Physical Therapy during COVID-19: reflections from Regis DPT Faculty

Regis DPT faculty Alicia Lovato, Amy Rich, and Jenny Logan share their experiences practicing during COVID-19 in both home health and inpatient settings.

Thank you so much for your tremendous service, your mentorship, and your vulnerability in sharing your experiences. We miss seeing you in person so much and are so proud to call you our faculty and mentors.

~Alicia Lovato, DPT, North Rehab Lead, SCL Home Health~

This Pandemic… Has established fierce leaders

  • Has brought valid fear and anxiety.
  • Has demonstrated the strength and resilience of our team.
  • Has excelled our Telehealth innovations.
  • Has promoted critical thinking on how to keep our Home Health clinicians and patients safe (have to get creative when you don’t have that lovely PPE bin set up for you in the hospital hallway). 
  • Has increased my knowledge and awareness of how to treat patients diagnosed with COVID.
  • Has taken its toll emotionally and taken me outside of my comfort zone.
  • Has made me so grateful for my health and ability to work.
  • Has amplified my fierceness for this profession.
  • Has reminded me to have compassion for myself and others.

I miss seeing all of your faces at Regis. I can’t imagine the feelings and emotions that this has brought up in your education and personal life. Like good ole Dolly Parton said, “Storms make trees take deeper roots.”  Hopefully by the end of this we will be like Wild Fig Trees (per Google search these tree roots can dig down 400ft!). 

 

Working as an inpatient acute care physical therapist during COVID-19: A perspective

~Amy J. Rich, PT, DPT, NCS, Senior PT, University of Colorado Health~

*this opinion reflects the perspective of the individual and not necessarily that of the organization*

It’s 11:15am and I’m getting ready to call into my daily COVID-19 phone call from the rehabilitation team leadership in order to get updated on daily changes and progress, personal protective equipment updates and the number of patients in house who have tested positive for COVID-19.  While I await to virtually connect into our meeting, I reflect on 5 words that seem to define my experience of watching COVID-19 flip all perspectives within my healthcare institution upside-down:  Anxiety, Grief, Compassion, Empathy and Innovation. Never in my 20 years of practicing in the hospital and ICU setting have I seen such circumstances as I have now due to COVID-19.  One vivid memory I will recall is working the Sunday after our Governor instituted a “stay at home” policy due to the Coronavirus.  It was such an odd sensation to be driving TO work in an environment where patients were positively infected with COVID-19 while the rest of the community stayed home.  I entered the hospital donning my newly mandated mask, keeping my head down, noting that the hallways were eerily silent.  Just a few days before, the hospital had mandated a “no visitor” policy in an effort to protect the safety of our patients.  This invisible virus, over the span of a few weeks, progressively took away our outpatient clinic visits, our non-emergent surgical procedures, our visitors, our administrative assistants and our cafeteria workers among others.  The hospital went from a bustling “city” of people and procedures and socialization to a quiet empty space where essential healthcare workers, with masks on at all times, prepared for the surge.  The surge of the virus bringing the sickest of the sick to our doorstep. 

During this time, my perspective was of an environment filled with anxiety and fear of the unknown mixed with a strength and courage to combat the COVID-19 virus.  It is difficult to feel calm when everyone around you is wiping all surfaces with cavi-wipes, keeping a 6-10 foot distance from one another and wearing masks at all times.  It is an odd feeling to practice social distancing with your peers, but then walk into a patient’s room to perform a max assist transfer with them to enable them to get out of bed to a chair.

As the days progressed and the rules for social distancing tightened, I felt a bit of grief surround our hospital community. Grief over losing our “normal,” grief over watching family members have to say their goodbyes and stay at home instead of by their loved one’s bedside, grief over watching our bustling hospital community slowly become quieter as we prepared for the surge.

But in the midst of this extreme fatigue and anxiety and grief, I also saw signs of hope.  Leadership gave constant reminders to show compassion for our patients and advocate on their behalf to their family members and compassion for ourselves during this time.  One such memory is facilitating ambulation for the first time with a patient who had a severe traumatic brain injury.  His wife had been at his bedside every day up until the moment she was asked to stay home due to COVID-19.  She needed to be a part of this milestone of walking.  As I prepared the patient for ambulation, the nurse was able to facetime his wife via iPad.  While this patient would not look up and out from under his helmet for myself or the nurse, he was able to stand upright, attend to task, and take steps under the encouragement of his wife from the iPad shown in front of him.  Another bright spot of hope is the unimaginable outpouring of support from within our organization and from our community.  We have had offers for home-made masks and food, free access to meditation smart phone applications and even free coffee!  Peers are offering to donate vacation pay and individuals without work can apply to be placed in a resource management pool in order to earn a paycheck during this stressful time. 

