found people who have post-operative care who are certainly not older that also have a hard time driving or finding somebody to drive them,” he explained.

Shaver had a physical clinic under the Northern Physical Therapy name until about three years ago, when his business partner, Don Bestwick, retired. That’s when Shaver was growing tired of the demands of running a clinic-based business.

“When you own a business and you have overhead and you’ve got staff, you work a lot of hours just to pay off your overhead. And I got just about all of that I wanted,” Shaver said.

Shaver’s new business model is still relatively uncommon, but it is becoming more of a trend, especially in more populated areas.

“It’s filling a niche,” he said.

But he is still treating the same ailments he would treat at a physical clinic – especially lower-back pain and neck pain.

A startling number of Americans are suffering from back pain. According to the Health Policy Institute at Georgetown University, nearly 65 million Americans reported a recent episode of back pain, and 16 million adults experience persistent or chronic back pain that limits their everyday activities.

Shaver said the main culprit is jobs where “people never get out of their chair.

“As long as people sit for a living we’re going to have back and neck issues,” he said.

He explained that exercises where the patient moves in the opposite direction of where they spend most of their time is the “golden nugget” for most joint pain. For people in office jobs who spend a lot of time in forward-bending positions, Shaver has them do back extension exercises that force the patient to move in the other direction.

This speaks to one of Shaver’s mantras: “Motion is lotion.

“We’re made to move, people are made to move. That’s just the way it is. Unfortunately we’re not necessarily a moving society, and jobs are moving away from moving jobs to more sedentary jobs,” he said.

Shaver himself has led a very active life. He grew up splitting time between Utah and Alaska, and had some demanding jobs in Alaska when he was younger. He worked on fishing boats, pipelines and at a homestead in Lime Village, Alaska, in 1977.

“We built a runway ... with just a pick and shovel,” Shaver recalled. “We’re out there in the middle of nowhere, there’s not a person … caribou are coming up to see what you’re doing, you’re trapping ptarmigan for supper. Just me and one other person.”

After graduating from the University of Montana in 1984 and working as a traveling therapist, Shaver settled down in Whitefish in 1987 as the rehab manager at North Valley Hospital. About 15 years ago he and his partner broke off and started Northern Physical Therapy.

Shaver and his wife, Cathy Relf, have no shortage of activities that keep them active and moving, such as running, backcountry skiing, cross-country skiing, mountain biking and canoeing.

The couple have a daughter, Megan, 28, who lives in Bozeman and works in adaptive recreation; she plans to return to school at Montana State University to study occupational therapy.

On his back porch – which looks directly over a lush forest in the foothills of Big Mountain – Shaver has a miniature gym with a bench and weights. He does not enjoy upper-body workouts, but forces himself to do them anyway.

“I can’t stand it. But I know enough about my profession to know that as I get older, keeping upper-body strength is important,” he said.

Shaver practices what he preaches, and is passionate about the potential benefits of physical therapy. He advocated for the field during his recent eight-year term as president of the Montana Physical Therapy Association.

He called physical therapy an “underserved profession,” as people often just want a “quick fix” like a shot of cortisone or surgery. But Shaver said the benefits of physical therapy – and the lifestyle changes that come with it – can be longer-lasting and more beneficial.

“Working with patients is such a rewarding aspect of the career,” Shaver said, “and working with people so they can do more and be independent of health care.”

Reporter Colin Gaiser may be reached at 758-4439 or cgaiser@dailyinterlake.com.