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Toni Talks about PT Today

A Visit to Outpatient Land

Published May 27, 2008 4:27 PM by Toni Patt

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.



As you know not all OP clinics are the same. It sounds like you were at your typical OP mill where manual therapy is minimized and cookbook protocols are followed.  As for not feeling challenged, that depends on you as a therapist and how much effort you put into your practice as a PT irregardless of the setting in either acute or outpatient.

John Sims July 6, 2008 2:10 PM

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