Health Services Research on the Rise; Adam Goode, PT, DPT, PhD
In the ever-changing world of health care policy, evidence is constantly needed to prove efficacy and guide legislation. The case is no different when it comes to policy relevant to the physical therapy profession. For so long, physical therapists relied on prescribing certain practices and treatments, yet failed to validate its necessity and cost-effectiveness. This was becoming a dilemma that urgently needed to be addressed.
Today more than ever, physical therapist researchers are beginning to delve into the study of health services research (HSR). One such researcher is past Foundation for Physical Therapy funding recipient, Adam Goode, PT, DPT, PhD.
Goode, 2-time scholarship recipient from the Foundation, is an associate professor at Duke University’s Division of Physical Therapy, with a focus in musculoskeletal epidemiology and health services research. Goode received a Florence P. Kendall Scholarship in 2007 and a Promotion of Doctoral Studies I Scholarship in 2008, which he says provided the first funding he received to support his academic pursuits that eventually led to additional external funding sources.
Because he grew up around sports, Goode indicates that physical therapy always seemed to be the most reasonable career fit. However, it was his love and appreciation for academia and mentorship from other physical therapy researchers that fueled his desire to pursue HSR.
“The most enticing aspect is the challenge that comes with designing studies that will have clinical significance and impact on patient care,” says Goode of his appreciation for research. What keeps him going, he adds, is that there are no limitations to what can be achieved. “There is really no end to an idea and what you can put into motion.”
Goode was able to further explore the world of HSR when he joined the Center on Health Services Training and Research (CoHSTAR) in 2015. After the 43rd Mary McMillan Lecture, titled “Face into the Storm,” was presented to attendees at the NEXT Conference & Exposition in 2012, a nationwide call was made to members of the profession to take a front-seat role and become proactive in devising, implementing, and evaluating health policy and cost-effective health care. 2012 would prove to be a pivotal point in the profession and spur the creation of this multi-institutional center dedicated to advancing health services and health policy research in physical therapy. Among its faculty fellowship recruits was Adam Goode.
Goode joined CoHSTAR as its first faculty fellow. Under the mentorship of Anthony Delitto, PT, PhD, FAPTA, and Kelley Fitzgerald, PT, PhD, of the University of Pittsburgh, Goode worked on developing integrated and collaborative care models between physical therapists and primary care physicians, and worked with CoHSTAR collaborators in the developing patient-reported outcome measures to be implemented in electronic health records for patients with knee osteoarthritis. The hope is that this would improve access and efficiency of musculoskeletal care and improve patient and provider satisfaction, as well as improve the efficiency of measuring functional outcomes for patients with knee osteoarthritis while simultaneously improving the ease of measuring functional outcomes for large-scale clinical studies.
Goode is hopeful that his work can show the successes in aligning musculoskeletal-focused treatment approaches early on in the process of care. “We would hope this would have positive outcomes not only on cost but also on functional outcomes for patients with pain.”
Among his other work through CoHSTAR, Goode worked to develop and refine the integration of a physical therapist within the patient-centered medical home model for the treatment of musculoskeletal complaints, and he continued working on a Veterans Affairs-funded project titled “Physical Activity for Older Adults With Chronic Low Back Pain,” which will appear in Physical Therapy’s May 2018 edition. Goode’s CoHSTAR faculty fellowship ended in November 2017.
“CoHSTAR offers unique advanced experiences with senior health services researchers at its [trio of collaborating institutions] that have a wealth of experience in conducting pilot studies to large pragmatic clinical trials,” says Goode of the benefits of CoHSTAR.
While the field of HSR is still growing among physical therapists, Goode notes that since the establishment of CoHSTAR, interest has been growing quickly. “Only a scarce number of physical therapist researchers had been involved in health services research, but over the past 4 years this has definitely changed,” says Goode. “CoHSTAR is bringing to light the opportunities that health services research can provide to investigators.”
Goode stresses the importance of HSR and the impact physical therapists can have. “Our health care system has many different areas of need for change, which can only come with understanding the system and how physical therapy falls into that system; [we as health services researchers] can make a difference.”
Goode recently was awarded a $2.4 million R01 grant from NIH’s National Institute of Arthritis, Musculoskeletal, and Skin Diseases to study biomarkers to advance clinical phenotypes of low back pain. From this longitudinal study, Goode hopes to use biochemical biomarkers related to mechanical cartilage degradation, inflammation, and pain to better understand individuals who may develop low back pain from intervertebral disc degeneration or facet joint osteoarthritis. “Being able to better understand the etiology of spine osteoarthritis, we can better target the right interventions for patients to prevent or slow progression,” says Goode.
Goode received his physical therapist assistant degree from the College of West Virginia in 1999, a bachelor’s degree in natural science in 2002 from Mountain State University, his doctorate of physical therapy in 2005 from Duke University’s School of Medicine, and a PhD in epidemiology from the University of North Carolina-Chapel Hill in 2011.