Hybrid Care: How Physical Therapy Was Meant to be Practiced
Dr Nadine Booysen PT, PhD
September 7, 2023

If you could rethink physical therapy from scratch, what would it look like? 

Here at Kins, we did just that. We looked at the biggest problems in conventional physical therapy and created a hybrid of home-based and virtual care that puts patients and physical therapists at the center.

The status quo fails practitioners and patients alike

Musculoskeletal (MSK) conditions are the number-one reason people visit their doctor in the United States. They affect half of all adults, creating huge demand for care and causing pain, missed work, and unnecessary, high-cost interventions

But access to physical therapy, often the most effective and evidence-based treatment, is challenging for many patients. Patients may wait weeks or even months as they work their way through primary care doctors, specialists, and referrals. Even after scheduling an appointment, they are up against a gauntlet of work, kids, and more to get to a clinic every week. 

Once in care, patients often waste hours in commutes and clinic waiting rooms. They may get only 15 minutes of an hour-long visit with their physical therapist, many of whom are burning out under the pressure to hit patient productivity quotas in less time. Patients may feel disengaged or dissatisfied and stop booking appointments and doing their exercises, with no one to check in and support their progress. 

This inconvenient, impersonal, fractured experience is why we started Kins.

The physical therapy industry recognizes these problems, and experts propose a range of solutions. Some recommend transitioning from funding high-cost care to more economical, high-value care, and realigning patients’ expectations to meet the reality of managing persistent MSK conditions with education, lifestyle change, physical activity, and self-management — with a physical therapist playing an essential role in their care. Others recommend that PTs build strong relationships with patients, make more shared decisions, and adopt a more patient-centered approach

But how could any PT possibly build rapport and implement self-management education, behavior change, and shared decision-making in just 15 minutes? And how many patients with MSK symptoms never even make it to a PT to begin with, when the biomedical model so pervasive in the U.S. creates financial incentives contrary to behavior change and self-management? In fact, 90% of those who qualify for physical therapy never start care due to barriers like location, access to childcare, and time requirements.

Hybrid care: Designed to be patient-centered

At Kins, we wanted to create something better — for patients and physical therapists. 

We started with first principles: Where do patients want to do physical therapy? What’s most convenient for them, and how can it fit seamlessly into their busy, tech-connected lives so that they stay engaged and even enjoy the experience? How can patients and PTs best interact and work together? What might give PTs the freedom to practice in line with their values and training, from full-scope biopsychosocial care to continuity with every patient? 

Our answers to these questions led us to create a wholly new model of delivery that we call hybrid care. And it’s how we think physical therapy was meant to be practiced. 

Hybrid care combines in-person, at-home sessions with virtual care, along with digital engagement between visits. This model intrinsically solves physical therapy’s most challenging problems, providing a higher-quality, more accessible and engaging experience with better outcomes — the best of both telehealth and in-person care.

So how does it work? Kins PTs meet each patient in their home, office, gym — wherever is most convenient for them — for an initial evaluation. Together, they build a customized care plan of in-person visits, telehealth visits, or a blend of the two which flexes to each patient’s individual needs and their PT’s clinical judgment. Between visits, patients can message their PT to report progress and ask questions, and PTs can offer support and update care plans on the fly.

More convenient and personalized care for patients

Patients can access care directly through Kins and start seeing a PT at home without having to jump through hoops. Kins PTs literally meet patients where they are — in their home and on their devices. This gives new meaning to the healthcare refrain, “right care, right place, right time.” There are no rushed visits, nor seeing several different providers; Kins patients get hour-long sessions and start and finish their care with the same physical therapist. 

More freedom for PTs

Kins PTs can practice the full scope of biopsychosocial care: They have the freedom and time to understand each patient’s experience and needs, build a strong relationship, help set long-term health goals, and train people to self-manage. What’s more, our PTs have the flexibility to create their own schedules and be their own boss, but without the overhead of running their own practice. They work how and when they want and take real ownership of their patients, leading to greater professional satisfaction and fulfillment.

Higher quality care and better outcomes

Studies show that early access to physical therapy and continuity of care with providers both lead to better outcomes. Emerging evidence on hybrid care shows improved outcomes in reducing pain compared to standalone in-person or telehealth treatments.

The results of Kins’s hybrid care speak for themselves:

  • Superior adherence: 79% of Kins patients complete their full course of care, more than 2x the industry average of 35%.
  • Better function and quality of life: 61% average improvement in functional outcomes, nearly 4x the industry average of 16%.
  • Less pain: 62% reduction in pain, 2x the industry average of 30%.
  • Lasting progress: 79% of Kins patients meet or exceed all of their long-term goals.
  • High patient satisfaction: A Net Promoter Score (NPS) of 90, compared to health care’s average of 58.

We believe that an important story behind these numbers is about relationships, behavior change, and patient empowerment. Our PTs really have time to get to know their patients as people and learn about their challenges and goals, whether it’s being able to sit on the floor to play with grandkids or run the New York Marathon. The therapeutic relationship that Kins PTs form with their patients, facilitated by regular visits and continuous digital engagement, is key to our unusually high rates of adherence and strong outcomes.

Our hybrid model also places the setting of care on the patient’s turf, rather than the provider’s. Instead of physical therapy being a place someone goes to get care, it becomes a routine or habit that takes place in a patient’s home, leading to better adherence and outcomes. 

In a clinic, PTs teach patients how to do exercises, but that doesn’t necessarily translate into their everyday life. For example, a patient may worry after a surgery about walking up a set of stairs at home thinking, “The practice stairs at the clinic are nothing like my stairs at home”. But a PT guiding them through the same exercise at home, incorporating the individual challenges patients may face in their own environment, can help patients build confidence and empower them to take ownership of their care and progress. Hybrid care may better facilitate an active approach to care, providing patients with confidence, self-efficacy, and self-management strategies, which we know yields more sustainable and long-term benefits.

Join the future of physical therapy at Kins

At Kins, we believe that hybrid care will play an important role in the future of physical therapy. Our better outcomes and lower costs position us well for the transition to value-based care. We’re tech-enabled but people-first; we leverage technology to enhance care and relationships, rather than replace them. Our flexible model supports PTs to enjoy greater sustainability and fulfillment in their work. 

We’re growing our practice, and we’re looking for like-minded practitioners who want to be a part of modernizing and innovating physical therapy. If you’re interested in learning more about hybrid care at Kins, send us a message at We’d be excited to hear your thoughts.

Share this article