Managing Your Posture in PT School

Name: Joshua Holland

Undergrad: Idaho State University

Hometown: Centennial, Colorado

Fun fact: Before PT school, I worked at a BBQ restaurant in Missoula, MT called Notorious P.I.G.

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Last week, I was editing my Biomechanics skills video when I noticed a curly-haired DPT student in my video with fairly poor posture. I was far from excited when I realized that student was me. I knew my posture wasn’t the greatest after years of asymmetrical shoulder position from college pole vaulting and poor lifting mechanics, but I had no idea it was THAT bad! My shoulders were protracted with my head in a significantly forward position. My initial thought was, “man, I am about to be a PT soon…how am I going to teach posture when my own posture is so poor?!”

An average day for PT students involves a heavy dose of lectures, studying, and an even heavier dose of sitting. Often a PT student may be seated in lectures for 8 hours a day. By the end of the day, professors may start to notice students performing many combinations of wiggling, shifting, and slouching, with many students standing up in the back of the class.

The field of physical therapy involves movement for rehabilitation and we often hear, “exercise is good!” However, within school, sometimes we neglect our own movement in order to remain studious. The intention of this blog post is to initiate the thought of posture and provide some quick exercises that DPT students can use throughout their day. As future clinicians, we are role models to many of our patients, so it is important that we recognize our own posture and work to preserve good body mechanics within ourselves in order to have long-lasting careers and fully help our patients.

I couldn’t sleep after seeing my poor posture! So, I set out the next day to find ways to correct and maintain posture and decided to share them with you all. In this blog post, I interviewed Dr. Alice Davis, an expert on the spine, and fellow first year DPT student, Sarah Spivey, a certified pilates instructor since 2007, to provide some tricks on improving posture!

 

Question and Answer Interview with Dr. Alice Davis

Q: Often our posture is poor in class, we tend to slump over to write down our notes, what are some cues we can use in class to correct this?

A: Make sure your feet are flat on the floor and use the back of the chair to support you. You are becoming kinesthetically aware of your body in space as PT students, so try to be aware of the weight on your ischial tuberosities as you sit. Try to make each ischial tuberosity level. The overuse of repetitive poor posture is what creates problems over time, so start to realize your body position while you sit in class.

Q: While we sit in class it feels like we roll our shoulders forward and lean forward to pay closer attention or write on our devices, what are some cues to get those shoulders back with a neutral head?

A: Because you are sitting at computers for most of the days, you tend to have some upper cervical extension and increased flexion in the lower cervical spine. Imagine there is a rope going straight through your head and down to your seat, try to make that rope as straight as possible. A quick exercise you can do in class is move your shoulders up an inch, back an inch, and down an inch, then hold this for ten seconds, and relax. Try to do 10 reps for 10 seconds of this exercise.

Q: For the anatomy nerds out there, what are some of the muscles that are affected by this forward leaning posture/slumped position?

A: The upper cervical spine is extended in this forward posture position. Suboccipitals are a major component in this and often called the headache muscles because it can result in cervicogenic headache. A cervicogenic headache is when the pain begins in the back of the neck first before it goes up to the skull. This can be posture and stress related. Other muscles that play into extensor moment of the upper-cervical spine are the splenius and semispinalis muscles.

Q: Is there any other tips and tricks we can use in the classroom and out of the classroom to help with posture?

A:  

  • Foam rollers are great! You can put the foam roller vertically along your spine with the head and sacrum supported. Using your arms, do some snow angels for pectoralis major and minor.
  • If you are feeling uncomfortable and wiggly, your body is telling you to move – get up and move around.
  • Do something during lunch time. Eating is important, but try not to study if you don’t have to. Give 30 minutes during lunch for your body and mind.
  • Breathing is important. Moving the body and getting the diaphragm to move through breathing helps those muscles that support the thorax. Watch your breathing pattern, especially when you are stressed. Try to do some slow inhales and exhales.
  • Try a simple nodding of your head, as if you’re saying yes. This lengthens the longus colli and capitis muscles that can help with postural support. You can even do this when you’re driving! Rest your occiput on the headrest and perform a little nod. Try to hold the nod for 10 seconds with 10 repetitions.

 

Here are some techniques and exercises for managing posture in graduate school (or any career environment!) brought to you by our very own DPT first year, Sarah Spivey!

 

Sit on deflated Gertie ball.

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This will allow you to sit up on your ischial tuberosities (IT) to encourage a more natural lordotic curve while also eliminating the pressure on the ITs. By sitting on a relatively unstable surface you will also increase the use of your postural stabilizers. Try to incorporate five minutes per hour of sitting.

