Tuesday, September 30, 2008

Two products I am considering...

I like to have all the PT toys... tools... to try out, to potentially recommend to my patients/clients in the future... you gotta experience as much of it yourself (part of the reason I beat my body up running)

Here are two products I am considering trying out:



And as cheesy as the infomercial style of the video on their site is... this is a pretty useful and practical product that I just got in the mail and am pretty happy with so far... I love pull-ups

Any products you guys like/recommend/hate (ideally related to PT)?

Friday, September 26, 2008

POPTS Clinic Interview

My mother set up an interview for me through one of her tax clients (she's an accountant). So I trekked over to Richmond Hills, Queens - about 1:45 each way for me via public transportation (maybe one day I will get a car... just trying to save the environment ;).

I knew very little about the "practice" until I got there. The location was not in the best part of Queens (and as much as I dislike Queens there are some real nice areas). Outside the office it said "Medical Office" with rehab as one of the listed services. As I sat and waited for the office manager to arrive I simply could not envision myself employed in this very sterile and cold environment.

When I sat down with the office manager he quickly broke into what the position entails: 5 days a week, 10 hours a day, 60-80 patients a day, all no fault insurance, I would have two aides to help me out. He showed me a chart and explained how each patient got basically the same treatment: ice or heat, electrical stimulation, "some massage" and he described how easy the documentation was. He told me he was ready to fire his current two PT's he had on staff to have me as the sole PT. The two PT's he was willing to let go had over 10 years experience each according to him. Please keep in mind that I just graduated, I only have a permit and not yet a license, the man did not even "interview" me, my presence and shirt and tie (I can look quite sharp) was enough for him to hire me on the spot. My first major question to him was "who owns this practice?" Lo and behold, it was a physician who "makes an appearance about once a week, if that."

Clearly I was a cheaper source of labor. The best part of all of this was the office manager, who was not a PT, and his complete lack of awareness of the regulations behind PT permits and licensure, along with clear issues with other aspects of the law. The particular regulation he was not informed of is the following:

Supervision of a permittee by a licensed physical therapist shall be on-site supervision and not necessarily direct personal supervision except that such supervision need not be on-site when the supervising physical therapist has determined, through evaluation, the setting of goals and the establishment of a treatment plan, that the program is one of maintenance as defined pursuant to title XVIII of the federal social security act.

Needless to say I took the job on the spot... JUST KIDDING!!! This was a clear abuse of "quality Physical Therapy" and part of the reason our health care system is all screwy... people cannot get better with this "mill" of rehab. My next step regarding this "business" is to figure out the most appropriate way to report this clear referral-for-profit situation to the state board.

I actually was at a Brooklyn/Staten Island district meeting of the NYPTA last night and the speaker was from the state board of Physical Therapists. She described the difficulty with anectodal evidence in reporting these situations is that often times it is not enough for the state board to begin an investigation, to which my response was... what other kind of evidence can we really provide - patient accounts, the stories of people who were foolish enough (or greedy/unethical [let's call it what it is] enough) to work at these establishments...? It's just a sad situation that needs a solution, but I need to deal with this after I pass my boards... stupid boards...

Tuesday, September 23, 2008

Urbanathlon Craziness

I dare you to even look at this course and the obstacles:


I just ran 55 flights of stairs to prepare and ouch!

The best news is the following day I am signed up for a marathon tune up which is 18 miles!

Although I will only be medically volunteering for the NYC marathon for the 3rd year in a row, I should be able to qualify to run next year's race which is a mini-dream of mine.

Hope you got your workout in today!

September Blues

I'm actually not blue, I'm quite the opposite (whichever color that would be...)

But I did end a pretty good position at HSS and then I failed my board exam, then all the funk surrounding the NYJets and Yankees... As for my exam, I took it before I was prepared and only to appease my employers at the time which was doubly foolish since they are no longer my employer. My biggest advice to anyone who is lacking common sense like I was (and hopefully no longer am) is to wait until you are ready and make sure your practice exams are higher than the 75 percent you need to pass (mine were not).

