Comment Response

I happened to see this comment from an old post that I never saw before... I found it quite interesting:

Super PT, you will soon find that everything you read in the book will come true right before your eyes. You however will forget that you read it and will act as if you already knew everything. It is the typical PT god syndrome and you have it bad. Take some time now to enjoy your status because when you get in the real world you will not last long with your currently mentality.

I also find it interesting that the only two comments I have ever received on this blog that were a bit "combative" were both from anonymous posters. This anonymous poster was very flattering though, they referred to me as a PT god... imagine that... do I give off that vibe to anyone else? I have been called cocky and my attention to detail seems to make people for some reason think I am arrogant-or the like (like our commenter's grammatical mistake at the end of his thoughts "currently mentality"). But I will never apologize for seeing errors and speaking up about it, nor for my attention to detail. But never before have I been called a god... nor do I think there is such a "typical" syndrome in PT.

I am far from thinking that 'I already know everything.' This is why I am constantly working to expand my knowledge base by going to as many extracurricular courses as I can (not to mention every class that is part of my program that I sit through). During my spring break (I meant to write a whole post about this)... actually I will save my spring break learning adventures for another post... good stuff about Low Back Pain... I digress back to the topic at hand. If you had read my post carefully perhaps you would have noticed that I was more upset at the grammar and unprofessional nature of the book then the message that is trying to turn me into a cynic about my own future. I am aware of many of the negative issues that the author brought up and how they may apply to the real world (I said many, not all, I certainly don't 'know it all'). So anonymous, whether you are the author of the book or a friend of the author, or even just a fan of it, I encourage you to write back and continue this dialogue in a professional manner. Perhaps you can offer some solutions for what you see in me as this "PT god syndrome" or how to deal with the problems of our profession, other than what was in the book. I wish you all the best anonymous and look forward to hearing from you again...

I would like to take this opportunity to reiterate my passion for the purity of this profession. I chose PT because of its basis in one on one patient care. I love the human body, I love learning about it, I love learning how to get the most out of it in every aspect and even how to repair it. The closer I get to the 'real world of PT' the more I realize how the purity of our profession is challenged, but that is why it is imperative that we justify our education and fight the good fight (as cliché as that sounds)... till next time...

April Health Observances

The latest PT Bulletin offers the following links for April:

Health observances for April begin with National Public Health Week, April 2-8, and World Health Day, April 7, which marks the founding of the World Health Organization. Later in the month are Cover the Uninsured Week, April 23-29 (see upcoming article on April 13); National Safe Kids Week, April 28 - May 6; WalkAmerica, April 27-29, sponsored by the March of Dimes Birth Defects Foundation; and World Tai Chi & Qigong Day, April 28.

Month-long observances include Foot Health Awareness Month, National Child Abuse Prevention Month, National Youth Sports Safety Month, and Occupational Therapy Month.

Legislative Update

Here is a post I put up on the myspace student PT message board:

I know many PT students who are content just studying and figure they can deal with legislative stuff when they are done with school - or let other people deal with it... but I wanted to do my part in getting the word out about some of the more recent developments...

APTA offers a lot of talking points and easy access to all your governmental reps at the APTA legislative action center (find it at www.apta.org, click on the "APTA in Action" link on the left)

A major bill for students is the Loan Forgiveness Act that is in Congress right now. This will aid PT's who work in underserved areas after graduation. The underlying part of this bill is that it would include PT in the group of "primary health services." As many of you hopefully realize PT as a profession has a bit of an uphill climb for respect in the medical community and victories such as getting this bill passed NOW are going to benefit us in the FUTURE.

Another huge bill is the one to repeal the therapy cap once and for all. The therapy cap applies to Medicare beneficiaries and can greatly limit the amount of visits patients can have per year. If Congress does not take action by January 1, 2008, the therapy cap will again be imposed on Medicare-covered physical therapy, occupational therapy, and speech language pathology services. We need to take action NOW to ensure the cap does not go back into place.

Also, there is legislation that would allow Medicare beneficiaries to directly access physical therapists for outpatient services as authorized by state law (states with Direct Access).

These would all be huge victories for our profession and can also be large losses if action is not taken. All it takes from you is contacting your legislator or for those on clinics asking your patients to do so (especially ones that are under Medicare and that would be affected negatively if these do not go into effect). Pass this on to friends and families...

I know it's real cheesy, but this is the reality of our profession and fighting now is going to make everything so much easier in the future. It is the most frustrating thing when other students are apathetic about the politics of their profession, because it is all of us who are affected by their inactivity.

Off the soap box now... If you want further info on any of this I would be glad to help or refer you to those who can best help you.

Lastly, I personally am very curious to hear from anyone out there on why they are or aren't involved in this kind of stuff and any feedback on the specific bills would be very interesting to me as well.
All the best.

