New Blog, PT on Forbes, and Grassroots Political Efforts

There’s a new PT blog to mention, with two very interesting posts which need to be highlighted. 

MCG Physical Therapy student, Ben Seagraves’ most recent post sends us to this blog from Rich Karlgaard on Forbes, who outlines how it cost $14,000, 3 specialists and 2 MRI’s before his son was able to access the services of a physical therapist.  Defensive medicine at it’s best! 

Most interestingly, Ben’s blog, "Views from a Georgia Boy" was welcomed to the scene with an interesting commentor on only his third post.  Ben’s post about GA bill HB 1055 provoked a very lengthy diatribe from GATA president Paul Higgs

I found it curious that such a comment would show up on what is very obviously a brand new, student-penned blog (not to take away from the blog, but traditionally, it takes at least a week or two to even tell your friends about your blog).  In order to find the post Higgs must have created a blog alert for the bill number, right?  This type of grassroots effort with collaborative technology is some solid stuff.  I would bet that Ben could comment on several hundred PT bills and issues and never get a direct comment from any APTA-ish entity. 

Reaching out and connecting through blogs and social networking is how relationships are being made.  Higg’s actions remind me of the Obama campaign, which has infiltrated almost every social networking site on the planet promoting his campaign.

There is a lesson to be learned here…maybe several, in fact.
ERIC

More Health Care Warning Signs

Warningsign
Sometimes just reading a few news articles gives you a pretty good idea of how some part of the world is working.  This morning, I found two articles suggestive of the deeper problems within health care. 

The first, outlines the competitiveness of certain types of residency programs and the lack of competition for others.  Dermatology is all the rage, while Family Medicine basically needs to accept all that apply.  Put differently, the system is designed to put the physicians who are the least competitive during schooling (translate that as you will, I will assume it means less competent for argument’s sake) into the driver’s seat for patient’s entry into the health "system". 

Then, the Well Blog at the New York Times highlights an essay from University of California, Davis physician, Dr. Faith Fitzgerald, which explores the very real barrier between patients and physicians.  Namely, why are patients not allowed to speak to a doctor?
Link [Bothering Your Doctor]

Here’s an experiment:  Try to phone your primary care physician with a real question about your health, then try the same with your physical therapist.  Which experience was easier, more enjoyable, and valuable to you?

ERIC

What Makes You Amazing?

I’ve always felt this about resumes, although I never knew others did as well.

"I think if you’re remarkable, amazing or just plain spectacular, you probably shouldn’t have a resume at all."  Link [Seth Godin]

Standardizing Practice Through Words

The current issue of the Journal of Manual and Manipulative Therapy (JMMT) is an important issue that all physical therapists and students should check out.  Important, as it contains the results of a task force charged with developing a standardized language with which to describe manual therapy techniques.  JMMT makes this content freely available. 

The editorial from new Editor in Chief, Chad Cook, is intriguing as it suggests the diversity of language within physical therapist practice is representative of deeper philosophical problems:

"Selected textbooks still support the use of archaic concepts such as Fryette’s law, usefulness of palpation of the sacroiliac joint, dogmatic use of the convex-concave rule for all joints, and the assumption that we can gainfully palpate and correct spinal subluxations."

Standardize your language here:
Task force for the American Academy of Orthopaedic Manual Physical Therapists.  A Model for Standardizing Manipulation Terminology in Physical Therapist Practice.

Thanks to Paul Mintken, Carl DeRosa, Tamara Little, and Britt Smith for authoring this important piece of literature.

ERIC

Push-ups and Stretching

Pushup
This week I found two nice articles in the New York Times regarding health and fitness. 

The first article looks at push-up as a measure of health. The second looks at the controversy that is stretching for sports. 

Did you even know stretching before your run is controversial? 

Push-up are totally under-rated and are not used very much in physical therapy clinics, often for good reason (fragile shoulders).

"Based on national averages, a 40-year-old woman should be able to do 16
push-ups and a man the same age should be able to do 27."

For the record, I stretch only those muscles which I feel are tight after a light 10 minute warm up, although I think taking your joints through their entire range of motion often is imperative.  And, I can do 27,000 push-ups.  Really!

ERIC

Wii Fun vs. Wii Funded

Hwdwii
Readers of this blog know that I think of Wii as fun, not therapy.  In the spirit of fairness, I must acknowledge that there might be a patient population which could benefit from gaming in rehabilitation. 

Checking in with a GUEST POST(the first ever guest post on NPA Think Tank!) is Stacy Fritz, PT, PHD, Clinical Assistant Professor of Physical Therapy at the University of South Carolina, who explains her research interest in Wiihab:

"Recent research has focused on identifying innovative and cost effective rehabilitative strategies to enhance function and quality of life in aging and/or neurologically compromised adults.  Virtual reality (VR) gaming may provide an ideal opportunity for motor learning and the recovery of lost function.1 First, the system allows for repetitive practice of activities, sometimes without the assistance of a rehabilitation specialist. Second, it has built-in augmented feedback, and the interactive interface helps to maintains participant interest and motivation. Third, the system may be an affordable option for many individuals.2

Research suggests that people with disabilities are capable of learning movement skills in virtual environments. Specifically, movements learned in a virtual environment transfer to real-world equivalent motor tasks; in some instances, evidence suggests that learning in a virtual environment has some advantages over real environment rehabilitation.1 Such findings paint an optimistic portrait for the future of VR in the treatment of balance and mobility deficits. To date, however, there is limited research that supports the use of VR in the treatment of balance and mobility deficits.3

The popularity of commercially-available gaming systems, such as Nintendo’s Wii, is extending beyond the teen gaming set. The systems are fast becoming an integral part of rehabilitation. Numerous news reports suggest that usual physical therapy such as stretching and/or lifting exercises can be “painful, repetitive and downright boring.” To avoid the “boring” therapy, therapists have been using gaming systems that involve interaction between the person and the video system through body actions that are similar to traditional therapy exercises. While there is considerable anecdotal evidence, as well as high utilization of gaming systems by hospitals, there has been limited research to indicate whether or not using virtual reality is effective for improving balance.