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Another technique is to use the Gertie ball between your lumbar spine and your chair. Find your ideal posture by allowing yourself to slump in your chair. Now, move into a full anterior tilt of your pelvis until you feel pressure in your lower back. Now, ease off until you feel the pressure disappear. Scoot back toward the back of your chair and place the ball at the level of the lumbar spine. The ball will help you maintain your neutral posture during sitting.

Head nods/nose circles on Gertie ball.

Lie in supine on a firm surface. Bend your knees and place your feet at the distance of your ASIS. Allow your sacrum to feel heavy and equally distributed on the floor/mat. Take a few breaths and notice if you have excessive space between your thoracic spine and the floor. If so, on an exhale, allow your t-spine to sink toward the floor. This should limit any rib flare. Place a 1/3 – ½ inflated Gertie ball (or folded towel) under your head. You should feel pressure evenly distributed near your occipital protuberance – this will insure you are lengthening your cervical extensors (especially for those of use with a forward head!). Take a few breaths and allow your head to feel heavy on the ball. Imagine a one-inch line on the ceiling and slowly trace this line down with your nose. Return to your starting position making sure to avoid moving into extension. Repeat this 8-10 times. Now draw slow circles with your nose around your one-inch line. Keep your circles small and controlled. Perform 6-8 in each direction.

Wall sit pelvic curls.

While sitting in class, if you start to feel your low back tighten up, try this stretch! Stand against a wall with your feet about 12 inches in front of the wall and hip distance apart. Try to feel contact of your sacrum, rib cage and the back of your head on the wall. You should have a very small space between your lumbar spine and the wall. As you exhale, draw your abdominals in and curl your pubic bone up toward your nose. You should feel your lumbar spine flatter against the wall. As you inhale, slowly allow your ischial tuberosities to widen until you are back in a neutral position. Repeat 10-12 times.

 Seated neck stretch – sitting on hand.

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Feeling tension in your neck during class? Scoot forward so your back is away from the chair and sit tall on your ischial tuberosities. Imagine lengthening your cervical spine and then gently tuck your chin toward your chest. Try not to flex your cervical spine! Now allow one ear to fall toward your shoulder. You should feel a stretch on the opposite side. If you would like to increase your stretch, you can sit on the hand of the side you are stretching. For example, if you are feeling the stretch on the right side, sit on your right hand. This will bring your shoulder down and away from your ear.

 

Overall, I hope  this post helped you become more aware of how important it is that we practice good posture while in school, or with any lifestyle! Do you have favorite exercises or tips to remind you to practice posture? Feel free to share with us in a comment below!

Finals Week: A Beautiful Struggle

It’s that time of the year again…

No, we’re not talking about the holidays.

It’s Finals Week, the crescendo of each physical therapy (PT) school semester.

If you haven’t experienced a finals week in PT school, then here are a few ideas of what Regis students encounter during this time each semester.

  1. …but first, Practicals Week

Gone are the days of “dead weeks” leading up to final exams. Practical Exam Week is usually the week prior to all of the written final exams. This is where the skills you have acquired over the entire semester are put to the test to see how you are able to apply them in a real-life situation. During the days leading up to these exams, you will often see students crowding into room PCH 409 to practice their skills and drill each other on the specific times to use them. Study sessions can extend late into the night for some students (Pssst…PT school secret: often these practicals require knowing information that will also be on the written final, so it’s like studying for two exams at once…now that’s a deal!)

  1. Review Sessions

It is not uncommon for faculty members to hold review sessions discussing what to expect on the final written exam. These are often a great help in refining study strategies (PT school pearl of wisdom: take advantage of these sessions!)

  1. Finals Week Schedules

Each class takes 4-5 exams the entire week, with one exam per day and each one for 2 hours. You can find last minute study sessions dispersed across Claver Hall in the hours leading up to the exams to review any lingering questions or fill any remaining knowledge gaps. And hey, after one exam is over, students have 22 hours to study for the next test…what an ample amount of time!

  1. Work-Life Balance

In the words of The Great Tom McPoil, “take a day for yourself every week.” This may be hard to remember during these challenging weeks, but still very relevant. Students usually make modifications to Tom’s “day” suggestion during finals week, and instead take a few hours to relax and meditate with various types of exercise (or naps) – whatever takes the mind off studying for a few moments.

  1. The Triumph of Completing a Semester of PT School

At the end of each finals week, you will find students celebrating another semester down and another job well done! It’s a time to look back at the terrific accomplishments with pride and relish in the fact that your hard work got you here

– Courtney Backward

Check out this video of first and second year students studying (and relaxing) for their finals!

