Regis DPT Global Health Pathway Immersion trip to Huancayo, Peru

This past spring, 8 students from the Regis DPT Global Health Pathway attended a 3-week global immersion trip to Huancayo, Peru, led by Regis DPT faculty member Dr. Heidi Eigsti and Regis DPT alumnus Dr. Amber Walker.

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“We were fortunate to have the expertise of Dr. Heidi Eigsti and Dr. Amber Walker. This was Dr. Eigsti’s third trip to Huancayo and it took about 5 seconds after our plane landed to realize how popular she is in Huancayo. It was quickly evident how much genuine compassion she invested into her relationships on previous trips. She developed trust, and what I realized is that when you care that deeply about others, they don’t forget. The foundation that Dr. Eigsti and past students built on previous trips allowed us to quickly build relationships with these individuals as well. As a result, we were able to hit the ground running with our purpose there in partnering with them.” -Dr. Jessica Kirkwood, Regis DPT Class of 2019

Family Nurse Practitioner and DPT students collaborated with the Catholic Medical Mission Board Community Based Rehabilitation program to provide inter-professional support and services to children who have disabilities and their families. Students had the opportunity to provide physical therapy services in a collaborative model of care at Carrion hospital outpatient physical therapy department.

“These experiences help both students and faculty more clearly define personal and professional values, acknowledge what we can learn from others, and ask us to expand our perception of how we can have a greater impact on the health outcomes of all members in our communities specifically those members who live on the margins.” -Dr. Heidi Eigsti.

 

Student Perspective on the value of the Global Pathway Immersion Trips

 “It was incredibly valuable to experience another culture in such an immersive way. We spent much of our time learning about the healthcare system in Peru while providing free health fairs and working at Carrion Hospital and CMMB, a non-profit organization that provides therapy for children with disabilities. I will never forget the people I met, the places I saw, the food I ate, and the lessons I learned during my 3 weeks in Huancayo.

I came into the trip with a very go-to attitude and I wanted to help as much as I possibly could. However, during this trip I realized that sometimes more important than doing is watching, listening, and going with the flow. This is something that I feel we’re taught in our global health pathway as a whole. However, the concept really hit home for me in Peru and I left with a humility that I had not expected to come away with. I realized that we weren’t there to “do it all”; we were there to learn and to do some good while we were at it. Sometimes our impact is big, like providing adaptive equipment to a child with cerebral palsy. Sometimes our impact is smaller, like putting a smile on someone else’s face for 0.5 seconds. I realized that sometimes the biggest impact is just showing up, learning, listening, and showing love.” -Dr. Amber Bolen, Class of 2019

 

“My experience in Huancayo, Peru was filled with endless learning. It did not take long for me to realize how often I take my resources for granted. As our trip coordinator Natalia reminded us, “You have amazing teachers, you have amazing resources, you have amazing opportunities. Take them.” This trip was a much needed reminder that I have been given endless privileges that others are not as fortunate to receive. It is my duty to consistently use these privileges to help others. Working with our community partners in Peru- Carrion Hospital, Continental University, and CMMB- taught me a lot about the differences in our healthcare system and how deeply limited resources acts as a restriction to outcomes. Navigating these relationships was also very impactful, as it taught me how to balance respect with education to work on both nurturing relationships while also promoting health in our profession. The change we made in those quick 3 weeks is really minimal in the big picture, but taking the lessons I learned and applying it to my future practice is what will make a difference. Witnessing the social injustices experienced in Huancayo firsthand has lit a fire inside of me- to open my eyes a little wider, listen a little clearer, and to act with more intention.”– Dr. Jessica Kirkwood, Class of 2019

 

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Charting Your Clinical Education Course

Name: Josh Hubert, Class of 2019

Undergrad: Bellarmine University

Hometown: St. Louis, MO

Fun-fact: I was told by a Greek reiki-master that I am a crystal baby

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Like any great exploration recorded in history, your clinical education at Regis will be a trip fueled by careful planning, curiosity, intrepid spirit, chance, and financial backing from a powerful monarch. Just kidding on the last fuel source, but the others may be necessary. I am the Clinical Education Representative for my cohort,  and I’d like to share how and why I chose my first few clinical experiences. Through my process, I hope you can draw parallels to your own clinical education journey and chart a course that is ultimately fulfilling to you and your future practice. In an effort to wring my exploration analogy dry, you may be seeking cities of gold, but much like Francisco Vasquez de Coronado, the late Spanish explorer, you may find that golden cities do not exist. There will be greater treasures on the journey itself (the Grand Canyon). Coronado was deemed a failure for his “fruitless” mission, but he and the Spanish people failed to recognize the beauty that had been found. Enjoy the journey and respect those you meet along the way. So, to continue with less figurative advice, here are the steps that led me to my decisions:

1. Assess your resources

a. Requirements/Desires

Forget ships and gold! Sit down and take inventory of available resources to direct your search, just as you would use MeSh terms when searching for relevant articles in databases. Firstly, consider your curriculum requirements to determine how and when to use your resources. You must complete an outpatient (OP) and an inpatient (IP) rotation. One of your rotations must be rural, and one must be out-of-state. However, one rotation may satisfy both the rural and out-of-state requirements. Lastly, rotations II, III and IV or III/IV combined cannot be in the same concentration area. Prioritize these requirements in such a way that aligns with your vision for future practice, which is bound to change and develop. Try to set aside time for deliberate development of your vision and allow growth to happen. Enjoy the journey. The chart below that depicts these requirements.

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b. Location

Next, consider a location with requirements and resources in mind. Is there a clinical site that happens to be in your hometown? Or a town in which you have a friend or relative? How will you get there? This can help to lower the cost of lodging and travel, which calls to mind your living situation in Denver. Based on the dates, could you create a situation that avoids the need to pay double rent while at clinical? Do you see yourself practicing in a rural setting or an IP setting? Or maybe not? Do you have a burning desire to work with a particular population? These answers help to filter out less practical locations off-the-bat.

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Bardstown, KY – the bourbon capital of the world

c. Connections

Did you develop any relationships with physical therapists before coming to Regis? Have you developed any relationships with faculty since being at Regis? Do these professionals practice in a place that you would like to practice? Talk to them and seek their counsel. If they work in an area that interests you, ask about potential or existing clinical education opportunities that they may know about. And don’t stop there. Research their suggestions for yourself. Just because you have developed a relationship does not mean they know exactly what’s best for you. Decide on your own when you feel enough information has been gathered.

d. Time

Do you have a good idea of what you want to do? If so, go with it. It may change after your first clinical, but we are fortunate to have time for reassessment. Consider a FCFS (first come first serve) or Corporate site if you have a strong sense of where you want to end up or where you don’t want to spend the majority of your clinical time. If you choose one of these sites or set one up, you are locked in. You may save yourself time required by deliberation and also open up spots in the lottery for your classmates. However, if  you are not completely sure, then consider the lottery. If a site you desire is not in contract with Regis, then explore building that bridge, under the direction of your Clinical Education advisor, and after accounting for all the sites available to you. In addition to Acadaware, there is a list of corporate companies which typically include a handful of sites in different cities both regionally and nationally. Setting up a rotation with one of these sites is much more manageable than starting from scratch, which will be more time-intensive, but worth it if you’re vision is clear.

