Father Woody’s Haven of Hope

Written by: Colleen Lopp, Regis DPT 2nd Year Student

How often do you drive by someone experiencing homelessness? What do you do? How do you feel? Maybe I am naïve and optimistic, but I like to believe everyone who is willing to beg in the street could use some help and I always want to offer what I can. I usually shift through my purse only to realize I don’t have cash. I look around my car hoping I managed to stow away a snack, but I don’t find one. On the rare chance where I do have something to offer them, I quickly hand it to them before the light changes, but I am left wondering if that was what they needed. I wonder who they are and wish I could have a conversation. Just a moment of passing someone in a car, doesn’t create an opportunity to understand or to let go of any judgments I might feel.

GHP Clinic (002)                            SAM_0885

At Father Woody’s Haven of Hope I feel like I get the chance to have a conversation. The shelter itself is open Monday through Friday from 7:00am to 1:00pm. There are countless resources such as laundry service, phone service, internet access, clothing donations, hygiene kits, distribution of over the country medications, an outreach coordinator to work one on one with guests on finding resources for employment, transportation, and housing opportunities. There are also many weekly resources such as representatives from stout street mobile medical clinic, VA representatives’ visits, dental clinic, yoga classes, and massage therapy. Every 1st and 3rd Wednesdays of the month Regis opens a physical therapy and wound clinic. This shelter fosters a safe community of support in which those experiencing homelessness can get the resources they need.

There are so many DPT students who have given up their Wednesday mornings to help run the clinic, make breakfast, sort through clothing donations, and lend a hand. It’s an opportunity to serve a population in need and often learn about someone’s experiences from their own perspective. For me, I have had a chance to work with a number of patients and it is eye opening. It is often a little intimidating trying to treat someone who is experiencing homelessness, but I try to be present for the patient and make seeing a health care provider a positive experience for them. One patient that really resonated with me was an older man who was covered in face tattoos. He was looking for wound care for his recently amputated toe, after losing it to frostbite. As I started to gather his history, he was very open with me about his drug usage and his journey with addition and told me he was currently coming off a high. He shared with me his story on losing love ones and how he started his substance abuse. He told me how his relationship with speed and other drugs lead him to the streets. He was currently searching for a rehab program that would allow him to remain on his medications for diabetes. It was really powerful to listen to his story and be able to create a space where he could share. Instead of coming from a place of judgement, I praised him on his journey and encourage him to keep looking for rehab centers. Dr. Alice Davis helped clean the wound and we were able to provide a new pair of socks to help keep his feet dry and clean. At the end of the session we were able to get him in contact with the Father Woody’s staff to help find more information on rehab centers in the Denver area.

SAM_0864

When working with those experiencing homelessness, there are so many factors contributing to their well-being, creating a space of understanding and openness is powerful and can help treat the patient. I believe that even a conversation can offer comfort and in some cases, can lead to further information on resources to address their needs. Father Woody’s allows for increased access to healthcare and connections to resources to really serve those in need. Spending time in the Father Woody’s clinic has made me want to work more with those experiencing homelessness even more and learn more about how I can help. Even a simple conversation can make a difference.

Student Spotlight: Johnny Herrera discuses the APTA National Student Conclave

Name: Johnny Herrera, Class of 2021, Colorado APTA Core Ambassador in 2018-2019

Undergrad: Grand View University

Hometown: Santiago, Dominican Republic

Fun Fact: During my junior and senior years of high school I only had class on Saturdays

ncs2

A couple of weekends ago, I had the pleasure of attending the National Student Conclave (NSC) in Albuquerque, New Mexico. For those of you who don’t know me, during my first year of PT school I was involved with the APTA through a position as the Colorado APTA Core Ambassador (feel free to contact me about what this position is!). I chose to attend this conference because it is the only conference that the APTA offers specifically for students, and it is also the only conference that is mainly put together by students. I believe NSC was put together as a conference where students vote for the upcoming term of Student Assembly Board of Directors (SABoD), and the students from the previous term hand over their positions. I figured I’m only a PT student once, so I might as well see what the APTA offers during a conference made for students. Most people viewed me as being nuts for leaving town during Halloween weekend, but when I look back on my time at the conference, I can truly say it was one of the best decisions I’ve ever made. Here are a few reasons why:

  • During my time as core ambassador, I worked under supervision of the SABoD. The SABoD is a board of current students from all over the country who serve every SPT/SPTA in the country and improve their interactions with the APTA. When I began this position as a first year student, it was daunting to think that I could have any sort of impact on other students. I had put the members of the SABoD on a pedestal for taking on such large roles within the APTA, and when I arrived at the NSC, I realized all of the members of the board during my term as Core Ambassador were there. Turns out, they’re a pretty cool group of humans. I had initially found myself intimidated because they were students who had these huge responsibilities and large platforms; but it turns out they were all just like any other student in PT school, just with a bit more responsibility. They are all broke college kids who study a ton, have doubts and fears about PT school and their futures, and love to have fun on the weekends with their friends. Being able to interact with them and get to know them personally was honestly refreshing. It was nice to see that those who had these high positions were no different than myself or any different than my current Regis classmates. They just had a passion for student involvement and they made sure to do something about it! I left having this renewed sense of ability to accomplish anything I really wanted to, and it was because of these amazing humans.
  • While reflecting about the NSC, I realized how similar it was to Regis DPT’s interview day. I know that for some, that day was super stressful, but for me, it was about getting to know people and further realizing why I wanted to join such an amazing profession. When I looked around at NSC, it was a huge melting pot of students from all around the country coming together to demonstrate their passion for PT and its future. It was so cool to hear about the amazing things that students all over the country are doing and how they’re making an impact within their communities.
  • People from all over the country recognize Regis, so when you tell them you go to school there, they WANT to talk to you. Selfishly, it was really cool to hear about how many students really wanted to go to Regis but didn’t get in (small pat on the back moment for getting in).
  • One of the talks was put together by Jimmy McKay, who is the CEO of the podcast “PT Pintcast”. For those of you who have never heard of it, definitely look into it and you might find some of our professors on previous episodes! The talk was a live podcast interview, where Jimmy interviewed Shante Cofield (AKA the Movement Maestro) and Josh D’Angelo (AKA founder of PT Day of Service) and then was interviewed by them. The point of the interviews was to share stories of how they used their passions to build what they now do for a living, and their stories ended by saying that all they had to do was ask. It sounds like such a simple thing, but when the worst thing that can be said to you after a question is “no”, then why not shoot for the stars? (I believe all 3 interviews are uploaded, so go listen to them for some motivation!) All weekend long, all 3 of these individuals were at some of the booths in the exhibit hall, so I got to meet them and have conversations with them. How often do you get to walk up to a stranger who you know has made a difference in the world of PT and just get to chat with them?!
  • Throughout the weekend, I was able to learn about a variety of travel companies, OP clinics, and residencies. I was even able to build rapport with specific clinic and residency directors, hopefully putting me in a good position in the future to pursue employment or a resident position within one of those companies if I choose to.
  • Lastly, the absurd amount of free stuff. Who doesn’t like soft t-shirts and pint glasses?!!
nsc1

The NSC Exhibit Hall

As exhausted (and possibly hungover) as I was during my drive back to Denver, there were so many good memories and great relationships built during that weekend. I hope I was able to give you some insight as to what these large conferences are all about. Last time I heard, NSC was going to be discontinued until the APTA found a better way of getting student involvement within the conference. That can change soon, so stay updated on NSC news, and if they decide to keep it rolling while you’re a student, I can promise you that the money and travel will be well worth it.