From an inpatient rehabilitation perspective, I feel this COVID-19 virus has bound my rehabilitation team in a way I could never have anticipated.  As the COVID-19 surge preparation began, our rehabilitation team leadership asked for volunteers to be on the COVID-19 “A” team.  These are the physical therapists, occupational therapists and speech language pathologists that have volunteered to step INTO the rooms to provide essential health care for patients with COVID-19. These therapists are working with these patients providing essential rehabilitation in order to maximize functional outcomes while also reducing the risk of their colleagues being exposed to this virus.  This self-less act has put me in awe of my team members.

The innovation seen during these times is also amazing.  For example, I was able to provide PT intervention for a patient intubated via endotrach to a BiPAP machine!  This innovation brought forth by an interprofessional team of physicians, nurses and respiratory therapists allowed for appropriate ventilation for the patient while saving a mechanical ventilator for those that have no other option.

Through the leadership of our Inpatient Rehabilitation Educator and fellow Regis graduate, Jennifer Gunlikson, the rehabilitation staff received constant and pertinent information along with a platform to be innovative.  Her efforts in combination with our entire organization’s leadership has kept us informed, safe and calm.  One of the greatest pieces of education was for all patient care employees to understand how and which personal protective equipment should be used with patients who have COVID-19 and for patients who need to be protected from the virus.  As information brought forth by the CDC was ever-changing, so was our education.  Detailed information frequently and in various platforms was provided so that use of PPE was safe, effective, and efficient.

As a rehabilitation team, we banded together to make innovative discharge plans and identify key needs for ongoing education surrounding the COVID-19 virus.  We came together as a team to facilitate quick and safe discharge plans for patients who were not positive with COVID-19 in order to get them out of the hospital.  We increased treatment times and frequencies, we increased family training (including virtual training over iPad and smart phones) in order to maximize function and facilitate a safe discharge out of the hospital.  We also came together to share our individual expertise to the rehabilitation team, providing increased mentoring of therapists for practice in the ICU and increased training on mechanical ventilators and respiratory equipment.  With collaboration from our community Doctor of Physical Therapy programs at Regis University and the University of Colorado, we were able to develop a training video on respiratory pathology and common interventions to maximize ventilation and mobilize secretions.

The battle to contain COVID-19 and care for our patients is not yet complete, and the future is still uncertain.   We will continue to feel anxiety, grief, compassion, empathy and innovation as we navigate these unexpected times.  But in the meantime, we hope we have flattened the curve, we are prepared, we are strong and we will overcome.

 

A Day in the Life of a PT Treating Patients with COVID-19: true stories from the front lines

~Jenny Logan, PT, DPT, NCS, Senior PT, University of Colorado Hospital~

I park my car in the parking lot of the University of Colorado Hospital and begin my walk into the hospital. I pass night shifters leaving the hospital still wearing a mask. I momentarily feel exposed and naked without a mask. I head to the small office that the COVID therapy team has been relegated to in order to decrease exposure. I grab my surgical mask and begin to chart review.

Patient A (55 y/o male, no past medical history, anesthesiologist), day 29 of hospital stay, 21 days in ICU, mechanically ventilated x 18 days. Per chart, patient is medically ready to discharge when cleared by PT.

Patient B (26 y/o male, no past medical history) 34 days in the ICU, 31 days on mechanical ventilation, decannulated from ECMO 6 days ago, extubated yesterday

Patient C (37 y/o female, history of HTN, DM, obesity, Spanish speaking, undocumented, no insurance), 27 days in ICU, trach placed five days ago, still mechanically ventilated. Decannulated from ECMO 10 days ago.

Patient D (65 y/o female, no past medical history, Spanish speaking, undocumented, no insurance), 18 days in the ICU, still mechanically ventilated x 15 days.

Patient E (39 y/o male, no past medical history), hospital stay x 32 days, mechanical ventilation x 28 days, trach placed 7 days ago.

