Fall, 2018: What Is “Defensible Documentation?”
 WelcomeNew Members to the bestPT Network!Each new member benefits from and contributes to our network strength. | |||||
Let’s welcome bestPT Billing’s newest members!
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Everyone Benefits from bestPT’sNew Refer-A-Friend Program!Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network.
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Summer, 2018: Is Physical Therapy the Worst Kept Secret in HealthCare?
I still believe physical therapy is the WORST kept secret in healthcare. Last year I wrote a blog titled “Physical Therapy – The WORST Kept Secret in Healthcare” which allowed for some great discussion by the readers on the topic of physical therapy and where we fit into the healthcare system. This blog post followed an open discussion called the “Chelan Chat” at the Washington State Private Practice Special Interest Group (PPSIG) spring conference at Lake Chelan, WA. The ‘Chelan Chat’ is a twist on the Annual Graham Sessions hosted by the Institute of Private Practice Physical Therapy and was moderated by Steve Anderson. This year I was asked to present an “I believe” speech, that I would like to share with everyone here as a means to continue the discussion and a call to action. Here it goes… I believe we are in the “story” business as physical therapists. We spend countless hours listening to patient stories, stories told by other therapists, stories told by doctors, stories told by friends and stories told by loved ones. We also tell a lot of stories too about weak muscles, weak cores and my favorite the infamous sacroiliac joint slippage! A vast majority of people fail to recognize the difference between a story and fact. In fact, most people view stories as facts and as Carnegie Mellon research shows, our stories carry far more weight than facts. In reality, a story is what we tell ourselves about the facts, it is not real. Our point of view is not the truth, it is our perspective. And perspective is based on our knowledge, previous beliefs, environment, the context or space we are in, our mood, our emotions, social pressures, and so on. Essentially our perspective is based on where we are at in life when we make up the story. I believe it is therefore important to remember that our perspective is just one angle on the facts, it is not the only story. Facts do not determine our point of view, our stories do.
Most of you are familiar with the common phrase “the best kept secret”. Being the best kept secret is great when you want to keep something a secret, such as your favorite coffee shop, restaurant or favorite place to vacation. However, when it comes to the role of physical therapy in healthcare, I believe that we are still a SECRET to a majority of consumers. This was highlighted in 2007 by Stephanie Carter and John Rizzo when they demonstrated that less than 7% of patients with musculoskeletal conditions utilize outpatient physical therapy services and again in 2012 in the Fritz and Childs study. So, hopefully you are sitting there asking yourselves, why are we a secret? I believe we are the worst kept secret in healthcare for four main reasons:
Despite our shortcomings as a profession, I believe we are the BEST profession in a broken healthcare system and it is our time to move into the limelight. |
WelcomeNew Members to the bestPT Network!Each new member benefits from and contributes to our network strength. | |||||||||||||
Let’s welcome bestPT Billing’s newest members!
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Everyone Benefits from bestPT’sNew Refer-A-Friend Program!Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network.