Feel free to reach out if you have any questions about anything or if you want to know more about APTA involvement! Can’t wait for everyone to experience this at CSM this year!

Faculty Spotlight: Dr. Ira Gorman discusses healthcare policy and PT advocacy

Like most physical therapists, my passion for PT arose from the desire to empower people to achieve their greatest state of well-being and functional independence. However, as I progress in my education, I am learning that the simple goal of helping people can be far more complex in our convoluted healthcare system. Furthermore, if I want to truly serve society, I cannot simply treat individual patients. I must advocate for larger changes through public health.

To elucidate some of the confusion around healthcare,  Dr. Ira Gorman speaks today about the current healthcare system, the need for awareness and advocacy to advance public health policies, and recent changes in the practice of PT.

-Priya Subramanian, SPT- Regis University

2019 APTA Federal Advocacy Forum – “Day on the Hill”

56610440_1121899427982296_3955834925961183232_n

Colorado members at the Forum representing and advocating for the #ChoosePT campaign.

Last week,  the APTA Federal Forum in Washington D.C. took place to advocate for important topics to physical therapists. The Forum brought together APTA members, speakers from the field, and stakeholders on the discussion of regulatory affairs and federal priorities that impact the physical therapy profession and its patients, as well as on learning about new information that comes with a new Congress. Attendees had the opportunity to speak with their representatives in person about issues facing their state and the profession as a whole. Among those in attendance were our very own Regis DPT students and faculty members. Second-year DPT student Hannah Clark reflects on her experience on the Hill and why it is crucial to not only advocate for our profession, but to be involved as a student, in her following essay:

“Issues Discussed at the Capital”

Hannah Clark, SPT – Regis University

To fundamentally agree with the policy positions held by the APTA is an exceptional feeling. As a DPT student who is hoping to delve headfirst into pain management and advocacy for marginalized communities in healthcare upon graduation, my decision to pursue this profession has been deeply validated by attending the Federal Advocacy Forum (FAF). Witnessing leaders within the APTA address topics related to population health, patient choice and access, value-based care and practice, and research and innovation helped me to fully recognize the crucial role the APTA has in influencing the policies that impact our ability to serve society. For these reasons, it felt important for me to join the GAC team advocating at the capital and I was deeply honored to be selected.

Due to the recent success regarding the removal of the Medicare cap, we were able to spend more time becoming educated and advocating for the field of physical therapy in a broader sense. On Monday, we spent the entire day learning about the current political climate in congress from Nation Gonzalez at CNN, the societal impact of healthcare policy from Sarah Kliff at Vox, and attended breakout sessions that detailed information regarding federal policy, payment, the ACA, Medicaid, and IDEA. One of the most emphasized topics throughout the day involved the #ChoosePT campaign. The APTA reminded those attending the FAF of the real impact physical therapists can have on the opioid epidemic through offering vulnerable populations access to non-pharmacological pain management. Clear objectives were presented that tackled this issue in addition to intra-professional issues such as student loan repayment. Several policy priorities were presented for every state to choose from when planning their congressional meetings.

The following topics were addressed by the Colorado GAC team when meeting with legislative assistants:

  • Our geriatric specialists spoke to the vital role in we play in exercise promotion and fall risk reduction in the community. Conversations were also had in the valuable perspective physical therapists can bring to park and recreational center design.
  • Our pediatric specialists asked congresspeople to consider expanding the budget for IDEA as they have witnessed the impact this program has on the lives of children.
  • Our outpatient clinicians provided examples of how they have successfully treated patients experiencing chronic pain and assisted them in weaning off opioids. These individuals also spoke to the measurable reduction in opioid use they have made in their local hospital system by implementing early access to physical therapy services.
  • Our students asked our congresspeople to cosponsor SB970 (and eventually the same bill when it is brought to the house) that would add physical therapists to the National Health Service Corps. This would allow graduates to serve rural populations, often most impacted by opioid addiction, and would offer student loan repayment as an incentive.
  • Our long-time advocates requested that physical therapists be added as community health center providers, as we are a vital element of the primary care team.

In addition to the invaluable time spent at the FAF learning about how physical therapists can impact healthcare quality and access in the U.S., one of the most important aspects of the weekend for my professional growth was getting to know the GAC members I accompanied. The people I spent time with exemplified everything I love and respect about our profession. They spoke with genuine care for their patients, integrity in leadership opportunities, intelligence in considering the complexity of pain, passion for their interventions, and commitment to social responsibility. Our conversations had a large impact on my personal development.

I returned to class following the Federal Advocacy Forum with a fresh perspective. I felt focused and calm as I approached coursework and simulation labs. Attending FAF granted me the opportunity to further shape who I aspire to be as a professional and world citizen. I am beyond grateful for this opportunity and truly believe that if any student were to have the chance to participate in this event, they would foster a deeper appreciation for the APTA and for healthcare advocacy at large.

56679436_596581000824361_6263839149833322496_n

Hannah (pictured second from right) was all smiles with fellow members of the Forum at the 2019 APTA Federal Forum in Washington D.C. 

Presenting At CSM 2019, Washington D.C.

It was a cold, rainy national Combined Sections Meeting (CSM) this year in Washington D.C., but that did not stop almost 17,000 people, including several from Regis University, to attend! Regis students and faculty not only learned the latest happenings from others in our field of physical therapy, but also took roles in presenting their research and/or speaking during educational sessions to inform our profession. Below are some highlights of their experiences.