 

Video Credit: Janki Patel

 

Meet the Class of 2019 President: David Cummins

Name: David Cummins, Class of 2019
Hometown: Cortez, CO
Undergrad: Fort Lewis College

Fun Fact: I’ve moved 17 times since graduating high school

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When I received a letter from Regis University notifying me that I’d been accepted into their DPT program, I panicked. I had been working hard to get into PT school, but the reality of the impending changes caught me off guard. As a non-traditional student who had been out of school for more than 10 years, I was nervous about leaving the career I had worked so hard to build. The thought of surrounding myself with young, smart, successful, and ambitious classmates only added to my anxiety.

By the end of the first week of classes, I realized I had found my new family. Classmates surprised me by being genuinely interested in my academic success. They shared study guides, strategies for achievement, and—most importantly—support. There is now a palpable (Ha! Get it?) mentality that we’re all going to get through this program together;  that has made my anxiety melt away.

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David and his classmates climbing a 14er with some time off from school (PC: Elizabeth Johnson)

I was honored when someone nominated me for class president and elated when I was elected because the role will give me a chance to foster the supportive environment that got me through my first few weeks. The position comes with a lot of extra stress, but I’ll be working with an incredible group of elected officers who share the same vision of creating a healthy and supportive environment that is conducive to academic growth and overall success.

The 14 elected officers come from a wide variety of different backgrounds. Some have extensive experience working with physical therapists, some have worked in completely unrelated fields, and some are coming straight from undergraduate programs. Together, we represent a holistic cross-section of knowledge and viewpoints. We will utilize our combined skills and knowledge to build upon the foundation that previous classes have established and add our own projects and ideas to make this experience our own.

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The new officers for the Class of 2019

We’ve already been through a lot in the 11 short weeks we’ve known each other. The support and encouragement I’ve experienced has been overwhelming. Over the next 2.5 years, I hope to cultivate a supportive cohort based on the values we all share: we will be a community that promotes shared academic success and continues to motivate us to be the best, most compassionate physical therapists we can be.

President: David Cummins

Vice President: Katarina Mendoza

APTA Rep: Grace-Marie Vega

Fundraising Rep: Kassidy Stecklein and Celisa Hahn

DPT Rep: Nina Carson

Media Rep: Courtney Backward

Diversity Rep: Stephanie Adams

Ministry Rep: Sarah Collins

Service Rep: Amber Bolen

Move Forward Rep: Sarah Pancoast

Clin Ed Rep: Josh Hubert

Admissions Rep: Kelsie Jordan

Secretary: LeeAnne Little

Treasurer: Jennifer Tram

 

 

Regis DPT gear sale: order before October 30th!

It’s that time of the year: the fall clothing order is here! The Class of 2018 will take orders until October 30th, so now is the time to get your Regis DPT swag.

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We have water bottles, wine glasses, hats, shirts and sweaters that will all be emblazoned with the Regis DPT logo upon ordering.  Whether you’re preparing for the winter season or looking for gift ideas, we recommend you check out the list and order before October 30th!

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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

 

 

6 Weeks into PT School: Meet Kelsie Jordan

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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If I had to describe the first few weeks of PT school in one word, it would probably be “overwhelming.” I don’t even mean that in a negative way— so many of the experiences I’ve had so far have been amazing—but I would definitely not say it’s been easy. My classmates and I have been overwhelmed with both the excitement and nervousness to finally start this next part of our lives: in the past month, we’ve been introduced to a new school, new people, new homes, new habits, and—of course—with the amount of information we’ve received since the first day of classes.  More than anything else, though, I’ve been overwhelmed by all the new opportunities at my disposal and all the great people I get to spend the next three years with.

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Free concerts and NFL kick off!

You’d think that having a class of 81 people would make getting to know everyone difficult, but it’s been quite the opposite at Regis. It turns out that when you spend roughly 40+ hours per week with the same people who are in the exact same boat, you get to know a lot about each other in a very short amount of time. Of course, I obviously don’t know absolutely everyone well at this point, but it’s still easy to forget that we all met less than two months ago. Before deciding on Regis, I was a little apprehensive about having such a large class compared to other DPT programs; now that I’m here, I wouldn’t want it any other way.

The biggest piece of advice I’ve heard time and time again from the second and third year students is to take time for myself and have fun outside of school. I’ve definitely taken that advice to heart!   Perhaps that means I should be spending more of my free time studying, but hey, at least I’m having fun, right? I’ve managed to leave plenty of time for hiking, camping, sporting events, concerts, Netflix, and IM sports—and I’ve been having a blast! Being a successful student is all about maintaining balance between work and play, so those mental health breaks are important to me for keeping my brain from being overloaded.