Supporters of the use of VR in a physical rehabilitation environment argue that it provides a non-threatening, fun, and motivating experience. However, there are concerns regarding the use of VR in individuals with physical limitations, including patient attitudes toward technology, equipment safety, feasibility of use, and lack of individualization of therapy. Despite these concerns, VR has been shown to be beneficial for a variety of populations.2,4,5

Anyone who has ever played the Wii, can not deny that it is fun, engaging, and many games are physically active. But is it appropriate for rehabilitation? The research needs to be done, this includes feasibility, efficacy, and determination if there is a need for a skilled therapist? Maybe it will be a good complement or adjunct to other falls prevention programs. Most important, it needs to be investigated before Wii Rehab centers start turning virtual reality into reality."

Thanks, Stacy!

Click on for references.

 

Continue reading “Wii Fun vs. Wii Funded”

MCG Tech Fair Features Wiihab!

I found this tucked away in the schedule for the Medical College of Georgia Tech Fair planned for tomorrow (3/12): 

12:15 p.m.

· Windows on my Mac?

· Getting the Word Out – Internal Communications at MCG 

 

1:00 p.m.

· Adobe Dreamweaver

·     Rehabilitation and the Nintendo Wii

 

1:45 p.m. 

· Collaboration Within an Online Course 

I guess Wiihab is everywhere!  At least I get to go see a presentation on it.  I’ll be sure to have some pertinent questions ready for the presenters!  Anyone wish to join me?

ERIC

Continue reading “MCG Tech Fair Features Wiihab!”

Can Health Care Be Green? See a Physical Therapist!

WaterSupply
Do you consider the environment when deciding whether or not to recycle?  Of course you do.  But do you consider the environment when you have back pain that needs treating?  Perhaps you should!

The current mantra among physical therapists, "You’ve got Drugs, you’ve got Surgery, or you’ve got Physical Therapists," attempts to explain the choices patients have in managing their musculoskeletal dysfunction.  It’s no secret that of those choices, the pharmaceutical option is the big winner from an economic standpoint, if not from an actual effectiveness standpoint. 

Now, with reports of drug residue in our water supply, scientists are becoming concerned with the effects of all these drugs patients have been taking.  As physicians prescribe more and more drugs each year, this pollution can only be expected to get worse.

It is also no secret that drugs are often no better than a temporary fix when managing musculoskeletal pain.  Back pain and osteoarthritis respond much better to exercise than they do to any pharmaceutical.  In that sense, physical therapists can provide the natural, holistic approach to healing.  Exercise is a  free, renewable resource, and physical therapists stand little chance of polluting the water supply when using spinal manipulation. 

Taking drugs unnecessarily is bad for the environment.  Going to see a physical therapist is your environmentally friendly health care choice.  I guess riding your bike to the local physical therapist is even better…

Here is a post I wrote last year that’s worth checking out:

[Top 5 Physical Therapist Recommended Body Hacks]

ERIC

Image courtesy of Jack Brauer.

An Interview Undone!

Physical Therapists don’t treat back pain!  Of course that’s not true.  Physical therapists are among the best providers for patients with back pain.  But, perceptions are everything.  Let me explain:

Earlier in February, an article was published in the Journal of the American Medical Association which described increased spending for patients with back pain along side decreased outcomes.  This strongly hints that the health care system is treating back pain poorly and a situation of medical waste is occurring.  Check out some related blog posts.

Well, I sent a press release from AAOMPT to my local news and a couple weeks later a camera crew showed up at my office for an interview.  I proudly explained how physical therapists could help solve this problem and even demonstrated some manipulations and exercises.  However, when the interview aired I was none too pleased.

As you can see, the interview was pretty decent until they cut back to the anchors for a wrap who began babbling about chiropractic care and finished with, "So if you are experiencing back pain, make sure you contact your doctor or your chiropractor.."

Link to Video [NBC Augusta]

[Update 3/8/08:  NBC Augusta has temporarily removed the story in response to viewer comments…click the comments to this post below for details and a nice letter.]

AHHH! 

Is Physical Therapy’s image problem is so bad that, despite just running an interview that was with a physical therapist, that demonstrated physical therapist interventions, and that included statements that physical therapists can do more for less, the anchor’s sub-conscious defaulted to "back pain treatment = physician or chiropractor"?  I guess so.

This really demonstrates the huge challenge that our profession faces.  And, the poignant need for marketing and branding help on all levels.  Back pain is big business, but until people relate their back pain to a physical therapist all the time, we’re not a big enough part of it.

By the way, I was bummed they didn’t use my carefully dropped tag line of, "You’ve got drugs, you’ve got surgery, or you’ve got physical therapists."  Maybe the media just doesn’t get that line.

ERIC

The Spirit of Massachusetts is…

The spirit of health care reform! 

Massachusetts, famous in health care reform for diving head first into universal health coverage, is now making news as the state senate proposes to ban ALL gift to docs from pharmaceutical companies.  That’s right, not even a cool pen would be available to drug reps as they try convincing doctors to use their drug.  The WSJ Heath Blog covers it well. 

This article from Wired Science News reminds us of just how sneaky those big pharmaceutical companies can be.

You can also check out the blog, Drug Rep Toys to see some of the threatened gifts.  I guess those MA drug reps might have to rely on evidence and research to push their products.  Crazy!