 

 

50639474_2400110950030890_5336687128036245504_n

DPT students Amber Bolen and Grace-Marie Vega with Dr. Andrew Littmann

“Going to CSM as a student researcher was a wonderful experience! Discussing our narrative review with PTs, students, and other researchers who shared our passion for regenerative medicine will always stand out as a highlight of my time at Regis.” — Grace-Marie Vega

“I loved working as a team with my research partner on our narrative review (the PT’s role in stem cell research for spinal cord injury). Presenting research at CSM was something I never expected to do when I first entered PT school, but Regis faculty encouraged our class to submit for review. We decided to give it a shot and we made it! Being able to speak with people interested in our field of research was an amazing feeling. We even attended a lecture in which one of our cited authors was present. It was also humbling to see how many research posters and lectures came out of Regis and its faculty and students. I look forward to seeing more as a proud future alumni!” — Amber Bolen

 

50646895_2400111196697532_3858855440590831616_n

DPT students David Cummins and Katherine Heller with Dr. Andrew Smith and Dr. Denise O’Dell

“Attending CSM in Washington, D.C. was an amazing experience. I had the opportunity to share my team’s research, chat with leaders in the profession, and meet dozens of potential employers. The energy and passion at the conference was infectious and I left feeling reinvigorated and excited about the future of our profession.” — David Cummins

 

IMG_0712

IMG_0515

DPT students Hannah Clark, Vivian He, Felix Hill, and Erin Lemberger with Dr. Karla Bell, Dr. Melissa Hoffman, and Dr. Nancy Mulligan

“I think that getting to present an educational session at CSM is a fairly rare opportunity, and our team definitely bonded through the intimidating experience of presenting to almost 300 people! In presenting our research on LGBTQ+ related cultural competency, we were also able to identify barriers and build broader awareness of LGBTQ+ issues in our profession. I feel so grateful to our lead researcher, Dr. Melissa Hoffman, for getting me involved in research and making it possible for us all to have this experience!

In addition to the educational session, many members of our research team are involved in PT Proud, an LGBTQIA+ committee in the Health Policy Administration Section of the APTA. As part of that group, we held a membership meeting and happy hour event, which provided a powerful space for LGBTQ+ people and allies in our profession to come together.” — Felix Hill

51221450_2401821396526512_8523294897342513152_n

Pam Soto, a third year DPT student, presented a platform on “The Impact of Leadership Development Curriculum Through the Eyes of the Physical Therapy Student.”

 

51162324_2399835433391775_2582866922336944128_n

Class of 2018 graduate Dr. Amanda Rixey presented on preferred method of feedback after simulation experiences for DPT students.

 

And even more!

This slideshow requires JavaScript.

Leadership Through Service: A Student Perspective

Name: Amber Bolen, Class of 2019 Service Representative

Undergrad: University of Oregon

Hometown: Eugene, OR

Fun Fact: In college I spontaneously gained the ability to wiggle my ears.

Picture1

Hi everyone! My name is Amber and I am the Regis DPT Class of 2019’s Service Representative. Being the service rep for my class means that I work with people and organizations in the community to plan and implement service projects for my class to participate in. I have also had the wonderful opportunity to be Regis’s PT Day of Service Representative for 2017, a title that has now been passed to Austin Adamson, the service rep for Regis’ class of 2020.

The prospect of serving others was one of the main draws for me to attend Regis University’s DPT program. One of the first questions I would ask my prospective schools was “what opportunities do you provide for students to be involved in serving the community?” Regis was by far the most equipped to answer this question. With service learning projects being embedded into almost every semester, domestic and international service opportunities through the Global Health Pathway, and countless opportunities and contacts for students to find more to be involved in, I was hooked.

Picture2.png

Regis DPT Class of 2019 students pose with Denver Parks and Rec employees after working hard mulching trees and raking leaves at Sloan’s Lake Park.

Before beginning my journey as my class’s service rep, I wanted to determine what my fellow classmates were really interested in. Being people who all made the conscious decision to live in Colorado for 2.5 years, outdoor projects were high on the list. In the past, I’ve organized day projects cleaning and keeping up parks surrounding Regis. For example, for PT Day of Service we worked at Berkeley Park to restore the playgrounds, repaint picnic tables, clear trash, and unearth perennial plants.

Another trip involved collaborating with Volunteers for Outdoor Colorado to provide trail restoration work at the Anna Mule Trails near Georgetown, Colorado. The trail restoration project was a weekend endeavor that resulted in sore muscles, a more refined grasp on what goes into creating a trail, great food, and excellent classmate bonding time.

Picture

Regis Class of 2019 students take a break for a photo op while they work on the Anna Mule Trail near Georgetown, CO.

Being the service rep for my class has truly been an honor and I would be remised not to reflect on what I’ve learned in the process. Here are some “pearls of wisdom” I was able to collect:

  • You don’t have to be outgoing to be a student representative, but in my case I did have to be comfortable reaching out to community partners I hadn’t met yet.
  • Sometimes what you think an individual or a community needs is not actually what they need. Our job when providing service is to listen and respond in kindness if we are to do anything tangible.
  • While direct service (working with people face-to-face) is valuable and rewarding, indirect service, such as maintaining community areas, has merits too. I can’t count how many people thanked us during our park clean ups!
  • An act of service does not have to be a huge, momentous task. Small acts of service are appreciated more than we think.
Picture4

Regis Class of 2019 and 2020 students and friends take a group photo in Berkeley Park on PT Day of Service.

The fact that so many Regis DPT students are willing and excited to take part in service projects beyond what is expected by their classes speaks volumes about the type of people that our program attracts. I have never met a group a people, students and faculty alike, that are so committed to doing more for others. Service is so inextricably linked to the curriculum, values, and culture here at Regis that it has become part of who we are. As my classes at Regis come to a close and I am getting precariously close to “real world PT,” I know that the emphasis placed on these values will make us excellent physical therapists. We have learned to be sensitive to the needs of our patients and our communities and understand that physical therapists have a unique position to advocate for and implement change on individual, community, and societal levels. My hope as we all eventually graduate is for us to take everything that we’ve learned and apply it to our own clinical practice. I hope for all of us to listen, ask questions, create connections, and take initiative to make a meaningful impact in the lives of others.

Picture6

Cleaning up trash at Berkeley Park!

Please stay tuned for PT Day of Service this year, happening in early October of this year! Look for announcements from Austin Adamson, the Regis DPT Class of 2020 Service Rep and PT Day of Service rep for 2018! If you have questions about anything involving student service at Regis, please feel free to email me at abolen@regis.edu. In addition, if you have any questions about PT Day of Service 2018, Austin’s email is aadamson001@regis.edu.

 

Regis DPT Students Present: “LGBT+ 101”

 

35896165_2112876905636736_4924859322661339136_o

Taylor Tso, Hannah Clark, Felix Hill (left to right)

Regis University first-year DPT students Felix Hill, Hannah Clark, and Taylor Tso recently held a session for their classmates entitled “LGBT+ 101 for Student Physical Therapists.” The presentation covered foundational terminology and concepts related to LGBTQIA+ communities, a brief overview of LGBT+ healthcare disparities, as well as tips for making clinical spaces more inclusive. Here are some thoughts from the presenters related to key foundational concepts, what motivated them to present on this topic, and what their plans are to expand on this work in the future:

What does LGBTQIA+ stand for?

LGBTQIA+ stands for Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning, Intersex, and Asexual.

