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Toni Talks about PT Today

Making a Successful Case
by Toni Patt
A few weeks ago, I expressed my frustration with our capital budget process . While I was gone, my coworkers submitted a request for, among others things, a stand lift transfer device. To say I was shocked was an understatement. Since that time I've campaigned Read More...
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I'm Always the Bad Guy
by Toni Patt
I'm noticing a disturbing trend. I'm always the one pointing out the bad news. I admit I do better with realistic than cheerfully optimistic, but it seems like it's always me pointing out the flaw with a plan. If I'm not pointing out the obvious, I'm Read More...
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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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Sometimes It's Hard to Feel Sorry for Patients
by Toni Patt
Last weekend I was describing a difficult patient I had worked with earlier in the month. It was someone with several chronic and out-of-control problems, obesity and medical noncompliance. I summarized my statement with, "I don't feel sorry for him. 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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‘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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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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‘I Can't Wait Until I Can Walk Again'
by Toni Patt
Last Saturday, one of my patients at the SNF was a woman with left femoral neck and humeral shaft fractures. She'd undergone an ORIF to repair the hip and the arm was immobilized. She was NWB on both extremities. Like many of our patients, this was not 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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Return to Manual Therapy... Not
by Toni Patt
This week a patient was referred to therapy because of neck pain. I quickly determined she had a mechanical derangement of her cervical spine. Something was locked in the upper cervical region that prevented her from rotating. Her complaints were inability Read More...
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Being Put on the Spot
by Toni Patt
I believe I've mentioned being a certified McKenzie therapist in my former (pre-neuro) life. I still use those skills, particularly when one of my horses needs some work. However, I generally don't talk about it. I like to avoid those "why aren't you 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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Very Acute Therapy
by Toni Patt
This week I found myself at an outpatient orthopedic clinic treating work-related injuries. The clinic was one of several in the area. They have agreements with many local industries to provide medical and therapy services to injured employees. The injured Read More...
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Respect for Clinical Judgment
by Toni Patt
Once in a while I work with patients who have a diagnosis other than stroke. Two or three weeks ago, I evaluated a young man who'd had a TBI and was in the ICU. I later re-evaluated him following transfer to the rehab unit. Last week his rehab doctor Read More...
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