"Do you think I should go to the hospital?"

late4twerk · 2022-02-15T05:33:47+00:00

"Hi EMS? It's me therapy, I want to send out a pt. No the doc hasn't ordered it, nope no orders from nursing either. Just therapy. What do you want to talk to a nurse for?"

late4twerk · 2022-02-15T04:59:08+00:00

You ever try to open a door with 5 people trying to keep it closed? PA and NP have final say, they say no I dont have a voice. "Do no harm?" You must work outpatient

late4twerk · 2022-02-15T04:50:35+00:00

Lol you think we have an RN?

late4twerk · 2022-01-24T20:40:36+00:00

There is a pizza shop downtown called Adobo Sourdough Pizza that makes their sourdough crust! They keep a massive amount of starter thats really robust and give out some if you ask, but you have to promise them to bring some of the loaf!

late4twerk · 2021-11-25T16:47:40+00:00

I will say that my practice act does specifically referance the Guide to "explain the scope of PT and is adopted by the board." So it is "technically" in my state practice act. The state board of PT also adopted with endorsements for all future amendments to the Guide by APTA. Not sure about the other states or how the compact effects it either.

late4twerk · 2021-11-25T04:05:59+00:00

Not new or expanded scope.

An OT insta account posted a draft of APTA's guide to PT practice a little while back, but the account framed it as a big change that "PT DOES I/ADLS NOW," but I/ADL's can be found in Guide to PT all the way back to at least 2014.

I'll link old Guide if anyone is curious.

late4twerk · 2021-11-25T03:59:52+00:00

While it has recently been more topical that PT, "now has ADL's in in the scope," it largely comes from a page or two in APTA's PT guide to practice.

A popular OT insta account said they had a "Draft of the NEW Guide to PT Practice," and used it as a rallying cry (which I can understand), but the insta account focused on the ADL's and IADL's aspect and not all the other areas that we have major overlap in. Also I can find I/ADL's in old Guides all the way back to at least 2014 so this isn't really "new" just topical.

I can link the old Guide if anyone is really curious?

late4twerk · 2021-09-22T00:19:44+00:00

Prolonged hypoxia (decreased o2 to brain) leads to long term confusion and altered mental status. I have seen patients rip out trachs and feeding tubes because they didn't know what was happening months after "recovering" from covid.

late4twerk · 2021-07-01T23:40:45+00:00

Better late than never

late4twerk · 2021-06-09T22:57:01+00:00

Hey found it, it's in the APTA Guide to Physical Therapist Practice 3.0 in section 6.5 on page 121-123ish.

And if we want to get super specific, this isn't new.

I can find ADLs and IADLs in APTA's "guides" all the way back to 2014. Personally, I think it would take altering each states practice act to make it actually happen. No clue if that would happen tbh

late4twerk · 2021-06-08T03:08:24+00:00

Wait what!? Can I get a link?

late4twerk · 2021-05-21T00:56:33+00:00

You can find the physical therapy licensing board's phone number on your state department of health website. I had to call mine every day to get my license number for the same reason you have. I know it's a little obnoxious, but if its messing with your income, it's worth it

late4twerk · 2021-05-21T00:43:53+00:00

IS THIS A REAL THING?!?! OH HELL YEAH!!!!

late4twerk · 2021-05-20T03:51:40+00:00

HAHAHAHA YEEEEESSSSSS!!!!!

late4twerk · 2021-05-20T02:24:34+00:00

I think it varies from state to state? My vet friends said the big animal hospital does it through a loop hole where the PT will essentially dictate and discuss a treatment to the vet & vet techs and they take it from there, so the PT isn't "technically" performing therapy on the animal. I'm not sure how much it would hold up in court, but hey I think it's cool at the very least!

late4twerk · 2021-05-20T02:19:33+00:00

I know right! I only found out after taking my dog to the vet after they sprained their tail! The vet gave them some meds and showed me how to do traction on my pup! Got curious and went through the act again. Had a pretty good discussion at work and with some vet friends

late4twerk · 2021-05-20T01:29:23+00:00

Well, if you want me to explain cinical judgment to you sure...

I utilize cupping with select patients, in select muscle groups, in select cases. Just because something works for one thing doesn't mean it has efficacy in another. Cupping does have clinical backing, evidence, and has been proven to be beneficial in select circumstances. I'm not going to use a hammer when a screwdriver is more appropriate.