 

What is the difference between gender and sex?

Both sex and gender exist on spectrums. A person’s sex is assigned to them at birth based on their genitalia, typically as either male or female. Intersex people are born with a unique combination of sex traits such as hormones, internal sex organs, and chromosomes. Gender involves a complex relationship between our bodies (think biology and societally determined physical masculine and/or feminine attributes), identities (think inherent internal experience), and expressions (think fashion and mannerisms). While gender is commonly thought of as a binary system (men and women, boys and girls), there are people whose identities do not fall within either of these categories exclusively, or even at all. While many people identify with the gender often attributed to the sex they were assigned at birth (cisgender), there are others who do not share this experience (transgender).

 

Does gender identity have anything to do with sexual orientation?

No! You cannot make assumptions concerning someone’s sexual orientation based on the way they express their gender or based on their gender identity. Sexual orientation simply has to do with whom someone is sexually attracted to or not. It also has nothing to do with how sexually active someone is!

 

Why did you feel it was important to present on this topics?

35963663_2112876912303402_6075835142658588672_o

 “In spite of our community’s unique healthcare needs and the stark disparities that affect LGBT+ people’s access to healthcare, typical DPT programs offer little to no education that would prepare you to treat LGBT+ patients. We wanted our cohort to be competent and confident in treating this population.” –Felix

“Felix recognized this need at Regis early on and has been working closely with our faculty to develop more inclusive and comprehensive educational materials. As an ally, I have been honored to work with Felix and other members of PT Proud (the first APTA recognized LGBT+ advocacy group) in this process of educating ourselves and others. I believe that the field of physical therapy can do a better job of caring for LGBT+ patients and I want to be a part of the solution.” –Hannah

 35885864_2112876885636738_6500950945487126528_o.jpg

What do you believe was the main impact of this presentation?

 “Facilitating educational exposure to LGBT+ topics that people may or may not have had knowledge of before. This presentation sparks curiosity and lays down a baseline understanding for healthcare professionals to better their communication, and thus, quality of care for their LGBT+ patients.” –Taylor

Picture3

So you have given this presentation—now what?

 This was just the beginning! Due to negative past experiences and fear of discrimination, many LGBT+ people will go to extremes to delay care. Even if someone has access to health insurance and can afford to come see a PT, which many do not, people are likely to wait until their condition is very serious, which then contributes to poorer outcomes.

We will work to share our knowledge widely throughout the U.S., starting with a presentation at CU in August. But ultimately, workshops are not enough! As board members of PT Proud, the LGBT+ catalyst group in the HPA section of the APTA, we want to ensure that physical therapy professionals across the country receive a basic level of LGBT+ competency training, which will ultimately require changes to DPT and PTA curricula. We will also be working with PT Proud’s Equity task force to influence laws and policies to increase LGBT+ healthcare access.

Felix, Hannah, and Taylor all look forward to the prospect of future presentations.

 

How can I learn more?

Follow PT Proud on Facebook! https://www.facebook.com/PTProud/

Feel free to leave a comment on this post with any questions or thoughts as well!

Mental Health Wellness in DPT School

Name: Abbey Ferguson

IMG_0864

With all of its incredible opportunities, graduate school, especially a doctorate program, also brings a new amount of stress and anxiety. It is a pressure cooker for bringing out both the best and the worst in us, and as my first year came to a close, I found myself drowning in mental illness and anxiety. I realized I wasn’t alone as we embraced vulnerability in our summer Psychosocial Aspects of Health Care class, and many of us found the courage to admit how exhausted we were with life, finding relief in common ground.

IMG_0901

We are literally on a common ground 🙂

Our Psych-Soc. class was one of the many resources I began to take advantage of in order to regain mental wellness. Regis’ counseling center provided free counseling, all of the advisors had their doors open, and with time many of my classmates became close friends as we continually showed support for each other. However, there was still a nagging sense that I couldn’t pursue full wellness in our program without bringing some sort of awareness to mental health issues that permeated our program.

 

When I was 19, I was diagnosed with Anorexia Nervosa. After years of treatment, bouncing in and out of recovery, I arrived at Regis ill-prepared to ward off another relapse. Being in a healthcare field is difficult as an individual trying to fight health and diet culture which often triggers eating disorder behavior. I found myself getting angry with some of the comments people would say or the culture that was fostered in the general population, and I felt helpless.

 

However, thanks to the community at Regis and within our DPT program, I was encouraged to do something about my feelings of anger and helplessness. I began to formulate an education program to advocate for those in recovery from eating disorders, and to educate the program on how to foster a less triggering environment. We had one of Regis’s counselors come and speak about the language health-care providers use and how these words can affect an individual’s perception about themselves. We also had a panel of three second-year DPT students who shared their own experiences recovering from an eating disorder in graduate school.

IMG_1163

I was overwhelmed by the support. As I looked out at the crowd that had showed up to my small education session, I grew misty-eyed and almost cried in front of everyone. My frustration dissipated, and  I was instead filled with pride for the program I am a part of. Fellow students asked questions, attempted to understand, and showed overwhelming empathy as the session continued. After the session, dozens of fellow DPT students came up to me, expressing similar experiences of recovery and wanting to continue the conversation. Weeks later, another DPT student came up to me at our national conference in New Orleans, excited and passionate about the topic and wanting to team up with me to advocate for mental health as well. I found it encouraging and exciting to see like-minded, future health care professionals so interested in becoming more familiar with these issues in order to properly care for individuals plagued by these illnesses.

 

IMG_1020

There is no question: graduate school is hard. It is intense, exhausting, and often times it feels like I am just crawling along. But, I have never been more thankful to be a part of a program that allows its students to own their mental health by advocating and educating the community.

Dry Needling…Not a Type of Craft that Your Grandmother Does

Name: Katherine Koch

Undergrad: The Ohio State University

Hometown: Cleveland, OH

Fun Fact: Last summer, I climbed six 14ers

pic

Dry needlingnot a type of craft that your grandmother does. This type of treatment uses thin filiform needles inserted by a physical therapist into myofascial trigger points, or a tight band of muscle that might be causing pain (1). Dry needling is based on physiological evidence supported by research that is usually part of a broader treatment plan (2). If this needling sounds familiar to you, you’re not alone. Acupuncturists use the same type of needle to adjust the flow of energy, or chi, throughout meridians in the body. Acupuncture is an ancient Chinese medicine and operates based on the belief that these thin needles can relieve tension, stress, and pain when inserted by an acupuncturist (3). While you won’t be getting an itchy sweater from this treatment, it can lead to pain relief for many people. 

