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  • Treating a Difficult Patient

    ''I'm paying to be here and be taken care of. You will do what I tell you.'' It's bad enough we struggle for respect from physicians and occasionally other disciplines. I would say the majority of the population doesn't know what we do or the amount of education required to be a therapist. Usually if we work hard and prove ourselves, the respect ...
    Posted to Toni Talks about PT Today (Weblog) on May 20, 2015
  • I'm Always the Bad Guy

    I'm noticing a disturbing trend. I'm always the one pointing out the bad news. I admit I do better with realistic than cheerfully optimistic, but it seems like it's always me pointing out the flaw with a plan. If I'm not pointing out the obvious, I'm explaining why the obvious isn't going to happen. It feels like everyone else is focusing on ...
    Posted to Toni Talks about PT Today (Weblog) on August 19, 2014
  • How Can This Be a Safe Discharge?

    This morning I was working on discharge planning with one of our case managers. A doctor was ready to discharge a patient and she had asked me for recommendations. I immediately said SNF. He wasn't able to safely transfer out of bed. I had yet to see him walk due to complaints of back pain. And he lacks insight into his limitations. The case ...
    Posted to Toni Talks about PT Today (Weblog) on July 30, 2014
  • She Loves Her Job

    I always enjoy talking to the therapists who come to my course. Last week I met a PT I'll call Dottie. I don't want to use her real name, but she reminds me of someone named Dottie. Dottie has been a therapist since back in the day. She graduated years before I even thought about PT school and is still going strong. Dottie is a home health ...
    Posted to Toni Talks about PT Today (Weblog) on May 13, 2014
  • Selection for Recognition

    Driving home from work today, I was listening to a podcast of a morning radio show. They were making fun of a man who had been given some awards because he had been contributing regularly to the organizations. Because it's a local show, I knew who they were talking about. I had to agree there was no reason other than money that the man was being ...
    Posted to Toni Talks about PT Today (Weblog) on April 29, 2014
  • The Declining Census

    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 doesn't seem to be an end in sight. As of the time I left work this afternoon, no admissions ...
    Posted to Toni Talks about PT Today (Weblog) on September 24, 2013
  • What's the Purpose of a PM & R Doctor?

    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 for being involved in the patient's care was clear. There was a PM & R service. From what I ...
    Posted to Toni Talks about PT Today (Weblog) on September 10, 2013
  • ‘I Can't Wait Until I Can Walk Again'

    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 a small woman. She was limited by bilateral knee arthritis and admitted she didn't walk much ...
    Posted to Toni Talks about PT Today (Weblog) on August 20, 2013
  • Sometimes Even the Doctor is Wrong

    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 threats. He demanded something be done by 7 p.m. this evening or he would do something. The ...
    Posted to Toni Talks about PT Today (Weblog) on August 6, 2013
  • My Fear of Maintenance Therapy

    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 receive treatment without first experiencing an exacerbation. This will undoubtedly result in an ...
    Posted to Toni Talks about PT Today (Weblog) on June 4, 2013
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