Jenny Murray is co-owner of Buckinghamshire based Excel Physiotherapy and Sports Injury Clinic. Now with three clinics and an ever-growing team of 6, Jenny and business partner Owen Gerrie started the business back in September 2016 having spent years working in private practices. During the coronavirus pandemic, Jenny has been quick to adapt and has managed to continue generating revenue through telehealth consultations.

We caught up with Jenny to find out a bit more about how patients are reacting to the change, why clinics should explore telehealth and other activities Excel are doing during these times.

Social distancing has obviously presented huge challenges for the MSK industry with many clinics closing their doors, it’s refreshing to see someone make the most of this situation. How have you adapted to the times with restrictions on delivering face-to-face consultations or hands-on treatments?

“The situation and public health advice was changing rapidly but we closed our clinics to face to face appointments on the 20th March and were seeing patients via Video Consultation by the following Monday. Initially we were unsure how effective Telehealth would be however we have found the experience to be really positive. We have always considered the hands-on part of physiotherapy to be a vital component in reducing pain, changing afferent input and giving patients confidence to move and therefore improving compliance.

Ensuring we were setup to work remotely was simple. We are fortunate in that we embraced web-based working through TM3 from its very beginning, so our clinic diaries were all online and we could all access patient notes remotely. We were also already using PhysioTec to send patients exercises and this has proved really helpful. It only took one call from Connor at TM3 and we switched our clinics into virtual mode and made them available for patients to book in online. The transition has been remarkably smooth.

Having to concentrate on education and exercise has really empowered patients to take control of their injuries and really focus them on the movement strategies, postural and behavioural modifications and improve their exercise compliance. These are all vital factors for all patients to recover and stay injury free.

Subjective assessment has not changed and is still the most crucial aspect of any assessment as it gives you information on the severity, nature and irritability of symptoms. The majority of the objective examination is still possible - sometimes I have asked a parent to assist if assessing a child (for example knee ligament stress tests) and functional tests also give clear information.

Through trial and error, I have managed to find best practice for virtual consultations with things such as getting patients to stand opposite a window helps as the lighting is better, and resting their phone or computer on the floor up against the wall gives a good view for objective examination.

Everyone knows it is anything but business as usual at the moment however how has the uptake on remote consultations been from clients? Have they been hesitant or welcomed the change?

“We have obviously seen a drop in the number of patients we see each week, but patients are starting to book in online, and once they have had one consultation they can see the benefit. I think the initial shock is beginning to wear off and that reality that this may be going on for months rather than weeks means patients realise they cannot just wait until restrictions are lifted to continue with their recovery journey.

This strange time we are in could be viewed as a unique opportunity. Many of our patients have a hectic pace of life and a poor work life balance meaning they found it difficult to make the time for themselves to get better or to make the changes at work that were attributing to their symptoms. They now have control over their diary, perhaps not commuting has given them more time and they can move around more during their working day so they can actually come out of this period fitter, stronger and pain free.

Also access to physiotherapy, exercise classes such as yoga and Pilates or even general keep fit has never been easier or more affordable so enabling patients to take part.”

Do you think the influx of home workouts and such puts people at greater risk of injury?

“There are the risks of over enthusiasm in taking on a new exercises or sport and not pacing properly. There is also the risk of not checking the credentials of the people running the online classes that we all should be aware of.

I am hopeful that even those who did not exercise much previously will now go out for that daily walk - and brisk walking is one of the best exercises you can do to keep fit and strong. I think the virus has also made many people consider co-morbidities and underlying health and make them more conscious of making change for the better.”

What sort of injuries are you able to triage and assist with via telehealth consultations?

“Over the past three weeks we have seen all our usual MSK conditions - acute tendinopathy from overzealous exercise, back or neck pain from not setting up a home workstation, the usual skiing injuries from the time of year and of course we are continuing to treat patients who were already attending. We are still able to advise on injury management, activity modification, pain relief, positions of comfort and initiate and then progress exercises. I saw a patient this week for advanced ACL rehab - we were both in our gardens with the sun shining and the birds singing, and it was an uplifting session.

I think that there are few injuries that we would not be able to assist with and as Chartered Physiotherapists we have all undertaken hospital wide training post-graduation and therefore have wide understanding disease and pathology. As a profession we are well skilled to recognise red flags and indicators for onward referral when needed. We are also aware that the greater implication of Covid-19 is nonrelated conditions that my be life threatening are not being picked up as face to face consultations have ceased across all areas of medicine.”

Besides from delivering remote consultations, are you using this time to undertake any other business activities?

“This has been the opportunity and push that we needed to start developing our social media profile to communicate with our patients and the wider community that will hopefully make our business known to a wider audience over the coming months.

It is also great to be able to offer practical and positive advice to our local community on exercising, working postures and general fitness. We usually run a weekly class for older patients, and we are now emailing or posting out a weekly exercise programme for them to continue with whilst in isolation and have had some great feedback.

We have moved our company CPD to online and that is a good way for our staff to all keep in touch. We all have a bit more time to attend webinars and widen our knowledge base by accessing all the online content and it has been really great to see many of the well-known names in physio makes courses and online content free during this time.”

Thanks for your insight Jenny, I’m sure it’ll be incredibly helpful to those considering a switch to virtual consultations. Before you go, do you have any advice for other businesses exploring making use of telehealth during these times?

“Don’t be daunted - it can be a really effective and gratifying way to still help patients during this time and an opportunity to broaden your knowledge, reach out to your wider community and improve your subjective and objective assessment skills.

Do make sure you have a quiet and uninterrupted space to do your consultations, ideally with enough space to be able to demonstrate exercises.”

Take a minute to explore Excel Physiotherapy's Facebook and Instagram channels and if you would like to learn more about telehealth and how TM3 can support your clinic with taking online bookings, payments and delivering remote consultations simply book a demo with one of our consultants.