Monday Memo 10/28/2019

The Monday Memo

October 28, 2019                                                                           PITT DPT STUDENTS

 

The OCA Clinic

As PT students, it is imperative to volunteer at as many opportunities as possible. These volunteer opportunities should spark an interest in you that goes beyond the scope of physical therapy, and should resonate with you as a person as well as a clinician. The OCA clinic served this purpose for me. For those of you who are unfamiliar (as I was), OCA stands for Organization of Chinese Americans which represents the local Asian American population within the Pittsburgh area. For a few decades now, the organization and the 2nd year medical students at the University of Pittsburgh host a pop up clinic every October where uninsured Asian Americans can obtain essentially “free” healthcare from medical students, dental students, and licensed physicians within the organization. These can serve as general checkups, blood tests, dental cleanings, or alleviating general musculoskeletal pain that so many individuals in this population are affected by.

 

By doing this, it serves as a learning experience for student clinicians as well as help an underserved population. This year’s OCA clinic was held on October 14th in UPMC Montefiore. This was the first year that the physical therapy department was able to offer our services, and a few of 2nd years, including myself, were able to help out.

I wanted to use this opportunity to accomplish a few things

  • Help uninsured individuals get better in a fun and interactive way
  • Advocate for the PT profession and our capabilities to other healthcare disciplines and to the Asian American population
  • Problem solve in a chaotic environment with little equipment and little room for exercise.
  • Practice my Mandarin
  • Eat some authentic Chinese food for free (I miss my mom’s cooking)

 

When we first arrived, I was initially intimidated by the number of white coats and unfamiliar faces. We had two students from China assigned to us as translators for communication purposes and they explained to us how PT was a new concept to them because it does not exist in China. The event initially started slow, but many individuals were eventually triaged to us to help with musculoskeletal pain. I do not recall any specific orthopedic doctors or students on staff, so we essentially served as the primary clinician for the patients with musculoskeletal concerns. Sessions were around 20 minutes in length and included a brief subjective history, a few manual techniques and demonstrating a few exercises to do at home. Our patients were genuinely thankful for our input, time, and expertise regarding their treatment and treated us with the same respect that they treated the medical students with. The medical students were thankful for our services and gained a firmer grasp for what it is that our profession does. After all, pain free movement is a language that everyBODY speaks.

 

In the end, our little PT gym saw 19 patients, with the OCA clinic as a whole gaining the attraction of 69 people within a span of 3 hours. 69 people who would not have received care if not for this clinic. In the future, we hope to maintain our connection with Pitt’s medical students in order for us to come back next year with a new slew of volunteers. Since this was the first year that the PT department was involved, it was primarily reserved for PT students with Asian backgrounds. But moving forward, we encourage other SPT’s who are interested to reach out in hopes to have a diverse PT student representation at future events.

 

-Sam Yip, SPT

**Pictured (L to R): 2nd year SPT’s Erin Dong, Jason Yang, Sam Yip, and Deborah Lee

References:
https://www.ocapghpa.org/programs/free_medical_clinic.html

October 28, 2019 |

Monday Memo 10/21/2019

The Monday Memo

October 21, 2019                                                                           PITT DPT STUDENTS

 

Is Travel Physical Therapy Right for You?

            Travel physical therapy can conjure a lot of different ideas in our heads. Some may find the idea of travel PT exhilarating picturing jumping into a new setting every couple of months, traveling from city to city, getting a chance to tour the countryside along the way. Others may find the idea frightening and prefer a sense of groundedness and home. Many however, are in between but find the idea of traveling physical therapy overwhelming and are unaware where to start the process. In order to combat some of that fear and level out some of the expectations I have gathered some important information regarding the basics of travel PT, the importance of selecting a trusted recruiter, the financial benefit, and some practical challenges such as licensure.

Normally, the first step in travel PT occurs when there is a facility in need and with the use of a staffing agency/recruiter they find a traveler to fill the position. The average length of a contract for a position is 13 weeks (about 3 months). Due to a plethora of different reasons there are many openings available across the country right now for travelers. In order to ensure you get the right fit it is vital to get the right recruiter. Wanderlust PT (a recommended resource by APTA) has a variety of different recommended recruiters listed on their website. Once you have chosen a recruiter you can discuss what type of position you are interested in, such as outpatient, inpatient, SNF, pediatric facilities, etc., as well as what area of the country you are interested in working. It is important to remember that popular travel states such as California and Hawaii are non-compact states and therefore, positions here may take longer to secure as you must not only apply for a license but compete against more physical therapists.

Along with licensure and red tape challenges many times travel positions are in places where the facility is understaffed or secluded meaning you would be the only PT on site. Therefore, it is important to know what type of staff support will be there when you walk into the clinic for your first day. Especially as a new graduate, you want to make sure you are in a facility that has adequate support staff and may even be able to supply you with a faculty member for mentoring. These types of questions should be posed to both your recruiter and again further down the road during the interview process.

