The Future Of Pediatric Therapy, What To Do When A Child Can’t Brush, & Strength Training & Special Needs

Healthcare is the last holdout, as far as customer service innovation goes. You should be concerned about this.

As Walmart and Amazon jump into the primary care space with their well-honed customer service machines, there’s no reason to think that rehab won’t be one of their next targets.

They have the real estate and the technology and payment infrastructure to make it super easy to get basic healthcare. It’s easy to imagine a future in which therapists are working inside of Walmart SuperStores.

Customer service and convenience are what made Walmart & Amazon successful. And they can use the full weight of their massive bank accounts to expand their healthcare offerings quickly.

This could be a really good thing.

When Walmart is operating a pediatric clinic up the street for the lowest price, you’re not going to be able to compete on price and access.

Should this come to pass (I’m just spit-balling here), Walmart and Amazon would likely be looking to standardize vs individualize how therapists treat, which is what will allow them to scale the business.

But you, as a private practitioner, will always be able to compete on building relationships and creating a high-touch, individualized customer experience.

What can you do today to start thinking of your patients and their families as customers? What can you do to keep them from defecting to the cheap Walmart clinic?

It can be slightly stressful to think along these lines. But I think the future is bright. Walmart and Amazon could definitely serve a certain subset of the population very well. But people who are really invested in therapy will always be looking for a less mass-produced approach.

Recently I’ve gone down the rabbit hole of learning more about dental care, mainly because I keep getting cavities despite brushing and flossing like it’s my job. It turns out that my cavity situation is probably related to the steady stream of bubbly water I drink all day.

Sodas, sugar, & carbs all make your mouth more acidic. And acid breaks down your enamel, which helps cavities flourish.

It’s not just a problem for me, it’s a huge issue for many of the kids I treat. Some of my patients can’t spit and many of them can’t brush their teeth without significant help.

During my deep dive (here’s one book I read*), I found out that the use of xylitol ( a sugar-free sweetener) for preventing cavities is very well supported in the literature. Here’s a PubMed search on the topic for your information.

In fact, studies show that children whose mothers chewed xylitol gum while they were breastfeeding have fewer cavities during childhood.

In my quest to help some of my little patients with oral hygiene, I came across Spiffies. If you haven’t heard of them, they are lifesavers for a lot of kids who can’t (or won’t) brush their teeth.

Spiffies are tooth wipes that are coated with xylitol. You can wrap them around your finger and rub a child’s teeth to help prevent cavities.

I’ve recently had pretty good success teaching a child how to use Spiffies himself (with supervision, of course).

I also keep some in my purse so I’ll have a backup strategy when I can’t brush.

I hate exercise. I’d rather lay around all day like a cat. It’s extraordinarily difficult for me to motivate myself to exercise.

About 10 years ago  I read this book* about how exercise affects your brain and had a revelation. I was being really dumb. How could I possibly try to help kids build their brains and bodies when I was setting such a bad example?

I’m also terrified of cognitive decline as I age.

So, I started lifting weights. Every morning during the work week I get up at 5, have a cup of really bad instant coffee, drive to the gym & get it done. During this “covid issue” I’ve had to invest in some weights at home, but I haven’t missed a beat.

I’ve become an exercise evangelist because I can see all of the great things it’s brought into my life, even if I still don’t enjoy the work.

I also believe in the power of strength training for kids. I use the principles I’ve learned in training my own body to help my patients become stronger.

Strength training with children is a bit different than training myself. And strength training in children with special needs is WAY different. But some of the principles of strength training hold true no matter what:

• You have to up the challenge over time to see results
• You have to train consistently (more than once a week)
• You have to measure progress
• You have to allow for adequate recovery (muscles grow when they are resting)
• Good nutrition is SUPER important for building strength in anyone, at any age

As pediatric therapists, we are always working on strength. But it’s nearly impossible to build real strength in an hour a week.

I encourage you to think bigger about how you’re training your kids and about how they can add strength challenges into their daily lives.

All insurance companies require home exercise programs, and everyone needs to build and maintain strength for daily life.

Here are some resources to get your wheels turning:

• An article about strength training written by an OT
• Group exercise programs are safe for children with disabilities
• The American Academy of Pediatrics has guidelines for strength training