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May 2018: Imposter Syndrome in Graduate Students
Imposter Syndrome: Dealing with Feelings of Self-Doubt and Inadequacy in a Doctorate Level Program Imposter syndrome (IS): a collection of feelings of inadequacy that persist despite evident success. ‘Imposters’ suffer from chronic self-doubt and a sense of intellectual fraudulence that override any feelings of success or external proof of their competence. Imposter syndrome is something we have heard about from professors, mentors, and advisors. They tell us that it is a normal experience for many graduate students, especially those in the field of healthcare. They tell us that this feeling may stick with us well into the first few years of our practice. While this is a well-known and widely experienced issue for many students of physical therapy, it feels anything but “normal.” On any given day of any given week, I’ll turn to any fellow classmate and we’ll crack a joke about how underprepared we feel for our next exam, clinic session, or rotation. It seems it is a constant feeling of under-preparedness, or lack of readiness, that weighs heavily on our shoulders. All this, despite the fact that we have made it well into our second year of didactics, and may even have a 4.0 GPA. We perform well in the classroom, but this does little to nothing to boost our confidence as proficient practitioners of physical therapy. How can we best deal with this feeling of inadequacy? An article from Psychology Today discusses tips on how to handle IS, and even make the best of it. First, appreciate your position as a novice. Consider that your perspective is fresh, and that of an outsider, due to inexperience. Therefore, the questions you ask may be very original, since you have not yet bulked up on conventional wisdom. Next, try to shift your mindset from one that focuses on performance, to a mindset that focuses on what you are learning. Realize that we learn the most when we make mistakes, so stop seeing mistakes as failures or inadequacies, and instead view them as opportunities to enrich your knowledge base. The third tip is to realize that perspective holds a lot of power. You may perceive yourself as the only one in the room who is truly experiencing IS, or that you are the person least worthy to be in the room. In reality, it’s likely that the majority of people in the room share that perspective, or have at some point in time. Realize that you are not alone with this feeling, that this is common, and that this is normal. This third tip feeds into my personal experience in dealing with IS. Positive perspective has helped me deal with IS thus far, and will continue to in the near future. I had never heard of the term “imposter syndrome” before grad school, even though I had experienced it personally from time to time in the past. Thankfully, as mentioned above, our faculty was quick to address the issue of IS early on, during our first year in the program. Hearing this coming from faculty, in a non-judgmental manner, was somewhat comforting. In a way, simply being made aware of IS from the get go made it a bit easier to accept, process, and handle moving forward in the program.
The Impostor Syndrome and How To Handle It. (n.d.). Retrieved March 28, 2018, from https://www.psychologytoday.com/blog/adaptation/201611/the-impostor-syndrome-and-how-handle-it
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Welcome New Members to the bestPT Network!
Each new member benefits from and contributes to our network strength. Let’s welcome bestPT Billing’s newest members! |
Kathleen Wiemold Pinnacle Chiropractic & Wellness, Fishers, IN |
Korey Wiemold Pinnacle Chiropractic & Wellness, Fishers, IN |
Kellie Martin Bassett Physical Therapy, Stanleytown, VA |
Kenisha Dickerson Melwood Rehabilitation, Upper Marlboro, MD |
Everyone Benefits from bestPT’sNew Refer-A-Friend Program!Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network.
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March 2018: Graded Imagery & Advanced Technology in the Treatment of a Patient Post-Stroke
