Have you ever wished you could get some help at home with rehabilitation after an orthopedic injury or elective surgery? Now, you can. Trainer Rx has developed a comprehensive program that you can use at home to augment the physical therapy your doctor has prescribed.
Here’s my interview with CEO & Founder, Michael Oberlander, MD, an orthopedic surgeon who was inspired by his own injuries and surgeries to develop a way for people to have a more complete recovery than is possible by only seeing a physical therapist for a limited number of office visits. [A short version of the video interview appears here. The entire video interview can be seen here. What follows is a transcription that has been shortened and edited for readability.]
From orthopedic surgeon to digital health entrepreneur
PS: How did you go from an orthopedic surgeon to a digital health entrepreneur?
MO: It was because of a series of injuries on my part. I was an extreme skier for years. I started at a young age. I was always pushing the limits of things. I sustained a number of injuries ranging from dislocations to a torn meniscus to broken ankles to dislocated SC joints to ruptured discs. The latter led to the first of my back surgeries.
PS: You didn’t learn your lesson?
MO: I didn’t exactly follow my doctor’s orders. My back got progressively worse over the years. Unfortunately, I had to have a third spinal surgery which was a fusion of my upper lumbar spine to L2 and the sacrum. At that stage, I did not have the mobility to perform in the operating room. So, I decided to change things up a bit.
PS: Did you keep on skiing?
MO: Unfortunately, I have not kept skiing. When I couldn’t practice anymore, like most doctors, I couldn’t just sit around. Instead of driving myself and everybody around me crazy, I decided to change horses a bit. I’d been involved in team athletics for years taking care of professional sports teams in the Bay Area and nationally, such as the San Jose Earthquakes and the US rugby team. We would typically try to keep injured players on the field during the season and then send them home where they got physical therapy. When they came back for their pre-season physical, they would be all over the place in terms of the recovery process. So we began giving them our rehab protocols that their therapists could follow when they went home. This led to a pie-in-the-sky vision that I had with the head athletic trainer from the San Jose Earthquakes, Bruce Morgan, who is one of my co-founders. Together, we started TrainerRx.
PS: So, there was not really any consistency either longitudinally or from player to player to player.
MO: Exactly. What we have developed is a program that is all-inclusive that provides a patient journey. And, it’s not just for athletes. Now it’s for anybody recovering from a musculoskeletal injury. From the time of an injury or after elective surgery, what you want to do is surgery avoidance. When we were rehabbing injured athletes during the season, we were trying to allow them to play – which is what they want to do, which is what most people want to do. They want to continue with the regular life. You really just want surgery to be the last option.
From the time of injury or post-elective surgery, we want to outline a patient journey that allows you to recover at home on your own time, one that can minimize your time lost from work, from sport, or from school. We want you to recover to the highest level you can possibly be. Ideally, we’d like you to get to a higher level of recovery than when you started. So, we’re going to give you programs above and beyond what we would expect you to do. We employ machine learning, we use evidence-based medicine, We dissect the literature and bring it from a very high level (the way it’s published) down to a very granular level where we’re actually inserting it into home self-care video content and self-care after surgery. Whether it’s how to care for your cast, how to do a wound change, or how to get in and out of the car safely after a hip replacement, we cover it.
Trainer Rx augments, not replaces doctor or PT visits
PS: Do you consider yourself a replacement for some doctor or PT visits? How does your program fill the gaps in the current system?
MO: It’s not a replacement for a physician, it’s not a replacement for a therapist or athletic trainer, it’s an augmentation.
PS: So, I’m going to give you a personal story. A couple of years ago, I fractured my shoulder. My orthopedic surgeon recommended a sling followed by physical therapy. I wasn’t prescribed 10 or 15 sessions as happens often today. Rather, I got the number of sessions that I needed.
MO: That’s an important point. Twenty years ago, you may have had an unlimited number of physical therapy visits but today they are limited by your health plan to a certain number, say 10 or 20. So, you have to find out ways to be able to recover above and beyond physical therapy appointments. That’s where we come into play.
There are other barriers to PT such as lack of health insurance or living in rural areas without access to transportation. There are also people who are not able to pay for a copay every time they go to a physical therapy appointment. Some of our patients with high deductible plans stopped going to PT when they thought they were good enough, however, that was usually way before they were fully recovered.
