top of page


Starbucks is one of my favorite places. It has excellent coffee, a friendly atmosphere, and great mugs to give as gifts. Another less apparent reason I am a massive fan of the coffee giant is its contribution to the physical therapy (PT) world. This "gift" to my chosen field is lesser known to the public unless you work in PT or perhaps have been an employee at Starbucks since 2006.

Rerouting the Patient Experience

In 2006, Virginia Mason Medical Center consulted with Starbucks and Aetna (insurance center) to attempt to cut health care costs. They assessed several aspects of their business, from internal procedures to how the government healthcare payment system affects their decision-making.

One assessment that captured the physical therapy world's attention was their study on how back pain patients routed through their system. Starbucks expressed concern about the lost time from work when several employees suffered back pain. After assessing several employees' typical experiences with the hospital system, they realized that it was much more timely, economical, and effective for the patient's recovery to go to PT before seeing the MD.

The "Medical Maze"

Historically, the employee with back pain would go to the MD first. Special tests such as MRI imaging would be ordered, and another visit would be scheduled with the doctor to provide the results. During this time, the employee would be off work, and the only treatment they would receive would be medications that often did not work and vague recommendations to rest.

Physical therapy was commonly ordered at the second MD appointment, usually weeks after the initial injury. By this time, the employee's pain may have worsened, the lost time at work compiled, and the dollars spent on two doctor visits and expensive tests have added up.

The New Standard Procedure

Starbucks and other well-known corporations such as Costco and Nordstrom were delighted when they learned they could get their employees feeling better faster and save over $1000 per back pain incident. All they needed to do was reroute the employee through the system.

The following image depicts this new standard procedure where the injured employee goes to physical therapy first. The PT with a doctorate could evaluate the patient and recognize red flags or critical signs and symptoms warranting an MD visit and imaging. They discovered that most employees did not need this, could be treated in PT, feel better, and return to work faster.

Image saved from Flynn, Timothy & Smith, Britt & Chou, Roger. (2011). Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder That Unnecessary Imaging May Do as Much Harm as Good. The Journal of orthopaedic and sports physical therapy. 41. 838-46. 10.2519/jospt.2011.3618.

We Need to Get Out of Our Way to Change Healthcare.

Although this study took place in 2006, the medical maze of unnecessary MD visits and expensive imaging continues to occur before physical therapy. Much of this can be related to societal habits and norms.

I share this study with you, the educated consumer, to illustrate an example of how a healthcare company and other big corporations can make positive progress in our healthcare system. I also wanted to highlight one of our healthcare system's many challenges - we often get in the way of improving healthcare by staying within our comfort lane. The lane in which the old way of doing things is the best. Yes, MDs are brilliant - but so are nurse practitioners, physician assistants, physical therapists, etc. There is a time and a place for the specialists and the MDs. But there is also a time to put our faith in other providers.

We must be willing to think outside the normative box to make a change in our healthcare system. High five to Virginia Mason Medical Center - they took a massive gamble during this study. They put their clients before the almighty dollar and did the right thing.

Bottom line: If your back (or other body part hurts), come to PT first - we will save you (not just Starbucks) time and money while getting you back on your feet faster.


Did you enjoy this information? If so, subscribe to my blog, and I will deliver a new researched article on mobility, strength, pain relief, running, or clean living to your inbox on Thursdays! Click HERE to get on the list! You can unsubscribe at any time.


bottom of page