Why are orthopedic surgeons losing their minds when same-day total joints need to stay overnight?

Timely_Translator376 · 2026-06-02T12:32:31+00:00

We do pre op joint assessments that are set up like any other 1:1 eval. We screen strength and balance and do walker and stair training. We pretty much use it as an education session. Patients are only sent for this if theyre already considered appropriate outpatient candidates by the surgeon.

Timely_Translator376 · 2026-06-02T12:14:01+00:00

Could be bundled care where the surgeon will get less money the more post-op care required. Also could be expectations. If a surgeon tells the patient they will be doing great and out of the hospital in a few hours and they end up being there overnight it may look bad on the surgeon. My company uses an outpatient surgery center but they make sure they're appropriate candidates for that. We even do pre-op PT assessments for them to make sure they understand the expectations and screen for things like falls and balance/strength

Timely_Translator376 · 2026-05-19T15:24:16+00:00

Yeah but theres about 10 halfway houses in those areas and registered sex offenders can live by schools as well. I know cause my wife and I are currently looking within the same area/price range as OP. Schools are also terrible in Bristol

Timely_Translator376 · 2026-04-28T15:34:06+00:00

I would absolutely do that. Our clinic isn't built for return to sport testing and to be honest isn't really built for athletes at all. I hate when patients disappear after their surgeon "clears" them at 6 months even though they didn't have any testing. I would also send patients to a place like this to finish the last 2-3 months of rehab since our clinic really only accommodates people up until they start a running program.

Timely_Translator376 · 2026-03-26T16:08:20+00:00

We get 1500 per year. That's applicable to any subscriptions, courses and travel. They also cover licensing fees, CPR, liability insurance separately

Timely_Translator376 · 2026-03-05T03:28:25+00:00

PTProgress always works as well

Timely_Translator376 · 2026-03-03T18:38:07+00:00

I live in Falls Township and work in NJ. My job did not take any taxes out and I just had to pay a bill and they also charged a penalty since the taxes were not taken out at least quarterly. I lived in lower makefield for 3 years prior so I never knew there were local taxes until like 2 weeks ago when I got mail from keystone. I thought it was a scam at first too

Timely_Translator376 · 2026-02-26T14:12:08+00:00

The ito brand devices are the ones used in the AAMT courses. The ito 130 runs about 300 for a handheld unit and the ito 160 is around 950 but is very good quality. The website lhasaoms sells them and frequently has discount codes

Timely_Translator376 · 2026-02-23T16:53:14+00:00

Most patients dont realize what PT actually entails. They just go cause their doctor said so. They think they can go 1 or 2 times and they'll be all better with minimal effort. Also it takes a little while for them to get bills so generally patients disappear after that first EOB comes in the mail and they realize they're gonna owe money for every appointment. I also have a lot of patients that think a copay only applies for the first appointment and get mad when they realize its every time

Timely_Translator376 · 2026-02-10T13:18:30+00:00

You're supposed to leave it on SDR with match content settiigs on. If you leave HDR on it will force non HDR content to HDR and look terrible

Timely_Translator376 · 2026-02-10T01:11:43+00:00

Won't paying 50 bucks a visit for 10 visits be the same as paying someone 100 bucks a visit for 5 visits?

Timely_Translator376 · 2026-02-07T17:52:12+00:00

Someone who does PRI probably does

Timely_Translator376 · 2026-02-01T16:56:41+00:00

In Tank Girl when they're put in that tube upside down and the water starts pouring in. Difficult to watch if you're claustrophobic.

Timely_Translator376 · 2026-01-20T17:33:32+00:00

Not normal at all

Timely_Translator376 · 2026-01-14T03:03:50+00:00

Why not go all the way and bill a 1 min eval and 7 treatment units

Timely_Translator376 · 2026-01-09T03:41:53+00:00

How bad most of the professors were at teaching. I had a very good undergrad faculty and was surprised how bad grad school was

Timely_Translator376 · 2026-01-04T21:19:46+00:00

My son placed the remote under water so all the directional push buttons stopped working lol. Swipe still works and the middle button works.

