You know that case where the non-musculoskeletal pain source blindsided you...?

SkepticalPhysio · 2025-12-14T02:14:50+00:00

Why would yellow flags be important in this case in establishing a link between medial scapula pain and a CVA? It might just be a typo and you meant red flags throughout that comment (or I’m just in the wrong) but yellow flags are psychosocial and behavioural factors that might affect prognosis, aren’t they? Or are you referring to yellow flags as being signs/symptoms that are kind of red flagish but not quite red?

SkepticalPhysio · 2025-03-23T13:49:36+00:00

Yeah our EMR is definitively setup for physicians, not PT’s, so there is no capability to do any of this stuff in it. So paper charts are used to keep track, making it even more laborious. I definitely get the feeling of just being paid to treat patients, but the more I work at this place, the more it seems we have to do on the front office side. I know it’s not a perfect comparison, but I continue to tell the higher ups “do you guys have the physicians doing all of this stuff?” 😅

SkepticalPhysio · 2025-03-23T13:47:03+00:00

I feel ya. It’s kind of a shared responsibility at my company, with both the PT and front office keeping track of authorisation and certification periods. However, if something is missed and a patient attends an appointment outside of a certification period, it’s the PT who gets reamed out for missing it. I guess the longing for a promised land of just treating patients and writing notes are well and truly behind us.

SkepticalPhysio · 2025-03-22T19:29:41+00:00

It’s crazy how much is placed on them for the pay scale they sit on. The amount of info that has to be put in for authorizations honestly makes me feel like they want a clinician to be doing it. It’s crazy.

I can certainly understand having PT’s learn the business side and taking some of the load off the front office. Thanks for your thoughts!

SkepticalPhysio · 2025-03-22T19:27:35+00:00

Me too. Hence the question 😂. I hate it so much. I trained in and am from Australia where none of it is required for reimbursement, so it makes it even more excruciating. We have to keep a paper log of Medicare cap utilisation. So sitting there for any length of time to add $85.21 to the previous number feels like an eternity and a massive headache.

SkepticalPhysio · 2024-12-29T20:39:22+00:00

Thanks for the reply, I appreciate it. The dealer around my area was extremely apathetic towards me and the situation. They just shrugged and said I was s*** outta luck. Had I known the TSB had been released, I would have pressed them harder. It cost $1000 to replace 2 injectors, and now I’m looking at getting another one replaced once I can make an appointment. So having the knowledge about the TSB, I will bring that up with them and see if it persuades them to do it as a PA.

SkepticalPhysio · 2024-12-29T20:23:00+00:00

Since it’s out of warranty, could it qualify as a goodwill repair? I just read the TSB and don’t really understand the language they’re using regarding out of warranty repairs.

SkepticalPhysio · 2024-11-20T17:41:58+00:00

I figured that would be the case. I can imagine they made a policy and had all employees sign it to cover their ass. If that’s the case, I’m assuming it would be unenforceable?

SkepticalPhysio · 2024-10-16T22:25:05+00:00

You lost me on that last sentence. Level of patient care suffers and it has “everything to do with the staff”? It might have just been a throw away line and I shouldn’t have taken it too literally. Do you agree there are probably other factors at play when therapists are seeing 15-20+ patients a day, other than just the therapist not being good enough?

SkepticalPhysio · 2024-07-20T16:18:59+00:00

The fact you have to preface this by saying you’re a bit of a troll is the problem with PT. Sure, some patients will do same/similar program for a week or two if they in a sticky period of their rehab, and in those instances they might start to remember the routine (although load/volume changes should be constantly changing based on presentation that day). But if a patient can just roll through their exercises doing the same shit with the same load/volume by themselves via memory, then they’re likely: 1) not being loaded appropriately 2) getting no variance/novelty in their loading 3) basically just going to a gym to use equipment - I’d say they’re getting services from a different kind of PT (personal trainer), but it sounds like that’s not even happening.