2. Mobilize your resources

a. Plan

I save your Clinical Education Team for this step because I believe it’s helpful to come to them with an idea of your requirements in order to direct the conversation. I think we can agree that sitting down for a 30-minute meeting regarding 3-5 prioritized sites will likely be more productive than a 30-minute meeting covering the possibility of 134 potential sites. Your advisor is your second most valuable resource, after your own brain of course, and it’s a good idea to develop a relationship with your advisor that fosters open dialogue.

b. Pursue Your Choice

Time is a resource. Consider a FCFS or corporate site if it aligns with your vision. With the blessing of your advisor, commit to that site on the list or create a site of your choosing, and do it with gumption. If you go the prior route, there is not much else required of you than a commitment, but if you go the latter route, put in work. Understand that if the site agrees to host you, you will be required to go. Take initiative and offer to establish initial contact with the new site. If your advisor approves, compose a professional and compelling email to get the ball rolling. See your choice through to the end. If a site is unavailable, refresh and continue with your next choice in the same manner.

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I completed my first clinical at KORT-Bardstown, a corporate site in KY. The site was not previously an option as a first clinical site.

c. Logistics

Piggybacking off the suggestion to narrow your site options before attempting heroic feats of decision amid many options, it is easier to cross-compare the logistics of a few sites rather than 100 sites. If you have 5 sites that all meet the same criteria you’ve established for the unfolding of your vision for practice, then maybe something simple like the cost or availability of housing distinguishes one site as the preferable option. What will weather be like during your clinical? Will there be unearthly traffic on your commute in one city? Is there good food and good beer there? These things, while seemingly superficial, may help with that final step of narrowing it down, since our quality of life is important too. #happyPThappypt

d. Enjoy the ride

Map it out as carefully as you like, but uncharted territory is only chartable once you get there. In other words, there is only so much calculation you can rely on in life before you need to simply rely on curiosity and spirit. There may not be golden cities on your course, but be sure to recognize a giant canyon for what it is…graaand. The reality is that you can take all these steps along with others and still end up with a site you did not chose. In this case, gear up for an adventure and come back with a map of your own for those that follow. Embrace each moment on your adventure as a learning opportunity whether it’s what you wanted to learn or not, and respect the people who teach you. Experience is a willing teacher and learning makes the vision clear.

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My CI and I enjoying homemade mint juleps, in accordance with KY tradition.

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Sentimental cookie-cake. I’ll miss them, too.

Feel free to stop me in the hall or email me if you have any more questions about my experience: Jhubert001@regis.edu

Bonus Fun-Fact: I did a project in 7th grade on Francisco Vasquez de Coronado.

 

Lessons Learned During the First Clinical Experience

Name: Kelsie Jordan, Class of 2019
Hometown: Portland, OR
Undergrad: Oregon State University
Fun Fact: I spent the summer of 2014 studying in Salamanca, Spain.
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When I tell people I was in California for my first clinical rotation, everyone’s minds seem to jump to the flashy big cities like Los Angeles, San Diego, or San Francisco. Sorry guys, I wasn’t lying on the beach or treating the movie stars; I was working more in the realm of Middle of Nowhere, CA in a small town called Orland. If you’ve ever driven to or from Oregon along I-5, you’ve probably driven right past it without ever even knowing it existed, as I actually have multiple times. I have lived in or near major cities all my life, so I had no idea what to expect from working in a rural setting. I was worried I was going to be bored, and that being away from everyone I know would make me lonely. But Orland, with its farmers, high school football, and Dollar General stores, turned out to be the best place I could have been for my first clinical.
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Welcome to Orland!

Here are just a few things I learned along the way:

Work schedules > school schedules

I’m not going to lie, clinicals are exhausting. Being on my feet all day, both literally and figuratively, drained the life out of me, especially in that first week. The good news is, I immediately discovered how great it is to come home at the end of a long, demanding day and have nothing–and I mean nothing–to worry about. After a year straight of exams, projects, and endless studying, I forgot how nice it was to have a mellow evening without feeling guilty about procrastinating. My clinical instructor (CI) once asked me what I generally do after work and I had to laugh; my nightly routine was pretty much eat dinner, drink an occasional glass of wine, and re-watch early episodes of Game of Thrones. Call me lazy, but I look at it as taking advantage of the free time I never get to have during school.

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Wine tasting in Sonoma!

It’s never easy, but it gets better

As barely a second year student going into this rotation, I was pretty much inexperienced in every sense of being a physical therapist. Even the skills I was most familiar with had a different feel to them when working with real patients instead of practicing on healthy classmates. Luckily, my CI was an amazing teacher. He did a great job of layering on responsibilities for me so I always felt challenged but never felt thrown into the deep end. After an observation-heavy first week, I was tasked with doing the subjective interview portion of every evaluation and taking over the exercises for a couple patients. At the time, that honestly made me nervous and it felt like a lot of independence. But fast forward to my final week: I had somewhere around 10 patients all to myself, I was flying solo on pretty much every lower extremity and back evaluation, I was completing all documentation, and I had discharged three of my patients. We had a packed 8-5 schedule and it was never easy because my CI always gave me more to do before I got fully comfortable. It was demanding, I made a lot of mistakes, and being challenged every day sometimes made me feel like I wasn’t improving or I shouldn’t still be struggling. But looking back at what was difficult for me in that very first week compared to what I was able to do by the end, it’s easy to see how much I learned and improved!

Confidence takes practice

I have always struggled with my outward displays of confidence in patient interactions because I get nervous and tend to doubt myself. I’ve always been told, “Fake it ‘til you make it,” but that’s a lot easier said than done; I guess I just don’t know how to fake confidence. Instead, my confidence builds gradually as I experience success and overcome challenges. And that’s exactly what happened during my clinical. From prescribing and teaching exercises on my own to completing several full evaluations in Spanish, I was definitely challenged, but I was also successful. Sure, I felt like I didn’t quite know what I was doing half the time, but I learned to not dwell on mistakes and to push myself out of my comfort zone. Most importantly, I gained confidence in my own knowledge and abilities, and I now feel more prepared to take on the rest of PT school. If there’s anything I learned from my clinical, it’s that I am capable of doing far more than I ever thought I was.

Solo adventures are good for the soul

I’m usually go go go from one thing to the next for fear of missing out on any fun, so being alone in a rural area was definitely a change of pace.  Although I was lucky enough to reunite with some college friends during trips to San Francisco and Lake Tahoe, I actually probably spent more time alone over the six weeks of clinicals than I did throughout the entire first year of PT school. It allowed a lot of time for self-reflection I didn’t even realize I needed. I was itching to get out and explore, and my weekend adventures were definitely worth all the miles I put on my car: I took my first solo camping trip, discovered a National Park I had never even heard of, and hiked upwards of 35 miles by myself. Of course I missed my friends and my normal crew of camping/hiking buddies, but I learned how to embrace time alone without being lonely.

I enjoyed the opportunity to appreciate silence and just be.