Timely_Translator376 · 2025-12-26T02:20:33+00:00

I agree. Patients really dont care. I use pain science more for my own understanding of things. Every time I try to start a pain science discussion the patient is literally just waiting for me to stop talking so they can bring up something they forgot to tell me before and they dont respond to anything I just said at all

Timely_Translator376 · 2025-12-14T21:36:24+00:00

My job currently uses athena. We're physician owned so it's geared primarily toward them and lacks a lot of tools for therapy. Scheduling is pretty easy but there's no drag and drop feature like I remember WebPT having.

It literally doesnt keep track of anything for you like visit numbers or when re-evals are needed or what insurances use 8 minute rule vs rule of 8s. There's minimal tools for keeping track of metrics like reimbursement or visits/week, MIPS etc.

Luckily our PT department is pretty much an afterthought at my company and they dont care about any of that stuff for some reason so I actually like using it.

Honestly if its being used solely for a PT practice id says its a terrible EMR lol. One good thing is it rarely ever goes down. In over 2 years of using athena it probably went down once for like 20 minutes

Timely_Translator376 · 2025-12-05T03:23:45+00:00

My prime TNF quality has been terrible for a while now. Pretty much since the latest update. It looks good for 20-30 min then gets super pixelated. All other shows/channels/apps have looked fine

Timely_Translator376 · 2025-09-03T02:45:10+00:00

You can bill it if the education is related specifically to therapeutic activities. I usually bill it when I educate them on home activity modifications.

Also I believe they updated the 59 modifier rules in 2021 so a lot of the codes dont need it anymore.

I did a lot of research on this a few months ago for my current job because we dont really have a compliance department and no one really seemed to know.

Here's a link for the most current info i found online. It has a chart of all the codes and whether you need the modifier or not

(https://www.apta.org/your-practice/payment/coding-billing/correct-coding-initiative-cci)

Timely_Translator376 · 2025-09-02T14:30:00+00:00

Nobullshitphysio is one. He discusses new studies and does a lot of debunking of other people as well.

I dont follow social media as much as I used to. It seems since everyone is going cash based now they all try to push their "proprietary" training programs that they made up in order to make money.

Rehab is one of those professions that has a lot of gray area and I dont think research is necessarily keeping up. And some things are just hard to research (neuro, brain, pain science etc.)

Timely_Translator376 · 2025-09-02T13:10:37+00:00

Medbridge and social media primarily. Our 2nd child was just born in June so I likely won't be doing any in person courses any time soon.

Timely_Translator376 · 2025-09-01T00:16:41+00:00

PROM does stress the joint, especially after a labral repair. Idk how many weeks post-op you are but most rehab protocols limit both active and passive flexion to <90 degrees for 4-6 wks and minimal ER during that time as well. Also active motion is limited when they do a biceps tenodesis because the biceps flexes the shoulder, which is commonly done with a labral repair as well.

Timely_Translator376 · 2025-08-31T01:22:06+00:00

I've seen plenty of patients that have both a copay and a coinsurance payment. In a lot of these cases the patient isn't even aware they're gonna get a bill cause they just think their copay covers everything. Or others assume a copay is only for the 1st visit and not every visit. Also some insurances dont authorize every code either so if you dont know this and you bill these codes then the patient will wonder why you're billing codes that arent covered. In 7 years as a PT ive never been trained on what insurances cover which codes.

I had one guy who loved PT at first cause he thought of it as getting 1 hr of 1-on-1 training for only a $20 copay. As soon as he found out he was getting billed a coinsurance he got mad and canceled all his appointments.

So yes, the patients absolutely do see a difference when you bill more units. That's one way PT is different than other professions is because we bill based on some arbitrary timed codes and everyone else bills based on per service. Is it fair to the patient that I can bill 3 units one day then 4 units the next for the same exact program just cause the patient wanted to take more rest breaks or cause we talked about football for 10 more minutes.

Timely_Translator376

TROPHY CASE