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A PT Blogger at ESPN!

I stumbled across this new blog at ESPN this morning and was very thrilled.  Stephania Bell, MS, PT, OCS, CSCS, has a new fantasy blog hosted at ESPN where she provides injury analysis for all of the worrisome fantasy sport managers around the globe.  This is a big time blog presence for a physical therapist.

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This is some solid PR for PTs!  This very excellent post on Greg Oden is just one example of the nice analysis Stephania is providing on ESPN.  But, perhaps Stephania has even more marketing savy than she lets on.  You see, when she posted that post about microfracture surgery, Google Hot Trends tells us that "microfracture surgery" was in the top 25 of all Google search queries.  So, we have poignant information, very large broadcasting platform, and good writing all in one.  Go Stephania!

The APTA has even gotten in the mix on this one and includes a link to the ESPN blog on their consumer page.  I do consider this a solid upgrade over conversations about backpacks.  As a fantasy football player, I appreciate the input and advice a therapist can bring to interpreting injuries.  For example, I understood that Eli Manning and his AC joint sprain would probably play, but why another player with a meniscus injury might not.  That type of information is gold to fantasy players and I can think of few others more qualified to offer it that a PT.
 

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Examining Epidemiologic Research…

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…or why you shouldn’t believe much of the health information coming to you from your local newscast.

The New York Times magazine has presented a wonderful article written by Gary Taubes, which describes the strengths, weaknesses and intricacies of epidemiological research studies.  It is lengthy, but contains more than its fair share of great quotes and good information.  It nicely concludes with some basic suggestions for how you or I, as individuals, should interpret what we hear from these type of investigations.

This is a great read for providing some good insight into complicated research in some nice, plain language.  The prescriber effect, healthy person effect, and the inability of observational cohort studies to conclude causality between variables are just a few of the topics discussed.  My favorite quote of the article: 

"There are, after all, an infinite number of wrong hypotheses for every
right one, and so the odds are always against any particular hypothesis
being true, no matter how obvious or vitally important it might seem."

Update:  The WSJ has checked in with another Hormone Replacement Therapy update at their blog this morning.  The title aptly mentions the words "clue" and "mystery."

ERIC

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Welcome the new NPA Think Tank!

Welcome!

Thanks for joining me here at the new domain for NPA Think Tank.  I do apologize if your feed e-mails have been a little weird lately, the transfer process wasn’t as smooth as I would have hoped.  Anyway, here we are.  I had a lot of help from Jessica King designing my site, so if you like the page and want one of your own, a link to Jessica can be found in the right sidebar.  I should also point out, that Jessica is also quite the musician and can help you out if you’d like to hear some nice music from someone who can work wonders on an acoustic guitar!

Some Updates:

Since this post isn’t really about anything, I’ll continue in the same direction and provide some updates about me.  Most of my readers are probably well aware of my new job by now, but to update, I’m now on the faculty at Medical College of Georgia teaching in the Physical Therapy department of course.  I’ve been there for about a month so far and I’m really loving it!  I hope to be able to explore some new twists in the field of evidence and technology as I go, so stay tuned.  As far as upcoming content goes, I plan is to use my teaching content as a generator for posts thoughts.  For example, if I’m teaching about Power Training, I might try to write a post on the same subject.  That way, the MCG students at least will be able to find something else to think about and the rest of you can keep up with where my brain is. 

I’ve run on for long enough!  Make sure to re-subscribe to the new feed for this site if you did not subscribe to the Feedburner feed.  Not sure if you need to resubscribe?  Do it anyway…if you get two feeds, just delete the old one.

Thanks for Reading!
ERIC

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Gotta love those ice packs!

Unless you’ve been living under a rock, pretty much everyone must be aware that Kevin Everett suffered a severe spinal cord injury this weekend in the Bills game.  At first, the prognosis was expectedly grim after an estimated impact force of 2/3 of a ton to Everett’s spine.  Now it seems a more positive outcome may be expected.

In listening to some of the interviews, a physician from the Miami Project made a statement that Everett benefited from the earliest application of moderate hypothermia after a spinal cord injury…ever.  That is rather profound.  From what I can gather as a very outside observer, doctors began lowering Everett’s body temperature in the ambulance and further reduced it once at the hospital by means of an IV catheter.

It is widely understood that cooling tissues reduces the damage cause by inflammation.  It is practiced in neurosurgery, with neonates, after sprained ankles, and now with spinal cord injuries.

