MyPhysicalTherapySpace.com - A part of the 1T - the "One Thing" you need for PT practice.

Please Don't Stay on the Couch!

Let's suffice it to say that I don't think APTA does an adequate job on the PR and media front. The infamous Couch Potato Workout is just one of several examples of where our own professional association set the profession back rather than positively influence consumer awareness with messaging consistent with Vision 2020 and that advances the public's appreciation for the benefits of physical therapy.

If you haven't seen the Couch Potato Workout, be thankful. Now that I am linking it here, please make a New Year's resolution not to share with anyone who might be on the fence about the value of physical therapy. The Couch Potato Workout will for sure persuade them to think the worst of physical therapy. This news article is just one of many print and television media outlets that picked up on the workout and subtlety or not so subtlety made jokes about our profession's inability to get consumers off the couch and actually move! It's frankly embarrassing, and I will confess to being reluctant to even post about it. Although I cannot locate the clip, I understand Jay Leno even picked up on the story during one of his monologues and poked fun at PTs. The Couch Potato Workout is definitely not the face of Vision 2020. APTA also talks far too much about esoteric topics like the 'dangers' of back packs and musculoskeletal injuries associated with snow shoveling (when frankly the risk of a sudden MI is much greater!) and not nearly enough about why consumers should demand to see their PT when they experience a neuromusculoskeletal condition.

Regardless of my criticism, it's good not to end the year on a negative note. This recent press release about the value of PT to relieve pain is a pleasant surprise. We should be bombarding the consumer in 2007 with information about the evidence to support PT practice and how to avoid many of the numerous harmful side effects associated with Big Pharma and the often completely unnecessary invasive procedures associated with surgical specialty care (in particular for back pain).

Hopefully we will see many more efforts like this throughout 2007 that reach out directly to consumers with messages that are consistent with Vision 2020 PT. I frankly believe that APTA should completely outsource its PR and media efforts to a professional PR and marketing firm. We should be paying experts, not PTs, to accomplish this most important function! Enough for now. Thank you to APTA for getting it right here. Join APTA and help make a difference in 2007.

Happy New Year...and by all means, do not exercise on the couch! Get off your rear end and do something physical!

John

A few movie recommendations

During the holidays, our family has watched a ton of movies, probably more than we did during the entire year! So, I thought it would be fitting to share a few highlights, The Notebook, World Trade Center, and United 93.

If you have note yet seen, The Notebook is a great story of 'in sickness and in health' love and commitment between an aging couple in which one spouse has a fading memory that can intermittently but only temporarily be revived by hearing stories of their youthful love. It's a great testament to lifelong commitment that endures beyond optimal physical and mental health. World Trade Center tells the events of 911 from the perspective of the families, both survivors and non-survivors. It vividly depicts the realities of the aftermath, both the devastation and resilient hope. The first part of United 93 depicts the inner workings and coordination (or lack thereof) of the FAA and the military after realizing that something was terribly amiss in the skies over the United States. The latter half of the movie is a startling dramatization of the suspected events that unfolded during the doomed United 93 flight. If you have not seen these movies yet, consider adding them to your viewing list.

We are also experimenting with Blockbuster Online (similar to Netflix) and looking to populate our movie queue. So, feel free to offer up any must see movies by adding comments to this post. Thanks!

Almost Happy New Year!

John

Giving Back

Many of you may have already made contributions throughout the year to your favorite charitable organizations. This post from one of my favorite blogs is a good reminder and highlights one organization in particular, Unitus, that is utilizing some very innovative microfinance strategies to tackle some of the world's most pressing social issues, primarily poverty, the secondary effects of which contribute to so many other social epidemics (eg, AIDS, unwanted pregnancy, etc.). The Network for Good would be a great place to search for organizations you might want to support, particularly if you're looking for some last minute year end contribution ideas.

On the professional front, don't forget the Foundation for Physical Therapy! Our profession owes a tremendous debt to the Foundation for its longstanding support of high quality physical therapy research that defines evidence-based physical therapy practice. The Foundation has had tremendous successes in the past, but we haven't seen anything yet! The best days of our profession remain ahead and draw closer each day in no small part due to the Foundation's efforts. If you are looking to support an organization likely to have the most impact in launching the careers of physical therapy researchers, defining evidence-based practice, and elevating the profession of physical therapy in general, there is no better choice than the Foundation. Give today! For other ideas from PTs on how to serve others, join the Serving the Common Good group on MyPhysicalTherapySpace. Discussions in this group will escalate in 2007 and offer up some outstanding ideas for how PTs can contribute to causes that serve the greater good.

Thanks again for your readership and loyalty! We look forward to continue serving the EIM and MyPhysicalTherapySpace communities in 2007. Evidence in Motion and MyPhysicalTherapySpace wishes you and your families a joyous, prosperous, and healthy New Year!

John

Top 10 Podcasts for 2006

You can't have a top 10 list of blogs without a top 10 for podcasts. So, here are some outstanding podcasts for you to consider in 2007. These are in no particular order and can all be easily found on iTunes. Most of these also made Apple's top 100 podcasts of the year list. Feel free to offer you own recommendations via comments. We wish you the happiest of New Years...may your family be well, may your health and fitness grow stronger, and please...may your practice earn you something greater than $35 a visit (inside joke that is not funny at all to EBP minded practitioners)! Happy New Year!