Patient F (53 year old male, no past medical history, Spanish speaking, undocumented, no insurance). 37 days in ICU, trach placed 4 days ago. PEA arrest x 3.

 Patient G (45 y/o female, history of HTN and obesity), 18 days in ICU, 12 days on mechanical ventilation.

I grab my N-95 mask that was reprocessed yesterday using UV light. Is it really still effective? I can’t think about this too much. I have work to do.

I head to see my first patient, Patient A. I don my N-95 mask, yellow gown, gloves and face shield. Immediately my nose begins to itch. Why does this always happen the moment I put on my mask?

The patient is sitting in bed, chatting on his phone but immediately hangs up when he realizes that I am from PT. I assist him to ambulate in the room without a walker. He is very unsteady on his feet and but he only loses his balance twice which is an improvement from yesterday. He can only tolerate 30’ to the door and back twice before needing a rest break. Despite his shortness of breath, his SpO2 remains above 90% on room air. I ask if we can call his wife to discuss discharge planning. Once she is on the phone, I explain that her husband is ready to discharge home today. She begins to cry tears of joy. It has been 29 days since they have seen each other. I explain that he will need to quarantine himself at home for 14 days to avoid exposure to his family. This means that we will need to send him home with a walker because he cannot walk safely or independently without it. Neither seems bothered by this despite the fact that he was working as an anesthesiologist prior to contracting COVID and was an avid cyclist and skier. I also explain that she will need to assist with his medications at home. This is for a man who managed medications for a living but now has cognitive impairments that will prevent him from doing this safely on his own. I review the home exercise program that I have created for him and provide a few TheraBands. He will likely be unable to receive home health PT as he has yet to test negative for COVID. I exit and wish him well at home. “Thank you for everything you have done for me,” he says.

I head to the Neuro ICU, which has been transformed into a COVID ICU. I catch a nurse as she heads from one room to the next.

“How is Patient B doing this morning? Stable after extubation? Can I work with him?” I say. Yes, please, says the nurse as she rushes into her next room where the patient is crashing.

The patient is drowsy but wakes easily when I say his name. I introduce myself and explain that I am here to help him get moving. His eyes widen and he whispers, barely audible, “ok.” His voice is very weak likely due to the amount of time spent on a ventilator. I administer a CAM-ICU, which is positive for ICU delirium. He does not know why he is in the hospital and he thinks that the date is in April. He was admitted in April but it is now May. He looks shocked when I tell him the date and that he is in the hospital for coronavirus. I explain that he has been very sick in the ICU for weeks and on many medications that have made him lose track of time and forget everything that has happened to him. I ask him to raise his arms and he can barely lift them past 30 degrees of shoulder flexion. He cannot lift his legs off the bed in a straight leg raise. I help him move to the edge of the bed with maximal assist. He feels very dizzy. His blood pressure drops initially but stabilizes quickly. He seems to have forgotten how to use his arms to help support him while sitting on the edge of bed. After several minutes, he finds his equilibrium and can sit up with only a minimal amount of assist. He whispers, “This is so cool.”

Periodically someone knocks on the glass door and gives a thumbs up. It is a question. Am I doing ok in the room? Do I need anything? Usually the answer is no. I’ve got this. This is what I do – working in an ICU to help patients regain function. But it’s nice to know that I am part of a team that has my back and is working to help each other.

I move on to the next patient, Patient C, who I have been working with for a few weeks. “Do you want to try standing today?” She vigorously nods her head. She can’t talk because she has a tracheostomy but she can write. She writes that she has been waiting for me all day because she can’t stand being in the bed any longer. She also writes that she feels sad today. She misses her family and really wants to talk to them, especially her sister. I tell her that her sister went to rehab today (her sister also has COVID and our rehab has been to converted to a COVID only rehab) so maybe we can try to arrange a Face Time session later. She needs less help to sit up at the edge of the bed today. With help from me and the nurse, she stands but can only stand for ~ 30 seconds. She sits back down and looks frustrated. “Why can’t I walk?” she writes. I try to explain that she has been in the hospital and very sick for weeks. It has made her muscles very weak and her lungs unable to provide enough oxygen to her body. She will have to re-learn how to do just about everything.

