Sunday, November 9, 2008

2 weeks in an outpatient practice

Wrap-up of my two weeks in an outpatient PT practice...

I learned way more in 2 weeks than 3 months in the hospital. The difference between outpatient and acute care is fairly significant. The real exciting aspect of outpatient care is the large amount of variability. Every patient is different. Not saying that isn't true at hospitals but there is only so much variability when you have protocols to follow and only see patients for a few days at the most (the ones you see any longer generally can't do much anyway hence why they are in a hospital).

I really wasn't able to blog much because of time/fatigue/studying/reading.
.. also I had too many thoughts... So I will get better at sorting out the most relevant to get to you the reader.

Here is a sampling of patients.diagnoses I saw:
Acl repair
ankle Fx ORIF
ankle sprain Grade 2
Ankle sprain Grade3
Knee DJD-B
Knee DJD-U
Knee OA
cervical strain
Hip Fx ORIF s/p
elbow Fx
Foot Fx (MT, forefoot)
Humerus Fx/lymphedema
ITB/glut med strain
Knee scope (ligs/menisc)
Lumbar DDD
Lumbar strain
Meniscus repair
peroneal tendon inj.
pop. bypass art. graft
RC repair
RCT release/lat epic
Sartorius/Vmo strain
Shldr impingement
thor. Strain
ulnar n. replacement/txfr

The single most common was "lumbar strain" (15x) aka low back pain which are not true diagnoses as the problem can stem from the disk, the facets, the muscles, etc. I did count the same patient if I saw them twice. I performed at least 7 initial evaluations and discharged only 2 people. I am keeping a log of the amount of patients I see and diagnoses, as well as initial evals and co-morbidities that may affect the treatment. This log is partly for my own growth and reflection and also because I eventually want to become a board-certified specialist in both orthopaedics and sports and they do ask for generalized patient population statistics, but why not be as accurate as possible?

It was a very diverse patient population from those recovering from ankle sprains and training for mixed martial arts to older patients who only spoke spanish and recovering from a total knee replacement (the TKR procedure seems to be more and more prevalent everytime I look up).

I have been told I will be starting my new job with a focus on working with spinal pathologies and upper extremity issues. A lot to learn/review. My biggest issue with the job is going to be working out travel and scheduling (currently looking for a new place to live, which in NYC is not the funnest thing ever)... More to come.

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