PTs in the ER: An Idea Whose Time Has Come?
A slowly emerging trend in healthcare is the addition of Physical Therapists as permanent staff members in ERs and EDs across the country. About seven states employ full-time PTs in their hospital ERs with Indiana, Missouri and Arizona leading the way, while other states' hospitals have expanded their on call PT consultations. This novel approach is the direct result of significant shifts in the healthcare delivery system in the United States. Nowadays the ERs/EDs, and not the family physician, are the primary healthcare choice for patients, particularly those lacking the resources and/or access to other avenues of care. Studies have shown that the inclusion of PTs in the ER results in higher patient satisfaction and reduced wait times, thus reducing ER physician workloads. The average wait time in an American ED is 1 hour and the average total length of stay for the patient is 4 hours. On the other hand, the ER/ED physician spends on average only 11 minutes with his patient, including time for diagnosis, research, orders and referrals. Doctors are clearly overtaxed and patients are clearly underserved.
Many of these ERs have been reporting an upsurge in cases presenting with musculoskeletal complaints. Some are life-threatening injuries due to trauma, but the bulk of these are nonemergent or minor injury cases. In those incidences, the ER physician is most likely to order multiple imaging tests, immobilize the patient and then discharge to home with a prescription for bed rest. Needless to say, the majority of sprained ankles and knees or chronic back and neck pains, don't require advanced imaging or long-term immobilization. It is at this point that the PT's expertise is most effective in evaluating the patient's physical condition and recommending a comprehensive treatment plan to be implemented upon discharge with outpatient follow up. PTs bring their knowledge and use of treatments such as spinal manipulation, joint mobilization, therapeutic exercise programs and the PRICE method (protection, rest, ice, compression, elevation) to educate their patients, ensure a speedy recovery and prevent reoccurrences or re-injuries.
The major sticking point preventing more hospitals from hiring PTs as full-time ER staff seems to be a billing issue. Each institution must decide whether or not to provide PT services without a separate charge or to bill for these services as outpatient care. As yet, there is no uniform national consensus as to which method is more financially advantageous and the most efficient for hospitals. North Shore-Long Island Jewish Hospital leans towards not charging for PT services citing savings from prevention of unnecessary admissions and the capturing of downstream revenue from outpatient follow-ups.
The ER is not for everyone, but if you are looking for a new and innovative use of your talents or just want to explore other therapeutic settings we can help. Contact Centra today at 800 535 0076.
- Category: Physical Therapy
Trends in Vestibular Rehabilitation Therapy
Vestibular disorders have several causes and their symptoms may manifest either on a temporary or recurring basis. Symptoms of vestibular disorders are commonly loss of balance and repeated incidents of falling; prolonged or frequent dizziness; trouble walking in the dark; and functional difficulty following riding in a vehicle. The most common causes of these disorders are otitis and labyrinthitis (ear infections and inflammations), cranial traumas, acoustic neuromas, Meniere's disease (fluid retention in the inner ear), and paroxysmal positional vertigo. In seniors, dizziness is most often attributed to presbyastasis, an impairment of vestibular function due to aging, and it can have devastating consequences if these patients are not given therapeutic remedies to prevent loss of balance. Falls account for about 50% of all accidental deaths in this population.
Vestibular Rehabilitation Therapy (VRT) administered by qualified PTs teaches clients to handle everyday activities requiring balance, and for the most part involves retraining of patients' eyes, ears and brain. Until recently, the core of VRT centered on the Cawthorne-Cooksey exercises developed in the 1950's. But exciting developments and new trends in this field are enhancing the effectiveness of treatment for both the patient and the professional. PTs are in the unique position to advance cutting edge research in VRT through documentation of their treatment of actual patients, and then sharing their findings with healthcare professionals and technologists studying and working in the field.
According to Drs. Michael Schubert and Susan Whitney in an article published in the "Journal of Neurologic Physical Therapy", we should expect many more exciting and innovative technological inventions, such as the "balance vest" invented by researchers at UCLA's Center for Advanced Surgical and Interventional Technology (CASIT). This vest provides vibro-tactile feedback to its wearers through tiny pneumatic balloons, alerting them to imbalances and helping to correct them. Other noteworthy developments anticipated are vestibular prostheses or implants; restoration of vestibular function using stem cells; and computerized techniques for gaze stability, the restoration of steady vision even as patients move their heads. Studies have shown that the restoration of gaze stability through exercise and other techniques can greatly reduce the risk of falling in older adults.
One of the technologies available right now for PTs performing VRT, is an app for the iPhone or iPad. TinettiX can be used to predict falls in older patients, which makes it an invaluable pocket tool in this field. The app, which objectively measures functional mobility, is HIPPA compliant, easily administered and useful in the formulation of treatment plans. We encourage PTs in this field to take advantage of this convenient and beneficial tool and others like it.
If you are a PT working with senior populations, vestibular disorders or other specializations, Centra can help you find new and stimulating opportunities to showcase your talents. Call us at 800 535 0076 or contact us to find out more.
- Category: Physical Therapy
Associations for Physical Therapists
Many physical therapists swear by the professional associations they've joined because these groups help them in so many ways.
Joining one or more professional associations gives a physical therapist:
- The opportunity to stay on top of trends in the field. Many associations publish academic or scholarly journals in which the latest treatments and trends are discussed and explained. In addition, these professional journals will keep you apprised of who the current and future leaders in physical therapy are.
- Joining a professional PT association also allows you to attend conferences and forums. These are terrific networking opportunities: you could meet someone who could lead you to a terrific position.
- As you well know, continuing education is key to a successful physical therapy career. Most associations offer CIE courses and also list relevant courses coming to your area.