As I walk down the hall to take a short break (ie remove my mask, breath some fresh air, scratch the itch I’ve had on my nose for hours), a physician assistant stops me. “We would really like for you to work with this patient because we think she is too weak to wean off the ventilator.” Roger that. Mask back on, no time to rest. This patient, Patient D, is on spontaneous settings on the ventilator, meaning that she is doing all of the work to breath on her own. Her respiratory rate is high so I cue her to breathe deeply and slowly. I show her the numbers on the telemetry monitor as visual feedback and she is able to slow her respiratory rate. I assist her to the edge of bed just as her medical team walks by. They wave at her through the glass and she waves back. After the session as I leave the room, the respiratory therapist tells me that the team was so impressed with how she did while mobilizing that they are going to extubate her today. “Yesssssss!” I think to myself.

I meet up with my OT colleague to see our next patient together, Patient E. He is too deconditioned to tolerate two separate sessions. He is awake but fidgety. I walk in and remind him who I am. He says, “Hey, how are you?” He has a speaking valve over his trach and I am hearing his voice for the first time in a week. “It’s so good to hear your voice,” I say. “Can I have a diet coke?” he asks. I explain that he has not yet been cleared to swallow by the speech therapist because his muscles for swallowing are weak just like the rest of his body. Once sitting at the edge of the bed, he asks again “Can I have a diet coke?” I explain again why this is not yet possible. OT and I assist him to stand and pivot onto the bedside commode. After he catches his breath, “Can I have a diet coke?” We stand and pivot into a chair. “Can I have a diet coke? Please let me have a diet coke. Can I talk to the diet coke boss?” I assure him that I will speak to the diet coke boss (ie SLP) when we are finished. Outside of the room, I say to OT, “He really presents like someone with an anoxic brain injury – so perseverative and unable to remember from one minute to the next.”  “Yeah, that’s tough. He’s so young,” she says.

As I gear up to head into my next patient’s room, someone walking by yells that the neighbor is disconnected from the ventilator. I already have on PPE so I go in. The patient has self-extubated and I suddenly find myself alone in a code-like situation. I scramble for the ambu bag and begin giving breaths to the patient manually. It takes a few minutes for nurses and doctors to get all of their PPE on. Once in the room, they take charge. The patient’s oxygen saturation is dropping quickly so I help to restrain the patient while the physicians quickly and expertly re-intubate him.

After my tachycardia subsides, I decide it is time for a break. I grab food that someone has donated to the hospital. Once back in the office, my OT colleague on rehab tells me “Remember that patient you worked with that had a brachial plexus injury from poor positioning in prone? She is getting some return in her arm and is now walking.”  “What?!? That’s awesome!” I say. “ I’m so happy she is making such good progress. She was a hot mess when I evaluated her in the ICU.”

I check in with the nurse for my next patient, Patient F. “I don’t know,” she says. “He has been really agitated and tried to pull out his trach a little while ago. But I guess you can try.” As I walk in, the patient is restless and attempting to get out of bed. I calmly begin speaking to him in Spanish, reminding him where he is and why he’s here. His body begins to relax a bit. His sheets still have bloodstains from when he tried to pull out his trach earlier today. I help him move to the edge of the bed and he is suddenly very calm. I notice photos of his family in the room so I bring them over and we talk about his family. I don’t recognize the patient from the photos as he has lost at least 50lbs from his time in the hospital. Like so many others, he has been in the ICU for weeks, most of that time on a ventilator with a trickle of nutrition going into his stomach from a tube in his nose. Today he takes his first steps. He is like a newborn learning to walk again, feet too narrow and then too wide, hands holding him up on either side. After the session the patient is calm in bed, his agitation having ceased. The nurse is amazed and grateful.

My final patient of the day, Patient G, is a nurse who works at a rehab facility. She has a gentle southern drawl and a great sense of humor. Her arms are so weak that she cannot bring her hand to scratch her face or feed herself or hold her phone to talk to her family. Her sister calls while I’m in the room and I hold the phone to her ear so she can talk to her. She is able to stand for the first time today with the Sara Stedy. She does a little shimmy while standing because she is so excited. We laugh. It feels good to laugh.

At the end of the day, back in my car, I breathe a sigh of relief. It’s been another good day of work but I’m exhausted. As I drive away, I see signs saying “Thank you healthcare workers.” I feel grateful to have chosen a career that allows me to fight this pandemic from the front lines, giving the gift of function back to my patients.

