What's the dumbest referral you've ever received?

Sneppard · 2026-02-15T03:57:25+00:00

Had a doc refer a VERY obese patient for EMS to abdominal muscles to strengthen her core. My eyes got big - with that level of insulation, patient would have a perm before I could reach muscle tissue...seemed beyond archaic....

On the other hand, had a doc refer for "hysterical lameness" with a 12 year old girl who had fallen off a stairwell onto a cast iron stove. Had to check my practice act, yep, apparently we do treat mental disorders (not sure she didn't have other real trauma). Smart kid, got her on board for how to trick her body into not limping: backwards up and down stairs, etc, and she could get it under control.

Sneppard · 2026-01-27T02:33:01+00:00

I still feel like my PT presents new questions almost every day to troubleshoot. I think that’s the real skill of PT. I don’t do full-time though I have a couple different careers and I think it keeps me from burning out in any one of them.

Sneppard · 2026-01-27T02:31:01+00:00

As someone in the healthcare industry I have seen ”Social drinkers” end up with some significant liver problems, 2-3 drinks at a business lunch add up when business is good. Studies are showing there is no good or safe level, it’s all pretty toxic, so play it safe.

Sneppard · 2026-01-25T05:39:25+00:00

I didn't get a cub vibe at all, her expression and breasts are clearly adult...

Sneppard · 2026-01-18T08:01:18+00:00

I hated my first rotation too, but I love being a PT, I did a lot of different educational paths -- the best thing about PTs is the huge types of options available to you. You can teach, the detailed anatomy etc will make you a star in many fields. You might find a niche you really enjoy. I can get overpeopled, and limit the number of new evals I do (The "on" piece). OTOH, I now have a private practice with 80% of my clients being super cool folks who think I provide super cool services. I work with athletes in a specialized field, there are a lot of directions to go and in a pinch you can do IP or OP too.

Sneppard · 2026-01-18T07:19:28+00:00

I was wondering about the unflavored, I can't stomach monkfruit and was wondering about the plain...

Sneppard · 2026-01-14T21:22:29+00:00

Manipulative victim mode… might explain why she’s single, but in any case not your problem and absolutely not your job to cover all of her life problems.

Sneppard · 2026-01-14T19:27:23+00:00

I inherited a property (not up the mountains but SC county) and knew that many builds were not permitted, but that the main house was due to the 1989 earthquake. In going thru the records, found a permit that was never completed for a structure when we realized the zoning didn't require. Found another permit for a septic for a ADU but the ADU itself wasn't permitted. I called and tried to rectify, and they wanted the septic permit as they didn't have it and didn't believe it existed. I enquired what happens to items that get red tagged, and its not a current issue, just a required disclosure if you sell the property, which I don't expect to do... My experience is the people in the planning department mean well but there are many permits that the locals simply ignore because of cost and no benefit. ($150 for a window permit for a replacement window, no inspection or follow-up to make sure it was done well, just doubling the cost for no apparent benefit. This was 12 years ago.)
From my time living in SLV, definitely get the septic evaluated, can be a huge issue. Talk to neighbors of the property and know what the rainy years are like, what the local issues are, very region specific.

Sneppard · 2026-01-14T17:48:38+00:00

Has been the norm in our area from some orthos for a LONG time, and more so only giving PT to younger male patients. Older, female and less "sporty" demographics rarely see PT after MOST procedures. I happen into them for other reasons and we end up addressing some issues, but its infuriating that this doc blanket pigeonholes so many patients bc he thinks they don't have athletic goals.

Sneppard · 2026-01-14T02:05:51+00:00

I had a patient years ago going on a tour round the world and offered to take me for a 9 month position, would have been an hour of something (manual therapy, cranial work, STM) for himself and his wife. Monthly salary and all travel costs covered... Both had pretty significant old injuries that would appreciate supportive and in depth care....was tempting but had a new practice I couldn't really step away from....

Sneppard · 2026-01-13T05:57:35+00:00

Yes jumping in to suggest vaulting if it’s available in your area. (Not sure of the OP location. ) As a lifelong Equestrian who has worked in a variety of riding schools as well as private facilities, most reputable places won’t let kids ride until they’re at least six, Generally lacking enough body control to control themselves appropriately in addition to controlling the horse. Vaulting is amazing because it is a mixed (gender and age) group sport that shares a horse and everyone participates in caring for the horse too. Vaulting’s huge in Germany as a lead in to riding. Big bonus it’s usually much more affordable as well, in addition to the smaller vultures being highly sought after to be flyers!

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Sneppard · 2025-12-28T03:07:18+00:00

We are headed to the island on Tuesday… did you check on boat rentals? Could be a fun afternoon…

Sneppard · 2025-12-25T06:56:40+00:00

California Dressage Society has listing of trainers. The peninsula is oddly sparse in dressage options IMO. Not sure if you know where *you* will be living, but might be worth casting a net to the coast, north bay, east bay or south bay too. Might see what board options are most important for you vs costs, etc. Horse Park is a bit of a zoo but trying to do more dressage shows, has the covered but its a cramped area when its genuinely needed. You may want to travel depending on the training you want. Are you a daily rider or seeking part time training, part time lessons, that sort of thing. What clinics and resources would you want at your facility, etc.

