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When I first began as a therapist in 2009, we typically saw two patients at once. We would split our time between the two or plan so that one was resting while the other was actively working. That soon changed to focus on treating one patient at a time, insurance carriers did not believe that they should pay for someone's therapy while another patient was also receiving treatment at the same time. This made complete sense because technically, the company was doubling their profit every hour, from every therapist. Treating one patient at a time went on for many years until someone found a loophole, there is a specified code for group therapy (3 or more) and concurrent therapy (2 patients) and every patient is allotted a specific number of units during their rehab stay. For patients that had short stays, it was beneficial to the company to put them into group treatments or concurrent treatments because they would be gone soon and the units would be useless.

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After many years of treating patients individually and having the time to truly focus on their needs and recovery, rehabilitation companies demanded therapists begin treating patients together again to maximize their profit. Rehab companies put tremendous pressure on therapists to comply. At first my therapy company asked that each therapist do one group a week, decide what patients would be appropriate and plan an hour-long group session. Many patients were not appropriate, not everyone has the same alertness level or physical abilities, many have cognitive deficits that wouldn't be appropriate or benefit from a group treatment. As therapists, I admit that we were hesitant and at times obstinate to the idea. This was mainly because we didn't feel that gathering a group together to exercise or make cookies was as beneficial as individual treatment that focused on their individual goals to get them home safely. We also felt this way because we were being told what we had to do from a corporate viewpoint, and they had no awareness about any of our patients or their needs.

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This transition was very frustrating to be a part of, it added more work to plan the group treatments, give everyone attention and make sure they were safe during the treatment session. We also didn't agree with managements reasonings for this approach and it showed to other therapists and to patients making it difficult to stay positive. We were feeling pressure from managers and corporate to do something we didn't feel was beneficial or functional to the patient. It was also difficult to watch new therapy students come into the field and experience this frustration and type of treatment sessions. It immediately put a sour taste for how the therapy world really worked.

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The company then began to ask we do two groups a week. This was causing a lot of stress on therapists plus hostility among patients because many of them would be upset they were being put into these groups. This anger would be taken out on the therapists and it made it look like we were not competent and not taking their rehab seriously. We as therapists began to push back, and explain the issues we were facing, the increase stress and paperwork however that turned into groups being scheduled for us. We truly felt like we were not being heard or understood and not given straightforward answers as to why we needed to do this if it wasn't in the best interest of the patient. We knew it was to make money, but that wasn't anything that was ever outright said to us.

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It is difficult to think of improvements on this treatment approach because it is not appropriate for everyone and should not be pushed onto therapists. That aside, from an organizational change perspective, there are things that could have been put in place to make the change more successful and our team work better.

Clear Vision & Purpose: Letting us know why the new procedure is needed and how it supports organizational goals.

Employee Involvement: Engage employees early in planning and decision-making to build buy-in.

Training & Resources: Offer practical training, mentoring, and tools so employees feel prepared instead of overwhelmed and frustrated.

Address Resistance: Listen to concerns, empathize, and explain benefits to reduce pushback.

Incentives & Recognition: Reinforce adoption through recognition, rewards, or linking outcomes to performance goals.

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What would help you most in successfully adapting to a new procedure?