 

 

Hey Class of 2022, Why Regis?

Interviews are right around the corner for prospective Regis DPT students, and current students and faculty could not be more excited to welcome them to our campus. We wanted to take the opportunity to reflect on just a few of the myriad of diverse reasons that our current students chose Regis. Some first-year students reflected on the major choice they made just one year ago. Radiating themes that seem to have drawn the class in include: obvious inclusiveness within the program, a unique emphasis on service to others, seemingly endless opportunities, and adventure in the beautiful state of Colorado. Meet some of our amazing students!

Brittney Galli

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Hey all! My name is Brittney, I am a Colorado native who knew I would miss the mountains WAY too much if I chose to attend grad school in another state. Luckily for me, Regis University offers one of the best DPT programs in the country complete with 3-4 different clinical opportunities, hands-on lab experiences, and a variety of different ways to get more involved in the community.  The core Jesuit values that Regis embodies really emphasize inclusiveness, justice, teamwork, and the importance of making the world a better place: these are all concepts that I hold dear to my heart, so I knew that Regis was exactly where I was meant to be.
I had a wonderful yet somewhat unique experience applying to Regis: I actually applied a total of THREE times before being accepted into the program. Throughout my journey, I had immense support from the admissions office on how to improve my application and set myself apart from other interviewees: with an excellent program comes an extremely competitive pool of applicants, so I kept improving and growing so that one day I would be among those accepted into the program.
All of the hard work and perseverance was COMPLETELY worth it: I am finally a member of the Regis DPT family and I would not want to be anywhere else! This program provides you all the support and tools you will need to succeed in whatever avenue you choose to pursue through a variety of intriguing coursework and a faculty who cares deeply about each and every individual in the program. Every day I am so excited to go to class and learn about how to become the best DPT I can possibly be all while still growing and improving as an individual. And in my spare time I am of course taking in all the beauty that Colorado has to offer.
Arianna Amendariz
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The interview process at Regis was my main drive to pursue my education here. The current students, faculty, and staff were all very welcoming and reassuring as to why we made it as far as we did–we all had the passion and desire to foster a positive difference in the community through physical therapy. The classes and professors continue to fuel that ambition every day.
Lena Parker 
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My name is Lena Parker and I am a first year SPT at Regis. My reason for choosing Regis University to receive my DPT degree is due to their strong value system. The Jesuit values of Regis University include cura personalis, doing more for others, and embracing a holistic approach. I had interviews at other schools that did not have an organized value system, and it absolutely made Regis stand out.
I was concerned at first because I am not a Jesuit, nor  have I ever practiced the Catholic faith. I was born and raised as a Shinnyo Buddhist. However, as I learned more about the Jesuit values, I found that they are broad and universal. Despite using language such as “God”, I could still deeply relate to and apply the Jesuit ideals. Another concern of mine was that the values were a facade and were not actually practiced by faculty and staff. During my first semester, I was relieved to see that the faculty regularly support the Jesuit values, without preaching them. I always feel supported physically and emotionally by the faculty. They emphasize community service as much as possible. We are always reflecting on our experiences to ensure that we as students can support ourselves, and therefore support our future patients.
Regis University is very accepting of people of all denominations, faiths, or lack of faith. I believe that these values are providing me with a unique and wholesome experience and shows that the school is not just trying to produce more robotic physical therapists. Regis truly cares about its students, and I am extremely glad that I chose this school to pursue my career goals.
Peter Lee 
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Regis stood out to me in my choices of DPT programs because I felt like Regis actively wanted me to be a part of their program. The general lack of responsiveness from programs during the application process can be discouraging, but Regis obviously placed value on their prospective students.
As an immigrant who came from a place that received assistance from all around the World in times of need, global health is important to me. I hope to one day be a patient-centered therapist who empowers diverse communities. Regis’s Global Health Pathway allows me to practice and serve with a global perspective; it played a big role in my decision to enroll.
Suzanne Peters
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I am an incredibly indecisive person. Therefore, I am thankful that Regis stood out so far above the other schools I was applying to, making this major life decision so easy. The highlights for me during my interview process included the abundance of opportunities and the personable attitudes of the students and staff on interview day and throughout my admissions process.
Opportunities at Regis include, but are by no means limited to, service learning, the Global Health Pathway, and many student government roles. Last year, I felt like I could see myself being apart of this intricate network of roles and growing opportunities. A year later, it has become a reality and I am so thankful! Anyone who is excited to be challenged and grow as a person, student, and a future clinician should pursue Regis.
Additionally, my personality meshed well with Regis students almost immediately both at interview day and a year later when I stepped into Claver Hall for the first time as an official student. The attitude here is friendly, helpful, and upbeat. I have found that the way the current students and staff interacted with us on interview day was direct and genuine, which to me is extremely important and reflective of the character here. Both the staff and students are true to themselves.
Lastly, you cannot beat this location! I am from the Midwest and have loved my move to Denver. It is so great to get out to the mountains every weekend and recharge. There are many new hobbies to explore here and there always seems to be a classmate who is an expert and is ready to help you learn. That’s why Regis!
@regis_dpt