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Support systems are necessary

As a class, we spend so much of our lives together throughout the year that, I have to admit, it was oddly nice to be away from everyone. No, I’m not saying I was sick of my classmates, but those 6+ weeks apart allowed me to actually miss my friends. And, although I already said I enjoyed my time alone, man did I miss them. When you go from sharing all of your time together to none of it, all while you’re being thrown into a new situation, there’s a lot to catch up on after just one day! I did my best to reach out to my friends here and there to see how their clinicals were going, and sometimes those check-ins turned into 2-hour phone conversations. Shout out to the two friends who kept up a group text with me every single day–we practically shared a play-by-play of our clinical experiences, from funny patient stories to weekend plans. Knowing everyone else was having similar challenges was reassuring, and receiving daily encouragement and sharing my accomplishments kept me excited to keep learning.


In a rural setting, a physical therapist needs to be a jack-of-all-trades and a master of none, as my CI once told me. As a result, I got to see a little bit of everything. Sure, there were quite a few back, shoulder, and knee injuries, but I also did some detective work with more neural issues, and I got to observe several vertigo treatments as well. I absolutely loved being in Orland, not only for the varied learning experiences, but also for the people and the small town charm. I found out the correct way to pronounce almond is “am-end” (according to Northern California farmers), and I even joined in on the tradition of wearing blue on Fridays in support of the high school football team.

“You are enough!”

That’s what we were told in our final pre-clinical prep session over the summer, and it turns out it’s true! At first it was easy to think,“I’m just a student” and feel as though I had to run every thought and decision by my CI. However, as he let me become more independent, I realized even as a student, I really did have enough knowledge and skill to make a difference in patients’ lives all on my own. Now, when people ask me how my clinical went, I have nothing but good things to say. I was pushed into recognizing how much I was capable of, and humbled into realizing how much more I still have to learn. Although it was a short period of time, those six weeks were like a refresh button to help me overcome the burnout I had experienced after a year in the classroom, and allowed me to come back to Regis ready to keep expanding my knowledge base before I head back into the real world again.

 

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.

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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.

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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.

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Let’s Talk About Mental Health

Name: Amanda Rixey, Class of 2018
Undergrad: University of Kansas, KS
Hometown: Overland Park, KS
Fun Fact: My massive bear dog, Sherlock, has over 7,000 followers on Instagram.

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I think most of my classmates would view me as the hyper, kind-of goofy, and giggly one in the class.  It’s easy for me to hide under that personality— especially after having suffered from generalized anxiety and PTSD.  Both inside and outside of PT school, mental health is my passion.  In 2012, I lost my dad to suicide; ever since, awareness and treatment of mental health has been the biggest thing I’ve ever advocated for.  Mental health and physical therapy go hand-in-hand.  However, mental health issues can sort of creep up on you as a busy physical therapy student when you least expect it.

There are days when I never want to get out of bed.  There are days when I come home from school and all I do is lie in bed.  There are days when I don’t study because I’m too nervous about not knowing all of the material for school.  There are days when all I do is study because I’m nervous I don’t know enough.  Regardless of the day, I have to keep reminding myself I am not crazy.  Graduate school is stressful and it is normal to have these feelings of anxiety.  The biggest key, however, is to seek help and do something about it.


Here is my list of how I “keep calm and carry on” during PT school:

1. Get help when you need it

The longer you wait to seek medical guidance, the harder it will be.  I sought out a counselor and take medications for my anxiety and depression.  Regis is awesome and offers free counseling to students—take advantage of it!

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Sharing hugs and thoracic manipulations during MMII lab

2. Don’t be afraid to take medications if that’s what’s right for you

I take an SSRI every day. I find that there is some sort of stigma regarding medicating for depression and anxiety. Overcoming this stigma allowed me to experience life to the fullest for the first time. Talk to your primary care physician or counselor; they can help.

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Spending Thanksgiving with the Class of 2018 and our puppies

3. Find a network of support

 Be open with classmates, professors, family members, friends, or even your dog about what you’re going through.  Let them know when you feel anxious or down and talk to them about it.  I text my friends when I don’t feel like myself.  They are there to help.

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My sisters and friend at the University of Kansas Out of the Darkness Suicide Prevention Walk with AFSP where I served as Chairperson in May 2014

4. Take days off from schoolwork

I know that school can seem overwhelming, but it is acceptable to take one or two days off during the week for yourself.  Do what you love: workout, hike, do some Pilates, lay on the sofa and watch Bridesmaids for the 50th time, walk your dog!

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Enjoying a beautiful day off in Vail with my best buddy, Sherlock and my boyfriend, Joe (not pictured)

5. Get involved in the community  

Through Regis, I was able to get involved with Spoke n Motion, an integrated dance company.  Sharing my experience with dancers of diverse backgrounds helped me feel wanted in a very close community and enjoy dance from a beautiful perspective.

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Dancing with my fellow Spokes during our May 2016 show at the Colorado Ballet. PC: Spoke N Motion

6. Believe in yourself

When I doubt my abilities in school, I notice that I often find myself in a rut.  Accept what you know and what you don’t know.  Cherish the moments your classmates compliment you and when you succeed.  These little moments add up and you will realize that you are a capable student in this profession.

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Enjoying a Friday night with classmates

7. Remember that mental health doesn’t have to take over your life

Taking the proper steps and finding the right help will put you on the pathway to overcoming it. Please feel free to email me with any questions at arixey@regis.edu.


If you or someone you know needs help contact the National Suicide Prevention Lifeline: 1-800-273-TALK

Regis Counseling Services: 303-458-3507

 

How to Make the Most of Your Clinical…in ITALY!

 

Name: Lydia Hamstra, Class of 2018
Undergrad: Gonzaga University, WA
Hometown: Tucson, AZ
Fun Fact: I am a huge Harry Potter nerd and to help prep for Italy I read Harry Potter in Italian (since I’ve read it so many times in English, I was able to figure out the gist—it gave me ideas for how to say certain phrases that I liked and thought I could use. I also believe reading in any language is the best way to learn new vocab!).

Lydia Hamstra is currently in Umbertide, Italy for her second clinical rotation. She advocated for and helped set up Regis’ first entire clinical rotation in another country.

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Ciao, mi chiamo Lydia Hamstra e sono una studentessa di fisioterepia di secondo anno a Regis University. I have a passion for neurological rehab and travel and my goal is to combine those in my future career. One of the reasons I applied to the DPT program at Regis is because of the global immersion and service they do. Traveling off the beaten path has been a value instilled in me by my parents from a young age. Immersing myself in different cultures helps me grow as a person and as a clinician; it also enables a different kind of learning. By being present, helping others, exploring, and embracing what and who you find, you can create durable bridges that connect you to the world. It also illuminates parts of yourself you may not have known about and fosters reflection. We all want to have a positive impact in some way–I find that I grow the most when I’m out of my comfort zone and helping others.

Over the years, I have come to the conclusion that the best way to travel is by combining it with education. Why Italy? Honestly, it is difficult to say where I got the idea. I thought the country was romantic and charming, and more approachable than other countries. I actually picked my undergraduate school because they offered an Italian degree and had a second campus in Italy. In 2012, I was fortunate to study and live in Italy with a family from Florence (I’m actually meeting up with them during clinical!). My experience in undergrad made me realize that despite it being a first-world country, there is still a lot of need and hardship. I experienced it from the student perspective and I wanted to give back from the clinician perspective. I also wanted to learn about a different healthcare system and the pros and cons of socialized medicine. The clinical education team at Regis is one of the best in the country, if not the best. They worked diligently to create this opportunity–not just for me ,but for all future DPT students. The DPT program at Regis now has a partnership with Eduglobal and I am doing in-patient neurological rehab at the Instituto Prosperius in rural Italia.


