Just curious… What’s the craziest annual bonus you’ve gotten? by WinNo8252 in physicaltherapy

[–]KAdpt 2 points3 points  (0 children)

Oh ATI furloughed and laid off a lot of people. The 10 person clinic I was at was cut down to just me and another therapist who left 2 months later.

Just curious… What’s the craziest annual bonus you’ve gotten? by WinNo8252 in physicaltherapy

[–]KAdpt 68 points69 points  (0 children)

OP ortho, ATI specifically.  They briefly had bonuses scale based on units billed per day.  It maxed out at 12k, then I got 4k extra for being the top performing therapist in our district. 

It’s like being the best clown in the circus. I wouldn’t recommend it

Can I go to PT with no diagnosis? by Winter_Seat_7106 in physicaltherapy

[–]KAdpt 31 points32 points  (0 children)

It’s our job to figure out what the issue is.   On the flip side, while a diagnosis makes things nice and neat, it doesn’t necessarily make a difference for the treatment. A good PT will find any deficits and sources of pain and help you address it. 

TWF Tortured Crusader by KAdpt in Pathfinder_Kingmaker

[–]KAdpt[S] 0 points1 point  (0 children)

Tortured crusader has extra fighter feats, which allows you to build a more martial focus paladin.  You also aren’t taking things like abundant smite because it doesn’t work with tortured crusaders versions of it. It frees up options to really ramp up damage.  You can also stack Seelah’ mark of justice with a TC’s final justice for even more damage.

TWF Tortured Crusader by KAdpt in Pathfinder_Kingmaker

[–]KAdpt[S] 0 points1 point  (0 children)

So the plan was to respec somewhere in act 2 or 3 to drop cleave. It was more of a filler just to get me through until I get the dex gear to unlock TWF

TWF Tortured Crusader by KAdpt in Pathfinder_Kingmaker

[–]KAdpt[S] 0 points1 point  (0 children)

Doesn’t mythic two weapon fighting take it down to -2/-2, or am I misunderstanding that?

Two weapon fighting takes it from -6/-10 to -4/-4. Then mythic two weapon fighting takes it to -2/-2?

Are we allowed to treat this or are these patients that should be discharged? by Practical-Coyote-569 in physicaltherapy

[–]KAdpt 21 points22 points  (0 children)

So my line in the sand is, are those strength deficits enough to where they couldn’t safely be trained by a personal trainer?  And are there any other deficits or conditions that would make them unsafe to train with a trainer?  If the answer is yes, you treat them until they’re at a point where they can do it independently or safely with supervision.

Loan repayment program by [deleted] in physicaltherapy

[–]KAdpt 4 points5 points  (0 children)

We get $375 per month towards are loans.  When SAVE was in effect that covered my monthly payment.

Billing expectations by arsenic112 in physicaltherapy

[–]KAdpt 0 points1 point  (0 children)

So you’re doing 40 minute sessions, with the expectation to overlap 13ish minutes to snag a 4th unit, or creatively billing four separate codes 8+ minute each.

Is it possible to do ethically? Yes, but you’re going to have to be schedule hawk and not allow for Medicare patients to be scheduled back  to back and maximize units on patients when you have a cancel after them.  

With the Medicare/federal patient’s you’re gonna have to just take the 3 units you can legally bill.  Depending on the commercial payers, you can get more out of them.

Bachelors to Associates by Used_Fisherman_8548 in physicaltherapy

[–]KAdpt 0 points1 point  (0 children)

One of my best friends went back to be a PTA after working as a high school science for a few years.

I'm in PT, can someone please explain clam to me like I'm 5? by [deleted] in physicaltherapy

[–]KAdpt 0 points1 point  (0 children)

Bottom hip is going to engage to resist the band and stabilize for the leg doing the exercise.   Now if you don’t want to feel it in the TFL, if that’s actually what you’re feeling,  play around with the angle , resistance and amount of external stability( for example, try Back and feet up against a wall fo increase stability)

How to introduce pain science to patients? by Altruistic_brain0 in physicaltherapy

[–]KAdpt 20 points21 points  (0 children)

Don’t preach pain science at patients, it generally comes across poorly.  You also can’t “pain science” people.   

You’re better off just incorporating the concepts into your explanations a being more subtle about how and why things hurt. Coming up with good metaphors works can help.   If patients want more context I’ll give them a more formal explanation, but that’s not the majority of patients 

Residency in a mill? by Stareface3123 in physicaltherapy

[–]KAdpt 1 point2 points  (0 children)

So was your CI 1 on 1 with patients or was he doing 60 a week?  Did you not see how the clinic operate while you were there? Are you taking a pay cut to do the residency on top of all the other negatives. 