However, there is still confusion and debate among physical therapists and acupuncturists concerning the rights and responsibilities of physical therapists in performing dry needling on their patients. This debate of dry needling by physical therapists was recently taken to a Denver district court when the Acupuncture Association of Colorado (AAC) challenged the Colorado State Physical Therapy Board (Board). The AAC claimed that physical therapists had not undergone enough training to perform dry needling and requested the Board reverse the rule that allows physical therapists to practice this method of treatment. The AAC argued that physical therapists only perform 46 hours of training to be certified to practice dry needling, while acupuncturists train for almost 2,000 hours. The association claimed this made dry needling by physical therapists an “unsafe practice of acupuncture” (4). However, this statement is strongly misleading due to the additional 3,400 hours of doctorate level schooling that physical therapists already have behind them before they complete those 46 hours specific to dry needling training. Physical therapists spend three years in graduate school learning how the human body works, what can go wrong with it, and how to fix it within the realm of physical therapy. Additionally, doctors of physical therapy are required to take continuing education courses throughout their careers.

Additionally, the AAC made the claim that dry needling is just a misnomer for acupuncture, while the two are fundamentally different practices. They may look similar to the untrained recipient, but physical therapists and acupuncturists perform their respective treatments with fundamental ideological differences between the two. This is not to say that one is better than the other, and patients may make the informed autonomous decision to receive either or both treatments. However, as the Denver District Court decided, there is no need to prevent members of one profession from performing treatments all together. In December 2017, the court recognized that physical therapists are acting within the Colorado Physical Therapy Practice Act when they perform dry needling.

As the Colorado Chapter of the APTA President Cameron MacDonald put so eloquently,

“this legal debate was brought forth by those who wished to restrict the practice of another profession from their own. This debate could have been about any intervention utilized by physical therapists, and not just dry needling. It is imperative to consider this legal challenge and the lawsuits brought against the Colorado PT Board through the lens of the Colorado consumer of healthcare. Consumers in Colorado are provided access to health care providers which have a defined scope of practice under which to deliver patient care. Health care professionals are expected to provide the best care they can, and to practice under a scope flexible enough to both protect the consumer and not limit the development of practice by health care providers.”

When physical therapists perform dry needling, they are practicing within their professional scope. When acupuncturists perform acupuncture, they are practicing within their professional scope. Both professions can live harmoniously alongside each other while helping patients within their respective realms.

Why does any of this matter? First, any judicial ruling or legislative rule concerning a profession as a whole likely has implications that affect many of its members. In this case, physical therapists that perform dry needling in Colorado were in danger of losing their legal right to treat patients in this way. Further, patients were in danger of losing out on a treatment that can benefit them. To be effective health care providers, it is imperative that physical therapists are informed practitioners in order to best advocate for their profession and best treat their patients. Denying to inform themselves and take positive action does a disservice to future physical therapists and patients who will benefit from the work done to advance the profession today. In order to practice as autonomous providers, physical therapists must continue to advocate for their profession and understand the issues surrounding it. It also stands to reason that since the American Physical Therapy Association participated in this case as an amicus party and presented information that no doubt helped sway the case, physical therapists should support and be members of the organization that advocates for them on this broad level.

This debate is not in Colorado alone; lawsuits in three states have gone the opposite way and the state boards have been forced to remove dry needling provisions from their practice acts.4 Since each state has their own physical therapy act, it is important that the Colorado practice act, which will be revised next year, continues to maintain its inclusive language that provides “for new developments in physical therapy practice, which includes dry needling” (Caplan and Earnest, LLC, personal communication, January 9, 2018). For the good of physical therapists, patients, and the future of physical therapy as a profession, this particular case is closed.


If you are a student physical therapist, like myself, who hopes to perform dry needling as a professional one day or if you simply would like to learn more about its practice, please refer to the references below.

  1. Dry Needling by a Physical Therapist: What You Should Know. American Physical Therapy Association. http://www.moveforwardpt.com/Resources/Detail/dry-needling-by-physical-therapist-what-you-should. Published December 25, 2017. Accessed January 28, 2018.
  2. Gattie E, Cleland JA, Snodgrass S. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;:1-41.
  3. Miller J. Physio Works – Physiotherapy Brisbane. Acupuncture and Dry Needling. https://physioworks.com.au/treatments-1/acupuncture-and-dry-needling. Accessed January 28, 2018.
  4. Migoya D. Acupuncturists sue Colorado’s physical therapy board over the very definition of their craft. The Denver Post. https://www.denverpost.com/2017/04/05/acupuncturists-sue-board/. Published April 7, 2017. Accessed January 28, 2018.

Chris Lew Reflects on Working With 2017 Opus Prize Winner

What is the Opus Prize? 

The Opus Prize is an annual faith-based humanitarian award that is designed to recognize and celebrate those people bringing creative solutions to the world’s most difficult problems. The award partners with Catholic universities, although recipients can be of any faith (Excerpt from Crux.).

Mercy Sister Marilyn Lacey received the Opus Prize from Regis, the host for 2017. Chris Lew, 3rd year Regis DPT student, assisted in her work in Haiti for displaced women and children as an Opus Student Scholar. Here is his reflection about his experience in Haiti, initially published in the Jesuit Journal of Higher Education.

Name: Chris Lew, Class of 2018
Undergrad: University of Portland
Hometown: Eugene, OR
Fun Fact: I have a whistle reminiscent of various fairy tale soundtracks…or so I’m told.

unspecified

Throughout my life I’ve had many opportunities for international travel – from travel abroad to Granada and London, a Fulbright scholarship to Madrid, and a service-learning immersion trip to Nicaragua, I have always considered myself blessed to be able to travel the world, experience different cultures, and see the world from a different perspective. Nevertheless, my time performing a site assessment in Haiti at Mercy Beyond Borders (MBB) for the Opus Prize was a unique and eye-opening experience.

MBB was founded more than 30 years ago by Sister Marilyn with the vision that education, especially of women, is the key to overcoming the widespread corruption and poverty that has consumed Haiti and South Sudan. Through my research of the Opus Prize, I understood this site assessment was different from the typical trip to an underserved community. From the initial interview to the final trip preparations, it was made very clear that the purpose of these trips was not to do; rather, the intention was to be, to see, and to experience. It was this aspect of the Opus Prize that interested me most in the organization and its mission. There is a plethora of groups in developing and underserved areas that perform charity work such as building houses and providing medical goods and services. While this service work provides a certain degree of benefit to the community, I have always been somewhat hesitant of this type of altruism because it generally fails to provide long-term, sustainable change to an underlying societal problem. What happens when the volunteers leave and no one is left to provide the necessary medical services? What happens when a fire destroys a new house and there are no resources to build a new one? This traditional type of charity work seems to be a superficial bandage over a much deeper, wider wound.

This is where Opus is different.

The Opus Prize Foundation emphasizes six values that it seeks in the recipient of the Prize. The one that stands out to me most is Sustainable Change. Rather than focusing on a top-down, government-focused approach to solve global issues, Opus intentionally sponsors and supports organizations directed towards community development and cooperation. Opus understands that the resolution of profound societal problems and corruption is ultimately driven internally, not externally. As such, the Prize acknowledges individuals who are addressing the root of social issues and are striving for change that is pioneered locally.

