Combining PT and ST
Lately I've had the opportunity to work with a wonderful ST. We bounce ideas off each other. We've even managed to co-treat a few times. In the course of working together, we've observed that improvement in one discipline carries over to improvement in the other. Although we're somewhat of a unique pairing, our combined efforts have had great results.
The idea of co-treatment between disciplines isn't new. PT and OTs frequently combine efforts, especially on challenging or difficult-to-mobilize patients. Usually the patient gets a better treatment on both fronts. We don't do it as often because payers won't reimburse for it. They call it duplication of services.
This isn't my first experience working closely with STs. When I was at the "Evil Empire," I worked with two. One was wonderful. She cared about her patients and always went the extra mile. The other was careless and rushed her treatments. Unfortunately she was the one I often found myself working with. Her idea of co-treatment was inserting herself into my treatments to assess a few swallows of food.
The PT/ST combination isn't new. They work together providing hippotherapy for children. Often vocalization and verbalization appear for the first time with the horses. It wouldn't surprise me to see a PT working on trunk control while the ST works on saying the word horse... children respond to that combination.
In our case, I work on sitting balance while the ST works on swallowing and feeding. It turns out people swallow better when they sit erect. At the same time, more effort goes into sitting so it is easier for them to eat. In the last three weeks, two patients with PEGs were progressed to actual diets while making significant functional progress with me.
I hope we're able to keep this up. I like seeing my patients get better. I know from experience that poor oral intake is a huge problem with stroke patients. Getting them on real diets not only helps with morale but also gives them energy to keep working with me.