We recently had another patient who seems to have fallen between the cracks in our wonderful health care system. He was initially in therapy for a variety of medical reasons and then a fracture was discovered in the mid-spinal region. Therapy was held per MD request for about two weeks. When therapy requested orders to resume activity, none were given. ...

I like to start work early; the earlier the better. Usually this means I start my day alone. I grab the first patient I find out of bed and get started. Not anymore. A few days ago, I was having trouble convincing a patient to come to therapy. In frustration, I offered her a cup of fresh coffee to sip while we were working. Little did I know it would open the floodgate. Now I have all the company I want and several ...

Graduation is upon me. I have to finish my final project and take a comprehensive examination on all I have learned in my MPH studies. All that will be done by early July. This means it is time to put a new CV together.

I've done a basic CV and sent it out to trusted friends and colleagues. The response was polite. They all praised my accomplishments and the work I've done over the past 20 years as a PT, ...

When Monday comes around, I will officially be in my second year of PT school. I looked over the curriculum for the next year, and it's amazing how the focus is shifting to a much more in-depth and complex view of physical therapy. The first year obviously included some basic core classes: gross anatomy, kinesiology, human disease, and neuroscience. This time around, we'll be applying that information to courses like ...

Often I find that I'll have a "favorite" patient on my schedule and will seek out that person's name on my list every morning as I begin my day. It can be something about their hard-working ethic -- knowing they'll always give me their best in therapy, or even their keen sense of humor that wins over my affection. I always assumed therapists should be like teachers; we should not have favorite "students." However, ...

A week has passed since completing the spring semester, and so much has been accomplished in seven days. My reading has switched from pharmacology to a popular trilogy, my hip pain has returned since increasing my tennis game and the animal sanctuary I call my home has grown, again. Senior prom is this weekend, and I am feverishly preparing my 18-year-old daughter for this most memorable event.

Even with ...

The discussion and use of dry needling in physical therapy practice has increased substantially within the last year. I graduated from PT school three years ago, and we rarely, if ever, heard or discussed dry needling as a treatment option. Reading through my JOSPT issue this morning, I came across two ads for dry needling certification within the first three pages. So what is dry needling? And what do our ...

My daughter had a follow-up appointment this week with the pediatric rheumatologist. This was our first time to visit his satellite office, so I called for directions. Good thing. The office is closed. Not just for today. Forever.

The machine says the hospital didn't renew its contract with the physician, so the office is permanently closed. The physician will still be seeing clients in his private clinic ...

After reading a patient's chart and looking at the eval, I usually have a plan formulated in my head on what I am going to do with that patient. Sometimes it does not go as my well as my meticulously thought-out plan and I feel like running right into some of the rooms screaming, "Leeroy Jenkins!" ("World of Warcraft" players will recognize this).

There will always be those patients who can hide their dementia ...

There is new evidence in the physical therapy world that creates a paradox. The patients who benefit the most are the patients who receive the least therapy. Everything I read demonstrated that the more impaired patients made the greatest improvement when provided with the most intense therapy. This was true in the acute, subacute and chronic stage. Higher-functioning patients tended to have similar results regardless ...

This weekend I had time to spend on a train so I read the latest issue of Frontline, the twice-monthly magazine published by the Chartered Society of Physiotherapists (CSP). In many ways it is similar to ADVANCE. It has articles highlighting outstanding facilities, unique contributions made by those in the profession, snippets of latest research findings and classified advertisements at the end. This ...

A big group of people from my class is going on a camping and rafting trip this week before we start back to class next Monday. I find it very hard to believe that one year ago, I didn't know any of these people. I know I have blogged about my classmates in the past, but as time goes on, I feel more and more lucky that I am surrounded by such amazing people.

A lot of my friends are in graduate school pursuing ...

My "official" one-year anniversary of being a working PTA came and went very quietly a few weeks ago. I was under the impression I would feel suddenly "experienced" and maybe given an "'Atta girl!" from the rehab director. No on both counts. Yet, I forgot the anniversary myself due to general craziness that is my life.