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Hiking Horsetooth Mountain in Fort Collins

So exploring Colorado has been the easy part of transitioning to Regis—I mean, what’s not to love? Starting school again, on the other hand…I only took one year off between graduation and PT school, but it still took some transition time to remember how to take notes and study. Fortunately for me, a lot of the material so far has been familiar information from undergrad, though it’s definitely more intense. One of the aspects of the Regis DPT program that I really appreciate is the collaborative atmosphere.  Anyone—students and faculty alike—with a little more expertise in a certain area has been doing their best to share that information by providing extra resources, study sessions, etc. It also helps that we’ve all been embraced right into the Regis DPT community by the second and third years, and I definitely get the sense that the faculty genuinely care about our success in school and in our future careers.

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We’re official! Our new PT supplies after the Professional Ceremony

We’re now six weeks into PT school and sometimes I still have these moments where I can’t believe I’m actually here. It’s crazy to think back to this time last year when I still hadn’t even submitted my first PTCAS application, and now here I am: a student physical therapist. Overall, it feels like I’ve adjusted well to my new home in Denver as well as the grad student life—despite the overwhelming moments. Now that we’re through our first round of exams, it’s probably a safe bet that our “honeymoon phase” has come to a close and we have an increasingly busy schedule looming ahead. I’m still developing responsible study habits and I have a lot to learn about how to be a successful student, but I look forward to the upcoming opportunities for service, leadership, and classmate bonding that the rest of the semester will bring!

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

 

What is it like to be in the military and PT school?

Name: Zach Taillie, Class of 2018

Hometown: Phoenix, NY

Undergrad: SUNY Cortland

Fun Fact: I’ve been in the Air Force for 6 years.
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You may not believe this, but NASCAR Technical Institute is a bit of a dead-end school.  You read that right—there is a school completely dedicated to folks who want to learn about race car maintenance and occasionally take them for a spin.  It is a one-year program outside Charlotte, NC, and was what I thought I wanted to do.  While the program set me up for an awesome career as a tire technician at Sears Auto while living out of my parents’ basement, I decided I wanted more out . I found myself over at the Air National Guard office, and in December of 2009, I enlisted.

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Once I was done with my training and learned that I could get school payed for while serving in the military, I was stoked to get started. Little did I know that when it comes to school and military duty, school usually doesn’t win. The biggest mission we undertake in the Air National Guard is state-level disaster response.  My first emergency response was to a winter storm, and to my surprise, I was told by my supervisor that school takes a backseat to duty.  I remember feeling frustrated at the situation, but once I showed up I realized how much of a positive impact we could have.  The feeling of helping out and giving back to those who needed it far outweighed any disappointment at missing classes or balancing class all day with working at night.  Luckily, I was blessed with great professors who would email me notes and allow me to reschedule tests if necessary.  This understanding and flexibility allowed me to respond whenever the call went out, and it allowed me to still excel in school.

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The military hasn’t been all rough, though.  During one of my winter breaks, I was sent to Germany for training.  I spent Christmas in Kaiserslauten, New Years in Berlin, and my birthday in Amsterdam.  Even when I wasn’t out exploring Europe, I was able to have fun at work coordinating air drops (think Humvees and supplies hopping out of planes) with the 86th Airlift Wing.  I’ve had the opportunity to deploy to the Middle East and serve with coalition troops from all over the world and make some lifelong friends.  Oh, and having part of school paid for is another perk!

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Although I originally thought I wanted to make a career of the military as an officer once I graduated from college, I stumbled upon physical therapy during my junior year and fell in love.  Due to a shoulder injury, I was able to experience what it was like to go from injured back to working out and wanted to give that gift to others.  Fast-forward a couple of years, and here I am: at Regis fulfilling me dream!  Currently, I serve with the 153rd Airlift Wing up in Cheyenne, Wyoming.  I go up once a month and spend at least half of my breaks working.  Luckily, my drill schedule and our finals week seem to always coincide…so I get the opportunity to test how long I can stay awake and study.  Two semesters down, and I’m still here!!  While I listen to my classmates plan super rad trips for our summer break, I’m looking forward to two weeks of work connected by a drill weekend.  All things considered, though, I would do all the same given another chance.  I work with some great people and get to do things for my job that most people only see in movies: riding on C-130s, running through live shoot houses, firing some pretty awesome weapons, and watching live gun runs from planes overhead.  The military/civilian balance can be a challenge at times, but it’s one that’s well worth it!

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If you have any questions about balancing school with the military, please feel free to contact me at ztaillie@regis.edu.

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.

 

 

Regis DPT Students Plan the Move Forward 5K/10K

Name: Ryan Bourdo, Class of 2018

Hometown: Corvallis, Oregon

Undergrad: University of Oregon

Fun Fact: I ran a 4K snow shoe race once.

