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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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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

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I've driven through Wayne, way too many times.

I finally caught up to my collection of feed items and news that I accumulated over the holidays.  I’m glad I stuck it out and deliberately plodded through the piles of reading.  Otherwise, I would have missed this ruling in Wayne, NJ against a doctor-owned surgical center.  The 1989 Codey Act?  Huh? 

I guess charging fees for your surgical center is good business:

"Many of the physician-investors earned more money from [Wayne Surgical
Center’s] facility fees than they do from practicing medicine full-time"

Someone should have told these physician-investors to skip medical school and just go into real estate.  It would have been cheaper.

By the way, the post title refers to the fact that everyone who hails from Sussex, NJ for any appreciable amount of time is forced to drive through Wayne, NJ more often than they ever thought possible.

ERIC

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How representative are blogs?

Question A previous post noted the fact that physicians outnumber physical therapists in their authorship of blogs.  I wonder how representative blog writing is of general technology use by medical professionals.  If we assumed maintaining a blog was something that technology savvy individuals tend to do, we could say that physical therapists are losing the technology race to physicians.  Does this lag extend into maintaining electronic health records in clinical practice? 

Although, its not too technical a thing to write a blog.  Perhaps blog writing speaks more to patterns of web use.  Why do PT’s remain so technophobic?

While we’re asking questions, the New York Times asks:  "Does exercise really keep you healthy?"

Speaking of exercise, UBC Physio Info blog has something to say about the Nintendo Wii and exercise!

ERIC

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Quadriplegia while seated at the office?

ImtThe Atlanta Journal-Constitution highlights an interesting case of quadriplegia and a solid article on physical therapy.  I think the article is referencing Intensive Movement Therapy (IMT), although it is difficult to read through the ‘every-man’ translation of what was actually being done. 

I have one thought on IMT, regardless of whether this article is about that type of intervention or not.  The above picture is reflective of most IMT treatments I’ve seen, with the physical therapist repetitively facilitating a gait pattern for long periods of time.  My thought, is that the posture and disregard for body mechanics I often see is unfortunate for those therapists performing the chore.  My bum knee would never tolerate providing that treatment!

ERIC

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Debt Relief

Physical Therapists:  Is there some debt relief in your future?  The Physical Therapist Student Loan Repayment Eligibility Act (S 2485),
introduced Friday, Dec 14, includes PTs in the National Health Service
Corps Loan Repayment Program.

"As a result of the extensive education and clinical training required
to become a physical therapist, students often begin their careers with
significant levels of debt," said American Physical Therapy Association
(APTA) President R Scott Ward, PT, PhD.

ERIC

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Wikipedia and PT

Wikipedia’s benefit lies in the collaborative nature of the knowledge within it.  Check out the Wikipedia pages for Physical Therapy and Orthopaedic Manual Physical Therapy. 

In general, I find the Wikipedia pages on physical therapy to be poorly written and not very fluid or informative.  So here is a project for the holidays:  Sign up for a Wikipedia account and edit pages until your heart is content.
The editing syntax is very simple and the help feature is solid.  This
is a simple, positive step we can take to solidify the branding of our
profession.

Still with a lot of energy?  Create a Squidoo Lens.  Here’s an example of a good one.

ERIC

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“Tot ziens en bedankt” (Farewell and thank you)

Jmmt_cover
The latest edition of JMMT is up and marks the final issue that Dr. Peter Huijbregts will serve as Editor-in-Chief.  As always, JMMT gets my nod for having full-text access to non-subscribers and an RSS feed for those fans of aggregation software. 

The open-access material for this issue includes a case report by Borgerding et al describing the use of the patellar-pubic percussion test (http://jmmtonline.com/documents/v15n4/BorgerdingV15N4E.pdf) and a research paper by Tucker et al on the reliability and measurement error of a modified slump test (http://jmmtonline.com/documents/v15n4/TuckerV15N4E.pdf). Other free online content accessible at http://jmmtonline.com/current/ includes the editorial, book and multimedia reviews, a thesis review, letters to the editor, an obituary for Dr. Joe Keating Jr., and an author and subject index for volume 15.

Peter_huijbregts
I recommend Peter’s editorial, although it surely does not top the ‘Chiropractic Legal Challenges’ manifesto.  He discusses a model of OMPT research, and includes a brief statement against "evidence-driven totalitarianism" in clinics as it pertains to utilization of research findings.  I will miss eagerly anticipating the next editorial, and wish Peter all the best in his next adventure.  "Tot ziens en bedankt."  Likewise, I’m looking forward to the stewardship of new Editor-in-Chief, Dr. Chad Cook.  Good Luck!

ERIC

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Ted Corbitt Runs Into Another World

Corbitt1

"The father of long distance running" and physical therapist, Ted Corbitt, has died.  Here is his obituary in the New York Times.  In addition to his running legend, he also taught physical therapy at Columbia and NYU.  He is known to have run more than 199 marathons and ultra marathons!

"Running is something you just do. You don’t need a goal. You don’t need
a race. You don’t need the hype of a so-called fitness craze. All you
need is a cheap pair of shoes and some time. The rest will follow.”  Ted Corbitt, 1998