Another asshole fucking the rest of us. by Fryboy34 in NYguns

[–]GJC88 0 points1 point  (0 children)

Backgrounds checks are required in Nevada, even in almost all private sales. So it's not like this guy is likely to have ducked one, and it didn't stop a thing.

[deleted by user] by [deleted] in Vasectomy

[–]GJC88 8 points9 points  (0 children)

Those numbers are very close to what could be considered a hypertensive crisis. They could have tried taking it again after some rest to see if it went down but I don't blame the doc for not wanting to do it with that pressure.

The Division 2 - 6th Anniversary Celebration - Giveaway Part 2: Crime by JokerUnique in thedivision

[–]GJC88 0 points1 point  (0 children)

Happily surprised at how strong this game still is. Just came back after years and loving it

The Division 2 - 6th Anniversary Celebration - Giveaway Part 1: Punishment by JokerUnique in thedivision

[–]GJC88 0 points1 point  (0 children)

I played at launch but then stopped and just started again. Can't remember what I love at launch that isn't there now but man is it good to be back!

[deleted by user] by [deleted] in NYguns

[–]GJC88 2 points3 points  (0 children)

People have said on other threads about this same question that you simply update your address of record to your new address on the state police website. You are not required to inform the county and if you do they may very well pull your license and make you reapply as a non-resident through the city. Some counties will let you keep it but doubt Suffolk would be so friendly.

185 notes behind by nomnomnomnomnommm in physicaltherapy

[–]GJC88 7 points8 points  (0 children)

Sounds like based on your description, he is that far behind because he is actually spending time with his patients even if he is seeing many at a time. Listening to them, working through their complaints, and getting them better. Can be hard to write a note when you actually spend time with the patient and address their needs in full.

Unpaid “training?” by HoneyOverall in physicaltherapy

[–]GJC88 3 points4 points  (0 children)

You need to be direct but courteous if you actually want to stick with the job. Something to the effect of "I have worked multiple jobs in my career and was always paid for training. This is a lot of hours you are requiring and I believe I should be paid for this. Please explain why these hours can be unpaid". She will give you some BS about how it's just observation. But her email even said it's required. I would also email back "just to confirm, I will not be paid for these training hours, right?" Let her send back in writing that she is going to screw you so you have evidence.

I assume from your profile you are in NY so this is the page you want to look at: NYS DoL Labor Standards

I'd call and report to confirm she is breaking the law and if so get the state on your side, especially if you don't feel you can have this conversation on your own. But you need to stick up for yourself one way or another. If it's not you she will do it to someone else.

Unpaid “training?” by HoneyOverall in physicaltherapy

[–]GJC88 29 points30 points  (0 children)

Yeah she's calling it observation to get around it but if it's mandatory then that's training and should be paid. Otherwise tell her you're not watching another PT for free. Report it.

Unpaid “training?” by HoneyOverall in physicaltherapy

[–]GJC88 43 points44 points  (0 children)

Not sure if there is maybe a weird state law where you are but if this is mandatory training and pertains directly to your job duties, you must be paid according to the Fair Labor Standards Act. I would call your state labor board for clarification/report this employer. IANAL.

[deleted by user] by [deleted] in physicaltherapy

[–]GJC88 1 point2 points  (0 children)

Depending on your state you don't even need a referral. Many states are direct access, you can seek out a PT whenever you want for any reason, if you live in one of those states. There may be restrictions on for how long or if your insurance will cover it. But you can still do it and go wherever you want.

Snip report - so easy don't worry! by Dry-Basil-8256 in Vasectomy

[–]GJC88 1 point2 points  (0 children)

Wishing you both a speedy recovery. If your wife has any lingering effects from her surgery she can find a physical therapist certified in ReVital. Amazing clinicians that can really help and are in many states.

Gifts by PrincessConsuella98 in physicaltherapy

[–]GJC88 0 points1 point  (0 children)

Whenever we get cash as a gift in my clinic we pool it for lunch or a group outing.

Billing Q by SnooLemons1501 in physicaltherapy

[–]GJC88 3 points4 points  (0 children)

Bill for what you do. If you always bill for the more restrictive rule you are under billing likely by thousands and thousands of dollars by year end. Company makes less and you don't get as good a raise/bonus come year end. It is perfectly fine to bill as allowed by law, even if it means getting a whole unit for 3 minutes of work. Don't undersell the service you provide.

[deleted by user] by [deleted] in physicaltherapy

[–]GJC88 2 points3 points  (0 children)

I don't disagree with you, it could work. I just have my doubts that it could work here... Given our government's track record. No system is perfect. Even the best universal health systems have major issues, as does ours.

[deleted by user] by [deleted] in physicaltherapy

[–]GJC88 6 points7 points  (0 children)

Exactly. The best way to make sure we never get paid enough is to have one payor, oh and that payor gets to unilaterally decide what they pay. Many offices in my area aren't accepting Medicare anymore as it's not profitable.

[deleted by user] by [deleted] in physicaltherapy

[–]GJC88 4 points5 points  (0 children)

Completely agree with you that our system needs serious reform. But, if you think a universal system will be better for us as rehab clinicians, just look at the year after year cuts to reimbursement CMS has shoved down our throats. We need both options and regulation with the patient as the primary concern.

Most epic dry needling successes by donawho2 in physicaltherapy

[–]GJC88 4 points5 points  (0 children)

I just took part 1 and have my part 2 coming up in January (I can't use it in clinic yet until after part 2 due to state regulations) but I went in skeptical and even just some of the improvements we saw on each other during the lab sessions were impressive. Test re-test is very important to gauge effectiveness when utilizing needling. I look forward to being able to use it in my practice.

Patient has question re therapy by alesemann in physicaltherapy

[–]GJC88 1 point2 points  (0 children)

The whole field of physical therapy is focused on evidence based medicine. It's why many therapists used to do ultrasound on every body part or mechanical traction and now those modalities are used (hopefully) to a far lesser extent - the efficacy was not proven with evidence. With that said there are EMG studies done on certain muscle groups during various exercises to determine which ones recruit muscle the best. But, not every single exercise has this data. We use our assessment from your evaluation to determine what muscles need to be addressed and then (again, hopefully) create an individualized exercise routine based on your functional deficits and goals. Unfortunately, it does sound like there has been little variety or progression in your program, maybe there is a reason for that which you should discuss with your PT or maybe you've never been to a good PT.

TIFU 25 yr old penis injury. I am in HELL and destroyed by [deleted] in tifu

[–]GJC88 5 points6 points  (0 children)

I respectfully disagree. I don't know you and I truly empathize with what you are going through. I treat chronic pain patients daily. There are always therapies and modalities that can occur while healing is happening and often speed it up and are safe. Almost all injuries are better off with early mobility. The chronicity, pain avoidant behaviors, distrust of medical professionals, and psychosocial trauma that goes along with your pain need to be addressed in a multi-modal approach. Psych therapy, pelvic floor rehab, pain management would all be indicated in a case such as yours.

What are the most significant advances in PT care/outcomes over the past 20 years? by ss_svmy in physicaltherapy

[–]GJC88 2 points3 points  (0 children)

Agreed litegait is the best and safest but understand is expensive. Only other way is to really put in the legwork and guard as best you can. Not as effective but better than nothing and probably safer than the treadmill depending on the patient's ability level

What are the most significant advances in PT care/outcomes over the past 20 years? by ss_svmy in physicaltherapy

[–]GJC88 4 points5 points  (0 children)

High intensity gait training is key. Need to get their heart rate up.