- Professional associations also offer certifications that can help you progress in your PT career.
Below is a list of some professional physical therapy associations.
The American Physical Therapy Association (www.apta.org) is the major professional association for PTs in the country. According to its website, the APTA "is a national professional organization representing more than 74,000 members. Its goal is to foster advancements in physical therapy practice, research, and education."
The APTA's stated mission is "is to further the profession's role in the prevention, diagnosis, and treatment of movement dysfunctions and the enhancement of the physical health and functional abilities of members of the public."
If you're a PT, you're undoubtedly a member. But if you're a student, or even if you're just thinking of pursuing a career as a physical therapist, joining the APTA definitely should be on your to-do list.
In addition, just about each state has its own PT association. Check out this link at HealthGuideUSA.org for a page with links to 47 state associations.
The Federation of State Boards of Physical Therapy (www.fsbpt.org) is the organization that creates and administers the PT licensure examination (the National Physical Therapy Examination) for all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands
The Federation's website states that its vision is "that the organization will achieve a high level of public protection through a strong foundation of laws and regulatory standards in physical therapy, effective tools and systems to assess entry-level and continuing competence, and public and professional awareness of resources for public protection."
The American Association of Intensive Pediatric Physical Therapy (www.aaippt.org) is, according to its website: "a non-profit organization devoted to providing a source of information and research for parents of disabled children who are searching for the most innovative pediatric physical therapy treatments."
Take your physical therapy skills and expertise to different PT and medical facilities all over the country with Centra Healthcare Solutions. We have many terrific travel assignments at facilities around the country. Contact us today!
- Category: Physical Therapy
Recent College Grads: How to Gain Experience in Physical Therapy
Gaining experience in anticipation of a physical therapy position requires time, patience and the willingness to work in a setting you might not otherwise choose for your full-time career. There are several ways in which college grads can get experience in this field. Experience is key because employers generally don't want a complete PT newbie who requires extensive on-the-job training. Physical therapy is such a client-intensive position in which a client's physical well-being is in your hands, so as much training as you can get prior to taking a full-time position is good.
To start, you can gain experience in physical therapy through volunteer work with a local senior care center or local clinic. In many instances, these facilities don't have the resources to pay full-time physical therapists and must rely on professionals willing to do pro bono work. The benefit of this type of volunteer position is that you will have a wide range of experiences that you can take into a full-time, paying position when it's time to pursue one.
If you are a recent college grad, you still may be able to pursue an internship with a reputable physical therapy office to gain some additional experience. These internships are generally reserved for students still in school, but there are some opportunities for recent graduates. These positions also generally are not paid or if they are, it is a small stipend but the ability to work with trained professionals is priceless, as you will learn physical therapy techniques that, when combined with your educational experience, can jump start your career. Even if a clinic or rehab facility is not actively advertising an internship position, you might still contact the facility's administrators to see if they would be interested in taking you on as an intern. They will appreciate your confidence and direct approach and you will learn on-the-job training that will prepare you for your first full-time PT position.
Between clinic experience gained in the last two years of school and an internship or volunteer position, you will have enough training and real world experience to pursue a full-time position. Just be sure to soak up everything possible in terms of knowledge and access to professionals who can teach you everything they know.
If you're a physical therapist with a desire to travel, contact Centra Healthcare Solutions. We have many terrific travel assignments at healthcare and rehab facilities around the country, facilities eager to use your much-needed physical therapy skills. Contact us today!
- Category: Physical Therapy
Continuing Education Opportunities for Physical Therapists in 2011
As a physical therapist, you well know how important -- and required -- taking continuing education courses is to your career, and your patients' rehabilitation.
Below are just a few of the hundreds of continuing education opportunities that will be held in 2011 around the country -- as well as online.
(A side note: a great place to search for CE opportunities is at www.rehabedge.com. The site lists courses from all over the globe under various topics [from acute care to yoga and all in between alphabetically], as well as home-study, post-professional, DVD-based or online and, of course, the more traditional "live" seminar/course.)
You may search for courses at this page: http://www.rehabedge.com/Search.aspx.
Here are just a very few PT CE courses coming up in 2011 that we think you may find of interest:
With so many aging baby boomers....well, aging, it's smart to learn how to help them stay loose and mobile as they get older. Cross Country Education is holding a one-day seminar in several locations in California and Nevada in January and February on "Are You Boomer Ready? Joint Replacement Rehabilitation." Cost is $199 and you may register at http://www.rehabedge.com/Detail.aspx?ID=2039.
Education Resources, Inc. is hosting a two-day seminar on "Effective Ways to Manage Behavior and Increase Functional Outcomes" in several states throughout the year. Cost is $425. More information and the registration form is at http://www.rehabedge.com/Detail.aspx?ID=1746.
If you're interested in how yoga, tai chi and Pilates can help your patients, you may be interested in "Maximizing Functional Outcomes: Integrating Pilates, Tai Chi and Yoga. This two-day seminar ($425) will be held several times in several states (Midwest and South) in 2011 starting in March. More information and registration may be found at http://www.rehabedge.com/Detail.aspx?ID=1458.
If you work with stroke patients, "Driving Neuroplastic Change in Stroke Survivors: Leading-Edge Treatments, Tools and Strategies" may be of interest. This two-day seminar (presented by Education Resources, Inc.), will be offered in a few cities on the East Coast beginning in March. Cost is $425. Check out http://www.rehabedge.com/Detail.aspx?ID=1479 for more information.
If you'd like to take your "continuing education" efforts on the road, contact Centra Healthcare Solutions. We have many positions for travel PTs at rehab sites all across the country. Contact us today!
- Category: Physical Therapy
Physical Therapy
