A Visit to Outpatient Land
Last week I had an opportunity to do something I rarely get to do. I worked in an OP ortho clinic. Since I usually work in acute care or SNFs it was a nice change of pace. I got a chance to visit OP land. Yet, by the time the day ended I was wondering why so many therapists want to work in this setting. I was ready to go back to the hospital and my medically complex geriatrics.
I had a full schedule of patients with several diagnoses. Still, it seemed to me that almost everyone did the same thing. Everyone got a hot pack prior to treatment. Almost everyone got an US. The knee patients did knee exercises. The back patients did back exercises. The ankle patients did ankle exercises. I wasn't bored. I was busy. I just don't understand why someone would want to do the same thing over and over. I can't tell you the number of times I counted to 20. I need variety, not repetition to enjoy work.
To be fair it was a small clinic. It has a limited referral source so patient variety was limited. A different clinic with different referral sources would have a greater patient mix. Plus, these weren't my patients. I didn't evaluate them. I didn't create the POCs. I filled in for someone else and continued his treatments. I'm a manual therapist. The person I replaced isn't. Back in the day I worked with spine patients. I remember that as being challenging.
I'm not complaining. It was nice. I wasn't rushed. I got to sit down and even got a lunch. The paperwork was much simpler. I didn't have to worry about HRs, O2 sats, isolation precautions and multiple co-morbidities. All of my patients were pleasant and talkative. Not once did I have to take someone to the bathroom. More importantly, I didn't have to lift anyone. I can see the appeal of that.
I don't want to irritate anyone. While I was there I didn't feel challenged. I didn't feel like I was using my clinical skills. Just because I felt that way doesn't mean someone else does. I greatly respect those who do OP and do it well. Treating orthopedic patients can be difficult. It can take a lot of skill to correctly identify what problem is causing what impairment. Manual therapy takes a lot of skill. It's clear to me that OP clinics and I aren't a good match.