Although it is important to ensure you are getting the support you need in the clinic, we all know too well the significance of paying back student loans. Travel physical therapy has a clear financial benefit when compared to the traditional PT market. According to one article published by APTA “typical travel physical therapy jobs can pay 15%-20% more on average than permanent positions. Add to that benefits which often include insurance (health, life, dental, and vision), licensure reimbursements, a housing allowance, travel reimbursements, referral bonuses, and a bonus for completing a 13-week assignment.” Not to mention that some of those benefits such as the funds allocated for housing and meals are considered per diems and therefore are not taxed.

The relevant and helpful information and travel PT could be a volume of books. If the idea of travel PT inspires you, then I suggest researching some of the resources listed below, watching some of the wanderlust webinars, and reaching out to past Pitt PT alumni who have gone on to travel PT.

-Janet Mitchell, SPT

 

References:

https://wanderlustpts.com/

The Medical Nomads- Podcast by Dylan Callier, PT, DPT

http://www.apta.org/PTinMotion/2019/8/Feature/TravelingPTs/

http://www.apta.org/PTinMotion/2008/2/Feature/TravelingPTs/

October 21, 2019 |

Wine Night

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You are cordially invited to…

WINE NIGHT

All proceeds benefit the Foundation for Physical Therapy Research

This fundraising event includes a wine tasting, food, and raffles!

Date: Nov 8, 2019

Time: 6:00-8:30pm

Location: Bridgeside Point 1

100 Technology Drive

Pittsburgh, PA 15219

Cost: $30 per person

Wine: Sponsored by J&D Cellars

 

Register below!
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Any questions, please contact: pittmarquettechallenge@gmail.com

UNABLE TO ATTEND? You will be missed. Image result for make a donation

October 15, 2019 |

Monday Memo 10/14/2019

The Monday Memo

October 14, 2019                                                                           PITT DPT STUDENTS

 

We Need to Talk About Sexual Assault

            A recent study by Hawks, et. al, published in JAMA Internal Medicine indicated that 1 in 16 women in the United States report rape as their first sexual encounter. This number may be astonishing, but the true number is likely much higher since the study only surveyed women ages 18-44. The study was also completed before the #MeToo movement began, so Hawks et. al. believe the number would increase if the study was repeated today. Women may feel more comfortable saying that they were sexually assaulted following the rise of the #MeToo movement.

You may be wondering how this relates to physical therapy. Well, Hawks, et.al. found that the women whose first sexual encounter was rape were more likely to suffer from health problems later in life. These health problems include an increased risk of endometriosis, pelvic pain, and psychiatric issues. Not only do physical therapists help treat patients with pelvic pain, but we are a very hands-on profession. We are often touching patients in intimate places and spend a lot of time in a patient’s personal space. Being aware of a patient’s past traumas, especially sexual assault, can make us better clinicians and provide better patient care.

Trauma-informed care is often taught extensively in medical school but is not emphasized as much in physical therapy school. The CDC states that one in five women and one in 71 men have experienced rape at some point in their life. This is an extremely important fact to know as a health professional. People who have been sexually assaulted often have post-traumatic stress and can be triggered by even the lightest touch. Whether a PT is working in an outpatient or inpatient setting, we are often placing our hands in sensitive areas. For example, an outpatient PT may palpate a patient’s gluteal muscles to see it they are activating appropriately. An inpatient PT may place their hands on a patient’s ischial tuberosities to do a transfer.

Trauma-informed care suggests that practitioners should be thorough in our exam, explaining every step of the way, and always ask consent before touching a patient. We need to do everything we can to make our patients feel comfortable before beginning an exam. This may include having a family member nearby or letting the patient ask as many questions as they would like. We need to be compassionate and understanding and accept the fact that not everyone is as comfortable with physical touch as we are. Not everyone has had the same experiences or is from the same background, so being able to adapt to each patient’s needs will show excellence as a professional.

Dr. Lincoln, a primary care physician at MGH, suggests that health professionals ask their patients “Is there anything in your history that makes seeing a practitioner or having a physical examination difficult?” or “is there anything I can do to make your visit and exam easier?” These questions can easily be integrated into our physical therapy examination. Similar to how it’s important to know about a patient’s history of hypertension or COPD, it’s important to know about a patient’s past psychological traumas as they can all equally affect their care.

Sexual assault should not be a taboo topic that we feel uncomfortable talking about. It is unfortunately not uncommon, and it not only affects the survivors, but it affects their partners, their family, and their friends as well. Since more physical therapists are obtaining direct access, now is the perfect time for PTs to become more educated in trauma-informed care and the long-term health deficits associated with sexual assault.

 

-Kara Kaniecki, SPT

 

References

Hawks, L., Woolhandler, S., Himmelstein, D., Bor, D., Gaffney, A., & McCormick, D. (2019). Association Between Forced Sexual Initiation and Health Outcomes Among US Women. JAMA Internal Medicine.

Tello, M. (2018, October 16). Trauma-informed care: What it is, and why it’s important. Retrieved from Harvard Health Publishing.