If you’re heading abroad for a clinical experience, here are 5 tips to help you make the most of your time!

1)    Find Ways Around the Language Barrier

First off, you don’t need to get OVER the language barrier—you don’t have to speak the language fluently (or even well) in order to communicate with your patients.  It is, however, helpful to learn simple commands in Italian; these are great to take back home and use in English if you’re someone like me who tends to be wordy (beware the rest of my post!).  Beyond that, focus on teaching by example and using non-verbal cues to get on the same page with your patient.

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Stander at the Institute Prosperius: she does not have voluntary control of her lower extremities.

2)    Learn to Go With the Flow

Yes, a global immersion or clinical is going to be different, and like any clinical out there, there will be things that you like and things that you don’t like about the system. Remember that Italian physical therapists, too, will be frustrated by certain parts of practice–be it communication, lack of resources, or decisions by doctors, to name a few.  Remind yourself that professional frustrations and problems are universal. And remember that you are there to learn about physical therapy and to embrace the culture as much as you can. Learn to breathe and be patient—both with yourself and with your colleagues.

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Home sweet home! @vignedipace

3)    Go Above and Beyond

Just like any class or clinical, the time and effort you put in will transfer to what you get out of it. I believe this is true with regards to patient management, the language, and your rapport with your CI, the other students, and the other Italian physical therapists. One of the biggest differences in Italy is that they do not document every session…or even every day. This has to do with healthcare being a constitutional right for Italians, whereas we practice defensive medicine #CYA. Even though that is the case here, I am documenting certain things because I want to know how my patients are progressing. In general, Italians have an expectation that you hold yourself accountable. They expect you to push yourself; don’t fall into the trap of doing only the minimum.

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Positano on a sailboat on the Almalfi Coast

4)    Exchange Ideas with Colleagues

Going to Italy is unique, also, because you are placed with other students from a variety of schools. They are all at different points in their schooling, which provides quite the mix of ideas and understanding. Take advantage of this to exchange ideas and techniques with other students. For example, one SPT from Shenandoah taught us how to do a CT manipulation in prone.

Side bar: It is awesome to have a group to explore Italy with.

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In Venice for the weekend!

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Venezia-social commentary on global warming and human efforts to maintain our structures. Venice is not actually “sinking”, rather the water is rising because of the human impact of warming the earth and melting the ice caps.

5)    Take Advantage of the Slow Internet

You may find you have extra time here, especially because the internet is not as fast or reliable as in the US and certain websites *ahem Xfinity ahem* are unavailable. (You can get Netflix and Spotify, though, so I can promise you will survive.)

Gripe about it for a day…and then let it go and be in the moment. Journal, walk around town, engage with the locals, practice Italian, talk to your peers, learn how to make pasta, or study for the comp exam. You’ll feel less dependent on technology and it’s actually been amazing to unplug. It has given me more time to reflect on what I’m learning about myself, our practice, the meaning of life, etc, and always with a glass of wine in hand.

Ciao bella,

Lydia

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Lovely day at Agriturismo Tenuta I Colli del Trasimeno!

Summer in Colorado: Dispersed Camping 101

Name: Kate Bostwick, Class of 2018
Undergrad: University of Portland, OR
Hometown: Pendleton, OR
Fun Fact: I actually enjoy doing burpees.

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First thing’s first: the answer is yes…yes, there is time to get away from Regis for a weekend and put off studying for Cliff’s neuroscience class or practicing manual therapy skills until Sunday night…AND you will still pass PT school. One of the biggest fears I had about going back to school was that I would never have any free time. Luckily, that is not the case. If you manage your time efficiently, you always have time to do the things you love. If being outdoors is one of those things—like it is for me—you will have the time to enjoy all that Colorado has to offer. In this post I have reflected (wow—Regis has rubbed off on me!) on some of my favorite weekends spent in the mountains with my fellow classmates and have put together a detailed guide for you to explore these regions on your own!

Something that you should know about me is that I am a small-town gal who gets pretty overwhelmed in the big city. Nothing makes me happier than beating the crowd and enjoying a slow-paced weekend in the mountains with some of my close friends doing some fishing, sipping a nice cold beverage by the fire, and talking about subjects far from clinical prediction rules, dermatomes or goniometry. Personally, I like roughing it a little more than staying in a busy campground for the weekend. In order to do this, my classmates and I have done some pretty fun dispersed camping trips. If you don’t know what the heck dispersed camping is, keep reading; I highly recommend it!

Dispersed Camping: What Is It?

Dispersed camping is the term used for camping anywhere in the National Forest outside of a designated campground. None of the services that are found at a campground (like potable water, trash removal, tables, firepits, etc.) can be found at these sites; they are found on public property off of National Forest Service roads and may require 4WD, depending on the location. Dispersed camping is FREE (yay for free things in grad school!) and requires you to bring all of your own gear. Although this seems like a free-for-all, there are rules that you must abide by:

  1. Place your campsite at least 100 feet from any stream/water source
  2. Leave no trace: you must pack out everything you pack in
  3. Be bear aware: store food in bear canisters…and just be cognizant of those dang bears cuz they’re out there!
  4. Drive on existing roads and try to camp in already designated dispersed areas

    Weekend Getaway to Buena Vista
    (2 hr 40 min from Denver)

If you’re looking for a drive with a beautiful view and plenty of options for camping, fishing, and hiking, look no further than this route to Buena Vista, CO!

Directions: I-70 W past Frisco, then to CO-91 S which turns to US-24 E.

Fishing: Twin Lakes are home to numerous brown, rainbow, cutthroat and lake trout. It is a great place for shore fishing and has access to the Arkansas River close by. The Arkansas lies just across US-24 E and has public access at several points along this highway.

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Fishing at Twin Lakes

Camping: About 6 miles south from Twin Lakes down US-24 E is Clear Creek Reservoir. Turn right onto CO Rd 390 and travel a few miles west (past private property) and you will see plenty of dispersed camping sites down by the river and up the hill on the base of the mountain. Be aware that there is no cell phone service–so be prepared to have a relaxing weekend without that iPhone 🙂

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Camping up past Clear Creek Reservoir

Hiking a 14er: If you continue down CO Rd 390 you will come upon the trailhead for a trifecta of 14ers: Mt. Belford, Mt. Missouri and Mt. Oxford. While I have not done this hike, it is a beautiful and challenging option for 14er-seekers. Remember to research your trail if you do decide to complete this voyage—it’s a long one!

Hiking to Ptargamin Lake: if you go back on US-24 E and head south towards Buena Vista, turn right on CO Rd 306 and head ~15 miles to the trailhead. This is a 2.74 mile hike with options for backcountry camping at the top–not to mention a large lake full of beautiful brook trout!

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Ptarmagin Lake

Breckenridge Beauty:
(1 hr 45 min from Denver)

Directions: I-70 W to CO 9 S to Breckenridge. From Breckenridge, drive 8 miles south on CO 9 and turn right on CO Rd 850; after a few hundred yards turn right on to CO Rd 851. Quandary’s Peak trailhead will be about 0.1 mi up the road on the left with parking on the right.