John

1) Harvard Business Review IdeaCast

2) NPR: Health and Science

3) NPR: 7 AM ET News Summary

4) This American Life

5) Podrunner: Exercise and fitness music

6) Rich Dad

7) Science Talk: The Podcast of Scientific American

8) TEDTalks

9) The Economist

10) TWIT: This Week in Tech

Top 10 Blogs-in no particular order.

1. Freakonomics-forget what you learned in psychology and sociology on your way to becoming a therapist.  If you want to learn how humans really behave, listen to Messers Levitt and Dubner.

2.  Gladwell.com.  The unofficial official writer emeritius of EIM, Malcom is a phenomenal writer.  His interview on the sports guy is classic.  You may not always agree with him but he will challenge your thinking-all the time (especially about health care).

3.  Feld.com.  The unofficial technical advisor to EIM and one of the first VC’s to blog.  His father is a physician and blogger as well and offers his own solutions to repairing the healthcare system.

4. Bill Simmons.  Without question, the best sportswriter of ESPN.  His style and interviews are classic.  Great combination of sports and humor.

5.  Health Business Blog.  If you have an interest.

6.  Techcrunch.  It goes without saying.  If you just want to try and keep up with Dr. Childs.

7.  Tom Peters.  You either love him or hate him.  He is always challenging.  His health care rant includes evidence based practice and for that you have to love him.

8.  Wait ‘til Next Year Again.  I am a native Clevelander and still consider all of their pro teams my teams.  This more than keeps me up to date. Forget the fact the he is my brother and a great writer, it is very well written.  If only I had his blogging talent.

9.  How to Change the World.  Guy Kawasaki is never boring.  His expertise holds no boundaries.  His top ten questions of various luminaries has inspired EIM to do the same.

10.  Blog Maverick.  He is an original thinker and has an uncanny ability to predict the future.  I personally am no fan of the NBA but I am a big fan of his.

Very difficult to come up with a top 10 when there are so many good blogs out there. 

Larry

Top 10 Technology Resources for 2006

Everyone seems to publish their top 10 lists at the end of each year, so why not have our own! We will begin to publish a couple of annual lists. The first one here is our 'Top 10 Technology Resources' list for 2006. I have made the case many times before (and believe more and more as time goes on) that you simply cannot be an evidence-based practitioner if you are technology averse. Quite simply, rapid advances in information technology solutions are the only reason why EBP is even possible, allowing individuals to efficiently consume massive amounts of information and filter out the 'noise'. You can't practice according to current evidence if you can't keep up. Note that not all of these technology resources are specifically related to health care. In fact, some of them will offer great benefits for both your professional and personal life. So, here are our top 10 technology recommendations that will make you a more savvy information consumer and leverage your most precious and scarce resource...time. Feel free to offer additional recommendations of your own via comments. We wish each of you a Happy New Year!

John

1) MyPhysicalTherapySpace.com and the Evidence in Motion blog (ok, so we're biased...but MyPhysicalTherapySpace will grow into the '1T'...the 'one thing' you need for PT practice in 2007)

2) Treo 650 (Treo 700p and 700w don't offer enough new features)

3) FeedDemon RSS reader (www.newsgator.com) (to keep up with all the other health care related and other personal blogs you follow)

4) iPoD nano or video iPod (www.apple.com/ipod)

5) Audible

6) Google Documents and Spreadsheets (formerly Writely) (www.writely.com)

7) Skype

8) del.icio.us

9) Wikipedia

10) MyCompass (must have a Compass checking account)

Disclaimer: I own a few shares of Compass stock but I assure you that it's not enough to influence this recommendation! My financial and consumer life runs on auto pilot because of MyCompass.

Up and Down

Holiday Greetings from the EIM team!

In the last few weeks, we have seen some feature integration between the EIM blog and the myphysicaltherapyspace interface.  We believe that this is critical to promote more blogging and interest in all facets of physical therapy.  You will definitely see a resurgence in activity on this blog.

For those of you who have followed the Barbaro saga, you will be pleased to note that it has been a great Christmas for him (lots of peppermint) and he apparently will be moved due to his progress physically.  As a horse enthusiast as well as a PT, it is good to know that the cap exemption process was heartily in place for him and that he continues to reach the goal of being able to strengthen and bear weight on his hind legs.

The last several days, I have been amazed at the number of articles in various health care reports about all facets of health care.