Graded Imagery and Advanced Technology in the Treatment of a Patient Post-Stroke Lisa Peterkin, SPT With the advancement of technology comes the advancement of treatment tools that can be used in all areas of physical therapy. Newer techniques used to treat patients after a cerebrovascular accident (CVA) have become more popular both in and out of the clinic setting to improve function. Traditionally, patients who have been affected by a stroke have been treated with Neurodevelopmental Treatment (NDT) techniques that include proper patient positioning and tactile cueing to progress the patient and improve their function. Once the patient has improved strength, special awareness and normalized tone, they can begin to work with a physical therapist on more functional activities such as transfers and improved ambulation. More frequently, now, physical therapists are including more advanced techniques such as Graded Motor Imagery (GMI) in their treatment of patients who have had a stroke. GMI is thought to promote cortical brain activation and promote motor recovery after a stroke, specifically in the upper extremity. Within the category of Graded Motor Imagery are subgroups that include Explicit Motor Imagery (EMI), Implicit Motor Imagery (IMI) and Mirror Therapy (MT). EMI uses the Kinesthetic and Visual Imagery Questionnaire (KVIQ), which includes 5 movements (shoulder flexion, finger tapping, trunk flexion, hip abduction, and ankle dorsiflexion) that are described to or demonstrated for the patient, then the patient is to imagine themselves performing the movement that was just described or demonstrated. This Questionnaire is graded on a 5-point scale, from 0, where the patient was unable to imagine demonstrating that movement, to 5, where the patient could imagine it clearly. The next area of IMI incorporates Left/Right Hand Judgement, where the patient is shown 60 images of a hand in various positions, and the patient has to determine whether the picture is of a left or a right hand. The last intervention is MT, where the patient is angled with their upper extremity next to a mirror so they have a clear view of the mirror with the reflection of their limb. The unaffected arm moves in various ways instructed by a physical therapist, and the illusion is perceived by the patient that their involved arm is moving. The benefit of using these techniques is that they are simple to teach from one physical therapist to another, and easy for the patient to understand and be able to perform. However, because patients who have suffered a stroke may have cognitive deficits, their lack of imaginary skills due to the CVA may influence the effectiveness of these techniques. There have been many studies that assess the effectiveness of using more advanced technology with post-stroke patients. The H2 robotic exoskeleton is used to improve gait in a post-stroke patient with hemiparesis who was able to walk only short distances at lower speeds. The robot has 6 joints and focuses on improving an asymmetric, deviant hemiparetic leg during the stance phase of the gait cycle. It allows the patient to walk farther distances and have more stability in the affected leg while ambulating. Robot-Assisted Game Training has also been studied on its effectiveness with post-stroke patients. Patients are given conventional therapy along with a secondary treatment that includes game training. This includes a robotic arm that allows the patient to adduct and abduct the shoulder, and flex and extend the elbow of the involved arm. By maneuvering the robotic arm, the patient can navigate through a gaming system on a computer and improve motor planning skills and cognition. While these techniques are still new and have minimal research, they open up a new world of treatment possibilities, especially in rural areas that are underserved with healthcare. With these techniques and newer technology, patients may be able to return home sooner and have effective treatment sessions without going into a clinic, while continuing to show improvement in gross motor skills and cognitive function.
Bortole, M., Venkatakrishnan, A., Zhu, F., Moreno, J. C., Francisco, G. E., Pons, J. L., & Contreras-Vidal, J. L. (2015). The H2 robotic exoskeleton for gait rehabilitation after stroke: early findings from a clinical study. Journal of neuroengineering and rehabilitation, 12(1), 54. Lee KW, Kim SB, Lee JH, Lee SJ, Kim JW. Effect of Robot-Assisted Game Training on Upper Extremity Function in Stroke Patients. Ann Rehabil Med. 2017 Aug;41(4):539-546. https://doi.org/10.5535/arm.2017.41.4.539 Polli, A., Moseley, G. L., Gioia, E., Beames, T., Baba, A., Agostini, M., … Turolla, A. (2017). Graded motor imagery for patients with stroke: a non-randomized controlled trial of a new approach. European Journal of Physical and Rehabilitation Medicine, 53(1), 14–23. https://doi.org/10.23736/S1973-9087.16.04215-5 |
Welcome New Members to the bestPT Network!
Each new member benefits from and contributes to our network strength. Let’s welcome bestPT Billing’s newest members! |
Ehrum Khan PT Max, Philadelphia, PA |
Alicia Molloy Padme Physical Therapy, Dedham, MA |
Jesslyn Scholl Bit-by-Bit Therapy, Davie, FL |
Morgan Helser Big Sky Pediatric Therapy, Austin, TX |
Joshua Castro PT Max, Philadelphia, PA |
Everyone Benefits from bestPT’sNew Refer-A-Friend Program!Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network.