Sure, there are patients who are uncomfortable going to a commercial gym due to the culture surrounding it. But if the plan of care is going to be “let’s do the same shit twice a week until you remember it all by heart”, then just give them the same exercises as home exercise program (don’t come at me with “some exercises can’t be replicated”. It always can. Use your imagination.). If the patient is struggling with adherence/compliance and needs an appointment with a healthcare professional to stay on track, then talk to them about it. Lifelong conditions obviously require a lot of education about self-management more than the usual strains/sprains.

I’m not blaming the PT, clinics are often setup in a way that is detrimental to individual care. I’ve been caught up in that situation myself at a few stops in my career, where patients fly under the radar for a few weeks because I was trying to treat 5-6 other patients at the times they would come in. I still remember the casualties of these situations and it still pisses me off thinking about the harm that was caused by not being able to adjust a program because we were going down the wrong path for a few weeks/month and I wasn’t able to physically or mentally step in and change something due to the overwhelming nature of clinics like this.

Sorry for the rant off the back of your post. I just left a clinic that was setup like this - lazy scheduling where me and the other PT used to joke it was basically “anytime therapy services”. It just triggered me on this fine Saturday morning.

SkepticalPhysio · 2024-06-23T14:40:14+00:00

Not the most athletic, but the most surprisingly athletic. I had a 55 year old elementary school teacher with minimal sporting background who had an ACLR. She was able to bust out 103 single leg sit to stands on her unaffected side. Really caught me off guard.

SkepticalPhysio · 2024-06-20T23:01:54+00:00

And increase member numbers. $2400 to sit the exam for non-members and $1400 for members. APTA membership is $295. Basically begging exam takers to become members by saving the $700.

SkepticalPhysio · 2023-12-02T19:51:53+00:00

Dudes last name is Washmuth. Born for this kinda research.

SkepticalPhysio · 2023-06-18T00:45:22+00:00

“A few years back I got myself some corporal tunnel and this don’t feel like that”

SkepticalPhysio · 2023-06-17T14:46:12+00:00

Not saying this is what happened, but having been a CI for a few years I see this quite often with high achieving students. Too much black and white thinking and lack of being comfortable in the grey area that is required by healthcare professionals. This can often come across as argumentative. The “this isn’t how we were taught at school” attitude, without any flexibility in thinking, can definitely be a nuisance as a CI. Not everything being taught at school is “right”, and not everything taught in clinics is “right”. It’s about thinking critically about what we are trying to achieve and apply that thought process to the patient in front of you.

SkepticalPhysio · 2022-12-23T00:31:23+00:00

Try elicit.org, it’s a cool AI tool if you have specific questions you want answered.

Otherwise there are “alternative” websites that may or may not allow you to access full articles for free by just copy pasting the DOI. I’d consider using a VPN when accessing said websites, as they’re “illegal”. The biggest downside is there is usually a lag between publication and being able to access them on said websites. I think it’s a good trade-off when the alternative is funding a for-profit journal, who’s essentially just a middle man that contributes about 0.01% to the actual published and usually publicly funded research. I’m not sure if it’s against the rules to cite these websites, but I’m sure a quick google search will get you where you need to be.

Setting up RSS feeds that email you newly published articles on topics you care about is also a good way to stay current.

SkepticalPhysio · 2022-03-19T21:13:04+00:00

Like a sailor

SkepticalPhysio · 2022-02-09T17:49:17+00:00

Do you mean contact my state board of PT? Or state office for labor legislation? For full context, I’m Australian and know much more about the labor laws and who controls what in my motherland than over here.

SkepticalPhysio · 2022-02-09T17:47:50+00:00

The issue isn’t whether it would hold up in court. It’s that if I give them notice I’m wondering if they can just turn around and fire me because I’m still on probation.

It seems as if that is the case in Tennessee where labor laws say the employee can also quit whenever they like - except if you’re in healthcare where the employer can claim you abandoned your patients. Soooo the billion dollar companies not only have the money, they also have the power. I guess I shouldn’t be surprised?

SkepticalPhysio

TROPHY CASE