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Toni Talks about PT Today

How Can This Be a Safe Discharge?
by Toni Patt
This morning I was working on discharge planning with one of our case managers. A doctor was ready to discharge a patient and she had asked me for recommendations. I immediately said SNF. He wasn't able to safely transfer out of bed. I had yet to see Read More...
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We're Not Going to Pay for That Brace
by Toni Patt
A few weeks ago, a woman was admitted to our facility with a knee injury. She appeared to have ligamentous damage on top of arthritic deformities. She came to us for medical management and antibiotics prior to surgery. Before she was admitted, her orthopedist Read More...
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She Loves Her Job
by Toni Patt
I always enjoy talking to the therapists who come to my course. Last week I met a PT I'll call Dottie. I don't want to use her real name, but she reminds me of someone named Dottie. Dottie has been a therapist since back in the day. She graduated years Read More...
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Selection for Recognition
by Toni Patt
Driving home from work today, I was listening to a podcast of a morning radio show. They were making fun of a man who had been given some awards because he had been contributing regularly to the organizations. Because it's a local show, I knew who they Read More...
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‘We're All Gonna Need Physical Therapy Soon'
by Toni Patt
I spent last weekend at a horse show in San Antonio. Even though I had both show horses with me, there was still a lot of down time. Since everything is close quarters it's easy to overhear conversations. While I was waiting I was surprised to hear someone Read More...
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‘Passive ROM Is Not a Skilled Therapy'
by Toni Patt
Let me clarify that statement before I go any further. I refer to performing PROM as the only treatment on patients who are sedated, minimally responsive, have significant neurological involvement and the like. I'm not referring to outpatient settings, Read More...
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The Declining Census
by Toni Patt
In previous posts, I've discussed staffing issues where I work. Those problems continue. So does the return of the frequent flyer. Now we have something even more troubling. Our census continues to drop. The facility is at one-tenth of its capacity. There Read More...
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What's the Purpose of a PM & R Doctor?
by Toni Patt
Until recently, I had never worked closely with PM & R (physical medicine & rehabilitation) physicians. When I worked at the "evil empire," I dealt exclusively with neurologists. Some were good. Some weren't so good. Either way, their purpose Read More...
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Unintended Consequences of Cutting Staff
by Toni Patt
In recent posts, fellow ADVANCE bloggers Dean and Michael have been discussing how companies cut staff as a measure to lower costs. Neither of them supports the idea. Both make valid arguments against the practice that I'm sure would fall on deaf ears. Read More...
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Sometimes Even the Doctor is Wrong
by Toni Patt
I had a good laugh this morning. A doctor was ranting and raving that an order he'd written two weeks ago still hadn't been followed. The order was for a pressure-relieving shoe for a patient with a plantar wound. The doctor was very upset. He was making Read More...
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My Fear of Maintenance Therapy
by Toni Patt
Last week in his post, fellow ADVANCE blogger Dean Metz shared some good news . CMS has ruled the need for skilled intervention, not functional improvement, makes therapy reimbursable. This means, as he pointed out, patients with chronic conditions can Read More...
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Group Think Evidence
by Toni Patt
When I was at the horse show last weekend, I learned one of the show kid mothers is a PT. I learned this because she was treating another of the mothers using cranio-sacral therapy. I'm not sure what pushed more of my buttons, her treating someone on Read More...
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‘I Can't Help, My Back Hurts'
by Toni Patt
This morning there was a patient on the floor so the request went out for lifting help. Four people responded, including me, a PTA, a male CNA and the patient's nurse. The patient was a big man, weak and in a narrow space so it wasn't going to be easy. Read More...
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Putting Up With Bad Behavior
by Toni Patt
Today was one of those days. There is a full moon. Healthcare workers often joke about the effects of the full moon on their patients. I believe there is something to that, which means my patients gets more of a workout than usual. I am used to brain-injured Read More...
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A Hostile Environment
by Toni Patt
I don't like my job very much right now. It was never my dream job, just a means to an end. The biggest attraction to me was the ability to leave work in time to ride my horses and do it whenever I want. The patients and other therapists I work with are Read More...
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