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Toni Talks about PT Today

‘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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‘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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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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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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‘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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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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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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A Dangerous Patient
by Toni Patt
Sooner or later, everyone comes in contact with a patient who swings at her, attempts to bite or scratch or spits. It goes with the territory, especially if you work with patients who have brain injury or Alzheimer's disease. We console ourselves with Read More...
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