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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

Being my cheerful self, I walked into the patient's room, introduced myself and immediately felt the frozen gazes of several family members. The one family member who could speak a little English told me it wasn't a good time to see his grandmother. I tried to get a commitment time from him but he deferred and suggested I come back later. No ...