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

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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?!!
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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”

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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.

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

Regis DPT Students Present: “LGBT+ 101”

 

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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?

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 “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

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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

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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!

How Can the APTA Help Me?

Name: Lina Kleinschmidt

Undergrad: Pacific University

Hometown: Stuttgart, Germany

Fun fact: I was born and raised in Stuttgart, Germany

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As a physical therapy student and future physical therapist, the APTA is something you will hear about over and over again. With job opportunities, continuing education classes, research updates and legislation information, the APTA has endless amounts of information at the hands of students and professionals. However, the website and all the resources may seem a little overwhelming. Therefore, here is a little introduction into the APTA and how you can use it to further your education and career.

What is the APTA?

The APTA, or the American Physical Therapy Association, is a professional organization that represents physical therapy students, physical therapists and physical therapy assistants and has over 103,000 members. It is divided into state chapters each with a governing board. We at Regis University are fortunate to have Cameron MacDonald as an assistant professor, and he is the current president of the Colorado chapter which currently has 2,700 members. It is vital for each state to have a chapter since each state has different practice guidelines and thus must have individual legislation.

There are also sections within the APTA, which include: acute care, aquatics, cardiovascular and pulmonary, education, federal, geriatrics, hand and upper extremity, home health, pediatrics, private practice and quite a few others.  These sections allow you as a student or current PT to learn more information about different specialties. For example, I am part of the neurology section and as such, I get quarterly journals that inform me on the latest research and new updates in the realm of neurology and how it affects the physical therapy industry.

Districts are even smaller groups which are broken up by geographical location and each chapter has SIGs or special interest groups. Colorado has five statewide SIGs which include: Colorado Acute/Rehab SIG, Pediatric SIG, Private Practice SIG, PTA SIG and the Student SIG.

Continuing education (CE) classes happen often and allow students or PTs/PTAs to learn more about a specific topic and have hands on practice. I attended a vestibular and concussion CE class last fall and it completely opened my eyes to a world of physical therapy I had never heard of before. The APTA has a national conference called Combined Sections Meeting, or CSM, which is an incredible opportunity to learn about the profession and what new research developments are forthcoming. CSM is also a great way to network and get to know other practitioners in the physical therapy profession. The Colorado Chapter also has an annual convention called the Fall Convention & Expo.

How can I use the APTA?

Now that you have an introduction, it is important to know what you can do NOW. Depending on where you are in your journey, this may be different for each of you. If you are currently applying to PT school, the APTA website can help guide you in preparing for your interview questions, help you understand what is in your scope of practice depending on the state and school you apply to, and impress the faculty by understanding what is happening in the PT profession.

As you start your graduate school career, the first step is to become an APTA member! Some graduate programs require it, others do not. Either way, I highly recommend you become part of the association so you can reap the full benefits of the APTA and have your voice heard. Click here for joining the APTA. Attending state and national conventions will also give you a huge head start on understanding what the real world of physical therapy is like and they are a great chance to meet students from all over the US and also network!  The easiest step is to get involved with SIGs. Each university will have student special interest groups which hold meetings and special guest lecturers which allow students to connect and communicate about a specific PT specialty.

At Regis and CU Denver, we have multiple sSIGs that our students are involved in and I am lucky enough to be involved with the APTA sSIG this year. I will be working closely with the other sSIGs as well as the PTA schools to have a year of amazing events for our students. We hope to open their eyes to all the opportunities in Colorado. These include: panels about specialties and what to do after graduation, a kickball tournament, a national advocacy dinner and so much more!