I have not failed many exams in my life, but I like to roll with the punches. I have plenty of excuses but at the end of it all that doesn't mean much. Bottom line is I still have my deep rooted passion for working with individuals to help improve their health, movement, and functional capacity. As far as my clinical abilities I am confident that I am more than competent. In my three months at HSS my patients gave me some really positive feedback as did my supervisors and that is the major litmus test for me right now. I realize for my sports/ortho focus I have a million and one more things to learn and smooth out and am excited to continue that process. In fact that is what I am doing with my time off, just reading and learning more and more along with studying for the boards properly.

I am also exploring my job opportunities. I will be doing some part time work at one outpatient clinic in Williamsburgh Brooklyn and am interviewing at a few others. Traveling to other cities is also a possibility. While it is hard to leave NYC, the capital of the earth, I am sure other cities have something to offer :-D
I am truly in that "new professional" stage of my career where I have oh so many possibilities. Should be a fun ride.

Friday, September 5, 2008

Final Tune Ups

Firstly, my time at HSS is over, sad to say, but that is what it is, and that is all there is to say until at least after I pass my exam, and who knows when that will be, I know quite a few people who just missed the passing grade, gulp...

License exam is in a few days... just need to get a few things straight that always seem to be pesky in my brain (usually because it is of little interest or little practical use in clinical settings)

1) Levels of measurement: nominal-yes or no, one or the other... ordinal-ranking scale with no equality btwn each category... interval-distance btwn each # is =, scale and 0 are arbitrary... ratio-has an absolute zero

2)PNF patterns, although seemingly useful for most major conditions, are just one thing I have yet to wrap my little brain around.

3)There will likely always be a nerve innervation or two that I forget... but this morning I blanked on the thoracodorsal nerve innervating the lat. dorsi... duh!

4)Modalities, especially TENS settings, i.e. sensory-level stimulation is characterized by a relatively short phase duration of 20-100 microseconds... I just haven't used most modalities pretty much in all my time in PT... and I have not committed the brain power to memorizing as much of this madness as possible... but I will try just so I don't fail by one question or so...

5)Conduction aphasia... I am good with Broca (difficulty speaking) and Wernicke (diff. understanding)

6)For the record, IER has much better explanations/rationales than Scorebuilders (not sure why that link has the book so expensive) but the latter has a clearer and fuller look into most of the actual information, especially the "other systems".

Alright, this post was drawn out over a few days... but now that the JETS won and I have less than 24 hours... I am going to cram a little more, watch a movie and let the PT gods decide what they want to do with me... hopefully they are kind

Have a great one, world!

Thursday, September 4, 2008

Body in Motion

Pretty cool website I stumbled upon when researching "thomas heel" (I especially like the runner one)... as a PT ya gotta love the body in motion... even if it is a sculpture that is not moving at all

Tuesday, September 2, 2008

More on running

On my morning commute I see a lot of people running/jogging. One thing I always look at when observing other runners is the trunk rotation. Simply look at where the arms would (or worse, do) cross. A long while ago, in the very scientific journal 'Men's Health', I read a piece of advice that if you were to extend your arms out while jogging that is only when the wrists should cross. Any extra trunk rotation is wasted energy.

Think about it. The idea of jogging is to go straight forward, why would you include any motion going sideways? Take a look next time you see a runner or are a runner...

Monday, September 1, 2008

Down to the wire

Studying is fun... not!

There are easy things to get, like the fact that women who are pregnant have an influx of a chemical called relaxin (which sounds like relax) which oddly enough "relaxes" the joints and ligaments to make the woman's joints more mobile to allow for an easier delivery, and the chemical can stay in place for up to 3 months after delivery.

Then there are ridiculously complex topics and topics that you really need to see for yourself or force yourself to learn because otherwise they make no sense! Almost anything that is an eponym fits that bill. Things like wound care and spinal tracts are just not areas of interest to name two...

Anywho... I will report back how the rest of studying is going...
I would like to throw out that I am really enjoying my time at the Hospital for Special Surgery despite up to 4 hours of commuting a day, I have some great co-workers throughout the hospital and some awesome patients, and I learn new stuff everyday, its a pretty awesome first job