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Race day is always the best. It is the culmination of months of training—immediately followed by the chance to take a well-deserved day, week, or month off from running. The atmosphere is always amazing, too. Everyone is still a little groggy from being up way too early for the weekend, but there is still a palpable excitement; the people next to you on the starting line are instant friends because you all share a common goal: finish the race. And that feeling you get after finishing? Incredible. No matter how tough a race is for me, I am always energetic and talkative afterwards. I have been fortunate enough to run some fun races in the last few years, and I want to bring some of that same excitement to Move Forward.

The Move Forward 5K/10K Race (September 17, 2016) is arguably THE most important event of the year for Regis University’s School of Physical Therapy. I argue this because I am the co-director of the race this year, and this is my blog post. Move Forward is a special event for me. It is a chance to help my school share what we know to be the best ways to live healthy lives. I firmly believe anyone can complete a 5K with practice, motivation, and a little help if needed. More than anything, what I want for people to get out of Move Forward this year is to have a good time and learn a little about taking care of themselves.

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Some of the Class of 2018 after the 2015 Move Forward Race

The idea behind this event is to get people to think about their health, get moving, and live better. For those already signed up, make sure to get to the race early to get your grab bags! We will have bagels, bananas, and coffee for those needing an extra boost in the morning. Several of our classmates will also lead group stretching as well. And then we are off! Music will be blaring, water stations will be flowing, people will be cheering. Whether you are running or walking, we will make sure you have a good time. Make sure to stay after the race, too, because we are planning a lot of post-race greatness. Not only will we have burgers, hot dogs, and beer (not the healthiest, we know, but you deserve it) but we are planning a lot of activities, as well. Informational booths will be there to help guide you in taking care of yourself through exercise, nutrition, and general wellness. We also hope to have some yoga and/or Zumba classes after the race. And, because we want this to be a family event, we are looking for fun activities for kids, tool. Check out our website for updates as our race schedule finalizes: https://moveforward5k10k.racedirector.com.

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Not only will this race be a great way to learn about how to stay healthy, but all of the proceeds will go to Canine for Companions and the Foundation for Physical Therapy. Canine for Companions is especially meaningful to us at Regis because we have an annual team of students that assists in raising a dog before it starts training to become a fully-fledged service dog. The Foundation for Physical Therapy is also a great cause; it helps support research in physical therapy. If you have not signed up for the race yet and I have thoroughly convinced you of how awesome this event will be, you can register here: https://moveforward5k10k.racedirector.com/registration-1.

Again, the race will be held on September 17, 2016 and begins at 9:00am.  If you have any questions, please feel free to email me directly at rbourdo@regis.edu.

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Many Ryans running

Ryan Bourdo graduated The University of Oregon with B.S. Degrees in Biology and Human Physiology in 2010. Originally thinking of medical school (never mind the fact that medical school rejected him twice), he soon fell in love with physical therapy, thanks to an amazing therapist in Portland, Vince Blaney, MSPT. Vince showed him everything he originally wanted to be as a physician: using anatomy and physiology to help those with injuries. He soon worked as a physical therapist aide for two years and is currently at Regis University completing a Doctor of Physical Therapy. In his free time, Ryan likes to run, hike, and cook. You can find Ryan at www.ryanbourdo.com, or on Twitter @RyanBourdo

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The Physical Therapy Outcomes Registry

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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.

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Data… I love it! As a former engineer who analyzed a lot of data in my pre-PT life, I find it fascinating to see how lots of tiny bits of information, combined together, can provide us with a more comprehensive picture.

The PT Outcomes Registry is one of APTA’s current projects to create a centralized database for outcome data. The idea is to track a set of prioritized outcome measures (currently there are nine outcomes, but this may expand) across the country. Clinicians perform the outcome assessment with the patient at the initial evaluation and again at discharge to measure the patient’s progress and then input the information into the computerized system. The PT Outcomes Registry then compiles the data from all practitioners so that practitioners can see how they measure against a benchmark of other providers.

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Timeline

The program is still in its pilot phase with 216 enrolled users (currently all practicing PTs, no PTAs) at 25 organizations. The most recent development is to include residents and fellows to compare their outcomes both during their residency/fellowship and again afterward to see how their outcomes change with time and experience. Later this year, APTA will collect feedback via user survey of pilot users regarding usability, pros/cons, glitches, and so forth. The team at APTA will then incorporate this feedback into the PT Outcomes Registry system.

The Registry will officially launch at the beginning of 2017, at which time any clinical site will be able to join. Clinicians will pay to enroll in the program, which will give them access to the aggregated data to see how their practice stacks up against national benchmarks. The service will not be limited to APTA members. Karen Chesbrough, the outcomes registry director, states that by the end of 2017 the APTA would love to have 1000 users, with the long-term goal of involving as many clinicians/sites as possible to get as accurate a picture of current practice as possible.

