PTA Blog Talk

Rain Makers

2013-05-23T20:09:00Z

From the moment we set foot in a facility, we're on the move. We're expected to be productive throughout our day by billing patients for our services. We make it rain for the facility but aren't always recognized for it. When I see every other department in a healthcare setting, they usually take up space and use resources that cost the facility money. Housekeepers use chemicals to clean a facility, nurses use syringes and bandages, the kitchen staff uses up food products. They don't directly contribute...(read more)

The Dungeon

2013-05-16T17:15:00Z

Years ago, I began working at a large nursing facility that also had an assistive living complex attached to it. The place was immaculate in every detail (except one), had a large library and two fancy dining rooms. There were multiple levels with stairs and elevators located at the end of the halls. To get to the therapy room with patients we had to take them in a wheelchair to the elevator and descend into a subterranean level. I felt like a level-three cleric from the game "Dungeon and Dragons."...(read more)

Patient Understanding

2013-05-08T13:37:00Z

I've spoken to patients from many countries and places around the globe. Sometimes it's like watching the movie Billy Elliot or trying to understand the lyrics of South African rap-rave crew Die Antwoord. I'm aghast, did they just curse? I wouldn't know because they speak so fast my mind can't keep up. It sounded like a curse word but there was an "O" sound instead of a "U." That's how it can be when we're explaining details or a procedure to patients. Do they really grasp the concepts I've just...(read more)

Gait Distance

2013-05-01T20:20:00Z

Where is the objective data regarding gait distances in hospitals, rehab centers and SNFs? What I mean is, when we write down a patient used a FWW and walked 100 feet, where is the data to prove the distance was exactly 100 feet? Did someone measure the distance and quantify the data and calibrate the measuring device to ensure its accuracy? Maybe the distance put in charts are guesstimates from therapists and there's no data to back up the claim about how far a patient actually walked. I think this...(read more)

Post-Operative Care

2013-04-26T15:57:00Z

We often see patients three to five days post-operatively in a SNF. The ortho docs, who send the patients to the facility, expect certain outcomes while the insurance companies have outcomes and agendas of their own. This creates some difficulty in managing the patient from a therapy standpoint. Most surgeons are somewhat familiar with what we do and some even send their protocols with the patient after surgery with the expectation we follow them closely. Insurance companies want to know when we're...(read more)

Nursing Can't Do That

2013-04-17T21:30:00Z

The patient I was supposed to see was in a RUG level that paid very well. He had some complications that prevented him from participating to get the full minutes for several days. On the patient's assessment day, I spoke to the nurse in charge of his care and she advised me not to see him that day due to a change in status, with a decline in health and inability to participate in functional and meaningful activity, i.e. ADL care. Because I know this nurse and her assessment of patients is very good,...(read more)

Reuse of Equipment

2013-04-10T19:29:00Z

I worked in a clinic that reused TENS pads. Cross-contamination anyone? I understood the financial aspect of it; the pads were expensive. But to jeopardize patients and expose them unnecessarily to a potential infection didn't seem worth it. Didn't a dentist recently get in trouble for not completely sterilizing equipment? I wonder what microorganisms lived under the pads after multiple patients had them against their skin. I often wonder about the blood pressure cuff and the finger pulse oximeter...(read more)

Future Care

2013-04-03T16:50:00Z

I've read about social security running out of money, reduced reimbursement rates, a decrease in the number of qualified providers, quicker discharges and supposedly better recovery after surgery. Where does this leave everyone? Social security has to be there to provide care for the blind and disabled; a reduction in reimbursements will always strain the health care system but will not put it out of business, there will be ways around the reduction. I can see a decrease in the number of qualified...(read more)

Let the Patient Decide

2013-03-29T14:38:00Z

We're all aware of the patient's bill of rights regarding treatment in a healthcare setting. They have the absolute right to refuse treatment and I think we should encourage them to invoke that right but with some consequences attached. First, we should provide a menu-type selection of which RUG level they'd like in regard to therapy. They could choose between 150 minutes and 720 minutes of therapy in a seven-day period beginning on the day of admission. This will allow patients to decide how much...(read more)

My New Revenue Source

2013-03-20T20:08:00Z

According to Medicare, I'm able to work under the direction of an MD. Imagine what that could do to the outpatient market in some areas. As a PTA, I could set up a clinic, hire an MD and begin to provide care based on the MD's plan of treatment. Of course the state rules would try to prevent this but I'm pretty sure federal law trumps state law any day of the week. I didn't see any particular rules in regard to having an MD "in the room" when I'd provide care to a patient; maybe that's only useful...(read more)

Off the Record

2013-03-13T18:21:00Z

We were treating a patient for several weeks and making some progress toward her discharge. There was a family conference and it was decided, with the patient's input, that she'd go back to her apartment. For the next couple of days, she seemed not to care where she went to live despite our encouragement. When a family member cornered me, we spoke about the patient's progress and the decision about having her go back to her own apartment. Then the family member said, "Off the record, how do you think...(read more)

License or Certificate?

2013-03-07T18:38:00Z

As I was perusing the various state board websites, I noticed several states offered licenses to PTs but required the PTA to have a certificate to practice and provide therapy care. I've been awarded certificates in achievement, performance and even have one as a geriatric wellness specialist. My children come home from school with certificates in the spelling bee, math, science etc. But state boards that give a certificate to the PTA and a license to the PT need to do some research about licensing...(read more)

Rankle Fracture

2013-02-27T20:40:00Z

I was reading the eval and came across a patient with a "Rankle fracture" to her lower extremity. I was thinking this is serious and went on a quest to look it up. I couldn't find what exactly a Rankle fracture was on the leg or the severity of it. When the chart is available I'll look through that prior to seeing a patient, but since it was missing I completely trusted the PT eval to include all the medical information I needed. I was thinking this patient had some complicated new fracture discovered...(read more)

Conditions for Licensing

2013-02-20T21:40:00Z

Once again, I was searching the state board websites and came across some applications that asked whether the prospective licensee had a disease or condition that interfered with the ability to perform the essential functions of the profession. If so, the PT or PTA was expected to give supporting documentation about this condition. I guess this information is not privacy-protected between an MD and a patient anymore. The problem with this is there are some medical diagnoses that therapists will receive...(read more)

Discriminatory Care: Part Two

2013-02-13T18:47:00Z

Because I'm male and have the same color hue as the patient, he probably thought I found his jokes about women and minorities funny. I didn't. I despised this patient and couldn't wait until he discharged. I spoke with supervisors about his remarks but the facility seemed to be more concerned about filling beds and Medicare reimbursement dollars than a crabby racist patient. The derogatory remarks were usually out of earshot of others and he always laughed at his own jokes. I wanted him off my list...(read more)