Camping: Follow the above directions but go past the trailhead on CO Rd 851 up the hill and there are many spots off of this road that you can camp. If you do a little scouting, there are some pretty sweet spots to set up camp on both sides of the road.

Fishing: Instead of turning right on to CO Rd 851, continue left and head towards Blue Lakes Reservoir for fishing of any kind. There are rainbow, cutthroat and brook trout in this reservoir and it can be accessed right off the shore at the base of Quandary Peak!

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Evening at Blue Lakes Reservoir (Amanda, me, Karlee and Taylor)

Hiking Quandary Peak 14er: 14,265’: highest summit of the Tenmile Range in the Rocky Mountains. The 6.75 miles round trip hike should not be overlooked because of its short distance. This is a challenging hike with exposure and, like any 14er, variable weather to be aware of…so do your research before you head out!

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Karlee and me at the top of Quandary’s Peak (60 mph winds not pictured)

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Buffalo Creek Campin’
(1 hr 10 min from Denver)

Directions: Take I-70 W to CO 470 E to 285 S, travel past Conifer and take a left onto Pine Valley/Deckers Road (CO 126) travel ~14 miles until you see a turn off for Wellington Lake/Buffalo Creek Recreation Area on the right, CO 550.
Camping: Along this road (CO Rd 550), travel until you find a spot that you like. You will see parking signs scattered along the road that have pullouts for your car/truck and campsites around them. You can take your pick of these sites for multiple miles; so if there is a crowd, just keep driving until you have room to yourself.

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Pitstop off of the Colorado Trail near our campsite

Fishing: Cheesman Canyon Trailhead is located 7 miles south of the CO 550 turn off on CO 126. Here, you can hike in to access South Platte River for some of the best fishing on this section of the river. I love this: because you have to hike in to access spots on the river, it’s  a little less crowded on a nice weekend as opposed to fishing right off the road.

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South Platte fishing access in Cheesman Canyon

Hiking: Along road CO 550, there are multiple access points to the Colorado Trail that you can hike any distance on. A few of the dispersed sites back right up to the trail—like ours did—which makes it super accessible.

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Happy campers (Karlee and me)

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Regis PT Students Run the Boston Marathon

Three Regis DPT students put aside their studies for a weekend and ran the Boston Marathon.  Congratulations to Jenna Carlson (3:43:44), Lauren Hill (3:06:06) and Nolan Ripple (2:49:29) for racing and representing our program! 


 

Name: Nolan Ripple, Class of 2018
Undergrad: University of Portland, OR
Hometown: Peoria, AZ
Fun Fact: Lacrosse player freshly converted to marathon enthusiast.

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Some History on the Boston Marathon:

The Boston Marathon is one of those things that runners dream about.  The legacy, culture, international diversity, and enthusiasm that it brings are bar-none top in the world for marathons.  The Boston Marathon is the oldest continuing running marathon in the world, with its debut in 1897.  On April 17 2017, I was fortunate enough to run in the 121st running of this prestigious event.  For a little background, there are qualifying times for each age group in order to partake.  In my own age group, males 18-34 years old, the cut-off times for selection were 3 hours, 2 minutes, 51 seconds.  That comes out to be just about 6:59 pace/mile for 26.2 miles.  Rigorous qualifying standards are one of the chief reasons why this race holds so much honor.

This was also the 50th year celebrating women running in the race.  The first woman to do so, Kathrine Switzer, was 20 years old when she ran and completed the Boston Marathon.  It’s an interesting story: she had to register under the name “K.V. Switzer” to feign a guy’s name, in order to receive a race bib.  And during the race, a Boston Athletic official tried to rip the bib off of her, but she kept running.  Eventually, she finished the race, and started a tradition of males and females competing each year in this run.  It’s the spirit that Kathrine had that inspires runners from all nations today.


I was a lax bro in undergrad, but a concussion my senior year made me decide it was time to be a Forest Gump for my last year college. Completing a marathon was my first official running goal, and I did that in May 2015 with a time of 3:25:32.  Shortly after, I set my sights on Boston, and worked my butt off to achieve a qualifying time in my next marathon—Phoenix 2016 with 3:01:59, and then Eugene 2016 at 2:55:44. Going to Boston was a dream—namely because it was the first big goal I had set for myself.  My marathon buddy, also conveniently named Nolan, was going to be running with me.  In addition, both of our families were there (shout out to my Crazy Aunt Cathy).  I scored big: a trip to Boston, time off of school, and my dad with his credit card to pay for everything out there!

Boston itself is worth another story.  Great place, amazing people, and awesome food.  Ask Leigh Dugan (’18) if you have further Boston questions.

Fast-forward to Race Day: April 17th.  I had to wake up bright and early to get shuttled from Boston out to Hopkinton because the race is a one-way shot starting in a suburb west of the city.  Upon arriving, there is a massive Athletes’ Village with bananas, bagels, coffee, Gatorade, water, and some tents to relax under.  I had been on an intentional 3-day coffee withdrawal, so the buzz was about to get real.  Thousands of people were shuttling in, and in total, 30,000 runners went through that village.  I met up with Lauren Hill (Class of 2017), and she hooked me up with some pre-workout gum and extra gels (aka liquid play-doh).  We chilled out at the tent for a bit, and then made our way on the .7 mile walk to the start line.  Love how we get to walk .7 miles to the start line pre-marathon… Not like I’m worried about hitting my daily FitBit goal.  I got to my corral, hit the bathroom like 4 times, and then joined a mob of skinny freaks like me in the gate.  Luckily, I was in Corral 2 of Wave 1, so I got in there early and all comfy with my fellow strangers.  We also got to watch the “elites” walk by, who are basically Olympian super-humans.

 

Fast-forward to Race Day: April 17th.  I had to wake up bright and early to get shuttled from Boston out to Hopkinton because the race is a one-way shot starting in a suburb west of the city.  Upon arriving, there is a massive Athletes’ Village with bananas, bagels, coffee, Gatorade, water, and some tents to relax under.  I had been on an intentional 3-day coffee withdrawal, so the bfuzz was about to get real.  Thousands of people were shuttling in, and in total, 30,000 runners went through that village.  I met up with Lauren Hill (Class of 2017), and she hooked me up with some pre-workout gum and extra gels (aka liquid play-doh).  We chilled out at the tent for a bit, and then made our way on the .7 mile walk to the start line.  Love how we get to walk .7 miles to the start line pre-marathon… Not like I’m worried about hitting my daily FitBit goal.  I got to my corral, hit the bathroom like 4 times, and then joined a mob of skinny freaks like me in the gate.  Luckily, I was in Corral 2 of Wave 1, so I got in there early and all comfy with my fellow strangers.  We also got to watch the “elites” walk by, who are basically Olympian super-humans.