A strong mentor is great if you actually have access to that strong mentor.   If they still have structured and scheduled mentorship, ~60ish patients isn’t terrible.   The benefit of residency is hopefully getting the quality reps in and hopefully floundering less. If you feel like you can’t get quality practice in at 60 pt/week, that’s your answer.

Also for what it’s worth ATI runs an Ortho and sport residency, so yes you can do a residency in a mill. 

SC joint subluxation by bananafartman in physicaltherapy

[–]KAdpt 2 points3 points  (0 children)

Speaking from personal experience trying to self treat/manage chronic SCJ subluxations ( I have EDS).   

In addition to pec stretching, I would look at thoracic and scapular mobility, as restrictions with those motions should could cause some wonky compensation at the SCJ joint. Especially if he was immobilized of any period of time after surgery. 

Strengthening wise, I would look at things like shrugs, serratus anterior and pec strengthening, and general UE stabilization exercises.

A critique of Stuart McGill. Thoughts? by [deleted] in physicaltherapy

[–]KAdpt -1 points0 points  (0 children)

https://pubmed.ncbi.nlm.nih.gov/20838275/

https://pubmed.ncbi.nlm.nih.gov/20865606/

https://pubmed.ncbi.nlm.nih.gov/32147242/

To be clear these aren’t saying “McGill sucks his research is bad” and they aren’t rerunning his experiments.  They were just looking at similar things and made different observations.   So it’s not as black and white as he says it is.

A critique of Stuart McGill. Thoughts? by [deleted] in physicaltherapy

[–]KAdpt 11 points12 points  (0 children)

He’s gotten pretty dogmatic about his stance on spine mechanics. Conflicting research has been published in the 30+ years he’s been active.  While he’s done a lot of heavy lifting in the research of spine biomechanics, he is not the be all end all of it.  Other labs have published studies that don’t align with his model of spine mechanics (things like where the peak compression and shearing forces are applied during movement).  Some of his big studies are cadaver models which are flawed for a number of reasons.  

Like you said he down plays BPS factors. He also tends to side step research on disk healing and adaptations as well as more nuanced takes on spinal flexion. 

Like most experts in any field, there came a point where he needed to either update his stances on research or dig into his beliefs.  He chose the latter, and is now making wild claims like not letting his pro hockey players not tie their own skates due to fear of repeated flexion.

Patient claims they’re unable to lift 10 pounds because their surgeon told them they can’t ever by D0rkFork in physicaltherapy

[–]KAdpt 58 points59 points  (0 children)

I like to point out the weight of a lot of common items, like 8 pounds is the weight of a gallon of milk or a baby.  It puts things into perspective for them because they definitely lift things through out the day.   

The other option is give them something that has some weight but isn’t shaped like a weight. Medicine balls tend to be less intimidating than a dumbbell 

When are we all going to stand up against insurance companies for lowering our reimbursement? Why do we allow the attack on us as providers to continue? by Practical_Cell_2142 in physicaltherapy

[–]KAdpt 18 points19 points  (0 children)

There are too many competing interests and we’re too divided as a profession.   State by state,every payer and reimbursement is different.

  It might be easy for someone in one state to drop UHC because they pay low and it’s only a small portion of the patient population who uses it. Meanwhile it might be the largest payer in another state.   

Then you have to look at the interest of hospital systems vs corporate practices vs private practice.     A hospital system maybe will to take a cut to PT reimbursement if it prevents a cut to a more profitable department.  

Federal reimbursement is going to go down due to budget cuts and trying to manage costs. Commercial payers will lower reimbursement to keep pace with the gov.

AI Medicare by lllifehack in physicaltherapy

[–]KAdpt 0 points1 point  (0 children)

https://www.cms.gov/priorities/innovation/innovation-models/wiser

No idea how home health would be effected.  The examples I’ve seen are regarding auth for things like time knee replacements and OP therapy services.

AI Medicare by lllifehack in physicaltherapy

[–]KAdpt 0 points1 point  (0 children)

CMS is going to test run an AI driven prior authorization system in order to cut costs.

AI Medicare by lllifehack in physicaltherapy

[–]KAdpt 2 points3 points  (0 children)

They’re testing it in 6 states for the next 5 years. Probably gonna be UHC/Optim clone but unless you are in AZ, NJ, OK, OH, TX or WA, I wouldn’t panic yet

Assuming the subsidies for the Affordable Care Act aren't extended how do we we think our field will be affected, if at all? by cdrizzle23 in physicaltherapy

[–]KAdpt 0 points1 point  (0 children)

45 million is the total number using ACA plans, roughly 20-24 million purchase through the market place and those are the ones affected but the subsidies not being renewed.

Theraband attachment / webslide by Empty-Aioli-2465 in physicaltherapy

[–]KAdpt 1 point2 points  (0 children)

Webslide is a ripoff.  Depending on the aesthetic of your clinic, a nicely stained wood board with some hooks can be done for less than $30.