Dr. Rehab
Los Angeles, CA
Female, 31
I'm a practicing PT with a Doctorate for the past 4 years now. Although it may not seem like a long time, I have gained extensive knowledge and experience in various PT settings. I've worked anywhere from outpatient therapy, home health, aquatic therapy, inpatient rehab, and private clients. I now also instruct on an online prep course for graduates seeking to pass their National Board Examination. PT is a very rewarding job, but can also SUCK, which explains my quest to find the ideal situation
Generally speaking, I'd have to say that the most common problem is low back pain. Seems like just about everyone has, at one point or another, experienced some sort of back pain. We are a society now that's glued to our computer or TV screens, which equates to a lot of sitting time. Add on poor posture and a weak core, and you've got back issues!
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I have heard of laser treatments, but know they are not as common as your typical therapeutic modality, such as heat, ice, traction, ultrasound, electrical stimulation, just to name a few. The use of therapeutic modalities are most effective in the acute stages of your injury, and can be used as a supplement to treatment to aide in tissue healing. However, it should never be used as a major part of your therapy. PT is most effective in conjunction with manual therapy (joint mobilizations), therapeutic exercises, and patient education. It's also the PT's job to inform you of these treatments and explain why they think you would benefit from it. Whether you are seeing your Physician, Dentist, Optometrist, etc., never be afraid to ask questions about your treatment plan or decision. It's your body and your health, and it's always a good idea to play an active role.
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It's really a shame when I hear that someone's PT experience was pointless or ineffective. Hearing that leads me to two possible conclusions; a) your therapist was not doing an effective job in identifying your needs and addressing those problems, b) your therapist was trying to keep the schedule full. Both are unacceptable. It is our ethical duty to treat patients until they have reached their max rehab potential, and discharge them to an independent home exercise program. The other scenario is if other issues have come up or there has been a decline in function. This would then lead to referral back to the physician for further follow-up. Half of PT is also patient education, so you know exactly what's going on in your body so that you are able to make the right choices in maintaining the benefits received during your skilled treatment sessions. I'm wondering what it was about your sessions you felt were pointless and ineffective. I don't know of PT's who keep patients on just to stay busy, but those that do, just bring our profession down. Like in any business/industry, there are always those bad eggs who ruin it for everyone.
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I understand that insurance companies are trying to protect themselves from those that abuse the system. And I'm not saying there isn't abuse of the system or that there aren't those that wouldn't take advantage of their insurance benefits if given the chance. I'm also only speaking from personal experience and have seen first-hand the difficulties of getting benefits for those that I truly feel need it. Blue Shield was one of those companies who required a secondary authorization for PT services. They would often cite that the national average to evaluate and discharge a patient was a total of 8 visits, which is very short. I wish insurance companies would understand that PT is also very much a wellness and preventative care service that can really limit the amount of surgery or other high costing medical procedure that's really costing the insurance companies. Why not spend less money on services that can improve a patient's health and well-being through PT education, rather than wait till it's so bad that they need high costing medical procedures?
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Meter Maid
What's the meanest thing anyone's ever said to you?
Air Traffic Controller
When would you order fighter jets to be scrambled?
Obstetrician Gynecologist
Has being an OBGYN affected your own beliefs about when "life" begins?
That's a good question! There really isn't one population that is harder to work with than some others. It's really dependent on someone's personality. There are elderly people who are sweet and do what we educate them on. And then, of course, we come across the stereotypical grumpy old man who thinks exercise is pointless at their age. From my experience, athletes are fun to work with since they are dedicated to their profession, which requires them to be in the best shape possible. I, personally, find it difficult to work with the pediatric population. But that's only because I don't have a lot of experience with kids in general. They need to be motivated, encouraged and entertained in a way that is pretty foreign to me. Asking me to keep the attention of a couple of toddlers for even a few minutes is like the blind leading the blind. The good part about PT is that you can work with just about any population you like and feel comfortable with. There are fantastic pediatric PT's who love kids, and kids love them. Same goes for any athlete, elderly, neurologic, and orthopedic client you may come across.
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Hmmm, I'm not sure if I'd consider PT a lucrative industry. It's no secret that I think insurance companies are making things difficult for our profession, so our salaries reflect that struggle. PT is also a pretty physical job where getting burned out early is not uncommon. In my earlier post regarding PT emerging as one of the best paying jobs of the future, I think it would be more appropriate if it was about job security. While in school, there seemed to be a general consensus that we weren't doing this job 'for the money', as they say. My student loans from getting my Doctorate were also astronomical. So I guess from my viewpoint, it's not quite lucrative. But I'm sure there are others out there who would disagree. Therefore, I do think most people go into PT because they're passionate about it. Most say they chose PT so they don't have to have a desk job in a cubicle, like being physically active, like working with people, and genuinely want to make a difference in other people's lives. It can, at times, get physically tiring and repetitive. But if you have a passion for PT, it'll all be worth it in the end!
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Yes, with any patient we must discharge them when they've reached their max rehab potential, achieved their attainable functional goals, or if they plateau. It gets a bit tricky when the don't make progress because they don't follow the prescribed regimen or do their HEP. In this case, it would be best to have open and honest communication about the importance of following the treatment plan. As I mentioned before, half of PT is patient education and teaching them how to take care of their own health and wellness. It's also important for the PT to try and understand why the patient is not following the prescribed regimen, and if modifications need to be made so they will be more successful. Earlier, I griped about the direction Insurance billing and reimbursement is going. They will most likely run out of benefits before anything else. Of course, you can then become a cash paying patient and are free to come as often you like. This happens often for those who like to come in for maintenance, which insurance does not cover. There are a select few who have the holy grail of unlimited benefits. If this is the case and they don't continue to show measurable improvements, I will have a discussion with them about a discharge to a HEP. I make it a point that I'm not abandoning them as they can contact me at any time with questions or concerns. They can always come back to therapy if a flare up occurs or a new injury happens. It is a bit like breaking up since we often develop close relationships through all the time spent together. But as long as you remain honest and open, people often are ok with this. Nothing that a pint of Haagen Daz can't fix.
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