Which types of data are included?

The current outcomes include global measures, such as AM-PAC™ (Activity Measure for Post-Acute Care™), PROMIS (Patient Reported Outcomes Measurement Information System), and OPTIMAL (Outpatient Physical Therapy Improvement in Movement Assessment Log). There are also regional/body-specific outcome measures such as NDI and Oswestry. Other data includes clinician profiles, patient demographics, and pain ratings; practitioners have the ability to enter data at treatment visits along with at initial evaluations, reassessment, and discharge. The types of outcomes included are vetted through an independent group of clinicians and academics (including one Canadian!) called the Scientific Advisory Panel.

The Scientific Advisory Panel is working in conjunction with the SIGs (Special Interest Groups) to develop prioritized objective data that the clinician would also collect as part of the PT Outcomes Registry based on the patient’s diagnosis. These modules may be specific to cervical pain or to infant torticollis, for example, and would include relevant ROM or other objective data.

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How does PT Outcomes Registry collect the data?

During the pilot program, enrollees are entering the data manually. Enrolled clinicians—or their clinic’s administrative support personnel—will log in to the system and select different tabs and boxes to enter the data, much like they do for electronic documentation of patient records.

However, manual data collection is time-consuming, so the current push within the project’s development is to build software “bridges” with all of the various EMR (electronic medical records) systems. These bridges would allow a computer program to connect the PT Outcomes Registry with each EMR system to pull the relevant pieces of data into the database. Each type of information (eg KOOS at initial eval, patient age, etc) will have an associated tag in the registry database, and each EMR will tag the same variable in their database so that the computer program will be able to match the data from the patient records to the PT Outcomes Registry. One EMR has already signed on to the project, and APTA is working to get more to participate. This will streamline the process significantly and will likely increase participation as less time and energy will be required for individual clinicians to enter the data by hand.

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What does this mean for clinicians?

Being a part of the PT Outcomes Registry would allow clinicians to see how their practice stacks up against others throughout the country. If a particular clinic performed very favorably within the Registry, it would be able to advertise this fact to patients and to different entities that may want to contract with the clinic. Participation in the PT Outcomes Registry would also enable a clinic to pinpoint how to improve poor performance in a particular area that they may not have previously recognized without the aggregate data.

The PT Outcomes Registry will provide objective information to support the assertion that PT restores function. We can then use this information to demonstrate our value to different organizations, whether that is with a hospital, an insurance organization, or to the general public.

The outcomes registry director also sees this information as eventually being linked to reimbursement. Linking outcomes to reimbursement would continue the trend to move away from fee-for-service and toward a value-based payment structure. A value-based payment structure rewards effective clinical practice, rather than performing treatment units with the highest reimbursement rates. This would be a win-win for evidence-based practitioners, as well as for their patients.

Eventually, with enough data, there is potential for the information to be used for research as well; the Outcomes Registry represents the exciting future of our profession!

PT Outcomes Registry Site | More info from the APTA

 

A Non-Native’s Guide to Colorado’s Summer Playground

Name: Evan Piche, Class of 2018

Hometown: Northampton, MA

Undergrad: Colorado State University

Fun Fact: I once thought I met Danny DeVito in an airport men’s room.

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Congratulations! If you’re reading this, there is a fair chance that you are either (a) my mother, or (b) a member of the incoming Class of 2019. Welcome, and since both parties will be visiting Colorado this summer, I’d like to help get you acquainted with some of the best trails Colorado has to offer. Denver is not, strictly speaking, a mountain town in the same sense as Telluride, Steamboat Springs, and Crested Butte are. We’re kind of out on the plains, straddling two worlds—but that doesn’t mean you’ll be short on options for running, hiking, or biking. We Denverites are fortunate enough to enjoy a wealth of those opportunities for after-school outdoor recreation, and when you have a long weekend and are up for a few hours in the car, the options for adventure are limitless.

With that, I’d like to offer my favorite hiking/trail running and mountain biking destinations in the Denver-metro area and beyond. From backcountry escapes to a quick after-class workout, you’re sure to find something to do this summer. (And, while I was not specifically asked to include this, I would be remiss in my duties if I did not use this opportunity to act as your ambassador to the world of Denver’s breakfast burritos.)

