Telehealth during Covid- from a patient’s perspective.
/in Physical Therapy patient care, Physical Therapy patient relationship management, Physical Therapy practice management /by bestPT
Over the past four months or so I have had the opportunity to see healthcare during the COVID-19 era from the perspective of a patient. This has allowed me to personally feel how the changes we have made to keep providing patient care during a global pandemic have impacted our patients. This opportunity has allowed me the chance to see the good and the bad of telehealth and social distanced health care. To begin I want to start by saying all the health care providers I have worked with have been wonderful and are all phenomenal providers, and second this is only my perspective and is not meant as a fully encompassed view of the current state of health care.
I wanted to start by stating how weird it is to go into potentially life changing appointments while sitting at home and staring at a computer waiting for the doctor in the virtual waiting room. The setup just feels a bit odd, one minute you are sitting there drinking your morning coffee in your PJ pants and then all of a sudden you are in a deep virtual conversation with a provider about information that changes the trajectory of your day to day life. Before you know it the zoom, or google chat room closes and you are left sitting there trying to process the news in your living room. The good news is many doctors have understood this concept and are willing to sit in the virtual chat and discuss details for as long as you need, however the difficulty with this is that there is always an abrupt ending to the call and the patient is still left sitting there with their mind racing and the urge to google what they were just told. One thing I have found that has helped is that when a doctor gives life changing information many of them have allowed me the opportunity to schedule an in person visit after the virtual call to follow-up and do the physical examination.
Another area that has been interesting to see is that there seems to be no set appointment length with patients during this time. My experience has been that my virtual appointments last anywhere between 6-45 minutes. This has been an adjustment as a patient because many times you go into physical appointments and can expect to be seen for around 20-30 minutes. My best virtual appointments have been with the doctors that take the time that would normally have been filled with physical examination and discussed research and things to try at home and scheduling in person visits as necessary. My less effective virtual appointments were doctors just telling me physical lab results that have already been uploaded to my patient portal and ending the call with no clear conclusion. As many professionals try to navigate this new era of health care one area that can not be lost is bedside manners.
One area that I have enjoyed about being a patient in this time is that it has expanded the network of clinicians I can see. I was able to see my PCP back in Minnesota, while still going to school in New Mexico and then within the same week see a specialist down in New Mexico. This type of care has allowed for a wider variety and a larger network of providers to work together. It makes it feel almost like you have your own personal pick of providers as long as they are covered by your personal insurance. This makes getting second opinions easier and more efficient than before.
Telehealth has provided many challenges for providers to work through on their end, but one area that can not be forgotten is the patient’s experience. The struggle of having to log into a virtual chat to hear news that could alter an individual’s whole life and having that chat end leaving them sitting in their living room is unprecedented for many individuals. Having had the opportunity to live this reality has made me recognize the struggle our patients are going through. The lack of face to face interaction has taken a piece of the compassion out of a professional field that strives to provide our patients what they need during major life changes. This isn’t to bash on telehealth. I have actually thoroughly enjoyed being able to utilize telehealth as a patient, it is just to remind ourselves that our bedside manners are even more important when social distance creates barriers to the compassion that many of our patients need. Through our own continuing education and experiences I think telehealth can become an important piece of health care going forward.
COVID-19 Telehealth Program.
/in Physical Therapy patient relationship management, Physical Therapy practice management /by bestPTTherapy specific telehealth services that Cigna will cover during COVID-19 pandemic.
/in Physical Therapy patient relationship management, Physical Therapy practice management /by bestPTCorona Virus Emergency Loan Program & Accelerated and Advance Payment Program with CMS
/in Physical Therapy Compliance, Physical Therapy News, Physical Therapy practice management /by Eldad De-Medonsa, PhDA message from the President of Billing Dynamix:
/in Physical Therapy Compliance, Physical Therapy practice management /by Eldad De-Medonsa, PhDFall, 2018: What Is “Defensible Documentation?”
/in BLOG, Physical Therapy Billing, Physical Therapy Dream Practice, Physical Therapy practice management /by bestPTWhat Is “Defensible Documentation?”Hannah MullaneyDefensible documentation in the physical therapy world — what does this entail? A paper chart donned with purple gloves, yellow gown, and p99 respiratory mask? Or maybe a sleek EMR (electronic medical record) laced with the defensive skills of a black belt extraordinaire. Actually, it harkens to the diligent PT typing notes over lunch, after work, and before patients arrive the next morning. What is documentation? It is the thorough note that a physical therapist writes explaining what happened during an appointment. How was the patient? What happened during therapy? Why should insurance pay the therapist? It needs to be detailed enough to stand trial in a court case yet succinct enough for a single person to document 6-16 appointments in a day. The American Physical Therapy Association (APTA) website faithfully reminds practicing PTs why documentation is so important. Health care consumers trust physical therapists to use their expert training to improve, maintain, restore, and enhance movement, activity, and health for optimal functioning and quality of life. While safety and quality of care is most important when caring for patients and clients, documentation throughout the episode of care is a professional responsibility and a legal requirement. It is also a tool to help ensure safety and the provision of high-quality care and to support payment of services. The national organization also provides tips and tricks for making high-quality documentation. First of all, these are the skeleton of a solid physical therapy note, with a little sample of what each part means.
Defensible documentation needs some muscles to give power to the treatment. This is the evidenced-based care. Tests, interventions, and exercises that scientific study has shown to be safe and effective encompass evidenced-based care. The ligaments and fascia that holds defensible documentation together is the risk management component. If something was not written in the documentation, it is as if it didn’t happen. Therefore, PTs need to be careful to be safe in action and documentation in every single encounter– for the patient’s sake as well as their own. Examples of risk management in note-writing include some of the following.
Whew! That’s a lot for a physical therapist to keep in mind while they do dozens of these documentations a week. However tedious it can be, it is important for PTs to stay true and keep their documentation strong. It needs to ricochet against the possible legal encounters. It needs to be armed with risk management and evidence-based care. And the tool that houses all of this defensible documentation is the electronic medical record (EMR). A defensible EMR will follow the guidelines suggested by the APTA to keep patients and practitioners safe in the current age of medicine. |
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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. |
Summer, 2018: Is Physical Therapy the Worst Kept Secret in HealthCare?
/in BLOG, Physical Therapy Billing, Physical Therapy Dream Practice, Physical Therapy practice management /by bestPTI 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. |
May 2018: Imposter Syndrome in Graduate Students
/in BLOG, Physical Therapy Billing, Physical Therapy Dream Practice, Physical Therapy practice management /by Tom JornoImposter 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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