October 14, 2019 |

Boot Camp for Lumbar Spinal Stenosis

Image result for Carlo Ammendolia
Dr. Carlo Ammendolia, DC, PhD

Boot Camp for Lumbar Spinal Stenosis

Dates: April 4, 2020 [8AM-5PM]

Price: $400

Continuing Education Units: 7 hours

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All proceeds from this course will be donated to the Foundation for Physical Therapy as part of the Mercer-Marquette Challenge

 Sorry, but we are unable to issue refunds

Course Description

The Boot camp program is an evidence-based multi-modal approach suited for practitioners who use manual therapy. The approach is focused on improving functional status especially walking ability. The program is directed to the multi-faceted aspects of DLSS that includes physical impairments (patho anatomy, spinal stiffness, lower extremity weakness and overall deconditioning), pathophysiology (neuro-ischemia) and psychosocial aspects (poor expectations and depression). This workshop will provide step-by-step training on how to perform all necessary patient exercises, manual therapy techniques and how to provide patents with self-management strategies. At the end of the workshop the learner will be able to implement the Boot Camp Program in their clinic.

Workshop Learning Objectives and Outcomes

Lecture Portion

  • Understand the etiology, patho-anatomy, patho-physiology, prevalence and burden of disease in symptomatic LSS
  • Understand the key features of the history and physical examination for patients presenting with back/lower extremity symptoms impacting walking and standing ability
  • Know common differential diagnoses for neurogenic claudication due to lumbar spinal stenosis
  • Know how to differentiate each of the diagnoses know red flags for potential serious disease among patients who present with back/lower extremity symptoms
  • Know the role of imaging for assessing patients with back/lower extremity symptoms impacting walking ability
  • Know when to recommend a surgical consult/epidural injection
  • Know potential effective non-surgical treatments for neurogenic claudication
  • Understand the chronic disease model of care and management
  • Understand the role of patient self-management and self-monitoring
  • Learn how to monitor patient outcomes and instruct on patient self-management
  • Learn results from clinical trials on the Boot Camp Program for LSS

Demonstration/Hands-On Portion

  • Learn to perform all the specific manual therapy techniques
    • Understand the rationale and learn to perform all the manual techniques in the boot camp program
  • Learn to perform all the specific patient exercises
    • Understand the rationale and learn to perform all patient exercises in the boot camp program
  • Learn how to implement the boot camp program in your clinic
    • Understand the rationale for the Boot Camp Program and its underlying principles
  • Learn how to integrate and implement program in your clinic

Course Education Materials

Lumbar Spinal Stenosis Patient Workbook

  • Written background information on the causes, common symptoms and available treatments for Lumbar Spinal Stenosis
  • An overview of the Boot Camp Program for Lumbar Spinal Stenosis 
  • Instructions and illustration of all patient exercises and self-management strategies
  • A schedule to record intensity and frequency of each exercises over the 6-week program

Lumbar Spinal Stenosis Patient Instructional DVD

  • Video presentation by Dr. Ammendolia on the causes, common symptoms and available treatments for Lumbar Spinal Stenosis and overview of the Boot Camp Program for Lumbar Spinal Stenosis 
  • Video demonstration of all exercises and self-management strategies including proper sitting/driving/standing/walking and sleeping postures

Lumbar Spinal Stenosis Practitioner Treatment Protocol DVD

  • Video demonstration on all manual therapy techniques
  • Instruction on how to implement the Boot Camp Program into clinical practice

Lumbar Spinal Stenosis Practitioner Implementation Guide

  • Written step-by-step and visit by visit instruction on implementing and integrating the boot camp program into clinical practice
  • Recommended patient schedule and progression for daily exercise intensity and frequency over the 6-week program

About the Speaker

Dr. Carlo Ammendolia is the Director of the Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases at Mount Sinai Hospital. He received his MSc degree in Clinical Epidemiology and Health Care Research and his PhD in Clinical Evaluative Sciences from the University of Toronto. Dr. Ammendolia is an Assistant Professor in the Institute of Health Policy, Management and Evaluation, the Department of Surgery and the Institute of Medical Sciences at the University of Toronto. 

In 2012 and 2017, Dr. Ammendolia was recipient of the Professorship in Spine Award from the Department of Surgery in the Faculty of Medicine. In 2015, he was awarded the Chiropractor of the Year Award from the Ontario Chiropractic Association and in 2016 the Researcher of the Year Award from the Canadian Chiropractic Association. Dr. Ammendolia has been in clinical practice for over 36 years and now combines clinical practice, research and teaching in the areas of non-operative treatment of mechanical, degenerative and inflammatory spinal disorders. He is the founder of spinemobility, a not-for-profit Research and Resource Centre aimed at developing and testing programs for spinal and other musculoskeletal conditions. Dr. Ammendolia developed the Boot Camp Programs for lumbar spinal stenosis, persistent low back pain, persistent neck pain, ankylosing spondylitis, sciatica, persistent shoulder pain, knee and hip OA and fibromyalgia. He conducts workshops worldwide on his boot camp programs.

October 12, 2019 |