As the dust begins to settle from separating one department into two, this extended break from school allows me to get a grasp on what being a manager really entails in an outpatient rehabilitation facility. From balancing payroll to juggling hours in three disciplines to staying productive, to completing performance appraisals and performing chart reviews, I quickly realize why I absorb only five hours of sleep ...

It's hard for me to believe it has been four years since I graduated PT school. I remember working as a student with physical therapists who had been practicing for four or five years and looking at them as a source of information and experience. Now that I'm on the other side of that spectrum, I still feel like I'm learning every day. As the hundreds of PT programs prepare for graduation, that's one of the main suggestions ...

Years ago, I began working at a large nursing facility that also had an assistive living complex attached to it. The place was immaculate in every detail (except one), had a large library and two fancy dining rooms. There were multiple levels with stairs and elevators located at the end of the halls. To get to the therapy room with patients we had to take them in a wheelchair to the elevator and descend into a subterranean ...

The American Physical Therapy Association (APTA), Alexandria, VA, announced in an April 30 press release that Indiana Gov. Mike Pence has signed HB 1034, granting Hoosiers direct access to evaluation and treatment by a physical therapist without a physician referral. Ensuring a patient's choice of which healthcare ...

An interesting article came out in the British popular press last week that states some chronic low-back pain can be cured by antibiotics. The writing is fairly clear that only certain cases would benefit from this approach and it includes links to the two scientific abstracts the article is based on:

Last week I described being warned not to make trouble by reporting the nurses watching the baby camera while at work. I've been thinking about that. Why would I be the troublemaker for reporting someone else doing something wrong? Shouldn't it be the other way around? You would think the person bringing it to attention would be thanked.

I worked at one SNF where I was considered a bad employee for complaining ...

I completed the first full week of my six-month clinical affiliation, and things are off to a tremendous start. This past week, I was assigned two patients of my very own who I'll likely see throughout their course of care on the inpatient rehab unit. It might not sound very monumental; however this is the first time that a patient has been "mine" and solely mine, and where I'm the primary decision maker.

There's ...

Amazing what can happen in one week. In a major healthcare system of a large metropolitan area surrounded by water, we've successfully accomplished separating pediatric from adult rehabilitation in preparation for our growth as the Rehabilitation Institute of South Florida. Every day of this mission has started at 5 a.m. with communication with one of my best friends, the leader of this department (in addition to ...

My newest thought project for this week is to better understand how physical therapist staffing is predicted for a new clinic. How does a new healthcare company or private practice facility estimate what kind of staffing it will need in a new location?

My general understanding of private practice is that due to limited funds, staffing will start whatever the owner can afford, not be based on the potential ...

I've spoken to patients from many countries and places around the globe. Sometimes it's like watching the movie Billy Elliot or trying to understand the lyrics of South African rap-rave crew Die Antwoord. I'm aghast, did they just curse? I wouldn't know because they speak so fast my mind can't keep up. It sounded like a curse word but there was an "O" sound instead of a "U."

That's how it can be when we're ...

There has always been some conflict between therapy and nursing. Each complains about what the other does or doesn't do. Last week I saw something that floored me. I went into the nursing office looking for a chart. I didn't find the chart. I did find three nurses watching someone's grandson through a web cam feed at his day care. It was on the computer screen. They'd apparently been watching a while. They were talking ...

I learned this expression while working in England. It was a way of getting to the core of something, often a product, to determine the original intent and whether it was accomplished. I wonder that about continuing education requirements. Florida has had them (12 hours/year) since I've been practicing (a long time) while New York has only recently adopted them (same 12 hours/year).

Why have these requirements ...

Please don't be fooled by the title of this post. I don't have a good method by which to accomplish this. However after starting my fifth clinical last Wednesday, I've realized that earning the trust of a clinical instructor is a very tricky game requiring a great amount of patience. I just began the first half of my final yearlong clinical internship on a traumatic brain injury unit at a well-respected hospital here ...

Since I've spent a lot of time in the past 18 months making changes in my own career and developing the content of the training and orientation program for new employees at my clinic, the concept of mentors has always been on my mind. Even when I graduated PT school (which seems like an era ago), the common words of wisdom from my professors were, "Find a job that offers mentorship." Seemed to make sense. I don't ...

A short break between semesters has proven to come at the best time for me. Today brings with it a major change in my facility, where one department is becoming two. Employees have been preparing for months for this change, with hopes that everything goes smoothly. In a large department where things don't always go smoothly on a regular day, we have great expectations that the preparation will pay off and a smooth ...

Where is the objective data regarding gait distances in hospitals, rehab centers and SNFs? What I mean is, when we write down a patient used a FWW and walked 100 feet, where is the data to prove the distance was exactly 100 feet? Did someone measure the distance and quantify the data and calibrate the measuring device to ensure its accuracy? Maybe the distance put in charts are guesstimates from therapists and there's ...

The positive influence of animals on healing is well known. Caring Critters now make regular visits to various facilities within the Houston area. Dogs can be certified as therapy animals. Horses are used for hippotherapy with great results. Now I'm going to try to combine the two.

Last Friday, my horse Expsychment (pronounced "excitement") made a visit to the SNF where I work. For me it's the best of both ...

So I'm back in the US about six months now and I've got a massive amount of continuing education to do. Before anyone starts wagging fingers about "serves you right" or anything else that sounds like your mother scolding, I had to do lots of CPD (continuous professional development) in the UK... none of it counts here. The UK accepts everything I've done here but New York doesn't even accept the poster presentation ...

I've been fortunate over the past two years to have very few life-related interruptions in my attempts to excel at this whole "PT" thing. However last weekend, right before the start of finals week, I received news that my grandfather passed away. The last week has been a complete whirlwind, and obviously final exams and presentations took a back seat to spending time with family.

I'm not the only one who ...

Over the weekend I was reading the article for our staff journal club this week, a recent research paper investigating the effects of thoracic thrust manipulation (with non-thrust cervical mobilization) for the treatment of neck pain. As you may recall, participating in our regular journal club was one of the professional ...

If someone had told me on November 13, 2007, that I was signing up for 66 consecutive months of blogging, I would have said, "There's no way!" But, 284 posts later, here we are. One post at a time, you've invited me into your work and home. You've shared your life through comments. It's been a wonderful five-and-a-half years. That makes it more difficult to say goodbye.

I love to write. I love to communicate. ...

We often see patients three to five days post-operatively in a SNF. The ortho docs, who send the patients to the facility, expect certain outcomes while the insurance companies have outcomes and agendas of their own. This creates some difficulty in managing the patient from a therapy standpoint.

Most surgeons are somewhat familiar with what we do and some even send their protocols with the patient after surgery ...

Registration for the final two courses has taken place. Mental, physical and emotional preparation is next on my agenda. Although I have a pretty good idea about what my case report will be, I often question myself and my ability to develop a doctoral-level document capable of being published. The exhaustive literature search has been literally exhausting. Many nights my bedtime story has been "How to Write a Case ...

Public health is a challenging field. It's an area focused on prevention so therefore not reimbursable by most third-party payers. It's primarily spearheaded by government bodies; therefore it is often not trusted or presented as too "nanny state" and interfering. The outcomes are that nothing bad happens; therefore it's difficult to demonstrate success or necessity.

It's not supported in the Constitution ...