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Feb 2018: Avoiding PT Burn Out While In School
Mini-Clinics Help Prevent Student Burnout Lisa Peterkin, SPT We hear about burnout after a physical therapist begins practicing for a few years. We also learn ways to prevent this from happening so that we remain interested and invested in our practices and in our patients However, we never talk about burnout while in school. After sitting in class, week after week, for 35+ hours, it can be mentally and physically taxing. It can be hard to still have that passion that we had when we first entered the program. In the Physical Therapy program at the University of New Mexico, we participate in weekly mini-clinics. We go to various clinics, rehabilitation facilities, and hospitals throughout the city and surrounding areas for 4 hours each Wednesday morning. We are partnered up with another student in our class and are assigned to a clinical instructor at the clinic we’re attending. This is extremely beneficial because it allows us to practice newly learned skills while brainstorming together as we’re presented with newer conditions or techniques. It’s also beneficial to be able to work with different physical therapists of different backgrounds, work experiences, ages, educations, and so much more. It exposes us to a variety of styles and techniques, and we gain little tips and tricks on how to transfer larger patients, hand placements to improve reliability of special tests and ease when performing them, or how to have proper body mechanics for different body types. These first-hand experiences also give us insight on what to prioritize when the physical therapist is running out of time with a patient during an evaluation or a follow- up treatment. Many of the physical therapists I’ve worked under have a different flow while doing an evaluation, it’s helpful to see what works and to think about what I would do differently to come up with my own flow. After every mini-clinic, we have a little reflection assignment due in our classes. We have a checklist of different things that we ideally would have seen in a morning at a clinic or hospital. This includes things such as testing sensation, proprioception, range of motion, balance, etc. It gives us an opportunity, once we’ve left the clinic, to reflect on everything we did, and why that was necessary for that patient. Occasionally, depending on the setting, we have the opportunity to work with, or alongside, other health care professionals, such as occupational therapists, speech and language pathologists, MDs, and nurses. We get to see how the physical therapist we are working under interacts with other health care professionals and see what role each of those people play in the patient’s overall health care. While all these tips and tricks and times to practice are valuable and helpful, I personally believe the most valuable part is actually being able to work with real patients in a real clinical setting. It breaks up the monotony of sitting in a classroom listening to lectures for 7-8 hours every day, and it gives us a chance to reignite the spark that made us all want to become physical therapists in the first place. It gives us half a day of problem solving with complex patients, talking with patients about their goals with physical therapy, and allows us to see even minor improvements with patients within one treatment session. Mini-clinics keep us interested and passionate about the profession when we start to feel burnout from being a student. |
Welcome New Members to the bestPT Network!
Each new member benefits from and contributes to our network strength. Let’s welcome bestPT Billing’s newest members! |
Sandre Allegre Big Sky Pediatric Therapy, Austin, TX |
Sue McKeown Asbury University, Wilmore, KY |
Sara Beckley & Chris Poveromo Thompson Physical Therapy. Fresno, CA |
Craig Brunson Axiom PT & OT Plus, Tuckahoe, NY |
Betsy Harnden & Gervante Millender Center for Orthopedic & Sports PT, Tallahasse, FL |
Everyone Benefits from bestPT’sNew Refer-A-Friend Program!Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network.
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Jan 2018: Importance of Developing Mentor-Mentee Relationships During PT School
The Importance of Developing Mentor-Mentee Relationships During PT School Lisa Peterkin, SPT At the University of New Mexico, Department of Physical Therapy, faculty, staff, and students all understand the rigor of the program and how much of an adjustment it can be to start a doctorate graduate program. It doesn’t matter if the student came directly from undergrad, from a different graduate program, or took time off between prior schooling and PT school; there is always an adjustment period and a learning curve for any change. We’ve developed a mentor-mentee program for all incoming students who are offered the opportunity to request having a mentor from the class above. Both mentors (soon to be second year students) and mentees (incoming first year students) fill out a questionnaire about interests, hobbies, and schooling background, and based on the responses, we pair people who have similar interests and we feel will be able to connect outside of PT school. Throughout the program, mentors are there to provide advice and support to their mentee, and to be another familiar face outside of their own classmates. In my personal experience, having a mentor made me less nervous about starting the program, and it gave me someone in the class above to look up to if I ever felt overly stressed or anxious about upcoming exams. It was also somebody who I could ask about tips for classes, certain professors, or even exams and quizzes. Mentors go beyond our student program. Our professors are all mentors to us every day, both inside and outside the classroom. They are always available to offer advice or answer questions via email, or if we’re lucky, we can catch them in their office when they’re not teaching or in clinic. We have a strong and close bond with every professor in our program that make it easy to look up to them as role models and mentors, which, in turn, makes it easy to reach out whenever we need assistance in classes or advice on a patient we see in clinic. In our student-led clinic, REACH, a handful of our professors participate as the licensed Physical Therapist when we see and treat patients. They guide us when we’ve hit a roadblock or jump at an opportunity to teach us new techniques during an examination. Based on their years of experience, they also offer new and creative exercises to use with our patients, or how to simplify an explanation for a patient. We also form mentorships with our clinical instructors who guide us in a more practical and hands on way with patients in the clinic. During my first rotation, my clinical instructor helped me to grow and improve my skills in physical therapy, but more importantly, she taught me how to think outside the box and to get creative with treatment ideas. I always looked up to her and she was always there to offer advice or to encourage me to struggle on my own so that I could learn from my mistakes or work through a problem, which I always thought was even more valuable. We are surrounded by mentors every day, even if we don’t necessarily realize it. It helps us to grow as students, future physical therapists, and life-long learners. We learn how to learn from other physical therapists’ and appreciate their styles and experience, and some of these mentors will continue to mentor us beyond our school years. |
Welcome New Members to the bestPT Network!