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Lauren Hill (’17) and Nolan Ripple (’18) share a picture before their race

The gun went off at 10:00, and we were under way.  The first 3 miles are almost impossible to pass, because it’s like an endless herd of cattle running to the feeding lot.  It’s also mostly downhill and flat for the first 5-10 miles, so 99% of runners go out too fast and have it come back to haunt them later.  At mile 5 it’s really hard to know how you’re going to feel at 25—pro tip.  It was also a really warm day for running.  The course started at 74 and sunny, which may sound perfect.  But when you’re depleting your body of water and electrolytes for 26+ miles, you’d rather have it 20 degrees cooler.  Anyways, you can’t bitch because it’s part of the fun, and a race is never perfect.  I digress, so back to the race! I’m sitting at a nice pace, feeling good, when I realize we’re running by the Wellesley College girls somewhere around mile 13.  It’s an extraordinary stretch of girls that are holding signs asking for all sorts of things, and a probable drop out point for single males.  I gave some high fives, laughed a bit, blew some kisses, and kept jamming.  Shortly after, I ran by a group that I presume to be Boston University students, which I would like to call the “Booze Tunnel.”  It was about 11:30 am, but 5 o’clock for this rowdy bunch.  I considered taking a celeb-shot on the Beer Pong table, but worried that I’d be left dusted by the Chilean dude running next to me.  Somewhere around mile 15 or 16, my GI system decided to implode, kinda like a Michael Bay film.  I found the nearest porta potty, deciding losing a couple minutes was better than dealing with a disaster situation.  Back on course after that though.  I decided Espresso Gu’s wouldn’t be the fuel of source anymore, because I’d end up comatose in a porta potty for sure.  So I took an endurance gum this time.  It gave quite the kick, and got me rolling again up to Heartbreak Hill.

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At the hill, I saw Tiffany (Class of 2018) and Mike who were cheering loudly.  Mike had a beer for me, but I had to politely pass (hopefully the only time I say no to a beer ever again).  Going up Heartbreak Hill was challenging, but I knew flats and downhills followed to the finish.  I popped another endurance gum in around mile 21 and kept going.  At this point, you just keep trying to put one foot in front of the other, because all joints start to hurt.  I always wonder if this is what old age is like. The last 5 miles of the course were completely packed with spectators; this was incredible.  I had an American flag on a stick that I kept with me all race (not sure why still), but people loved it.  Coming down the final corner on Boylston street, I saw my family and family friends… alas!  I was in a mental limbo of ecstasy and fatigue, but passing them was the final fuel for me to finish.  They are all amazing!  I came across that final stretch thinking of all the friends, family, colleagues, teachers, and strangers who have supported me in running, and in life altogether.  I had tears in my eyes when I finished, not from pain, but joy, gratitude, and humility.

If you have read this far, you are one of those people I am talking about.  The support you guys have given me is UNREAL.  This was more than a race to me, it was about setting a goal, working hard, and having others propel me towards a dream.  I lived that dream on April 17, 2017.  I finished in 2:49:29, which was a PR for me.  I have many more goals now set, but this was a big one.  I run because I love it, and I love to compete.  Boston gave me both.

Passion and persistence are two tenants I strive to live by.  Finding a passion, and pursuing it are two staples that I cling close to.  It’s easy to be passionate about something for a week, two weeks, or even a year.  But keeping the same drive day in and day out is a bear.  People saw the last 26.2 miles of training, but not the 1,500 miles that preceded it.

This whole experience was so rewarding because I saw 30,000 other people pursuing something similar to me, and that fire that comes with running.  It’s an art, an expression of oneself.  Others find it in different ways, whether it be in their profession, other hobbies, or relationships they build with others.  It’s amazing to see what’s possible when you love something, and when so many other people go out of their way to support you on that journey.  I love you all for being the kindling to my fire.  Thank you!!!


 

Name: Jenna (Carlson) Jarvis, Class of 2017
Undergrad: Boise State University
Hometown: Broomfield, CO
Fun Fact: My personal record in the mile is a 5:09, but I still would really like to go sub-5 someday.

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Boston is a one of a kind race. Beyond the prestige associated with running one of the few US marathons that requires a qualifying time, everyone told me that people would be cheering me on the entire 26.2 miles and the magic of the race would carry me.  They were right.

The race starts off with you and your closest 7,000 similarly paced friends, standing too close for comfort in a small coral, waiting for that gun to go off.  When it finally does go off, don’t expect to actually start: it will take a while for everyone in front of you to start moving!  The next few miles are still crowded with people running a similar pace, guiding you along to the pace you should be running when you want to hurry down the hills.  The remainder of the race follows the roads of different towns going toward Boston; they’re all lined with cheering fans and accessorized with an insane number of volunteers handing out hundreds of cups of water and police officers and military personal ensuring you are safe.

When people told me there would be people cheering the entire course, I thought they were exaggerating.  They were not.  It is one of the most incredible and exhilarating things I have experienced in a race.  Within each town, there were hundreds of people that line the streets, screaming, holding signs, handing out orange slices and water bottles, and giving you all the encouragement you could possibly need from a crowd.

One of my favorite parts of the race was around mile 13 in Wellesley, MA, home to Wellesley College.  Here, the enthusiasm and energy of the college students was even higher than the previous crowds; I got a big boost of energy, purely because these women looked like they are having so much fun cheering people on and it reminded me that I should be having fun, too!

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The thing I loved the most about running the Boston marathon, however, was the incredible people running the race.  The elites run the marathon in incredible times, but I can’t help but be amazed by what can be done by the rest of us 40,000 mortals.  The energy at the starting line is so supportive and exciting.  Then, as the course drags on and on and as people are getting more and more exhausted, there was (if possible) even more encouragement given to each other. A man came up to me around mile 11 and asked how I was doing.  I lied and told him I was doing alright, and he replied that he was having a hard time with the heat.  I told him he would get through and be fine and he told me the same; this little act of encouragement and kindness meant so much to me.  I saw athletes with amputations and in wheelchairs powering up hills, and it inspired me to keep pushing on when I was hurting because they were probably working harder and hurting more.  I saw runners helping others who were delirious from exhaustion.  I saw some runners carry a woman across the finish line when her legs were no longer willing to carry her.  How can you not be inspired by these people and the incredible things they do for each other?

The race I ran was not what I had wanted.  It was certainly the hardest, most painful race I have ever run.  As a PT student, very often our clinicals, boards, and life take precedence over training (as they rightfully should!). Those things took a much larger toll on me and my training than I thought and would have liked.  Even so, I gave everything I had out on that course that day, and for that I am happy.  Overall, the Boston Marathon did not disappoint.