With this in mind, I embarked on my site assessment trip to Haiti with a very different perspective and intention than my previous international travels. The first stop on our trip was in Ft. Lauderdale, FL , where we met Sr. Marilyn, who lives in California and operates MBB in both Haiti and South Sudan. She introduced us to her story and illuminated details of the work she does with MBB. Her work in Haiti revolves around empowerment and opportunity for girls and women. Extreme poverty and corruption of the educational system prevent most children from obtaining a basic education. Most primary schools are private and, as such, require tuition as well as uniforms and books. Many families cannot afford to send their children to school or can only afford to send one child. In the latter case, most families opt to send boys rather than girls because males typically have greater opportunity for success than females in Haiti. As a result, most girls in Haiti only receive up to a 1st or 2nd grade level education. Sr. Marilyn and MBB attempt to ameliorate this disparity by providing secondary school scholarships, leadership development opportunities, and a safe and supportive living environment for girls who demonstrate academic potential. Additionally, MBB provides vocational and literacy training for young adult mothers and older women to develop skills such as reading, writing, computer skills, and baking. These skills provide women with greater independence and self-sufficiency and can even allow them to earn money through both formal and informal work.

This slideshow requires JavaScript.

The following morning we took a short early morning flight from Ft. Lauderdale and landed in Port-au-Prince, Haiti. The contrast between our departure and arrival city–only a quick two-hour flight apart–was profound. Destitution was apparent on our short drive from the airport out of the city. Litter filled the streets and empty plots of land and stray animals ran largely unmonitored throughout the city. Sr. Marilyn explained that, due to political and financial reasons, much of the rubble from the 2010 earthquake was never adequately disposed of in many of the poorer areas of the capital. As a result, many parts of the city appear recently destroyed even though the earthquake was seven years ago.

Our initial stay in Port-au-Prince was short as our first destination was Gros Morne, about a five-hour drive north of the city. Gros Morne, a town of about 35,000 people, is the community that MBB primarily serves in Haiti. Following the earthquake in 2010, Sr. Marilyn noticed that many relief efforts developed in Port-au-Prince but much fewer resources made their way out of the city and into the more rural parts of the country. She understood that her vision for MBB in Haiti had its limitations and saw the most potential for change in a smaller community.

Our time spent in Gros Morne and the surrounding area was quick but powerful. To gain insight into the MBB’s operations and its community impact, we met with several partners and individuals associated with the organization. We were able to meet several of the girls who are a part of the educational program as well as their families and see the personal impact that MBB has on their lives and their future. We interviewed the principal of a primary school that hosts several of the MBB students; he had high praise for the organization, stating that many, if not all, of the students would be unable to afford their school dues if it wasn’t for the support of MBB. On our final day in Gros Morne we also met with Sr. Jackie, a missionary sister who has worked in Haiti for almost two decades. She provided insight into the corruption in the Haitian political and educational systems. She explained that the private school system is largely unregulated, meaning almost anyone can start a school. This inhibits children from receiving a high-quality education and prevents those students who have the potential to succeed academically from actually achieving success. Overall, these interviews and personal interactions further highlighted the need for an organization like MBB in Haiti.

Sr. Marilyn embodies the spirit of the Opus Prize and models many of the Opus values, including Sustainable Change, Faith, and a Life of Service. She understands that long-term transformation is driven from within, not purely from her work, and this is what directs her vision for MBB. Through empowerment and leadership training of the girls she sponsors, employment opportunities for the local people, and a conscious effort to have Haitian and South Sudanese representation on her Board of Directors, she demonstrates a continued commitment to sustainable change in these countries. A woman humble in both stature and personality, she demonstrates her love and passion for her work in Haiti and South Sudan through her relentless work. I was most impressed by her ability to understand the needs of the communities she works with, while also maintaining a realistic expectation of how many people one person and one organization such as MBB can effectively impact. Although her work may be relatively small in the scope of the vast corruption and poverty in Haiti and South Sudan, her heart is big, and it shines through in both her actions and words.

MBB_2017.JPGMBB_2017-2.JPG

April Recap: National Advocacy Dinner

Name: Grace-Marie Vega, Class of 2019
Undergrad: Arizona State University
Hometown: Placentia, California
Fun Fact: One time, I drove a fire truck.

image1.JPGIf you were there on April 12, 2017, you hardly need me to recount the evening to you, but if you were not, here’s what you missed at this year’s Denver National Advocacy Dinner. First, allow me to set the scene. Room 210 of Claver hall, around dusk. As you walk into the room, you are immediately impressed by the free pizza AND La Croix. You look around and realize you are in the company of well-dressed professionals, esteemed professors, and the most promising physical therapy students in all of North America. You are here partially to avoid yet another night of diligent and thorough studying, but in a truer, more important sense, to get a handle on professional advocacy and how you as a student can become involved.

***

The evening opened with an introduction from Dr. Ira Gorman. “Politics: you can’t ignore it, because it won’t ignore you!” And of course, he is right. Advocacy is inherently and perhaps lamentably inextricable from policy. Dr. Gorman went on to explain that in physical therapy, advocacy happens on different levels: at the level of the patient, the professional, the professional organization, and the healthcare environment as a whole. All of these levels are effected by legislation, and legislation can be effected by you. Dr. Gorman outlined political advocacy in a sequence of steps to follow.

First, you must arm yourself with knowledge. This can mean simply being aware of your professional organization, local government officials, and media you can utilize or connect with. The next step is research. This involves investigation of the issue you’re interested in, typically in the form of reading into the specifics and history of proposed legislation, and knowing a little about allies and opponents of that legislation. Then comes implementation. This means taking political action, possibly in the form of writing letters to or visiting elected officials, getting patient testimony, or connecting with legislative staff. The last step is reflection. Ultimately, healthcare reform will not happen by itself. It is up to you to be part of the creation of a system that best serves you and your patients. Your vote and your participation in democracy absolutely matters.

After Dr. Gorman’s talk, Dr. Hope Yasbin, Federal Affairs Liaison for the Colorado chapter of the APTA, talked to us about her own experiences in advocacy. Dr. Yasmin gave us the run down on a few of the biggest issues currently effecting our profession, including:

  • Repeal of the Medicare Therapy Cap: an arbitrary dollar amount limiting outpatient physical therapy and speech therapy coverage.
  • The PT Workforce Bill: which would incentivize PTs to build careers in underserved areas by offering loan forgiveness.
  • The SAFE PLAY Act: which sets up school districts with concussion education for young athletes.
  • The #ChoosePT campaign: an initiative to combat the prescription opioid epidemic.

If you would like more information on any of these topics, you might consider checking out the APTA action center webpage, and downloading the APTA Action app.