Brooklyn, NY was gorgeous today! Haven't seen 70 degrees here in a long time... I took full advantage by going for a run today (click on this link to see the route I ran, this website is great for anyone who runs the streets).

Also, I posted the following in a message board for manual therapy in the 1T: The One Thing You Need For Physical Therapy - hope the link takes you there, if not here is my post anyway:

I get pubmed e-mails on updates of specific topics like "low back pain." Today, I received an abstract of an article from France that only had 64 patients and found short-term vertebral manips to be effective for treating chronic LBP. What I found most interesting from a PT perspective, was the last two lines:
"The assessment of vertebral manipulation effectiveness is difficult. This manual therapy must be preceeded by a specific clinical exam performed by a trained physician."

I cannot draw too many conclusions from this abstract but have to keep in mind: 1) I do not have the full text of the article 2) there is no mention of who performed this manual therapy nor of PT's in the abstract 3) I don't have a great understanding of the French medical system and the role PT plays there (especially when it comes to manips)

Most PT's are trained in manual therapy and many go on to get certifications in the practice of manipulations so would we qualify as a trained physician (A person who heals or exerts a healing influence)?

Here is the link to the pubmed abstract.

Stamps and Stomachs...

Stamps are going up to 41 cents...

And I have a specific systems test to study for. Covering dermatology, trans-femoral prostheses, diabetes, Inflammatory Bowel Disease (IBD) - this is an umbrella term for Crohn's Disease and Ulcerative Colitis, Peptic Ulcer Disease, Hyper and Hypo-thyroidism, among other things... so I am off to study... enjoy the return of warm weather (I forget that people from all over the world read this... so enjoy whatever weather you have wherever you are)

More details about school visit... & News

This is a PR summary about a school visit I recently mentioned in the blog:

The PT students covered topics such as the importance of sitting up straight, not sitting in a "W" position, the importance of diet and exercise, and what Physical Therapy entails among other topics. The whole class took part in an exercise session led by Tracy Adams that got the energy even higher. This led to a Question & Answer session full of curiosity and clear passion from the PT students about the human body. As the event winded down, Ryanne Glasper issued a challenge to the students to minimize their video game playing so as to leave more room for fun exercise. Overall the day was a great success and hopefully these kids futures will be filled with a great deal of health.

Congress Renews Push for Medicare Direct Access

Legislation to improve access to physical therapists for Medicare beneficiaries was reintroduced in the US Senate this week (http://www.apta.org/AM/Template.cfm?Template=/CM/HTMLDisplay.cfm&ContentID=38145), following the filing of identical legislation last week in the House of Representatives. Blanche Lincoln (D-AR) and Arlen Specter (R-PA) were joined Tuesday by five fellow Senators in introducing the “Medicare Patient Access to Physical Therapists Act” (HR 1552/S 932) to provide beneficiaries with the same direct access to physical therapist evaluation and treatment that 43 states and the District of Columbia (see below) provide for non-Medicare patients. Representatives Earl Pomeroy (D-ND), Jim Ramstad (R-MN), Tammy Baldwin (D-WI), Ron Lewis (R-KY), and Tim Murphy (R-PA) introduced the same measure in the House last week with the bipartisan support of 42 cosponsors. APTA urges all members to contact their Senators and Representative to ask them to cosponsor the “Medicare Patient Access to Physical Therapists Act.” Talking points, sample letters, and more information is available in the Medicare Direct Access Resource Center (http://www.apta.org/AM/Template.cfm?Section=Direct_Access&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=187&ContentID=18637) on the APTA Web site, and information to help get patients involved can be found in the Patient Action Center (http://www.apta.org/AM/Template.cfm?Section=Patient_Action_Center1&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=279&ContentID=31728).

DC Residents Gain Direct Access to PTs

The District of Columbia became the latest jurisdiction to provide residents with direct access to physical therapists with final publication of an ordinance adopted by the District Council. The measure provides patients with unrestricted access to physical therapists for evaluation and treatment. The DC Council also finalized a statute providing licensure for physical therapist assistants. In other direct access developments, Virginia Governor Tim Kaine signed legislation (HB 2087/SB 1305) that removes some of the restrictions on patient access to physical therapists in that state. The Virginia Board of Physical Therapy must promulgate regulations before the new access provisions can go into effect.

PT Marketing

The following is a response to the March Topic of the Month on the APTA Student Message Board (a great resource for communicating with other PT students - must be a member to log in). I placed this here because I felt it was too long for a message board (a little ironic I suppose)... Enjoy :)

Firstly, I would like to say this is a great and vital topic for our profession, good job Sean in picking it. Secondly, I would like to apologize for my lengthy post and hope you bear with me.

