The Evolution of PORi

In early 2002, a Denver oncologist needed a physical therapist to provide rehabilitation for a patient who was battling with the effects of breast cancer treatment. After calling multiple PT practices, the oncologist came across the clinic where Julia Osborne was working and asked if any of the therapists would be prepared to treat an oncology patient. With her vast clinical experience, Julia accepted the patient, and while she was able to help, she was struck by the lack of clinical rehab guidelines for this population. The experience for Julia was so inspirational and impacted her so much, she decided to dedicate her entire professional career to treating this population, and so began a passionate 22-year quest to make oncology rehab the norm across the world.

She went on to pursue her lymphedema qualifications, then developed a novel breast cancer treatment protocol that amalgamated these lymphedema treatment methodologies with other evidence-based "traditional" physical therapy techniques such as trigger point release, joint mobilization, and myofascial release.  This new treatment protocol proved to be both revolutionary and extremely successful for the breast cancer population that she quickly became known for treating.

Between 2002 and 2009 the demand for Julia’s care exceeded her capacity so she decided to open her own clinic with a view to bringing on one or two therapists to help her.  At that time the clinic’s focus was still on breast cancer, but with big dreams to one day serve the ever-growing, ever-diverse population of all cancer diagnoses, it was rightly named Oncology Rehab. Over the ensuing years, Julia established the Physiological Oncology Rehabilitation Institute (PORi), a comprehensive system of oncologic rehab management, which now has international acclaim and is the most sought-after certification course for oncology rehab among physical therapists, occupational therapists, and speech therapists. Her growing practice caught the attention of a nearby Hospital Corporation of America (HCA) hospital, who was looking to add a comprehensive oncology rehab program.  The result was a long-standing partnership with the area hospital, the first of its kind, which greatly increased patient access to cancer rehab and advanced Julia’s vision of rehab for all cancer patients.

Meanwhile, as Julia was growing her clinic and developing the treatment protocols, Rachel Larsen was forging her path in oncology rehabilitation in San Antonio, TX. Her career in oncology rehabilitation began in 1997, when she was tasked with starting a lymphedema clinic at the hospital where she was working at the time. She became certified in lymphedema management then launched and managed the growing clinic for 5 years until establishing her own lymphedema-focused clinic in 2002. During this time, she attended one of Julia’s courses and immediately incorporated those protocols into her own practice and expanded her oncology rehab services beyond lymphedema. Over the next 17 years, Rachel’s clinic, Forte Rehabilitation and Wellness Center remained the premier center for breast cancer patients needing rehab. Then, in 2019, on the brink of COVID, Rachel and Julia were reintroduced by the leadership at HCA.

The goal was to form a partnership with an HCA hospital in San Antonio like the successful model in Denver. The plans were delayed because of COVID but the association between Rachel, Julia, and Julia’s business partner, Guy Osborne, grew during this time. Over the next 2 years, all therapists at Rachel’s clinic became PORi certified, and Forte Rehab and Wellness became a Bronze Level PORi Center of Excellence. An immediate jump in revenue was achieved and Forte enjoyed a 50% increase in patient visits. As the collaboration with the nearby hospital began to take hold, clinical pathways and internal processes were put into practice, which elevated Forte to a Silver level Center of Excellence.

Finally, in 2022, Rachel and her clinician team joined Oncology Rehab and a formalized collaboration and eventual partnership with the local HCA facility gave Rachel and her team in San Antonio unprecedented access to physicians, navigators, and hospital leadership in the form of tumor boards, cancer committees, and cancer work groups, elevating the clinic to Gold Status PORi Center of Excellence, resulting in over a 100% increase in patient visits with no signs of slowing down.

With Rachel's experience complementing the existing leadership team, PORi is leveraging the unique talents of each, ensuring program congruency, a unified vision, and the ability to reach new markets.

Today, the work continues at the local level, but the vision that all cancer patients have access to specialized oncology rehab has been the driving force behind the expansion of Oncology Rehab services worldwide; supporting clinicians, oncology rehab facilities, and health systems as they launch and sustain oncology rehab programs in their own communities.