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My Immersion Trip in Ethiopia: A Reminder About the Importance of Communication

Name: Matt Gervais, Class of 2017
Hometown: Medford, OR
Undergrad: University of Portland
Fun Fact: I actually enjoy wearing ties.
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Matt Gervais, disguised as a bottle of Sriracha sauce, ran the Move Forward 5K/10K with his classmates in the fall

Every year, the Regis University School of Physical Therapy puts on a series of immersion trips around the world as part of students’ 3rd or 4th clinical rotation. Through an application process, around 25 students in each class get selected to participate in 1 of 4 immersion experiences. This year, the options were Ethiopia (available in Fall and Spring), Peru (Fall), and Nicaragua (Spring). I applied for and was fortunately selected to go on the Fall Ethiopia trip. The experience did not disappoint!
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Regis DPT students on the Ethiopia immersion trip (from left to right): Brent Ingelman, Alexander William, Matt Gervais, Elizabeth Heckmuller, Morgan Pearson, and Amanda Morrow

Six of us students and three faculty members took part in the trip.  We students worked in several different hospitals around Addis Ababa, the capital city of Ethiopia.  One other classmate and I worked in an outpatient clinic at Yekatit Twelve Hospital, a government-run hospital near the center of the city.  In Ethiopia, inpatient physical therapy and initial mobility work is far less common than it is in the US, so most PT is outpatient PT.  The Yekatit 12 clinic sees a huge variety of patients: post-stroke, spinal cord injury, low back pain, post-fracture contracture, post-burn contracture, Guillaine-Barré syndrome, and many others.  Several things jumped out to me about the clinic: the small space available (coupled with a ton of patients), the lack of clinic resources, and the positive mindsets of the patients.

img_3531The small clinic was very crowded from the time we arrived at work in the morning until the time we left the clinic at noon. Because physical therapy is not the most lucrative career in Ethiopia, many PTs only work 3-4 hours per day in the morning and work other jobs in the evening. As such, every patient with a prescription for physical therapy would come to the clinic early in the morning and wait—sometimes up to 2-3 hours—to be seen. Naturally, this meant we had very limited space to use for treatment in the clinic.

Also, the clinic lacked many resources that we take for granted in outpatient clinics in the US; we learn to expect high-low tables/mat tables, exercise equipment, private rooms, a large selection of weights, and space to do a variety of PT interventions. I believe every student on the trip learned to be significantly more creative through the process.  For example, several times we used a makeshift combination of theraband, a dumbbell, and an ankle cable attachment cuff to create a forefoot weight, along with many other techniques that can only be described as “winging it.”

In any event, we made the small space and relative lack of resources work. And, despite the shortage of space and equipment, patients managed to maintain a very positive attitude and constantly work towards their goals. These attributes, coupled with an unwavering respect for healthcare practitioners, undoubtedly contributed to improving their outcomes.

Because of our short clinic hours during the mornings, we worked with many Non-Government Organizations in the afternoons. Our work included teaching basic nutrition, basic first aid, and performing PT at several different aid organizations. We also collaborated with students from the Regis-sponsored DPT program at Addis Ababa University—the first program of its kind in the country. Between our work and simply exploring the city, it was an incredibly busy and transformative trip.

Ultimately, my greatest takeaway from our trip to Ethiopia was the importance of communication. I started the trip assuming that many of our patients would understand English, at least to some extent. My first day in the clinic disproved that assumption, though, and I had to rapidly scramble to learn basic Amharic words so I could create some form of communication with my patients. In the end, I was not very successful during my short trip, but I learned to lean more on teaching through demonstration. I was reminded that, even in patients that do speak English, you can never underestimate the value of demonstrating a task to help a patient learn.

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Beyond all else, my immersion trip to Ethiopia reminded me that communication is paramount. As PT students and future healthcare professionals, we often are focused entirely on providing the most optimal care as efficiently as possible. However, without effective communication and rapport, that optimal care will likely never be delivered effectively. This program was a tangible reminder that sometimes strong communication can trump every piece of optimal practice that research can provide. I believe I can speak for every student and faculty member on my trip in saying that the Ethiopia immersion trip was a fantastic and informative experience. I highly recommend it to anyone in the program—even if you don’t necessarily have an interest in travel. Each trip is an invaluable experience to work with populations you rarely get to work with and is a unique opportunity to hone your clinical skills, communication skills, and intercultural awareness.

Wrapping Up the Fall Semester

Michael Young, second year Regis DPT student, writes in about his shifting perspective on the world of PT and reflections on this past year.  Michael serves as the Vice President for the Class of 2018 and hosts phenomenal game nights.

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Name: Michael Young, Class of 2018
Hometown: Madison, WI
Undergrad: University of Wisconsin, Madison
Fun Fact: When people tell me to put my money where my mouth is, I tell them I already have. I’ve had 16 teeth pulled(some baby, some permanent), braces 3 times, and reconstructive jaw surgery!

As a first year Regis DPT student, life was an anxious blur of due dates, exams, group meetings, and basically doing my best to hold on to the wild ride that we call PT school. As a second year student, I’m sorry to report that PT school is still a blur of due dates, exams, and group meetings. However, I no longer have to hold on quite as tight. I discovered over the last year that I am capable of learning at a graduate level. That knowledge alone takes an incredible amount of stress off my shoulders. However, now that I know I can make it through the struggles of the short-term, I’ve gotten to worrying about my long-term future. The stakes feel higher, and now I’m more concerned with who I will be when this graduate program spits me out into the real world.

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Michael takes a break from school and explores CO

That “real world” of physical therapy is starting to make more sense to me every day. It’s not that I have eureka moments with every lecture or lab; it’s actually the opposite. The amount of information in every lecture is overwhelming, the concepts are more difficult, and the clinical reasoning is not as straight forward. However, this year, I’m not worried about all those things. I understand that I am going to be overwhelmed by information in my classes and what is asked of me, but you know what? I’m going to pass my exams, I’m not going to fail out of school, and I’m going to be a certified PT in a year and a half. The light, however dim, is at the end of the tunnel.

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Michael and Alison got married over the winter break last year!

As a second year student, I don’t worry about school anymore. Instead, I worry about grown-up things. Where will my wife and I live after I graduate? What sort of setting will I practice in, and will it be the right fit for me? If I stay and practice in Denver, will high prices in the housing market and relatively low PT salaries allow me to buy a house while simultaneously paying off student loans? These are the questions that I get to worry about this year. True, I don’t have anatomy exams or human physiology practicals to worry about, but just writing about my newly found grown-up questions makes me anxious.

What else do I know as a 2nd year DPT student? I know that I am about to earn a doctoral degree, which according to the 2012 US census puts me in a category I’ll share with fewer than 2% of all Americans. I also know that there aren’t many better ways to isolate yourself from the general population than by being a student for 25 years of your life. I know that the community members I meet through my upcoming clinical experiences and patients I will treat as a future physical therapist will profoundly change the way I see my community, myself, and my nation. I cannot wait to surround myself with the people I have trained my whole life to treat, yet have met only briefly.

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Michael has had adventures both in school and out of school in the past year.

So here I am: a second year DPT student just realizing that the real world is coming, and I finally get to be a part of it. I am more excited than ever to get back into the clinic to meet a slice of this nation that I have been isolated from over these last years in academia. As I continue to study as a student and learn as a clinician, I hope to grow as a person. And, if the rest of my time at Regis is anything like what I have already experienced, I am confident that I will have success as a physical therapist and success in life.

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Pelvic Health Physical Therapy: First Clinical Experience Reflection

Name: Maggie Nguyen, Class of 2018
Hometown: San Jose, CA
Undergrad: UC Santa Barbara

Fun Fact: I got 33 stitches across my forehead in high school.

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What is pelvic physical therapy?

I never would have guessed that my first clinical rotation would land me in rural Montrose, Colorado with a Clinical Instructor who specializes in pelvic health. I walked in on the first day absolutely terrified and with no idea what pelvic PT entailed. It turns out that pelvic physical therapy encompasses a wide range of diagnoses ranging from pre/post-surgery (hysterectomy, prostatectomy, C-section, etc.), pregnancy, sexual trauma, interstitial cystitis, urinary and fecal incontinence, rectal/uterine prolapse, and—essentially—anyone who is experiencing pelvic pain. We treat both women and men; we practiced manual therapy externally and internally using our hands and various tools.