An interesting article on medicare and the physician fee schedule appeared today in the Sarasota Herald.  Many fear that certain physicians (e.g. primary care) will simply not be able to see medicare patients in the future as the costs have exceeded the reimbursement.  Hooray! Finally, a legit position for providers is being trumpeted.  The freeze in rate reduction is not a raise for anybody-it is a reduction in future losses.  Unlike physician services that are procedurally driven, PT services are by and large “time oriented” (due to the superimposed and preposterous coding requirements by CMS).  Unlike many physicians who are responding by seeing more patients and working more hours, PT services as time based are more like lawyers (and to a large extent primary care physicians) and “billeable time”.  This trend does not bode well for us anytime soon.  Furthermore, as the article points out most practitioners will simply not care about the 1.5% for reporting of quality measures as that amount will probably not cover the cost of doing so and as I have repeatedly trumpeted-we get way too concerned about medicare policy and not enough about the other bothersome trends in reimbursement (starting with accepting fee schedules below our costs-but that is another blog post entirely).  Lastly, fee schedules reductions or freezes only serve to drive more procedures as the article points out.

In perhaps a more relevant issues,Robert Laszewski and his health care blog have provided a significant analysis of the issues surrounding cost trends.  To put it simply, employer rates (and then to employees) rises in health care premiums are exceeding the actual cost for insurers.  Cost controls (in large part decreased reimbursement), are working and keeping costs of health services lower but these savings are not being passed onto the customers (employers) but rather serving better margins for payors. The point that is largely missing from all of these analysis is the cost to providers including regulatory compliance, labor, utilities, rent, liability premiums, etc.  These costs are well exceeding the real and nominal reductions in reimbursement.  Provider margins are getting lower all the time and the only beneficiary is insurance companies and not their employer customers! 

It is time for a fundamental change for providers.  The pendulum needs to swing a little the other way.

Thoughts?

 

Larry

Upcoming Evidence in Motion Courses!!

Check out upcoming Evidence in Motion courses currently open for registration! Learn more about MyEIM and our new Articulate course format!

Download WhatIsMyEIM.pdf

Download ArticulateFormat.pdf

***Indicates course open for internal registration only. Contact facility POC listed on website.

Evidence-based Examination and Selected Interventions for Patients with Lumbopelvic Spine and Hip Disorders

Jan 13, 2007***
Palm Harbor, FL (USA)

Jan 13-14, 2007***
W. Palm Beach, FL (USA)

Jan 20-21, 2007***
Navarre, FL (USA)

Mar 31-Apr 1, 2007
Burlington, NC (USA)

Evidence-based Examination and Selected Interventions for Patients with Cervical Spine Disorders

Jan 14, 2007***
Palm Harbor, FL (USA)

Jan 20, 2007***
St. Louis Park, MN (USA)

Feb 3-4, 2007***
Navarre, FL (USA)

Mar 10-11, 2007***
W. Palm Beach, FL (USA)

Mar 10-11, 2007***
New York, NY (USA)

Sep 15-16, 2007
Burlington, NC (USA)

Evidence-based Examination and Selected Interventions for Patients with Upper Extremity Disorders

Feb 24-25, 2007***
Colorado Springs, CO (USA)

Evidence-based Examination and Selected Interventions for Patients with Lumbar Instability

Feb 3-4, 2007***
Cary, NC (USA)

Evidence-based Introduction to Rehabilitative Ultrasound Imaging of the Lumbopelvic Region as an Adjunct to Treatment of those with Lumbopelvic Disorders

Mar 10-11, 2007***
Marshalltown, IA (USA)

We encourage early registration to insure a seat. Extensive hands-on lab sessions are included.  Visit us on the web at www.evidenceinmotion.com to get more details, learn about other 2007 course dates and locations. Register online today!

Feel free to email us at courses@evidenceinmotion.com if you have any questions or need additional information. Consider passing this post on as an email to your colleagues who might benefit from this information. Hope to see you at an Evidence in Motion course in 2007! We sincerely thank you for joining with us to translate evidence into practice.

The Evidence in Motion Team

Note:  This post will also be posted in the 'Upcoming Events' group on MyPTConnect.  All comments and questions should be added there.  The comments feature on this blog is turned off for this post.  Email us at info@myptspace1T.com if you have any questions.  See you on MyPTConnect!
 

Quote of the Week

"We are seeing a revolution growing out of the old orthopedic concept of the 'dynasty of the disc' into a more integrated biopsychosocial model of back pain."

-Alf Nachemson MD, 1998

I just had a conversation with a newly-trained McKenzie practitioner this week. He told me all about lateral and posterolateral componenets of disc pathology responsible for peripheral pain and the mechanical diagnostic process. It makes me wonder, where's the revolution?  Any comments?

Congratulations to Dr. Jay Irrgang, Our New Ortho Section President!!!

The EIM Team and Community extends a well deserved congratulations to James J. Irrgang, PT, PhD, ATC for having been elected as the next Orthopaedic Section, APTA President. Jay has a long history of outstanding academic and clinical practice at the University of Pittsburgh (you could probably count the number of Pitt football games he has missed in the last 15-20 years on 1 hand). A highly accomplished educator, researcher, and clinician, Jay has a history of lifelong service to APTA and the Orthopaedic Section, most recently having served on the Ortho Section's Board of Directors.

Jay, there could not have been a more right person for the right time to lead the Ortho Section in the coming years. We look forward to getting behind you to continue elevating orthopaedic physical therapy practice! Feel free to directly pass along your congrats to him by adding a comment to this post in MyPhysicalTherapySpace!

John