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Who Cares About Their Physiotherapist?

Ronaldo
Ronaldo does.  Seen here trying desperately to stabilize his patella after he tore a tendon in his left knee, which has put the career of the soccer star in jeopardy. 

"That will depend not only on the surgery, but also on physical therapy
and the motivation of Ronaldo – currently 31 years old – to return to
high-level sports.” a Paris hospital reported.

Physical Therapy…Paris…not Physiotherapy?  Hmm. 

Am I the only one who wishes American PT’s were called physiotherapists as the rest of the world refers to us/them?  Perhaps having a profession that was it’s own word would reconcile many of the branding and legal problems encountered by naming a profession simply by combining an adjective and a noun that are used 10 million other places in the English language.

Here’s to the American Physiotherapy Association.  (APtA)
ERIC

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"Wiihab" Hurts my Brain!

ArtwiirehabapI’m still conflicted about this whole Wii-physical therapy link.  One side of me cringes when the concept of Wiihab has become so pervasive that, indeed, a phrase has been coined.  One side of me asks, "Is it so bad?  Maybe it’s professional insecurity creeping up on me that drives my discontent related to Wii-habilitation?"

I do know that I have almost completely stopped reading my Google News "physical therapy" feed.  It seems like for any 20 articles about physical therapy, 19 of them are about this clinic or that clinic using a Nintendo Wii. 

This is not my first post about the conflict the Wii presents.

I was glad to see Science Blogger, Karen Ventii brings this up on her blog, Science to Life.  She points out the lack of science behind the use of the Wii, and even points us to a pending study on just that topic.  She has a nice video parody of Wiihab linked in as well.

The thing is, I don’t care if there is science that says a Wii produced good results in a physical therapy setting.  I really don’t!  Here is why:

Movement, coordination, muscle control, etc., all combined is not a new concept for physical therapists.  We know how these principles impact healing and outcomes, which is why function and active-based treatments are the hallmarks of physical therapist treatments.  Exercise with a Wii, my friends, will only ever be functional for helping people to play the Wii. 

If you, as a patient, suffer from such disinterest in your health and how your body works that you need a toy to provoke interest in healing, I say, "Shame on you!"

And will all those articles on Wiihab please also mention two things:  1)  The clinic in this article is looking for gimmicky, cheap press, and, 2) physical therapists (good ones, at least) do not provide painful, dreadful treatments that are so awful as to require a parlor trick to enable a patient’s endurance of said treatments!

Come on, Wiihab providers!  Are you physical therapists, medical professionals with a doctorate-level education and significant musculoskeletal expertise, or are you a sideshow performer interested in games and cheap thrills?  I guess it depends on whether you give out stuffed animals to patients who beat the video games prior to discharge!

I guess I’m less conflicted than I thought on this…

ERIC

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Not Just Clothes, Performance Enhancing Clothes

Phelpsspeedo

FanHouse checks in with this little bit about the fancy new swimsuits to be worn in the upcoming Olympics, and how Michael Phelps describes them as the best swimsuit ever made.

“It literally feels like you are a rocket coming off the wall,” said Phelps.

This makes me think of poor Oscar Pistorius.  At what point does technological clothing provide enough of a competitive advantage to warrant it an "unfair advantage" that Pistorius is proposed to have? 

I know, many countries will have access to the suits, which is different from a double amputee except for the most dedicated of competitors.  If running on prostheses was such an advantage, why doesn’t every sprinter have a surgeon and a stump wrapper in their contact list?

But just because everyone has the suit, it still  raises a question of competition.  Perhaps the swim suit could also come with flippers.  Should all the marathon runners ride motorcycles this summer?

It might not be a bad idea considering the expected air quality in China!

ERIC

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Article Chronicles Poor State of Business for PT's

I can’t believe I read this in the actual news…one not written or published by a PT, that is.

"At least 10 outpatient physical therapy clinics across Southwest
Florida have closed since midsummer as a trio of trends has sapped the
businesses’ income."

The article goes on to give an excellent summary of the state of the PT union, including some notes on big mergers, Stark laws, Medicare caps, and the works. 

"If you’re going to do things the right way, what is best for the
patients and the ethical way, you’re going to lose a lot of money,"
said Karen Fitzpatrick, account Specialist for Bay Area Physical Therapy & Wellness.

