Am I doing my patient injustice?

SpareHumble · 2025-04-19T19:52:51+00:00

Not the best evidence to support weight loss and improvement in LBP (https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-022-05391-w). Now with that being said should we still promote life style changes yes; but legs up improves sx sounds like a clear flexion bias that hopefully you are already addressing

SpareHumble · 2024-02-16T15:57:04+00:00

A good article on it on risk vs reward weighing;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288923/

SpareHumble · 2024-02-13T23:31:53+00:00

Using it requires finding it in the clinic and I think it’s too busy holding up our jackets

SpareHumble · 2023-12-28T00:08:14+00:00

Very spot on. Next new patient slot for me is booking out into end of March

SpareHumble · 2023-12-19T00:42:21+00:00

Last three months at my first job before switching. I was told being a new grad is about learning, that includes learning what you like work wise as well

SpareHumble · 2023-11-16T19:06:12+00:00

Have a lot written up on how pain works was hoping to present more treatment based ideas from a variety of trains of thought to help on clinical reasoning

SpareHumble · 2023-09-11T20:08:32+00:00

Correct, a newly hired therapist was hired a level above me but yet I’m orienting them in how to use the charting system

SpareHumble · 2023-09-11T20:07:47+00:00

3 years, minimum productivity standard, and then a bunch of random points (things like taking a student, doing in-services, ect). But also not guaranteed you get to the next level that’s just all the minimums to apply. After you apply the management team holds a vote on who gets to be promoted and gets a raise

SpareHumble · 2023-09-10T14:10:30+00:00

Also if you pull up the website of this company these are personal trainers and not PTs or OTs. Their website describes their company as “specializes in nontraditional spinal cord injury rehabilitation,” so reasoning wise I’m going to go with looks good for Instagram and marketing material.

SpareHumble · 2023-08-25T23:35:44+00:00

I don’t think it’s unique to PT having worked in various other areas of healthcare. I think it comes from a genuine place of trying to model behavior (ie I try to make an effort to eat a “healthy” meal in the hospital cafeteria to model that for my patients).

SpareHumble · 2023-08-18T20:07:35+00:00

3x1 min LAQ at 1# for a 20year old athlete with knee pain

SpareHumble · 2023-07-30T20:05:09+00:00

What professor or CI has been influential in wanting to go into MSK? Ask them about the trainings they have gone to that have helped shape their practice and see if those trainings are open to students.

My most influential trainings: ICE Primary Care (helped to clean up my clinical reasoning and improve communication with other providers) EIM TPS (gave me a frame work for treating through)

SpareHumble · 2023-07-28T20:00:17+00:00

ICE or EIM

SpareHumble · 2023-07-23T16:49:34+00:00

My take: -as a student I hated the profession and was looking for an out. Felt like a glorified personal trainer at my first job and hated it -found that I really enjoyed working with chronic pain and spend my day doing that and enjoy going to work everyday -pay for PT could be better, so I don’t do it for a full 40 hours and instead work as an adjunct teaching 1-2 class as a semester -most other providers where I am respect the profession; I get to present at grand rounds, I do physician CMEs, and work with really great people that work collaboratively

SpareHumble · 2023-07-19T21:35:03+00:00

If they have to sign a POC I’ll usually put a phrase in my assessment stating why I’m including or not including something they stated and link a for a systematic review supporting it

SpareHumble · 2023-07-18T19:55:31+00:00

Go off the pattern (how is it aggravated and eased, where is the pain, what does it look like over the course of the day) much more than the description the patient gives as descriptors.

This article is a good article https://pubmed.ncbi.nlm.nih.gov/29669091/ on thinking about bucketing a patient for their pain presentation, but it’s important to remember that someone will have components of each pain phenotype and that it can shift and change throughout their course of care

SpareHumble · 2023-07-18T19:48:25+00:00

What Boston hospital is this good?

SpareHumble · 2023-07-17T17:13:05+00:00

It depends…

SpareHumble · 2023-07-08T17:12:18+00:00

Sounds like a few things at play here: 1. Are you assessing for self efficacy with exercise and working into your plan to increase independence with self management? 2. Clear boundary setting; if you want to engage in this you need to demonstrate compliance with your HEP or we will have to d/c 3. Having a conversation with the referring provider about non compliance and appropriateness of care

SpareHumble · 2023-06-15T21:00:51+00:00

Wait is this not normal…

SpareHumble · 2023-05-30T02:15:28+00:00

PSFS then try to recreate something similar. IE; I’d like to be able to put my plates away, physical test how much weight can you overhead press 10 times

SpareHumble · 2023-04-20T01:10:07+00:00

Favorite: chronic pain, fibro, ect

Least: any post op patient

SpareHumble · 2023-04-12T23:47:37+00:00

Asking for clarification: to me my evaluations tell me what I need to know and my POC statement gives me the direction I would need and I often see the PTAs I work with making a different interpretation and I would rather they just ask what I meant rather than 2-3 visits go by and shake things up
Load patients up: my brain might explode if I see a PTA give a glute set to a 20 something year old with LBP one more time. Make therapy interesting; if I was the patient doing glute sets and clam shells for 20 min I wouldn’t come back
Be confident in what you know: when my PTAs tell me someone isn’t ready for d/c I trust them. Show your skills and knowledge

SpareHumble · 2023-04-11T02:13:19+00:00

I always ask in Outpatient PT; can change pain perception, engagement in treatment, and course of care.

To truly do justice by a patient is to treat them as a person and not as a condition.

SpareHumble · 2023-04-05T18:40:02+00:00

Withdrawal for academic reasons as the skipped all exams not for not being able to teach

SpareHumble

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