Hiking/Trail Running

School day: when you only have an hour or two after class, these are the places to check out! (15- 20 minutes away)

  • Matthews/Winters – Red Rocks Loop
    • A rolling, rocky 5-7 mile loop with fantastic views of the foothills west of Denver and the world-famous and aptly named Red Rocks Amphitheater.Mathew_Winters

trailrunproject.com/…/matthewswinters-red-rocks-loop

  • Falcon
    • Hands down the best climb in the Denver area, this trail winds its way up four steep technical miles to the summit of Mount Falcon. From here, either retrace your steps to the parking lot nearly 2,000 feet below or continue on to explore a vast trail network.Mt_Falcon.jpg

trailrunproject.com/…/mount-falcon-east-loop

  • Green Mountain, Lakewood
    • A mostly gentle 5-8 mile single track loop featuring the Front Range’s best sunrise and sunset views.Green_Mtn

trailrunproject.com/…/green-mountain-trail

Weekend: about a 90-minute drive from Denver

  • Sky Pond, Rocky Mountain National Park
    • A classic RMNP hike; after meandering around the base of Long’s Peak, the trail turns vertical and ends with a fun scramble to Sky Pond amid boulder fields and some of the Park’s most impressive glaciers.Sky_Pond_RMNP

trailrunproject.com/…ail/7002175/sky-pond

Long Weekend: 3-5 hours from Denver

  • West Maroon Pass, Aspen to Crested Butte
    • This is considered a rite of passage among Colorado hikers and trail runners. While the towns of Crested Butte and Aspen are separated by one hundred miles of highway, this challenging, backcountry trail connects them so that “only” 10 miles sit between them. Pack a bathing suit (or not) for a dip in Conundrum Hot Springs if you plan to do this trip properly.

cascadedesigns.com/…/hiking-west-maroon-pass-from-aspen-to-crested-butte

Mountain Biking

School day:

  • Lair O’ the Bear 
    • Swoopy, flowing lines, grinding climbs, open meadows, and a breathtaking view of Mount Evans—all less than 30 minutes from Denver. After riding, grab a burger or brew in one of Morrison’s quaint eateries.Lair_of_the_bear

mtbproject.com/trail/703097

  • White Ranch 
    • This is a gem of a park and located only a few miles north of Golden; it offers trails that rival anything in Boulder (after all, you can see the iconic Flatirons from the parking lot) with a fraction of the traffic.White_Ranch

mtbproject.com/trail/632917

  • Apex Mountain Park, Enchanted Forest Trail 
    • Apex is one of Denver’s most well-utilized mountain bike trail networks, and with good reason. The Enchanted Forest descent is not to be missed. Be sure to check the link provided for alternate direction riding restrictions on odd/even days before you go. Bonus: these trails are a blast to ride in the snow after the fat bikers, skiers, and snowshoers do all the dirty work of packing down the snow.Apex_EnchantedF_Forest

mtbproject.com/trail/616137

Weekend:

  • Blue Sky to Indian Summer
    • Regardless of whether you mountain bike or hike (or climb, or paddle, or just enjoy beer), a trip to Fort Collins is always enjoyable. Fort Fun is home to one of the Front Range’s finest fast, flowing mountain bike trails. While options abound for long climbs up to the summit of Horsetooth Mountain Park, the Blue Sky Trail sticks to the lowlands, traversing a spectacular cliff line with scenery reminiscent of your favorite Western movie. Also, New Belgium brewery is not to be missed.

mtbproject.com/…/blue-sky-to-indian-summer

Long Weekend:

  • 401 Trail, Crested Butte, CO
    • Come spring and early summer, the wildflowers on this ultra-classic trail grow to be chest-high. Imagine ripping down 14 miles of high country singletrack, with views of snowcapped mountains disappearing and reappearing as you dive into and out of fields of wildflowers so high and dense as to obscure your line of sight. Be sure to grab tacos at Teocalli Tamale once back in town.401_Trail_CB

mtbproject.com/trail/338027

  • Slickrock Trail, Moab Utah
    • Quite possibly the most famous mountain bike trail in the world—and for good reason. Slickrock offers an other-worldly experience: an ocean of red sandstone surrounds you, with views of the Colorado River far below in the canyon. In the distance, the snowcapped La Sal Mountains dwarf the landscape and offer a stunning contrast to the red, pink, and orange hues of the desert. For après ride fun, check out the Moab Brewery, located right in the center of town—it’s an oasis of alcohol and burgers in an otherwise remarkably dry state.Slickrock

mtbproject.com/trail/158941

Burritos

The breakfast burrito was invented in the kitchen of Tia Sophia’s in Santa Fe, New Mexico in 1975. Since that historic day, it has been possible to eat a burrito for all 3 (or more) meals of the day, a feat now commonly referred to as a “hat trick.” Like most of Denver, the breakfast burrito is not native to Colorado, but found in our city a welcoming home. I am unsure of whether or not Colorado has an “official” state food, but I would nominate the breakfast burrito for that honor.