Last year at PT 2006, Dr. Stanley Paris gave the prestigious McMillan lecture. Dr. Paris said we need to do "something desperate to establish an identity for this profession....Think of the medical profession, and you think of illness...Think of dentists and it's teeth. Of veterinary and it's animals. Chiropractors and it's back pain. Athletic trainers and it's sport. Physical therapy and it's—what?" He argued for continued aggressive marketing, saying "It is the Guide and Vision 2020 that will get us to the summit, but it's marketing that will have us reach the tipping point."

Under the idea of the Guide we can market ourselves by the 4 systems we are focused on treating: Musculoskeletal, Neurological, Cardiopulmonary, and Integumentary. The trouble is all of the various niches that break off of these 4 systems. Just take a look at the 18 sections in the APTA and I believe 42 SIG's that branch under those sections. While all are not practice area's, my point is that we have such a wide field it is difficult to know what exactly to market. Furthermore, we are in constant battles (legally and philosophically) to change what PT is (i.e. DPT as a clinical designator, etc.) and this dynamic factor adds to the difficulty of marketing.

In taking on a marketing initiative it is vital to not get pigeon-holed into being something we aren't, such as the "PT-massage guys" made fairly popular by a few early Seinfeld episodes. APTA does have a number of marketing strategies and materials that they make available and I think they do a good job covering some of the basic rehab functions we serve. With as much "constructive criticism" as the APTA receives, having been part of the Student Assembly Nom Com and being more involved with APTA in general, I have come to realize they do a very good job and they seem to utilize all of the available strategies while maintaining a conservative feel. For those that have not seen all of their approaches recently, they include PT Month topics such as "walking for exercise", "bike right, bike fit", and other campaigns such as avoiding "blackberry thumb"/"video gamers thumb". An alternative to this is the American Academy of Orthopaedic Manual PT's (AAOMPT) slogan “You’ve got drugs, you’ve got surgery, or you’ve got US.”

When I take part in community outreach efforts which include going to classrooms from elementary school all the way up to college level students, my starting point is explaining that PT's work in the 4 systems discussed earlier. I then go on to put up a diagram I put together that breaks off into parts that include "rehabilitation", "prevention", "education", "research", and "health & wellness". This seems to help people understand what the profession entails a little bit better.

I am not sure the best way to market ourselves, although I have a few more ideas... but I will save them for now until I can be more confident with these ideas... I look forward to hearing all of the other responses on this topic as it can be one that highly influences our future as a profession.

Unique DPT Programs

I apologize to my loyal readers for not posting in almost a week... spring break probably managed to keep me busier than when I normally have classes... just got back from a wedding and all the love there inspired me to get back to my blog and readers, because I have nothing but love for you all :)

So one of the things I wanted to share with you all for a while is the unique academic programs that I have discovered (many of them at Boston for CSM)...
**Disclaimer: I am far from 100% certain of the details of the following so if you are more familiar with them I honestly would enjoy hearing from you**

1. St. Augustine has a dual Physical Therapy/Occupational Therapy degree

2. Emory has a dual DPT/MBA program

3. Bradley University recently had a collaboration of their DPT students with their Public Relations students which I am told was a big success.

4. Nazareth College has a very unique business model that they did a whole presentation about in Boston (CSM). I do not want to shortchange what they do but the gist of it is at some point of their curriculum all the students are given a role in running a PT clinic. They then actually have a real life clinic with real life patients and not only do they treat these patients but they carry out their assigned roles to be part of this business model (if you will)... I will look back at more of the specifics of their program at a later date as I find this model very intriguing.

These are the 4 major ones I am aware of. If you know of any more please leave them in the comment section. I am sure there are numerous other very unique programs out there and this was one of my original aims of this blog, to bring out these different programs.

A few reminders:

• If you haven't done so please contact your legislators about HR 1134 (the bill to provide relief to PT student loan debt)... this contact can come from anyone who votes, but I would hope all students would make their voice heard in support of this bill as it can help us all out.
• The deadline to run for a national student office with the APTA is approaching (July 1st)... This is a great opportunity on so many levels and believe it or not does not take up too much time (this time thing seems to be many peoples biggest concern). Either contact me via this blog or just fill out an application at this link.
• I am currently working on (among all my schoolwork) an article about internet resources for the student PT. I will discuss a little bit about this blog as well as other PT related blogs and numerous research related sites. Any suggestions or comments would be greatly appreciated...

That's about it for now, off to sleep... good night and keep on smiling :)

Title Protection

I asked a question about title protection and here was the response... thanks...