The APTA even makes a slightly weak appearance as physician self-referral is discussed.

ERIC

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Paperless!

Paper
I really like this piece in the NY Times about one person’s quest for a paperless home.  I never have liked paper, it creeps me out a bit.  Think about this quote:

“Paper is no longer the master copy; the digital version is,”

I consider this a very valid point and one to consider in my own profession.  Electronic medical records have been adopted very slowly by physicians, but perhaps even more slowly by physical therapists. 

Going digital can have many benefits for a business in terms of storage, efficiency, and increased organization.  Data can be found only when it is needed, and virtually hidden when it is not.  That’s just perfect, no?

As delightful and warming as this image is, for me it would be more pleasing with a nice, slick, minimalist laptop.  Unless it was fine linen paper, I secretly still enjoy that.

Is your physical therapy clinic digitized?  Has anyone experienced a health care provider’s office with a complete electronic medical record?  I wish I have.

ERIC

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The weather hates the APTA

Nashvilletornadowarning

Last year at this time I was anxiously watching the forecast as I waited for my flight to CSM in Boston which was eventually canceled.  My flight, not CSM.  Although, the annual Combined Sections Meeting took place with quite a few PT’s left at home (including me) due to a heavy winter ice storm in the northeast.

This year, Nashville is in trouble with a tornado warning.  Severe storms have caused much havoc in Tennessee today already.  Yikes!  I hope everyone is safe in Nashville, but I have to wonder why the weather gods have become upset with the APTA.

ERIC

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Go Big Blue!

Somehow I managed to travel through 3 airports and not find out about the game on my way back from San Antonio last night.  So, at 1am, my recording of the Super Bowl ended and I was happy. 

Very Happy!

Tyreecatch

Giantscatch

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Health care costs a bunch!

The Agency for Health Care Quality and Research estimated
spending for the 10 most expensive health conditions as follows: (2005 data)

  • $76 billion – heart
    conditions
  • $72 billion – trauma
    disorders
  • $70
    billion – cancer
  • $56 billion – mental
    disorders, including depression
  • $54 billion – asthma and
    chronic obstructive pulmonary disease
  • $42 billion –  high blood
    pressure
  • $34 billion – type 2
    diabetes
  • $34 billion – osteoarthritis

    and other joint diseases

  • $32 billion – back problems
  • $32 billion – normal
    childbirth

Interesting List!  You can find more tables and interactive data about health care costs at the agency’s website.  How many of these things can physical therapists help with?  I find it interesting that a natural event has made the list.

What I really wonder, however, is how much "back problems"  could be reduced by proper management of this condition including direct patient access to physical therapists as opposed to primary care physicians.

ERIC

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Evolution of a profession?

The proposed changes for specialty certification in orthopaedics were sent out this week.  The basic premise is a move towards a requirement for completing a Residency in order to obtain board certification.  This is a model proven in the medical field, and described well here at the EIM blog.

But, John writes:

"Therefore, none of this will lead to immediate changes in compensation,
nor does having a DPT or residency training itself make you immediately
deserving of a high salary. However, standardizing our training around
a medical model with legitimate post graduate residency training that
is so common you wouldn’t seriously consider practicing as a physical
therapist without it (and no consumer would want to see a non board
certified PT), will go a long ways in improving our brand,
differentiating physical therapists as experts in managing patients
with musculoskeletal conditions. PT compensation will adjust
upwards once we lay claim to our brand…"

I agree, but in the short-term there is a real incentive problem.  Is specialty certification so valuable to the individual that they are willing to lay out even more cash than they already have in obtaining a DPT in a profession with a real ceiling on income?  The result of the extra training is a very, very well educated Physical Therapist, but one who probably has quite a bit more outstanding student debt with NO increased ability to repay.  The answer to my question is, "not unless the process of residency training is so ubiquitous (among other specialty certifications as well) that no other way is an option." 

Until that time happens, employers will need to step up and support new graduates in their residency training.  The incentive for graduates is to seek out these employers.

In a sense, I stand against ANY alternative Continuing Education-based option for board certification.  I know that’s the plan here, and I get that professional evolution must be a deliberate process, but until the "CEU" actually correlates with learning or evidence-based practice, we must be on guard against questionable continuing education providers. 

In the mean time, I will keep promoting Residency training and hope employers and students have some sense of altruism for the evolution of the physical therapist.

ERIC