The following is a guest article written by Ryan Eder, Founder of LainaHealth, and published in Healthcare IT Today
November 17, 2025
Virtual musculoskeletal care has surged into prominence, drawing billions in venture funding, capturing headlines, and fueling major IPOs. Yet beneath the hype lies a misunderstood story.
Despite impressive valuations and revenue, actual patient engagement with these virtual platforms remains low – averaging just 3% of those that have access, according to publicly available IPO filings. The problem isn’t the technology itself, but how it’s deployed: disconnected from local provider networks, offered as siloed wellness benefits, and too often focused on replacing clinicians instead of empowering them.
In reality, 99% of physical therapy is accessed through local physician referrals. A better model is integrated virtual care: collaborating with a patient’s primary care physician or orthopedist and delivering accessible care with measurable outcomes at a lower cost. The true promise of virtual PT isn’t displacement of the human relationship, but its extension: collaboration that opens high-quality medical care to millions underserved today.
We’ve normalized failure because PT has been structured for decades in ways that ensure it. Rural communities often lack clinics altogether. Those who do have access juggle work schedules, transportation costs, and caregiving duties that make adherence nearly impossible. Even in urban centers, patients face long waitlists, crowded clinics, and insurance rules that limit the number of sessions covered. In other words, the barriers are not accidental. Rather, they are the predictable result of a system designed around providers’ availability rather than patients’ realities. The outcome is inevitable: even when PT is prescribed, the majority of patients can’t fully access it.
The predictable consequence is poor adherence, the Achilles’ heel of physical therapy. More than half of PT patients quit before completing their plan of care. At-home exercises are often done incorrectly, and feedback loops are infrequent, typically once a week, if that. Inequities widen the gap: those with robust insurance or disposable income can attend multiple sessions weekly; everyone else makes do.
The result is care access dictated by geography and privilege – a paradox for one of medicine’s most democratic and cost-effective interventions.
Now, amid debates about AI’s role in healthcare, we stand at an inflection point. CMS’s July 2025 expansion of value-based models signals a shift: the next era will be judged not by how many procedures we perform, but by how well we keep people out of the hospital. This, combined with the national conversation on responsible AI, creates a rare chance to reimagine PT access.
Here, AI is not a gimmick but an enabler.
Computer vision and machine learning can now assess whether a patient performs an exercise correctly using only a phone or tablet camera. Feedback is instant, progress is logged in real time, and clinicians get dashboards that flag deteriorating form or declining adherence. Rural patients can receive the same quality of care as those in urban centers.
Crucially, this doesn’t replace clinicians but extends them. Patients and PTs maintain continuous communication. Clinicians can see further, intervene sooner, and prescribe care plans with greater precision. Expertise leaves the clinic and enters the patient’s daily life.
This is already happening. A veteran in Appalachia avoids a second surgery by completing exercises correctly at home. A grandmother in the Bronx recovers mobility after a fall, keeping pace with her grandchildren. A teen athlete’s ACL rehab is fine-tuned in real time, letting her return to sport confidently.
If we get this right, PT can prove what AI in healthcare should do: extend care, not automate it. Reduce costs not by cutting services, but by improving access and adherence so that surgeries, readmissions, and chronic pain become rarer. Narrow the gap between who gets care and who doesn’t.
But this will only happen if leaders act with intention. Health systems must adopt these capabilities as core infrastructure, not just pilots. CMS and commercial payers must design reimbursement models that support equitable PT access regardless of geography, income, or mobility, and remove logistical and economic barriers that keep patients from completing care.
AI’s real test isn’t whether it can write notes or code claims. It’s whether it can restore a patient’s ability to live without pain.
This is the opportunity: to make AI an active assistant in direct care delivery – helping someone return to work, to sport, to holding a grandchild – by extending clinicians’ reach. It’s happening now, with thousands regaining pain-free lives.
When we look back, this moment won’t be remembered as the dawn of AI, but as the beginning of democratized physical therapy.