Following Dr. Yasmin was Regis’ own Ryan Tollis, a second year student and government affairs committee member. Ryan was chosen to attend this year’s Federal Advocacy Forum, a 2-day adventure/visit to Washington DC during which students, physical therapists, and lobbyists represent our profession and meet with elected officials. By Ryan’s account, it was a whirlwind of networking, briefing, and nonstop political action. Attending events like this is an awesome way to get involved, but there are other ways too.  You can:

To wrap up what was, by all accounts, a thoroughly informative and enjoyable evening, Dr. Cameron MacDonald reminded us that advocacy that best serves the public is when professionals in every field are practicing at the top of their scope. It is our right and duty to be bold in the development of our profession, and to take ownership of the skills we work hard to learn in order to offer the best service we can to our patients. In summation, physical therapy has grown to be what it is today due to the efforts of our professional organization, and the advocacy of many therapists before us. The future of our profession will depend on the work we do to advance it.

***

By the end of the evening, you are very satisfied with the food (obviously), but even more so with yourself, for leaving as a more informed person than you were when you arrived. You tell yourself you will definitely be coming back next year, and you will be bringing all your friends.

Thanks to everyone who attended!

Special thanks to:

Speakers: Dr. Ira Gorman, Dr. Cameron MacDonald, and Dr. Hope Yasbin

Coordinators: Carol Passarelli and Ryan Tollis

Team: Kiki Anderton, Brianna Henggeler, Rachel Maass, Katie Ragle, Grace-Marie Vega

Funding: Dave Law and the Graduate Student Council, Dr. Mark Reinking and the Regis School of Physical Therapy

IMG_1304.jpeg

Denver National Advocacy Dinner: April 12th

Mark your calendars!  Whether you just got into PT/PTA school or have been practicing for 20 years, we invite you to come to Regis University for a free dinner and discussion about current legislation that is pertinent to our profession.

StudentAdvocacyDinner2017_800x343

Become an advocate and learn how get more involved with the APTA. RSVP on the Facebook event.

WHEN: Wednesday, April 12th from 6:30pm-8:30pm

WHERE: 210 Claver Hall at Regis University

WHY: Be part of the future of the PT profession!

Want more details? Read all about last year’s event here.

Screen Shot 2017-03-16 at 2.07.16 PM.png

Mmmm…did someone say FREE PIZZA? Zuma, our service puppy in training, is excited for the Denver National Advocacy Dinner! Yum.

 

The Best Loss I’ve Ever Had

Blogger Katie Ragle, Class of 2018, writes about her experience at the National Student Conclave held in Miami, Florida over the October 27-29th weekend.  

DSC_0004

Let me tell you about my trip to Miami.

It all started with an email from a fellow Regis student that read, “Hey Katie! I just tagged you in a Twitter post about the Student Assembly Board of Directors. Take a look at the application :). Deadline 7/1.” This began my journey into a passion for the APTA. But first, a history lesson:

If you are a PT or PTA student and an APTA member, then you are in the Student Assembly. There are around 29,000 of us, and we’re all led by a board of 10 people—the Student Assembly Board of Directors (SABoD). This board is comprised of positions such as president, vice president, and other director positions that help to make the student APTA experience a great one.

aptayay.png

That aforementioned email referred to the Director of Communications position on the SABoD. This person creates content to engage the Student Assembly through emails, social media, and videos. You may not realize it, but you receive emails from the Director of Communications on a regular basis.

As a broadcasting major with a minor in editing and publishing, this position was right up my alley. After I was encouraged to apply, I decided that I wanted this position to get more involved in the APTA and to use my talents to further the profession of physical therapy by engaging students from across the county.

After an application and a Skype interview, I was chosen to run alongside three other candidates for the Director of Communications. The election occurs every year at the National Student Conclave (NSC), which is the annual national APTA meeting that is just for students. Two weeks ago, I packed my suitcase and headed to Miami for the final election.

katie1.png

The Regis representation at NSC.  I’m so glad they were there!

I arrived in Miami with nearly 1,000 PT and PTA students from around the country who gathered to learn how to be better practitioners and how to advocate for our profession. I was immediately blown away by the amount of enthusiasm and support for our field. Everyone eagerly engaged in meaningful conversations about their program and what they’re doing for the field of PT. Rather than simply clustering together with individuals from their schools, people branched out and met students from around the country. The excitement was palpable!

katie2

These are the incredible candidates I got to interact with all weekend.

Little did I know that I would receive a ribbon that read “Candidate” all weekend so that people could ask me about my slated position. I had the opportunity to meet so many amazing people in my field! These people inspired me to not only be the best PT that I can be, but also to advocate for our profession and to represent it well. The speakers empowered us with knowledge in entertaining ways and generated passion for the field.

katie3

This is one of my new friends, Alicia from MA

But more than passively attending, I got to actively participate in the conference. I participated in focus groups on how to make communication within the APTA better. I introduced a few speakers before their talks, and I met with the leaders of the Student Assembly to discuss the future of the organization. I also got to meet the president of the APTA, Dr. Sharon Dunn. She held an open Q&A for students to ask her any questions they had. She is both incredibly intelligent and personable. The APTA is fortunate to have her!

katie5

APTA President, Dr. Sharon Dunn, gave all of us candidates a pep talk.

Did I win the election? No. Am I upset? Absolutely not. I wouldn’t trade my experience at NSC for anything. I made connections that will last a lifetime. This conference opened doors that I otherwise would have never been able to encounter. I still receive emails and messages from other students and professionals asking to keep in touch and encouraging future connection at upcoming APTA events. Best of all, NSC lit a fire within me for my future profession and for the organization that represents us so well.

katie6.png

This is the amazing group of individuals with whom I ran for Director of Communications.  The one standing next to me (second from the left) was elected to the position.  His name is Cruz, and he will do great things for the Student Assembly!

In a future post, I will share some of the tips I learned at NSC about how to get plugged into the APTA;  for now, think about attending NSC 2017. It’s in Portland, Oregon, so how can you turn it down? You won’t regret it. We are the future of PT. Let’s be the best that we can be!

aptayay2.pngFollow NSC’s twitter to start counting down to next year!

Student Involvement in the Colorado APTA

The faculty at Regis strongly encourages leadership from its students because it knows that those who care enough to be the change they want to see move our profession forward. Rest assured that over the course of your time at Regis there are many opportunities, both formal and informal, to either try leadership for the first time or to grow your current skillset. One of those ways is to become involved in the Student Special Interest Group for the Colorado Chapter of the American Physical Therapy Association, (CO APTA sSIG for short).

I am the current 2016-2017 Chair of the CO APTA sSIG and a third year student in the Regis DPT program, and I would like to say something to those of you considering if the Regis DPT program is right for you, to the first years are who are about to embark on their first semester, and to the second years about to experience their first clinical rotation: you can do more than you think you can.

