This week a patient was referred to therapy because of neck pain. I quickly determined she had a mechanical derangement of her cervical spine. Something was locked in the upper cervical region that prevented her from rotating. Her complaints were inability to sleep and turn her head. Once a manual therapist, always a manual therapist, I guess. ...

  Working as a COTA I have noticed more and more people of larger size on my caseload recently. I tend to note that as much as their admitting diagnosis can vary, many have similar health issues. Working with people of size is no different than working with any other patient, but it will require good strength and body ...

This weekend I taught a continuing education course with three other therapists. It took well over a year for us to organize the content, create the handouts and visual displays and market the course to get as many participants as possible. It was a fun process to figure out the best way to engage the participants and relay the most important ...

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 ...

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 ...

  It was another day of treating low level patients for high minutes. This really makes me miss one of my old supervisors who stood his ground against management, allowing the therapy team to determine minutes. Completing nearly an hour of treatment with a person who is either barely responsive or has severe memory deficits is a challenge, ...

This week during the show ''The Voice'' on NBC, Aflac aired a 60-second commercial showing the Aflac duck working with a physical therapist to recover from some injuries. (The injuries were aired in earlier commercials). I think Aflac is marketing services their clients receive while off work due to injury, including money for bills and other ...

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 ...

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 ...

Anyone who reads my blog with regularity knows the last year has been a struggle for me. I lost my beloved job. I was fired for being ethical. I encountered more than my share of unethical and self-serving people. During all of that, I hung on and kept going to work. Every so often I made a difference to someone, which kept me going. For the ...