“Western medicine is reactive, not pro-active,” says John Astrab, a physical therapist from Garrison.
A single practitioner, he says that insurance companies do not reimburse for prevention or for minor ailments that in time could become major disabilities. “It”™s mortgaging the future,” he says. “Small problems become bigger problems. It”™s shortsighted.”
With an aging population, more patients are coming to him with existing problems. “We can”™t reverse significant structural things, but we can help the person. I feel rewarded when I can get someone back on the golf course or playing again with their grandchildren.”
The Route 9 office serves a number of young people with problems resulting from sports. “Years ago young people played multiple sports,” Astrab says. “It”™s different now. A soccer player is in a single sport all year round. There used to be built-in periods of rest and recuperation.”
Astrab is particularly concerned about female soccer knee problems.
“Women have inherent mechanical and hormonal differences, affecting the integrity of the knee,” he says. With swimmers he finds shoulder issues, especially of the overuse variety. Diabetes and neuropathies present their own particular challenges among the aging. One example is that diabetes slows healing, he says.
Patients are referred by doctors or are allowed by insurers to come to a therapist on their own. “New York is a direct access state. Within limits New York state insurers allow patients to go to a physical therapist without a physician”™s prescription.”
Each new patient is evaluated before treatment begins.
“People have a misconception that therapy consists of hot and cold packs,” Astrab says. In addition to on-premises treatment, he teaches patients self-management so that they don”™t have to continue to depend on a therapist.
Astrab smiles as he recalls the woman who came to him after receiving three medical opinions, all indicating need for knee surgery. “She was frightened of the prospect of surgery and anesthesia and was seeking to avoid it,” he says. “We had a one hundred percent good outcome.”
Astrab traces his need to heal back to his close childhood association with a cousin disabled following a traumatic birth. Raised in Continental Village in Garrison, where he still resides, he graduated from Walter Panas High School in Cortlandt Manor and went on to earn a B.A. degree from Manhattan College followed by a master”™s degree in exercise science from Long Island University. A second master”™s degree followed, this time in physical therapy at Mercy College. Rounding out his education is a doctorate in physical therapy from the University of St. Augustine in Florida.
Working in a support capacity during student years, Astrab was affiliated with Pleasantville Physical Therapy and Sports Care for 15 years before joining Hudson Valley Hospital, where he was assigned to the Carolyn Lahey Pavilion in Cold Spring.
Individual practice has its positives and negatives, Astrab says. He misses the water cooler conversation with associates, but he does his own scheduling, allowing time to intently listen to a patient”™s concerns. “This is not assembly line treatment.”
To be in private practice a therapist has to have working capital and watch the overhead, Astrab says. “Payments from insurers come at a slow pace.” As a novice in private practice, he does many of the chores normally done by the front desk or the billing department.
In choosing to go it alone, Astrab had the support of his wife, Jennifer, a Yorktown teacher. They share responsibility for a son, daughter and two mixed-breed adopted dogs.
Challenging Careers focuses on the exciting and unusual business lives of Hudson Valley residents. Comments or suggestions may be emailed to Catherine Portman-Laux at cplaux@optonline.net.