Each new member benefits from and contributes to our network strength. Let’s welcome bestPT Billing’s newest members! |
Becky Staudt Big Sky Pediatric Therapy, Austin, TX |
Jaidy Matos PT Max Pain Management Clinic, Philadelphia, PA |
Tammy Duncan & Savanna Booker Kid’s Creek Therapy, Suwanee, GA |
Amanda Newman Elite Orthosport Physical Therapy, Los Angeles, CA |
Brooke McAdam Health & Rehab Solutions, Kalispell, MT |
Everyone Benefits from bestPT’sNew Refer-A-Friend Program!Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network.
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Oct 2017 Newsletter: How the Cloud Protects Your Practice in a Disaster
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October, 2017 Newsletter
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Let’s welcome bestPT Billing’s newest members!
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Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network. | |
 | If your friend schedules a demonstration of the system, we’ll send you a $25 Amazon gift card! |
 | For each friend that you refer that joins our network, we’ll credit you $50 each month the office is contracted with us through the first year! |
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Sept. 2017 Newsletter: 7 Ways to Build a Sales Culture Within Your Practice
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September, 2017 Newsletter
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136 New members joined bestPT in August, 2017. Let’s welcome bestPT Billing’s newest members!
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Looking at the landscape of physical therapy practice management, we see a playing field tipped to benefit the payers and hurt the provider. The relationship between payers and providers is adversarial, but billing networks offer solid strategies that allow providers to get back into–and win–the game. The “network effect” allows a large number of unique providers to capitalize upon their strength in numbers. Please help us strengthen that network. | |
| If your friend schedules a demonstration of the system, we’ll send you a $25 Amazon gift card! |
| For each friend that you refer that joins our network, we’ll credit you $50 each month the office is contracted with us through the first year! |
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Welcome New Members to the bestPT Team in April 2017
11 New members joined bestPT in April 2017.
Each new member benefits from and contributes to the strength of our network of physical therapists.
Let’s welcome bestPT newest members!
- Ahmed Abualala of Melwood Rehabilitation Center, in Upper Marlboro, MD.
- Sara Styles, Kelly Tennyson, and Kimberly Nicholson of Health Rehab Solutions.
- Glenn Hamilton of Asbury University in Wilmore, KY.
- Samantha Lenox of Mike Walsh Physical Therapy, in Milford, DE.
- Leah Larkin of Equilibrium Balance Performance Center in Ventura, CA.
- Chastity Eaton of Bassett Physical Therapy, in Stanleytown, VA.
- Brenda Gonzalez, Jerry Parks, and Ted Stebens of Kulagy Physical Therapy.
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Clearwater, FL 33762
2 Hudson Street
Marlboro, NJ 07746
(727) 386-9497
thomasj@espoc.com
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To innovate Physical Therapy technology and service for independent practice growth.
