Digital vs In-Person Physical Therapy: What Happened to Surgery Rates

Physical therapists and physical therapist assistants who treat spine, knee, hip and shoulder conditions and who field questions about digital or remote musculoskeletal programs from patients, employers and payers.

Physical therapists and physical therapist assistants working in outpatient orthopedics, hospital-based rehabilitation, occupational health and payer or employer-sponsored care settings.

Intended audience

Physical Therapy

Level

Introductory

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is based on a single source: a retrospective, matched-cohort study using a nationwide, HIPAA-deidentified United States medical claims dataset spanning July 2022 to February 2025. The study compared adults with spine, knee, hip or shoulder conditions who enrolled in a multimodal employer-sponsored Digital Care Program with a matched group of adults who started in-person physical therapy, and it counted musculoskeletal surgeries and Choosing Wisely-aligned low-value surgeries in the 12 months that followed.

All figures, findings and conclusions in this course come from that source document. The study was sponsored by Sword Health; most authors are employees of the company, several hold equity, and one author is the company’s chief executive. One author is an independent consultant who received an adviser honorarium from the company. Readers should weigh those disclosures alongside the findings.

After completing this course, you will be able to:

1. Describe the population, the two care pathways and the 12-month outcomes compared in this nationwide matched-cohort claims study.
2. State the direction and size of the difference the study reported in overall musculoskeletal surgery and in low-value surgery between the digital and in-person groups.
3. Explain the main limitations the authors named and what they concluded a digital musculoskeletal program may and may not be shown to do.

1. Start Here: how this course works
2. Podcast: Digital vs In-Person Physical Therapy and Surgery Rates (about nine minutes)
3. Who Was Studied and What the Researchers Asked
4. How Two Care Pathways Were Matched and Compared
5. Surgery and Low-Value Surgery at One Year
6. Where the Claims Data Ran Out: Limits and Conflicts
7. What This Could Mean for Musculoskeletal Care Delivery
8. Key Takeaways
9. Post-test and course evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course is based on a single source: a retrospective, matched-cohort study using a nationwide, HIPAA-deidentified United States medical claims dataset spanning July 2022 to February 2025. The study compared adults with spine, knee, hip or shoulder conditions who enrolled in a multimodal employer-sponsored Digital Care Program with a matched group of adults who started in-person physical therapy, and it counted musculoskeletal surgeries and Choosing Wisely-aligned low-value surgeries in the 12 months that followed.
2. All figures, findings and conclusions in this course come from that source document. The study was sponsored by Sword Health; most authors are employees of the company, several hold equity, and one author is the company's chief executive. One author is an independent consultant who received an adviser honorarium from the company. Readers should weigh those disclosures alongside the findings.