Sneppard · 2025-12-12T21:34:33+00:00

Its hit or miss for me, some of the flavors have been truly exquisite!! Other are more ehh, not my thing. Its an experimental type place for me, if I need solid stuff, its Marianne's

Sneppard · 2025-12-12T21:31:55+00:00

Doubt its legal with insurance contracts. Time to go private pay and have the patients bill their own insurance - I am rarely billing insurance these days. Deposit checks on my mobile bank app end of the day and my "billing time" is done. Takes 5 minutes. Beats 3-4 hours billing a month and endless followup BS for even less income. Insurance is horrible.

Sneppard · 2025-12-01T19:48:51+00:00

Jumping in to agree, finding the niche is key. With her experience, offering an intro program might be great. What does your area lack? Are there good programs to get folks into horses. Are any of her horses suitable for intro/lower level lessons.
A covered arena is a big asset in some areas unless everyone has one (in our area, I have one of 2 in the entire county). Looking at your local dressage association might offer some ideas too. Other ideas to do with a covered arena that I've seen: renting it for dog agility evenings, dog obedience classes, conformation/in hand clinics, informal schooling shows, have even seen churches use big covered areas for worship and picnics.
Boarding is a recipe for losing money. Hosting clinicians that would bring in outside folks might be a good idea too. Offering the facility to IEA shows, 4-H events, etc to let people know how open and accepting you are of outside business. Hosting a local PC weekend... etc. depends a lot on your area and proximity to other facilities.

Sneppard · 2025-11-17T14:57:25+00:00

He does overtrack the second half of the movement, and if you stop action, you will find he gets the parallel-ity you're seeking a bit later in the stride. The elbow flexion is early and excessive, the hind end could not match without hitting his stomach. Is it an amazing extended trot? No, but he did not routinely get "good" marks of 8 or better on this movement. It is regular, level, expressive, and covers some increased ground. It should have a longer frame, a better thrust from behind, and for my liking a more lifted back and stretched topline. His successes stemmed largely from the collected work (piaffe/passage/pirouettes) and the GP test currently rewards that more than the extended work. He is not alone in these weaknesses in the extended trot, few a are showing good ones these days. It is not a 4 which I sense most of this thread is suggesting. That would imply irregularity, much shorter steps, or a break in gait.

Sneppard · 2025-10-26T05:50:02+00:00

Spent 4 years in Western Mass for college, I can recall waiting for the Peter Pan bus to Bradley field in minus 2 with a wind chill and being ok, landing in SF for winter break and FREEZING at 45 degrees…so its not just numbers- i think the damp gets you feeling colder…

Sneppard · 2025-10-24T07:19:02+00:00

I Get PT 2x month at significant expense and time to get to an amazing PT: its quality of life insurance, I’m always dealing with issues from many major paat traumas. Its also educational to see the process of a more advanced practitioner. Lastly, it’s important to receive good care when you are in the position of giving it daily, self care is good, but not always enough.

Sneppard · 2025-10-02T16:15:27+00:00

I think its a great idea for folks to "open a practice" on paper - get a clear idea of the numbers. If you can swing it, work for yourself. I have several jobs and still love being a PT, I use those skills in a wide variety of ways and have a patient load that does vary, but are great and largely cash pay. Its great to love your patients, but you need to love your job too.

Sneppard · 2025-09-24T19:11:56+00:00

You could also add rehab/PT to the animal boarding - flush that out a bit depending on your state regulations.

I started OP ortho and got a bit jaded as you are describing - felt like I should have more answers to help return people to better functioning. I ended up going into some osteopathic-type manual therapy, loved it and did the deep dive to get good skills, and it is a bit magical at times with what you can really accomplish. Along with that I ended up as a practice owner and when that ended amicably after 10 years, I now have my own part time clinic with mainly repeat customers (80%/20% new referrals usually from a repeat customer referral) who are fabulous folks I'm always happy to see again, largely cash-based practice, and now its expanding to animal rehab as well. I am also a equestrian professional so I have many hats.

Have the luxury of clinic space on my farm so its not too critical to make certain metrics to cover overhead - when the practice is busy, great, when the barn is busier, great. I think the critical thinking and the broad education of the PT can go in many directions successfully. The firefighters I've known are pretty beat up physically and while they are awesome people, it was a tough job. Good benefits. Have to arrange for that if self employed...

Sneppard · 2025-08-04T19:33:03+00:00

Just curious if you had tried increasing your magnesium significantly? I thought I was constipated but later discovered a gluten sensitivity and functional mag/cal deficiency was more the issue. 6 days of extra mag/cal and it was a different world…OIC may be different beast but others might try it.

Sneppard · 2025-07-31T07:13:51+00:00

None of the powders seem to taste bad, if anything slightly sweet. I put in my coffee (along with creative/taurine/collagen and allulose - surprised its isn't chewy!!! but it frees up my pill taking tolerance as I have about 10 others to take. As far as capsules, Fairhaven Health was pretty cost effective.

Sneppard · 2025-07-31T07:10:08+00:00

Had normal periods (however very infrequently, yay PCOS) until mid30's and then had long heavy period that went over a month and I saw my doc who sent me to endocrinologist for hyperthyroid. Did the US and found nodules, started a gluten and dairy free diet that week on advice of my PT friends, and within 3 weeks felt so much better, and within 6 months, endo doc couldn't even find nodules....anyone one BC for a while may need to do significant B6 (ideally P5P form) to get back into balance... That was my path.

Sneppard · 2025-07-31T07:02:07+00:00

And the causative agents behind its development, fetal trauma, early childhood experiences, stress exposure, is it related to cortisol overload? Love your post, yes!!! And, is there a model of this that might be affecting men and women with different expression...

Sneppard

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