PT and the Greater Good

More Harm Than Good?

2013-05-14T14:12:00Z

An interesting article came out in the British popular press last week that states some chronic low-back pain can be cured by antibiotics. The writing is fairly clear that only certain cases would benefit from this approach and it includes links to the two scientific abstracts the article is based on: http://link.springer.com/article/10.1007%2Fs00586-013-2674-z and http://link.springer.com/article/10.1007%2Fs00586-013-2675-y . Articles like this can help patients become better-educated consumers...(read more)

‘Does it Do What It Says on the Tin?'

2013-05-07T16:17:00Z

I learned this expression while working in England. It was a way of getting to the core of something, often a product, to determine the original intent and whether it was accomplished. I wonder that about continuing education requirements. Florida has had them (12 hours/year) since I've been practicing (a long time) while New York has only recently adopted them (same 12 hours/year). Why have these requirements that we go and study for half of one day a year? What is the original intent behind them?...(read more)

Continuing Education Continues

2013-05-01T13:25:00Z

So I'm back in the US about six months now and I've got a massive amount of continuing education to do. Before anyone starts wagging fingers about "serves you right" or anything else that sounds like your mother scolding, I had to do lots of CPD (continuous professional development) in the UK... none of it counts here. The UK accepts everything I've done here but New York doesn't even accept the poster presentation I did at the Chartered Society of Physiotherapy conference in Liverpool last year....(read more)

Is It Any Wonder?

2013-04-25T13:46:00Z

Public health is a challenging field. It's an area focused on prevention so therefore not reimbursable by most third-party payers. It's primarily spearheaded by government bodies; therefore it is often not trusted or presented as too "nanny state" and interfering. The outcomes are that nothing bad happens; therefore it's difficult to demonstrate success or necessity. It's not supported in the Constitution beyond "provide for the general welfare of the public" -- therefore it is subject to wide interpretation....(read more)

Being an English Versus American Health Consumer

2013-04-16T16:40:00Z

Last week I got to experience being a consumer in the US health system again. What fun!... not. I have a relative who was an emergent inpatient in a hospital in the southern part of the country. I traveled down to assist my relative at home and be present for the discharge. It's easy to see how discharges are one of the most risky parts of the healthcare journey for a patient. In this particular state, where I'm licensed as well, all professionals are required to take a course every two years on...(read more)

Dancing Faster and Faster

2013-04-10T15:18:00Z

New York state has made remarkable changes to the way it's administering Medicaid. The Medicaid Redesign Team has enacted changes that will completely alter the current practices and expectations of both providers and patients. As of May 1, all long-term home health programs will cease to exist and patients must enroll in a managed long-term care (MLTC) plan. As of July 1, all participating providers must use the Universal Assessment System (UAS) for assessing their members. Starting next year, all...(read more)

The Road Paved with Good Intentions

2013-04-03T14:43:00Z

Last week my ADVANCE colleague, Janey Goude, wrote a piece about the Medicare plan to charge penalties to hospitals with excessive readmission rates. I had to reluctantly agree with her assessment... the plan isn't working the way it should. This is one of the problems of public health. The field tries to ensure that the population is protected from harm in many ways, including from hospitals and other health providers. It's one of the reasons we're required to be licensed as professionals. Sometimes...(read more)

Showing Our Age

2013-03-28T19:07:00Z

I read this article on NPR (National Public Radio) about how people of a certain age, which includes me, are less fit than their counterparts of two decades ago. How can this be? With all the advances in knowledge and availability of information, how can this group of people have missed the boat? Actually, we haven't missed the boat on everything; incidence rates of COPD and lung cancer are less. Unfortunately, hypertension and diabetes have gone up! Why? We are less physically active than we were...(read more)

Personal Accountability

2013-03-19T14:38:00Z

In response to my blog from last week, one Facebook reader suggested that laws such as Mayor Bloomberg's ban on super-sized drinks started a slide down a slippery slope into a nanny state. Simultaneously fellow ADVANCE blogger, Toni Patt, DPT, reflected on the priorities patients choose when in rehab facilities . Both seem to focus on the idea of personal responsibility and/or accountability. This made me recall a lesson from my "Public Health Law and Ethics" course. The question presented to us...(read more)

The Obesity Fight

2013-03-12T15:44:00Z

By now, many people have heard about New York City Mayor Michael Bloomberg's attempt to combat obesity by limiting the size of soft drinks containing sugar. There has been both an aggressive ad campaign and a new ban on beverages over 16 ounces. He has quite a few professional voices backing these decisions . Today, though, a state Supreme Court judge overturned this new law , saying the mayor reached beyond his authority in an "arbitrary and capricious" way. Obesity is a growing problem in developed...(read more)

Goodbye Fee for Service!

2013-03-05T15:48:00Z

For most of my professional life, except when I worked in the NHS in England, either I was paid on a fee-for-service basis or the employer I worked for was reimbursed that way. Essentially, "make a visit, get paid" was the way it worked. That's a very expensive way to do things and one that promotes a practice of visiting more rather than figuring out how to achieve outcomes with fewer visits. PTs aren't the only ones who get paid this way. This week, doctors are being shoved into the spotlight with...(read more)

Just Phone It In!

2013-02-26T17:45:00Z

A piece of research came out in the British Medical Journal at the end of last month regarding tele-physio. I've been a vocal critic of this practice "development" in this blog and to anyone who will listen. This is an important piece of research. If American PTs are inclined to brush it off as some silly NHS protocol, they'd be wise to contemplate whether or not managed care companies might pay close attention to it! This is not a bad piece of research, but there are some areas that I think need...(read more)

The Vitamin D Question

2013-02-19T15:56:00Z

As many readers of this blog know, I'm fairly passionate about fall prevention and have been trying to incorporate my work in that arena into my public health work. The potential impact on our aging population, and cost the rest of us will bear as a result, is significant and deserves attention. I was at a seminar last week about this very topic and the question of Vitamin D supplementation arose. The geriatric MD specialist was a brilliant speaker and among other things, she advocated supplementation...(read more)

We Should Watch (Read) Gretchen Reynolds

2013-02-13T16:29:00Z

Who is Gretchen Reynolds, you may ask? She's a columnist for The New York Times , and journalist for other publications as well, who writes about exercise and fitness . She brings reports about studies on exercise, fitness and aging to the general public in a simple, easy-to-understand manner. She's not a physical therapist. The comments from readers after her columns are sometimes as interesting as the article itself. This week's comments come from a number of doctors. Why should you care? This...(read more)

Gina Kolata, Voodoo, and PT in Journalism

2013-02-06T15:49:00Z

It has been just over three years since " Treat Me, but No Tricks Please " appeared in The New York Times . In this scathing piece about inconsistency in physical therapy, Gina Kolata roiled emotions and got a lot of people thinking about whether what we do actually works or not. It was of little help that the president of the orthopedic section of the APTA, James J. Irrgang, PhD, PT, ATC, repeatedly referred to the "voodoo" that physical therapists do for treatment, giving a sense of validity to...(read more)