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PT and the Greater Good

Finally! A Group I Can Work With!

Published March 24, 2010 11:21 AM by Dean Metz
Last week I ranted about some physiotherapists (and other rehab professionals) who were essentially obstructionists. Those are people who just seem to want to be the "No" guy. Right after I submitted that piece I had a meeting with a group of therapists that I had little if any contact with to date. They are wonderful! They are from all different areas including community rehab, intermediate care in skilled nursing facilities and at home, the rapid response teams, and the falls clinic.

We sat and brainstormed about how to be better "joined up" meaning how do we help patients get from one service level to the next smoothly? How do we keep each other informed about projects we are working on? How do we support each other through difficulties of staff shortages, inappropriate referrals and education of other professions about our services? In short, a professional network was established.

For the past few months, I had felt very isolated in a sea of nurses (lovely and well-skilled, but still nurses) and some very unreceptive therapists. It is such a breath of fresh air to finally connect with a group of like-minded professionals.

Why did the first group of therapists isolate me from this second group? I assume the nurses simply didn't know about them, and that needs to change! I'm feeling positive about the possibilities here again!

posted by Dean Metz


Janey, good questions actually. There are 2 ways services are commissioned here in the UK. There are Foundation trusts which, typically, employ the staff in hospital and some care home settings, and Primary Care Trusts, which employ the staff in walk in centers, community based programmes and some care homes. The two types of trusts actually are competitive for business and will sometimes provide a service you'd expect to be provided by the other. For instance the hospital therapists will follow people into the community once they are discharged. The patient won't be seen by the "community" therapists. The community therapists see people who are referred whilst already at home. I tried applying the US model of hospital therapists tend to work only in that location and a separate home care therapist took over once a patient was discharged. It just doesn't work that way here and can be very confusing when you don't know the system.

The therapists I met recently are mostly Foundation Trust staff where I'm Primary Care Trust staff, hence our paths rarely if ever crossed. Because the role I'm in is brand new, they had no idea to look out for me and because I didn't know the system had not idea they existed. The two other senior therapists in my area are very accustomed to being the only fish in the pond and my arrival was less than welcome to them. There is also a fear of the US health care system here which is fueled by the fact that many trusts have adopted the Virginia Mason Production System of management from Seattle. My being American has not helped them to embrace me.

For as much as American's don't want an NHS like system, the English are equally sure that they don't want a system like the US. As we have heard horror stories of people waiting inordinate periods of time for care in the UK, they have heard of people going bankrupt or not receiving any care at all due to inability to pay in the US. "Barbaric" is the most common word I've heard here to describe the US health care system. It is completely understandable that my arrival has been greeted with a certain amount of wariness.

This new group of therapists understand the changes coming to the NHS with severe budget restrictions down the road. They want to assure that patients are cared for, that we can be resources to each other, and that by providing a "joined up" service, we will continue to have jobs. The others who have been less then helpful, I fear, will wind up asking "Who moved my Cheese?!" when their posts are perhaps reevaluated.

Long answer to a short question! Hope that cleared things up for you. Cheers, Dean

Dean Metz March 28, 2010 8:15 AM

Great questions for all of us to ask in the work setting!  

Glad to hear you are finding like minded professionals.  I'm thinking I'm missing a piece of the puzzle.  Maybe I'm applying the medical infrastructure here to the UK and that is why my brain can't figure this out...How did you get a meeting with these therapists?  Where have they been all your UK life?  You said they are from all different areas, so I'm curious what kind of meeting it was - if you received an invite or if you initiated.  

Please forgive me if I am asking questions you have already answered.  I'm on a relative techno blackout - doing very little while I'm in a course.  But wanted to check in on everyone's blogs.  Glad to hear you've hooked up with comrades to fight the good fight.


Janey Goude March 27, 2010 10:44 PM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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