Monday, March 23, 2009

Moving Day!

It has been fun while it lasted but thanks to an invitation from my physical therapist colleague Dr. Eric Robertson, I will now be doing my Physical Therapy related blog authoring at (soon to be  We will also be joined by fellow colleague and blogger Roderick Henderson, PT for what should be topically varied content relevant to our profession from various perspectives.

I hope you will follow and join us at this new virtual water cooler as fellow community members and stakeholders in our future as physical therapists.  I’m looking very forward to what should be an informative, enlightening and occasionally even entertaining venture with my fellow bloggers and colleagues.

Sunday, February 08, 2009

The “Socialized” Practice – Part II

With the advent of the various Internet social networking mediums on the world wide web such as Facebook, MySpace, Orkut, and a host of others combined with other communication tools such as blogs, Twitter, Friendfeed and others, the challenge for any professional or in this case physical therapists is to find a way to effectively use these tools to promote their practice and communicate with their patients and/or clients.

Scott Shreeve, who founded Medsphere Systems, coined the term “Millenial Patients” and described them as “defined by their behavior rather than their  age, sex, or demographic.  He goes on to describe how they utilize the Internet for almost every aspect of their daily lives to “meet their personal, social and professional needs.”

This group of people, the so called millenial patients, are not interested in an authoritarian, top down relationship from a professional such as a physical therapist or physician.  They are far more interested in finding a trusted partner with whom they have an ongoing relationship “based on trust, mutual respect and open communication” according to Shreeve.

My experience leads to me to strongly agree with this paradigm and therefore makes me wonder how I can best serve these patients.  I believe that the answer lies within the integration of the various communication tools available through the Internet including email, social network sites such as Facebook, Twitter, Skype, and website based discussion forums into our practices.  The challenge will be determining best practices in the integration and utilization of these amazing tools and I think perhaps the best tool currently at my disposal might just be TxXchange.  (A disclaimer: I do not have any financial involvement with TxXchange other than as a customer.)

In the third party of this series I will look at how I am envisioning the use of the aforementioned tools and particularly TxXchange in tackling some of the challenges of modern practice.

Friday, February 06, 2009

The Socialized Practice - Part I

With the advent and evolution of “the web” that part of the Internet that most people see as “The Internet”, the previously held notion that all information was proprietary and commoditized has been supplanted by the notion that information should be free and open and the normal socioeconomic barriers that determine who knew what have been shattered in the phenomenon frequently referred to the democratizing effects of information on the Internet. 

Professionals who previously held tight control on information within their domain, whether it was lawyers, physicians, physical therapists or any other profession, need to recognize that their closely held treasure trove of information is no longer their proprietary commodity to be doled out at a price they solely determine. 

Citizens can now look up medical conditions, treatments, drug trials, laws, regulations, court filings, contracts, rehabilitation regimens or practically any other information that is able to be printed or disseminated in some form of media as it all eventually ends up freely available on the web somewhere.

If we stipulate that information is not the proprietary commodity it once was and is likely never to be again, what value do professionals bring to the table that consumers will be willing to pay for?  Simply it is Expertise.  Expertise is not easily or quickly acquired.  It is an accumulation of skill, knowledge and experience.

The question then becomes how does one market expertise versus knowledge.  In my next post we will examine some tools and potential tools to address this issue.

New Blog Category: Cases!

After reading a Twitter post from a physician twitterer who commented that he has posted far more cases to his blog than he would have ever have considered submitting for publication in a more mainstream journal I had an idea.

What the heck, why not do it myself when one of those very interesting cases comes along?  So the next time one of those cases comes along, I’ll share.  Who knows?  It might just help someone else in the process.

Friday, January 23, 2009

Just When You Thought You Were Safe From Outsourcing Because You Are in Healthcare…

Apparently the safety of the notion that healthcare providers are practically immune from outsourcing overseas is being challenged if not crushed.  Note this article from have long clung to International Medical Trade Turns Big Business.

According to the article in India alone revenue from so called “Medical Tourism” rose from $264 million in 2000 to $4.07 billion (yes that is BILLION with a B) in 2005.

This will be a trend worth watching.

Thursday, January 22, 2009

Physiopedia – A Challenge

I have had many conversations recently with those noting a dearth of openly available information directly related to Physical Therapy particularly when looking for information in the Physical Therapist’s voice.  Like many issues in our profession, many complain but nobody does anything.  To my relief Physiopedia is finally looking to do something about it and looks to resolve that issue.

While there is no shortage of information regarding conditions commonly treated such as ACL injury or Lower Back Pain there is a serious lack of information written in the Physical Therapists voice or that adequately demonstrates the wealth of information that comprises the unique knowledge base of Physical Therapy.  What information that is available is shielded by a legacy and in my opinion outmoded and outdated system of "by subscription only” scholarly journals.

I would urge our colleagues, particularly those who possess a unique and credible expertise in particular Physical Therapy subject matter to start or at least contribute to entries in the Physiopedia Wiki such as this entry on The Glenohumeral Joint started by Tyler Shultz, PT.

By building this open and freely available compendium of information we will demonstrate the uniqueness, credibility and value to the world, and perhaps raising the visibility of our profession just a notch higher.

My thanks to all involved with the Physiopedia project.  It is a project deserving of our time and contributions.

Tuesday, January 06, 2009

WSJ Story Pulls Back the Veil of Woo Surrounding Complementary Alternative Medicine (CAM)

Steve Salerno does an excellent job in his Wall Street Journal (WSJ) article The Touch That Doesn’t Heal.  In this article he points out some of the myths surrounding treatments that are not grounded in science and exposes them to the skeptical treatment they so deserve.

He also exposes how these pseudoscientific treatments are then passed on to insurers using rather dubious and self serving interpretations of the Current Procedural Terminology codes used to bill third parties for medical services.

This is an article well worth reading and should serve as a wake up call to the third party payer community who should be far more concerned with reducing true fraud and abuse rather than arbitrarily reducing reimbursement to all providers across the spectrum.

Well done Mr. Salerno and let’s hope that policy makers now endeavoring to clean up the mess that our healthcare system has become take notice.

Sunday, January 04, 2009

New Kid/Journal on the Block

Friday January 2nd, 2008 I received what has turned out to be a pleasant surprise in the mail in the form of a free copy of a newly published journal Sports Health.  They must have known my birthday was coming up the following day.

This particular journal is published with an emphasis on “A Multidisciplinary Approach” and is a collaborative publication of the American Orthopaedic Society for Sports Medicine, North American Society for Sports Medicine, National Athletic Trainer’s Association and the Sports Physical Therapy Section of the American Physical Therapy Association.

The Table of Contents is divided up based up the discipline.  The Sports Physical Therapy articles were solidly written and similar in quality and content as what is typically found in the Journal of Orthopedic and Sports Physical Therapy.  The focus on this particular discipline content was on ACL treatment including the article I found most interesting by Hurd, Axe, Snyder-Mackler describing Management of the Athlete with Acute Anterior Cruciate Ligament Deficiency (ACL-D).  This article goes into excellent detail in the use of a treatment algorithm developed at the University of Delaware. 

I find this publication interesting in the multidisciplinary approach and frankly I think that this will further enhance the collaborative and collegial relationship that should exist between physicians and physical therapists.  Perhaps it will help to shine a light on the significant contribution of physical therapists to the body of knowledge in the management of orthopedic conditions for physicians.

So thank you the thoughtful person who sent me this early birthday gift and I think it will even be worth the dues to join the Sports Physical Therapy Section of APTA.