With the help of acclaimed writer and Denver resident Brendan Leonard, I have assembled the definitive guide to Denver’s Best Breakfast Burritos:

  • Grand Prize: El Taco de Mexico on Santa Fe
  • First Runner Up: Bocaza on 17th Ave.
  • Second Runner Up: Steve’s Snappin’ Dogs
  • Honorable Mention: Illegal Pete’s
  • People’s Choice: Campfire Burritos (food truck)

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    Evan is an avid biker, trail runner and climber.  We hope you enjoyed his pictures and guide to an adventurous CO summer!

 

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.

From Practicing Clinician to APTA Employee: an Interview with Anne Reicherter

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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 Anne Reicherter PT, DPT, PhD, OCS, CHES

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What do you do at the APTA?

Anne was hired by the APTA last spring (2015) and works as a Senior Practice Specialist. In this position, she oversees the PTnow website, which provides practicing therapists with tools for evidence-based practice and includes access to current research and other clinical resources. A good portion of her workweek is dedicated to improving the services offered by PTnow* and working to facilitate access and utilization by APTA members.

Practice Specialists at the APTA are all licensed PTs and also work as consultants on whichever issues are current hot topics regarding our scope of practice. For example, dry needling is currently being discussed and spinal manipulation has been a historically important issue.  As one of the few PTs on staff at the APTA, Anne and her colleagues in the Practice Department review products created by the APTA marketing team or other departments prior to publication to ensure that they are accurate from a clinical and research perspective. She says she will sometimes look at a photo and say that “a PT wouldn’t perform that intervention,” or  that they “wouldn’t stand that far from the patient.” Another current project of Anne’s is a collaboration with APTA researchers on an article for the Journal of Health Policy and Administration about obesity. One of her other areas of focus is the importance of work-life balance within the profession.

How did you come to work at the APTA?

Anne graduated with a BS in Physical Therapy at University of Pittsburgh and then worked in a mixed inpatient and outpatient setting at a hospital. She describes that this was fairly common at the time, and that–with few exceptions–PTs were given a lot of autonomy from their referring providers, and that there was not yet a fee-for-service model at the HMO for which she worked. After ten years in that setting, she wanted to progress her career and knowledge, so she attended night school to obtain her Masters of Health Education. In subsequent years she held a variety of jobs in the educational setting (working for Howard University in DC and the University of Maryland, Baltimore) as well as in other clinical settings, including orthopedics and home health. During this time, she obtained her PhD in Educational Psychology, as well as her transitional DPT. She has also performed some educational consulting for various DPT programs.

The position at the APTA for a PT Practice Specialist opened up at the same time that Anne was searching for something more. She wanted a job that fit with her interests and values: the ability to participate in  writing and publishing, advancing the profession through APTA initiatives, and expanding her own knowledge made the job an excellent fit. She says that these meaningful components–including continuing education–were built into her practice as a new clinician (for example, if there was a “lunch and learn” on a given day, the clinicians would leave a bit early that day), as well as into her work as faculty. Today, however, there is an increased emphasis on productivity and fee-for-service; thus, there is limited time and resources allocated to the pursuit of continuing education that distinguish us as professionals. Anne described the difference between professionals and technicians: professionals design a plan of care and add value to the system with professional discernment, and technicians simply deliver a procedure. To maintain the high expectations set of PTs as professionals, most PTs today must spend time beyond their paid workweek to pursue continuing education, APTA involvement, and evidence-based practice.

Where do we plan to see change in the typical PT’s work-life balance?

Anne replied that one of the biggest initiatives currently is the push to change from a billing system with a procedural focus (for example, billing for “therapeutic exercises” x15 min or “therapeutic ultrasound” x15 min) to one based on value. Current reimbursement accounts merely for the delivery of a procedure or modality for a set unit of time, but it does not account for our clinical judgement as professionals. I’ll go more into this initiative in next week’s blog post.

Any advice for new clinicians starting out in their career?

Anne’s advice to new graduates is to consider whether a job or position allows for and encourages professional development: do they fund continuing education? Do they have on-site mentoring programs you can participate in? She also advises new graduates to not allow mentoring to be limited to colleagues within your particular clinical setting but to continue to seek out a supportive network of clinicians for support as you begin to navigate your professional career.

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*PTnow is a valuable resource for us, as new clinicians, to perform literature searches after graduation (as we’ll no longer have access to the school’s library search function) as well as to access clinical reviews, clinical practice guidelines, and clinical summaries prepared by respected experts within the field of physical therapy.

If you haven’t visited the website, you should definitely check it out: ptnow.org