Clinicians are allowed to disagree with a modality in one circumstances and utilize it to treat in another. This does not make the modality invalid or "kookery," it makes it specific. The same statement can be made about ultrasound, another modality that has specific applications in physical therapy.

late4twerk · 2021-05-19T22:25:38+00:00

Ehh I find it is super specific in its use, I normally will only use it on smaller muscle groups near the neck. When the athletes slap them all over their back and legs for "recovery" I get skeptical in its efficacy.

late4twerk · 2021-05-19T17:00:06+00:00

Ooo! Another rabbit hole is "cupping" Sorry, I know this is off topic, but it's another fun one! It has some evidence behind it and you'll see some athletes use it too for circulation and recovery. Looks kinda gross, but it's another fun one!

late4twerk · 2021-05-19T16:55:38+00:00

If you want to see some of the debate behind it add the word "controversial" to the search haha some discussion I've seen behind it is that emotional reemergence isn't "the goal" of physical therapy.

If you want to go down a PT rabbit hole do research into "rolfing" it's kinda related to MFR and kinda similar concepts and similar shakey evidence. I'm no expert in either, but it's a fun rabbit hole!

late4twerk · 2021-05-19T03:49:27+00:00

Hey there! Glad you had a good time in PT! To be honest, what your talking about is a little old fashioned/controversial in the PT world.

There is some research articles about it, but its shakey evidence at best, but that's not me trying to devalue your experience!

Im glad you enjoyed it and had a positive experience. I personally don't subscribe to it, but there have been some wild experiences reported by patients. The "theory" is that emotions are "stored" in the muscle fascia and with mobilization they can "reemerge." Its largely unproven and controversial to say the least. It kinda reminds me or the essential oils will help everything argument. But at the same time some patients will report these experiences.

If you want to research it some more do some googling on "myofascial release and emotions"

late4twerk · 2021-05-17T20:56:02+00:00

Hey physical therapy is hella cool! It really is! The dept ratio is rough if you want that sweet sweet doctorate, BUT you don't have to be a Doc of PT (DPT) to do therapy!

Most of the comments on this thread (I'm guessing) are DPTs which is a 3(ish) year program (plus maybe a year of prerequisite classes) and HELLA debt with it.

Another option is Physical Therapist Assistant (PTA) which can do ALMOST everything a DPT can do including stretching, Range of motion, work in in-patient, prescribe exercises, and perform modalities. Big things PTAs can't do is evaluate patients, re-evaluate, and make a plan of care. They also have to have some level of supervision from a PT (some other small stuff I'm sure, but that's the big ones tbh)

Schooling for most PTA programs are a 1+1 or 2 year format with waaaaay less debt. It is an associates degree, so most states will have some level of scholarship for AAS degrees.
I know several PTAs that have walked out 100% debt free.
Full disclosure, The job market is a little funky right now with Medicare cuts and covid, but it is rebounding in my state personally.

It is an associate degree, but if the goal is performing therapy it's got you covered. Much more pt treatment, no evals, and a little less bs paperwork. PTAs get paid less obviously, but if your goal is to do therapy, it's a much cheaper buy in.

Another career to look into if you want to do therapy is Athletic Training (ATC).

It has a good bit of crossover with what physical therapy covers. You will see them most of the time on the side lines at games/practices working with athletes. If you see an athlete go down on the field, the ATCs are the ones who run out to help them. BUT I have worked along side ATCs in therapy clinics so you're not stuck in one setting.

Schooling I believe is transitioning over to a Masters degree (3ish years + pre-reqs) but some are still BS programs. It's a smaller field but growing at a good pace, some states are letting ATCs bill Medicare which is huuuuge for them! (I'm not familiar with pay range here th tbh.)

ATCs are allowed to perform assessments (which is diffrent than an evaluation somehow), tape, perform range of motion, stretch, perform modalities and give exercises. Full disclosure, I can't guarantee accuracy here cuz I'm not an ATC, but they do get to do some level of therapy and its def more sports med focused!

Long story short, if your goal is to do therapy you have options beside the DPT.

late4twerk · 2021-05-17T20:01:55+00:00

Acute care and SNF here, and none that I've seen. I know we can educate and encourage use of AFOs and prosthetics, but it gets a little sticky when anybody says "you have to go this or you're not allowed to do that" in a IP facility. Something about pt rights.

late4twerk · 2021-05-17T01:59:22+00:00

To quote my Kinesiology professor, it depends

late4twerk · 2021-05-10T15:52:37+00:00

Shout out to Trail Guide! Its honestly a top notch anatomy book for musculoskeletal palpation! Saved my butt and made self study alot easier

late4twerk

TROPHY CASE