Running for a position on the CO APTA sSIG is an amazing way to broaden your perspective on what students of Physical Therapy, both Student Physical Therapists and Student Physical Therapist Assistants, are all about. The current board has 10 positions (http://coloradophysicaltherapists.org/student-sig/), and this year we are focusing on the following areas:

  • Creating a framework-for-action for the 2017-2018 sSIG
  • Growing student involvement with the APTA across the state through education and outreach
  • Building networking opportunities amongst students as well as between students and current professionals
  • Advocating for student issues at the state and federal level
  • Fundraising

With growing communication between APTA sSIGs across the nation, this is an exciting time to be involved. Aligning the sSIG with the CO APTA Chapter’s strategic plan provides a built in way to move forward, but there is plenty of room to grow new projects.

In the spring of 2017, we will be holding elections for the 2017-2018 CO APTA sSIG board. If you are interested in pushing yourself a little further, I encourage you to run for office, to use this as an opportunity to broaden your perspective beyond the next exam, and to begin shaping the future as a leader.

 

Engelsgjerd-Headshot

Blogger: Adam Engelsgjerd

 

 

Physical Therapy Classification and Payment System: a Discussion with Lindsay Still

 

katie1

Blogger: Katie Baratta

My name is Katie Baratta and I just graduated from the Regis University School of Physical Therapy. I had the opportunity to spend two weeks at the APTA doing a student internship. I was able to talk to many different members of the APTA, attend the Federal Advocacy Forum, and learn more about what the APTA has been doing to move our profession forward. I’ve written a series of essays about my experiences here at the Association.

Interview with Lindsay Still, Senior Payment Specialist

lindsaystill

I talked with Lindsay Still, a Senior Payment Specialist, and she explained the current state of the PTCPS.  Read a summary of our interview below!

Overview

The Physical Therapy Classification and Payment System (PTCPS) is an ongoing initiative that was developed as an alternative to the current, fee-for-service codes—ones that easily fail to capture the true value of what PTs do—and instead particularly account for the complexity and skill of clinical expertise required for patients with more involved presentations. It also incorporates the use of standardized outcome measures. PTCPS would include a single CPT (Current Procedural Technology) code for the entire treatment session versus the assortment of 15-minute unit codes that we’re used to today.

The system has gone through multiple iterations in the past several years, and was developed by the APTA in collaboration with a specialty work group within the AMA (American Medical Association) involving members from the professional organizations of OTs, massage therapists, athletic trainers, speech-language pathologists, chiropractors, psychologists, optometrists, podiatrists, physiatrists, neurologists, orthopedic surgeons, osteopathic physicians, and representatives of CMS (Centers for Medicare & Medicaid Services).

Structure of the new coding system

Under the new system, there would be three new evaluation codes that puts a patient into an initial category of lower, moderate, or higher complexity. Certain documentation criteria (e.g. under patient history, presentation, or plan of care) would determine which of the three eval codes you would select. For example, the number of comorbidities for a given patient would play a role in the eval code selection. There would also be a single code for any re-eval visit.

As currently structured, the proposed PTCPS would also incorporate five treatment codes, based on the overall complexity of the patient’s presentation and treatments. These codes, much like our current CPT code for evals (97001 Physical Therapy Evaluation), would not have a set time frame or number of units associated with it. However, treatment billed under the lowest complexity code would likely be much shorter than a treatment session under the highest complexity code, and the reimbursements would reflect this fact.

Implementation

In 2014, pilot testing of the new system was performed with PTs using the new system to code/bill for hypothetical patients, as well as using the new system to code the treatments of actual patients previously coded with the existing system. This testing occurred in various care settings. Overall, the clinicians were very consistent in their ability to categorize patients with the new initial eval codes. However, for the intervention codes, the pilot clinicians were only able to consistently categorize those patients with the least complex and most complex presentations. There was significant disagreement between PTs in regards to cases that fell within the different “moderate” treatment categories.

The definitions and valuation of the proposed eval codes were reviewed and approved by the RUC (Relative Value Scale Update Committee) and will now require CMS approval. Lindsay is hopeful that CMS will accept the new eval codes, as they will be budget-neutral. In August of 2016, CMS will release the 2017 Medicare Physician Fee Schedule Final Rule; this should include the new PT evaluation and reevaluation codes. The new codes will go live on January 1, 2017. PTs will have three brand-new CPT codes to replace the current 97001 Physical Therapy Evaluation. The APTA will provide training and support to clinicians during the time leading up to the release of the new eval codes.

Impediments to the impending treatment code change

The new treatment codes will require further review and refinement, given their inconsistency of use during the pilot testing. This will likely be an interactive process, and not without controversy from the perspective of payers (insurance companies). In the meantime, the RUC has requested a “backup plan” to address ten CPT codes commonly used by PTs which have been identified as “potentially misvalued codes,” most of which PTs probably use frequently:

  • 97032 attended electrical stimulation
  • 97035 ultrasound
  • 97110 therapeutic exercise
  • 97112 neuromuscular reeducation
  • 97113 aquatic therapy with therapeutic exercise
  • 97116 gait training
  • 97140 manual therapy
  • 97530 therapeutic activities
  • 97535 self care home management training
  • G0283 unattended electrical stimulation (non-wound)

These codes are flagged  because they represent a high reimbursement rate and have not been assessed since 1994.

As a result, the APTA is currently redirecting efforts to provide replacements to those 10 codes rather than waiting for the codes to be reevaluated for us. The new treatment codes the APTA envisions to replace them with would be procedure-based: you would still bill in 15-minute increments. However, they would be streamlined; there would be fewer codes, and the codes would reflect the types of treatment PTs currently perform in practice (as opposed to focusing on what treatments PTs may have historically performed).

Future of the proposed treatment codes

The more general patient- and value-based treatment codes initially envisioned by the APTA are still in the works, but Lindsay foresees a longer process before fruition: it will require all parties to agree on a coding system that accurately and cost-effectively describes the type of treatments that PTs perform for patients. This includes the third-party payers who generally prefer the current setup of treatment codes based on billable units. The current coding system is easy to monitor for abuse or overuse of treatments.

I asked Lindsay if she saw outcome measures as one way of giving insurance companies some power to track the value of treatments under the proposed system. While they wouldn’t be able to screen specific procedures in the same way that they are able to under the current system, they would be able to, for example, monitor whether the progress of a “low complexity” patient was lagging behind what would be expected given that patient’s presentation.

She agreed that this could work in theory, but felt that we still have a long way to go in terms of standardization of outcome data across the spectrum of patient presentation. This is one of the reasons the PT Outcomes Registry will be so important! These two issues truly are intertwined in the future of value-based billing for PT services.

For more information, visit: http://www.apta.org/PTCPS and check out the Timeline for payment reform.