On the home front, out small chicken flock has grown to more than 30, which doesn't include ...

It's easy to accept stereotypes about elderly clients in nursing homes. As we age, our bodies and minds deteriorate. Those stereotypes lead to assumptions. "Prior functional level" is a worthy goal. A video* has me rethinking my paradigm.

The video showcases Henry, a long-term resident in Brooklyn's

The police, fire department, EMTs and MDs are a few of the professionals that seem to be on duty all the time. In therapy, we are not and in most cases we do not make truly independent decisions. This might be due to the training and thought processing that has been taught.

We consult with the nurse or other health professional before seeing patients in a hospital setting and a SNF. When X-ray and blood ...

Another semester of school, finished! What an amazing journey this has become. "Differential Diagnosis" and "Pharmacology for Physical Medicine," so appropriate for therapists in so many ways. The past semester has brought up some interesting situations in our department, from a therapist who had severe abdominal pain and was sent to the ER by a classmate who suspected appendicitis, to more than one patient with drug ...

Usually about once or twice a year, I break down and make an appointment for a massage. As all the hours add up of providing manual therapy for my patients, as well as my moderately rigorous exercise routine, I feel like I need some relief to start fresh again. It's one of the best gifts I give myself. I am a new person after those massages. My body feels more relaxed and my mind appreciates the hour of total silence. ...

This morning I had a conversation with an OT who has as much experience or more than I do. I mentioned my frustration with employers desiring low pay over experienced therapists. I don't think my tDPT and geriatric specialization have made me more attractive to employers. If anything, they have made me less attractive. Having them makes me more expensive.

Her response was interesting. She said she wasn't sure ...

This is the slogan that emerged from the NHS White Paper, "Equity and Excellence, Liberating the NHS," that came out in 2010. I return to this slogan after a reader posted some thoughts on patient-centered care in response to

As of last Friday, I officially completed my first year of PT school. A few people have asked if, given the opportunity, I would go back and change anything that happened throughout the whole process, or if I have any advice for those of you entering your first year. I have to say that overall I'm happy with how things have gone in the past 12 months.

A year ago at this time, I was getting ready to move back ...

As of the beginning of April, I reduced my work week from ?ve to four days a week. Initially, I felt guilty that I couldn't "hack" a full-time schedule and then I realized I was being far too hard on myself. My usual work day starts around 8:30 in the morning and I'm not coming up for air until 12 or 12:30 for a quick bite to eat and then back to therapy until 6 p.m. (and sometimes 7 p.m.).

My cell phone is ...

I'm sure many of you have read articles or attended work meetings focused on the topic of communication. Regardless of your work setting, communication is one of the most important pieces of being successful. Knowing information that will help your patient or client is useless if you cannot convey that knowledge to the patient. Obviously, I'm telling you something here you have likely already learned.

There ...

Another eventful week in outpatient rehabilitation. Seems as though we are seeing many "repeat offenders," as some call them; however, for different diagnoses than before. Working in the same facility for 20 years, we have patients who started with us when the hospital opened. They are proud of the fact that they knew us "back in the day," when in fact, we are proud of the fact they have stayed with us for their medical ...

Years ago, I was new to an area and began to secure employment as a per-diem PTA. One of the first places I worked was a hospital. After educating them on the per-diem pay scale, I was hired to work almost every weekend. I explained to HR that I needed full-time work since I had a family but no insurance to cover them and that I would be looking for full-time employment while I worked.

Two months passed and ...

My husband and I will celebrate our 21^st anniversary next week. If there's one thing I've learned, cruising on autopilot is a sure recipe for failure. You have to invest time and energy to cultivate a healthy marriage. Physical therapy, or any career, is the same. Therapists at the top of their field know they have to invest in continuing education.

We volunteer at a marriage conference. Being ...