Thursday, March 14, 2013

Therapydia PT TV Episode 12: Acute Care, Promoting Best Practice

Hello everyone!

I hope you were able to watch Therapydia's PT TV tonight. In case you weren't able to, Episode 12: Acute Care, Promoting Best Practice is available here:


PT TV was an incredible experience - talking live and discussing the cutting edge concepts and practice patterns with two of the industries most prominent physical therapists was true honor - not to mention a complete pleasure. You should've seen our off the air discussions - we really should do outtakes!

In any case, I wanted to highlight some of the top thought take-aways that I felt were critically important to physical therapy practice.

Top Thoughts (in no particular order):

  • Physical therapy schools need to make Acute Care PT a mandatory clinical rotation.
  • To truly be ready for direct access, physical therapists MUST be thoroughly trained in the complex setting of an acute hospital.
  • Physical therapy professional education and training models need change. Especially in acute care, a  2:1, 3:1, or even more perhaps - needs to be implemented to reduce strain on both students and hospitals. After all, all other disciplines have operated in this manner.
  • Clinical independence is insane. Physical therapy has a strange culture of valuing, requiring, guarding, and being emotionally defensive about clinical independence. However, no other profession does this. Most notably in acute care, hospitals & internists constantly consult other disciplines, physician specialists, and order diagnostic tests BECAUSE they are NOT independent - the complex medical involvements seen in the acute care hospital is far too complex for any one practitioner to actually be "independent" - this leads to the unspoken (and politically avoided) question of accountability within the physical therapy profession.
  • For lack of a better description, "hardcore" acute care residency and fellowships must pave the way for not just the future of acute care PT, but all settings of PT - particularly in the wake of direct access. If physical therapists are truly to understand medical screening, acute care is not just the best; it is the ONLY place to truly absorb and appreciate the content. Additionally, such post-graduate programs would create a new culture of constructively challenging clinical thought, fostering professional accountability, and developing new business models of physical therapy practice.
  • Physical therapists in acute care need to find ways to breach new healthcare roles; case management, healthcare administration, business operations, research BEYOND functional measures - these MUST be championed.
  • Early ICU intervention and Emergency Department practice patterns are the new clinical wave in acute care PT.
  • Acute care physical therapists bring value to the health system NOT by productivity numbers; physical therapists bring value by adding expert solutions for healthcare professionals, health systems at large... by decreasing readmission rates, decreasing lengths of stay, increasing customer surplus, adding to social welfare, pioneering a triple-thread cord of TRUE continuity of care throughout a health system, and, by improving the medical status of patients via physical therapy interventions - of particular focus,  to positively impact that of non-threatening/non-pathological physiological/pain/movement dysfunctions which are costing healthcare enormous amounts of money as is.
Please feel free to comment here on this blog - and - to tweet myself, Dr. Gorman, & Dr. Ridgeway with any  thoughts, questions, or concerns about acute care!

Sincerely & Respectfully,
-Ben Fung

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