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The pelvic floor

Your pelvic floor has two main purposes: it is a network of muscles that stabilize your entire pelvis and hips—so it affects your back and down to your knees—and it also relaxes and contracts at the appropriate times; this allows you to jump, run, and laugh without urinating or having a bowel movement when you don’t want to. If your pelvis is out of alignment or the muscles of the pelvic floor are not firing correctly, it throws off your entire body and is extremely painful. Just like you can get knots in the muscles of your neck and back, you can also get knots within your pelvic floor.

It was a world of PT that I didn’t even know existed. My CI was a Regis graduate and her treatment revolves mainly around manual therapy—specifically, trigger point release and soft tissue massage. She also uses biofeedback: by putting electrodes around the rectum, patients are given a visual of how strong or weak their pelvic floor muscle contractions are. The first four weeks of my rotation were spent mostly observing my CI. Every once in a while, she’d let me palpate external muscles that felt abnormal. By the fifth week, I had a foundation strong enough to be able to assess and treat some patients entirely on my own!

Did I feel prepared?

Yes and no. Who remembers the origin, insertion or innervation of the bulbocavernosus? I sure didn’t; a lot of our pelvic floor knowledge came from the first semester of PT school, and it took a little bit of time to refresh on the details. On the other hand, I had a tool belt filled with knowledge that I could draw from: I used the lower quarter scan we learned in our PT Exam class, manual muscle testing, motivational interviewing and, most importantly, palpation. Palpation allowed me to do an external assessment of posture and pelvic alignment despite not having a thorough background of pelvic health.

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Biggest Takeaway?

My first clinical rotation gave me my “breakthrough moment.” We all start school questioning whether or not we deserve to be here, whether or not we’re as smart as our peers, and whether or not we’re going to be good practitioners. For the past year, I wasn’t sure of any of those things until my fourth week of this first clinical. I had an overwhelming feeling of gratitude from my patients and a feeling of capability that reignited my passion for PT and reminded me of why I started the whole journey in the first place.

And, if you ever find yourself exploring the Western Slope, make sure to check out Telluride, Ouray, Black Canyon National Park, and the breathtaking Blue Lakes!

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Upcoming Event: ADVENTURE FEST!

If you love mini golf, go karts, food and craft beer, you do not want to miss the awesome event coming up this Saturday, October 8th! The Regis DPT class of 2018 is hosting Adventure Fest to raise money for our Regis graduation celebration.  It’s also an opportunity to celebrate fall, have fun with family and friends, and get to know the Class of 2019.

When: Saturday, October 8, 2016 from 10am-2pm!

Why: All proceeds from this event will go towards our end of the year bash!

Price: You can purchase one ticket for $18 or 2 tickets for $30.

Children (ages 4-15): $8; those under the age of 4 are FREE!

Tickets: sold Monday-Friday the week of Oct. 3-7th from 12-1pm in the Claver Café as well as in front of the Main Café!

You can buy your tickets with cash, check, or remotely by VENMO (@RegisDPT2018).

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This is an event for all ages and there is something to do for everyone. Each ticket includes free food, $2 craft beers, and a park bracelet that provides you unlimited access to mini golf, go karting, and rope courses! Furthermore, Regis DPT mentors and mentees can enter into a mini-golf competition together and the team with the best score wins a prize. Come out and have a great time while supporting the Regis DPT class of 2018!

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Blogger: Emily Symon, Class of 2018

 

 

Counting down to more blog posts…

The school year has ramped up!  Our Class of 2019 just finished their first set of exams, the Class of 2018 is finishing their last week of clinicals, and the Class of 2017 is preparing for their third clinical rotation next week.

Along with that, the blog committee has new members and we’re excited to begin posting for the 2016-2017 school year!

Check out our website tomorrow to hear from Kelsie Jordan, our first Class of 2019 featured blogger.

Flat Stanley Goes to Clinical

Name: Nicole Darragh, Class of 2017

Hometown: Columbus, OH

Undergrad: Regis University

Fun Fact: I think kale is totally overrated.

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The Class of 2017 recently returned from their second clinical rotations with a plethora of new knowledge and stories to share.  Some students even had a visitor along the way: Flat Stanley.  Flat Stanley is a small paper figurine that keeps students connected outside of the classroom.  Students take a photo of Flat Stanley completing an activity, learning a new technique, or going to a cool new location, and share those photos with their classmates through social media.  This helped us learn a little bit about each rotation, and keep in touch with our classmates.

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Pictured: Sarah Campbell ’17 with Flat Stanley on her first day of clinical (PC: Sarah Campbell)

Flat Stanley traveled to a wide variety of locations across the country including California, Wyoming, Kentucky, and even Alaska!  Along the way, Flat Stanley learned new documentation systems, new techniques in the clinics, and went on a lot of hikes.  Really, what Flat Stanley is trying to tell you is that while you’re on your clinical rotation, don’t forget to take the time to explore your new surroundings!

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Flat Stanley reviews Functional Electrical Stimulation (FES) while at clinic in Chico, CA (PC: Adam Engelsgjerd)

 

Clinical rotations work in a variety of ways.  The first is the lottery option; students choose ten clinical sites from a large list compiled by the clinical education faculty, and rank them in order from 1-10.  Once the lottery is generated, students are placed at a site.  The second is the first come, first serve option; students can choose a site before the lottery begins that they are particularly interested in, and request to be placed at that site before it is taken.  The third is the set-up option: students are allowed to contact a clinical site that is not affiliated with Regis and set up a clinical rotation with them if they are interested.  When rotations get closer, you’ll learn more specifics about how they work, requirements, etc.

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Flat Stanley’s meet up at Devil’s Tower outside of Gillette, WY (PC: Amanda Morrow)

 

Throughout the clinical process, it is important to know that you might not always end up in Denver, and you’ll have to try something new!  Wherever you do end up, make sure to enjoy your free time.  Clinical can sometimes be very overwhelming, and it is crucial to take time for yourself, whether that be exploring your new surroundings, trying a local restaurant, or binging on Netflix.  And if the thought of being gone for six, eight, or twelve weeks scares you a little, all of us will tell you that the time flies by so quickly.  There isn’t much time to be bored!

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Flat Stanley goes sandboarding in the Great Sand Dunes National Park in southern Colorado (PC: Lauren Hill)

 

If you have any further questions about clinical rotations–or other places Flat Stanley and/or students traveled–please feel free to contact me at darra608@regis.edu!  Also, I would recommend reading the post below called “Class of 2017 DPT Student Lindsay Mayors Reflects on Her Clinical Rotation.” (https://regisdpt.org/2016/05/27/class-of-2017-dpt-student-lindsay-mayors-reflects-on-her-clinical-rotation/)

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Flat Stanley helps out with some end-of-the-day documentation (PC: Amy Medlock)

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Flat Stanley enjoying a nice Moscow Mule after a long week at clinical (PC: Amy Medlock)

 

 

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Flat Stanley joins Lauren Hill and Jenna Carlson to run the Bolder Boulder race (PC: Lauren Hill)

Cover PC: David Cummins, Class of 2019

 

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.