Yes, this was a lot of information. No, I do not expect anyone to remember it all. But it is important that you get involved and find what you are passionate about. So now, go to www.apta.org and become a member today!

How to Rock a CSM Conference

Name: Grace-Marie Vega

Undergrad: Arizona State University

Hometown: Placentia, CA

Fun Fact: I take pub trivia very seriously!

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CSM, or the Combined Sections Meeting of APTA, is a 4-day national conference held annually,  attracting thousands of students, practitioners, and researchers in the physical therapy field. These are some things I learned from CSM 2018 in New Orleans that I hope will help you navigate through future conferences:

  1. There are so many possibilities! CSM had over 300 educational sessions over the course of three days, not including poster presentations, platform presentations, and networking events. It was a whirlwind of people, places, and free giveaways. To get the experience that you want, and to avoid option paralysis, take some time beforehand to prioritize what you really want to see! In preparation for your own national conference, download the APTA conferences app so you can add programming to your own schedule. The WiFi in the conference halls can be unreliable, so I suggest that you make a plan before you get there, and glance at the map too.

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  1. Do not underestimate your knowledge. On my first day of CSM, I chose programming with subject matter that I felt I knew well enough to discuss. It turns out that I did know it well, because I had already studied it in my coursework, and even read some of the referenced articles. Basically that program was review, and a reassurance that Regis DPT coursework incorporates current best evidence. But I could have learned new things and expanded my awareness of topics that may not get as much coverage in coursework. For the rest of the conference, I tried to pick topics that I was interested in, but not experienced in, and in doing so, I realized that I was not out of my depth. Challenge yourself, and trust that you probably know more than you think.

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  1. Use public transit! Although less convenient, it’s cheaper and arguably more fun than taxis, ubers, and car rentals. I purchased a transit pass that allowed me to utilize all local buses and trolleys. For 3 dollars a day, I rode around New Orleans with locals and CSM attendees alike, and I felt like I was experiencing the city in a much more intimate capacity. Shoutout to the good people of New Orleans who always seem willing to make conversation and give restaurant recommendations while waiting for trolleys.

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  1. Network! As a self-proclaimed hater of all networking-related activity, I urge you to do this! Allow me to make a blanket statement and say that physical therapists are friendly, kind, and wonderful people who love talking to students, sharing their knowledge, and saving lives. Asking questions in educational sessions, talking to vendors in the exhibit hall, and even making small talk with the PT sitting next to you are all ways to get more out of your CSM experience. It’s also a way to dip your toes into the ocean of job hunting. I left with business cards, new aspirations to become a travel therapist, and more free t-shirts than I care to admit.

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  1. Quality over quantity! Strike a balance between conference time and exploration time. You could easily spend your time doing nothing but CSM from dawn to dusk, and that’s awesome! But, you don’t have to do that. You can get there a day early or take a later flight out if it means you have time to wander and be inspired by a new city, new friends, or live music. Your memory of this time will likely not only include the conference, but the people you were with and the place you were in. In my opinion, when you finally get home, your heart should be full, and your feet should be sore.

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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

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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.

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.

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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.

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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

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How to Be an Active Student APTA Member

Hello, APTA stars! In my previous post, I talked about my experience at 2016 National Student Conclave, and I promised to share some tips on how to get involved in the APTA. Here are a few ways (some easier than others) to kickstart your APTA involvement. I have personally used all of these methods, and I don’t regret any of them!

Action Plan for APTA involvement:

  1. Join (or resurface) Twitter. I know it may seem like Twitter is old hat, but trust me; everyone who’s anyone in the PT world is on Twitter. At the recommendation of a colleague, I resurfaced my dormant Twitter account this past summer after a couple years of inactivity, and I am so glad I did. I now connect with other students and professionals from around the nation, and I follow PT organizations that give me good information. Don’t know how to start? Create an account and follow me @KatieRagle. I’ll tweet you a shout-out, and you’ll have followers in no time.

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    Follow @APTAtweets for direct information on involvement!