This image demonstrates the reduction in neural tissue possible with hypothermia treatment.  The top two tissue samples were controls, and the bottom sample was cooled to 32 degrees C.  The highlighted parts of the image shows areas of tissue death.  Pretty amazing!

And, in a big example of "what comes around, goes around," it was reported that the Buffalo Bills owner is a large donor to the Miami Project.

One final note, the Miami Project doctor I cited earlier did upset me with the quote, "…will walk out of the hospital."  This is far from a foregone conclusion and seemed a bit overzealous and self-promoting to say that on ESPN.  Either way, I’m writing about him.

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A sadly growning market


The US Census announced today (pg 26-28 of pdf) the latest numbers on income, poverty and health insurance for 2006.  For the 6th year in a row, the number of uninsured Americans rose.  For 2006, the number was 15.8% of all Americans or 47 million were uninsured.

While this is a somber fact, I would like to look at it another way:  a growing market.  Whoever figures out how to provide inexpensive health care to this population has a steadily growing market on their hands.  It could be good business.  Again, I refer you to retail health clinics.

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The intellectual downhiller


This story about professional mountain biker Neven Steinmetz, caught my eye for sure.  I have a special place in my heart for downhill mountain bikers, people who survive smashing into things, intellectual pursuits and stories about physical therapy.  This one has it all! An inspiring tale of what a driven person can accomplish.  I’m so inspired, I’m going to start commuting to work on my downhill bike!

Steinmetz has been nominated to represent the United States at the upcoming 2007 UCI Mountain Bike World Championships in Fort William, Scotland, Sept. 3-9.  I will be watching her results for sure!

As an interesting note, this woman suffered a head injury that went undiagnosed, a very popular story in the media right now as it relates to injured troops.

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Will consumers fix healthcare?

All the rage of late in the medical business world is about retail medical clinics (or more aptly named, "convenience health clinics").  For Wall Street Journal readers, you know what I’m talking about.  You may also know that the American Medical Association has declared war on these clinics.  You may read their declaration here.

 

So far, customer satisfaction for this clinics has been high, around 97%.  Its not surprise then, that this business model is taking off, with clinics popping up in Walgreen’s and Wal-Marts all over the country.  It is obvious that the AMA’s opposition to these clinics is simply a turf battle and not legitimately about patient care quality.  It reminds me of physician’s opposition to direct access to physical therapists, and the battle over referral for profit arrangements; both battles also fought under the guise of physician’s altruism.

The all-seeing Seth Godin, had a nice post a while back on "Stuck Systems."  Here is a quote from that post:

"So, the marketer faces a challenge similar to the disruption challenge that most marketers face–how do you take a system filled with an inefficient, annoying, time-consuming, wasteful and yes, even stupid task and make it better in a way that serves all sides? 

If it were me, I’d focus on being cheap and fast and viral. And the more you break the system, the better your upside."

 

Healthcare is a stuck system.  I don’t think it can stay that way for long.  In the end, consumer choice of convenient services will rule the day.  It could be an incredibly ironic moment in the upcoming presidential election, where health policy is expected to play such a large role, that consumers have already chosen their "fix" for healthcare in the marketplace.

Physical Therapists must acknowledge they are part of a stuck system!  Third-party payment, regulatory woes, and limited access characterize our jobs.  The convenience model needs greater attention.  We are continually growing the research evidence base to support this model for physical therapist practice.  We might think about acting quickly, it could be embarrassing for a physical therapist to get beat in a race by a nurse practitioner!

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Some good science reading


The LA Times is in the third installment of a series entitled, "Chasing Memory."  I have enjoyed the stories, although a bit length.  They chronicle neuroscientist Gary Lynch at UC Irvine.  Here is my favorite Lynch quote so far:

"If you’re good, if you’re any good at all, you put yourself in a situation where reality could come around and — WHACK! — knock you down. That’s what you really are afraid of. If you don’t have that, you’re not playing science,"

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The next big advance?

At one point in time, scientists did not know that germs caused disease.  The reason:  they were not able to see the germs.  Well, as optical technology improved, it became easy to study and examine the little buggers causing our body harm.  The knowledge now seems commonplace today.

One lasting barrier to all imaging is the ability to see inside living cells.  An MRI can image tissue well, but not at a cellular level. A study in the online journal, Nature Methods, discusses a technology that could change the way we think about how our bodies work.  Scientists have been able to construct an view of the inner workings of living cells in your body!

Tomographic Phase Microscopy.

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