You want the physical therapist to spend their time with doing the hands-on stuff but what you can do at home is also a big part of the whole rehab process. You need to be empowered with the information to recover on your own, take ownership of your injury, and reach your maximum level of improvement. That’s where we step in.
PS: We all know you can do an exercise right or you can do an exercise wrong, you can do physical therapy properly or you can do it improperly. How do your videos help people be sure that they’re doing the physical therapy exactly the right way?
MO: We have audio, video and text instruction within each program. It shows you how to do each exercise. We also have closed caption. We try to deliver that information at somewhere between a fifth and eighth-grade level so that the average person can understand it easily.
PS: That sounds great but how do you know it works?
MO: We know that patients are staying engaged on the program and we constantly reach out to our patients and providers to see how they liked the program. Further, we have a Net Promoter Score of 87 percent which is very high for a medical software company.
PS: And one final question, how can people access your program? Can I go out and download it from the App Store?
MO: You can download the app but you can’t get the program because it is currently a prescribed program. Your physical therapist, your doctor, your chiropractor, your athletic trainer can sign you up on the program. We have a direct-to-consumer release coming out soon that we will contain our very common programs such as ones for knee osteoarthritis, hip osteoarthritis, low back pain, neck pain, tennis elbow, and plantar fasciitis. If you need a program that requires a prescription we can help you with that. You will be able to see the prescription programs that are available and then you can ask your physician or provider for an e-prescription so we can get you signed up. We also provide an outline to help you advance while you’re on the program so you don’t have to reach back to your medical provider all the time to have adjustments made.
PS: Who pays and how much?
MO: That’s all over the place. A lot of private practices that instituted TrainerRx in their practices pass the cost on to the consumer/patient. It’s $45 to use the program for an entire year. We priced it less than the cost of a single copay for an entire year.
PS: Any final comments?
MO: It’s been interesting and obviously it’s been very fulfilling on this side of the equation. But I know that being on the other side of the table is difficult, literally. Having the unique perspective as both patient and a provider has allowed us to produce a program that is very consumer-centric and much tailored to the real needs.
Related Content: What You Need to Know About Surgery for Plantar Fasciitis
The video interview at HiMSS was sponsored by Trainer Rx.
Patricia Salber, MD, MBA
Patricia Salber, MD, MBA is the Founder. CEO, and Editor-in-Chief of The Doctor Weighs In (TDWI). Founded in 2005 as a single-author blog, it has evolved into a multi-authored, multi-media health information site with a global audience. She has worked hard to ensure that TDWI is a trusted resource for health information on a wide variety of health topics. Moreover, Dr. Salber is widely acknowledged as an important contributor to the health information space, including having been honored by LinkedIn as one of ten Top Voices in Healthcare in both 2017 and 2018.
Dr. Salber has a long list of peer-reviewed publications as well as publications in trade and popular press. She has published two books, the latest being “Connected Health: Improving Care, Safety, and Efficiency with Wearables and IoT solutions. She has hosted podcasts and video interviews with many well-known healthcare experts and innovators. Spreading the word about health and healthcare innovation is her passion.
She attended the University of California Berkeley for her undergraduate and graduate studies and UC San Francisco for medical school, internal medicine residency, and endocrine fellowship. She also completed a Pew Fellowship in Health Policy at the affiliated Institute for Health Policy Studies. She earned an MBA with a health focus at the University of California Irvine.
She joined Kaiser Permanente (KP)where she practiced emergency medicine as a board-certified internist and emergency physician before moving into administration. She served as the first Physician Director for National Accounts at the Permanente Federation. And, also served as the lead on a dedicated Kaiser Permanente-General Motors team to help GM with its managed care strategy. GM was the largest private purchaser of healthcare in the world at that time. After leaving KP, she worked as a physician executive in a number of health plans, including serving as EVP and Chief Medical Officer at Universal American.
She consults and/or advises a wide variety of organizations including digital start-ups such as CliniOps, My Safety Nest, and Doctor Base (acquired). She currently consults with Duty First Consulting as well as Faegre, Drinker, Biddle, and Reath, LLP.
Pat serves on the Board of Trustees of MedShare, a global humanitarian organization. She chairs the organization’s Development Committee and she also chairs MedShare's Western Regional Council.
Dr. Salber is married and lives with her husband and dog in beautiful Marin County in California. She has three grown children and two granddaughters with whom she loves to travel.