  2. Attend APTA conferences. And when I say attend, I mean actually engage with the sessions and attendees. You won’t get anything out of conferences where you float in to meet a school requirement, half-heartedly listen to a couple speakers, and ditch early because you’re tired. Actively listen to the sessions. Resist the temptation to only talk to people from your class who go with you. Put yourself out there, and introduce yourself to people. PT is an amazingly friendly profession, and the people who sacrifice the time and money to attend conferences are generally the ones who want to network and meet others.
  3. Read your APTA emails! I know it can be overwhelming, but you can adjust the number of emails you receive if you log into your APTA account. One of the most important emails you can read is the Pulse—the Student Assembly newsletter/blog with all kinds of great information just for us students.

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    Student happens can be followed at @APTASA

  4. Check out the #XchangeSA. This is a monthly chat that the Student Assembly Director of Communications holds with a professional in the PT field. These chats have covered everything from student debt management to mentorship to the value of APTA membership. Take a look at the archived podcasts and plan to watch the next one!

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    Our new Director of Communications is Cruz Romero, SPT CSCS.  Follow him at @cruzromero602

  5. Find someone who is actively involved in the APTA and pick his or her brain about how to get started. Don’t be ashamed to ask! I got my start by sending a simple email, and the next thing I knew, I was sitting in a state APTA meeting with the influential leaders in our field. One of the speakers at NSC told us that nearly every person who is actively involved in the APTA had someone who inspired them to do so. Please find that person. If you need it to be me, then let me know, and I’ll get you amped about the APTA. Both professionals and other students want to help you get involved, but you have to ask!

I know this is a lot of information, but hopefully, this gives you a few concrete things that you can do right now to get more plugged in. It may not seem like much, but you’d be surprised how more connected you’ll be by following these steps.

If you have any questions, please don’t hesitate to contact me at raglekatie@gmail.com or on Twitter @KatieRagle.

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Blogger: Katie Ragle, Class of 2018

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.  

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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.

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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.

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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!

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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.

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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!

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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.

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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.

 

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Blogger: Adam Engelsgjerd

 

 

How to Have Fun in PT School

Name: Connor Longacre, Class of 2018

Undergrad: Colorado State University

Hometown: Wyomissing, PA

Fun Fact: I am a huge of soccer, though I haven’t formally played since I was 11.

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“It’s fun to have fun but you have to know how.” (Dr. Seuss, DPT)

Many of you reading this may think of the classroom as a no-nonsense place of learning. Those who distract others with joking and laughter are often unwelcome in such environments.

Hear me out, though.

If, in my time as a Student Physical Therapist, I choose to spend every hour of class, every day, for three years, as a solemn study machine, then what do I expect my career after PT school to look like? I would probably know as much as the dictionary, with the interpersonal skills of … well, a dictionary. Don’t get me wrong. School is serious. Working with patients is serious. Physical therapists must know how to be professional and serious. However, having fun is also an essential part of being a PT. From becoming friendly with our patients to creating engaging ways to make exercises more enjoyable, there is an occupational requirement to be fun-loving, which is why fun belongs in the classroom.

So, how does Regis University put the “fun” back in the fundamentals? Long story short, it doesn’t. All the university can do is give us (the students) time, space, and some freedom. It is not the professor’s job to bring in a beach ball or play funny YouTube videos. Adding the element of fun to academia is the sole responsibility of the student. When done well, it can be seamless—and even educational.

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At the risk of sounding as arrogant as I probably am, I’ve included some tips on how even you can have fun in the classroom:

  1. Learn to love where you are. If you’re in PT school, then the prospect of learning about PT things should be pretty darn exciting. Stay excited. Stay motivated. Learn to dwell on the details like they are the difference between being a good PT and a great PT (because they are).
  2. Find time to unwind. Everyone’s brain candle burns at a different speed. Some people can sit in class for 8 hours attentively, but when they get home, they’re spent. Other students may need to get up and walk around every hour, maybe chit-chat a little between lectures, but will buckle down during independent study. Give your brain time to rest.
  3. Get moving. Hours on hours of lectures can put you into a comatose-like state. Get up and walk around when given the chance. Personally, I like to kick a soccer ball around at breaks.
  4. Finally, get to know those lovely people you call classmates. Play intramural sports, go out to a brewery, maybe even hit a weekend camping trip. Warning: spending time with people may lead to smiling, laughing, inside jokes, and friendships. Friends make class fun.

There you have it, folks, a helpful-ish guide on how to have fun in PT School.

*Shoot, I should have added “write blog post” to the list of ways to have fun.

 

 

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

 

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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

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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.