Synopsis. Dec 2024 - I had a total knee replacement (TKR) on my right knee.

Spring 2026 - My knee was still in chronic pain, swollen, not healed. I was referred to Dr. Mac, a physiotherapist in Phoenix, AZ, by someone who had a great experience with him.

I live in Flagstaff - 2, 2.5 hours away from Dr. Mac, but I was game. This means that I would spend about 7 hours in a car to get treatment - 2, 2.5 hours driving down, driving to get something to eat, driving to charge my car, charging, and driving home.

Initial phone consult - Dr. Mac explained that he is a complex pain specialist. He offered an ultrasound as a diagnostic. I WAS EXCITED.

First meeting - No ultrasound but the dry needling seemed to help.

The $3.000.00 Front Loaded Package - I was told that the best and most cost-effective way to get his services was to pre-pay $3,000.00 for a 20 session pack.

I made the commitment. I paid.

Second Session - No ultrasound, treatment seemed to help for a couple of days, then back to the same symptoms and pain.

Prior To Third Session - Requested promised ultrasound. Was told he would bring it.

Third Session - No ultrasound.

By the end of the Fourth Session, I knew something was really wrong, and this therapy was not fixing it.

Surgical Consult - I consulted a new surgeon. Given that I am 1.5 years out of my TKR, my symptoms, my prior bone scans (Dr. Mac did not ask to see them), I was told it is a likely loose tibial plate. Devastating.

The fix is a new surgery.

My medical conditions changed. My medical needs changed.

I used 4 sessions. I had 16 unused sessions.

Facing surgery and the painful recovery I had already experienced, I knew I would not jump in the car and drive 7 hours for PT. Nobody would. This is contrary to the purpose of physical therapy/physiotherapy and a medical hardship.

I respectfully requested a refund for the 16 sessions not rendered. I will repeat that. I asked for a refund for sessions not provided and that would never be provided.

I was told - NO REFUND. I signed a form. NO REFUND.

The Punchline - Dr. Mac presented several "options" to the refund, described in the video at 4:49 , two of which provide nothing close to the value of services paid for, (like, really?), the third of which entails making the drive.

One - Zoom Physical Therapy - how does that work when you are a dry-needle specialist?

Two - He will consult with my local PT. Wait. He missed my diagnosis. Even if he hadn't missed it, consulting with local PTs will help me..... how? Is his knowledge, shared over the phone with a well-qualified, successful PT so "superior" that these consultations will provide anything close to the same value as one-on-one dry needling and exercise sessions?

Can you imagine a well-respected, accomplished PT agreeing to this type of "consult"? What do you think??

Three - Make the drive for treatment further down the line. If someone, for example, you, gets a second knee replacement, do you expect to heal this time, or do you anticipate untreatable issues for which you will need to drive 7 hours for a complex pain specialist?

Physical therapy (or Physiotherapy) is intended to support healing, restore mobility, improve function, and help patients safely return to health. In my opinion, not providing a refund for services that were not, and would never be rendered, to a client whose medical condition and needs changed, is contrary to the purpose, goals and mission of a Doctor of Physical Therapy.