We do have title protection of "PT, PTA, SPT, SPTA" in all 50 states. We also have term protection of "physical therapy" in all 50 states so only licensed PT/PTAs can provide physical therapy. Reporting infractions depends. If the person violating this is a licensed professional (ie. MD, DC, DPM, ATC) then reports should be filed to the state licensing board of that specialty practice area. If the person is not licensed (ie. personal trainer, exercise phys...) then infractions should be taken to the State PT Board.

The original question came from our vice chair in the NYSSIG in regards to Bally's using the term "PT" to promote their personal trainers... the last thing we need is more confusion in the medical field... that's all for now... I am on spring break, enjoying my time off, but I can't leave you all without something fun to read ;)

Children Are The Future

Yesterday was a fun day. I got to go speak about PT and Health & Wellness to some 2nd and 3rd graders up in Harlem. It was the first time I had tried that presentation with kids that were so young but it was good to see how curious they were about health issues and how receptive they were to some of the things we covered.

Now I go pass on what little wisdom I have to the oft injured football players of my old high school where I coach.

And as a note to myself I am putting in the link to my friends new page and a reminder to myself that I will be reviewing transtibial lectures at 12 next monday. And for anyone in my class who stumbles upon this, we were given 6 extra points on that Peds Midterm, so rejoice.

Hope you are enjoying yourself today and thanks for stopping by the blog :-D

Down the short stretch

Only two more days until spring break...
Have a quiz tomorrow and a big chunk of a research project due Wednesday, along with two other lectures it should be pretty clear sailing in this blistering cold up here...

Thursday I will be going with a few of my program mates to speak about health promotion and wellness and PT to a few 2nd and 3rd graders up in Harlem. I am looking forward to that... just have to make it past these minor speed bumps...

For the quiz tomorrow we are given a patient and asked what additional tests and measures we would like to perform, use some health models to design a wellness program for the patient, and describe what goals we would set for him... I am going to go use the Guide to Physical Therapist Practice along with my notes to study. This is a seminal text in our profession and is meant to well... help GUIDE practice. I am still learning a lot about the use or lack thereof of this text in PT practice, but for now I will embrace it as best I can.

The ideal and logical idea does not always apply to reality... if that makes any sense... I tried googling a good quote on this but got impatient... off to study... "good night and good luck"

Pediatric Review

So we have a midterm in our "peds" class coming up. Here is a quick review with many many hyperlinks:

• Embryology and Fetal Development
• Primitive/Spinal Reflexes (Other Interesting Reflex Link)
  
• Flexor withdrawal, crossed extension, traction, moro, startle, grasp, galant
  
• Tonic/Brainstem Reflexes
• ATNR, STNR, Symmetrical tonic labyrinthine, positive supporting, associated reactions
• Screening Tests:
• Milani-Comparetti (6 mo's-2 yrs), Denver Developmental (birth-6 yrs)
• Motor Function Tests:
• TIMP, AIMS, BOT MPT
• Peabody Developmental Gross Motor Scale: Subtests: reflex, stationary, locomotion, object manipulation, grasping, visual motor integration
  
• Comprehensive Tests:
• Bayley II (BSID), HELP, Early Intervention Developmental Profile, PEDI (breaks down into self-care, mobility, and social function), WeeFIM
• Children with Down Syndrome
• Generally present with hypotonia and ligamentous laxity causing instability of joints and increase in incidence of atlantoaxial subluxation
• Torticollis
• Obstetric Brachial Plexus Injury
• External Rotation and Supination are last to recover
• The NICU
• Major milestones of development (these vary by source):
• 1 mo. - prone --> supine with gravity
• 2 mo. - supine --> prone against gravity
• 2/3 mo's - head control in supine (45 degrees)
• 4/5 mo's - 90 degree head control, prop on forearms ("puppy prop")
• 5/6 mo's - roll
• 6 mo's - sit when placed
• 7 mo's - parachute response
• 8 mo's - sit by self, pivot crawl
• 10 mo's - belly crawl/creep
• 10/11 mo's - pull to stand
• 12 mo's - steps
• 12-15 mo's - walking

Feeling ill

This student is not feeling very good and thus is passing on two great events on this Saturday... The 9th Annual Sports Symposium for the Young Athlete and a football game I was supposed to play in. I feel like I am letting down my professional growth and my teammates, but in my current state I don't think it would be beneficial for me to be at either of these events.

While I attempt to heal myself, please read up on the multiple health events in March as presented in the APTA PT Bulleting Online:
Health observances for March include National Brain Injury Awareness Month, National Multiple Sclerosis Education and Awareness Month, and National Nutrition Month. March 4-10 marks the observance of National Patient Safety Awareness Week; March 5 - 11 is Multiple Sclerosis Awareness Week; and March 12-18 is Brain Awareness Week. At the month's end is American Diabetes Alert Day on March 27. Click here for other March events.