Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 " Sayin' 'see-ya' to the PTs would not be a bad idea! In this job climate, you have more options than in earlier times. Their attitude is disturbing and irresponsible. Not the kind of PT I would want in my clinic! Lucy Buckley PT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Ann, We have a documentation island and I want to get rid of it! They still congregate and chat! I want to install wall shelves/counters just big enough for charts/clipboards. Sincerely Lucille M. Byrne Administrative Director Pathology/Rehabilitation Jeanes Hospital Temple University Health System 7600 Central Ave. Phila., Pa. 19111 Re: documentation island I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at (248) 370-4041. Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Ann, I believe that you are being more than generous if you schedule blocked time for documentation. That is a luxury that not many therapists have. An island for documentation is a good idea, but I am afraid it will not solve your problem. I would recommend that you establish objective and measurable goals for changing your therapists behavior, have them sign the goals and action plan with the understanding of the consequences if their behavior does not change. Just my 2 cents. Pomatto, PT Dir Rehab Services Ransom Memorial Hosp Ottawa, KS Re: documentation island I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Ann, I think that you need to make it clear that what they are doing is not only unethical but also can be seen as fraudulent. Why is the patient coming to physical therapy if they do not require the skills of a Physical Therapist? As for your worry about them getting upset and leaving, let them. I have a stack of resumes for people who would love to have their job and from what you are saying they would be much better for your facility, patients and the profession as a whole. The documentation island would only accommodate their unacceptable behavior. I would highly recommend against it. Good luck. Cheryl Talamo, PT Manager Doylestown Hospital > Re: documentation island > > I am having problems in our facility with our PTs disappearing into the > staff > office and allowing the techs to perform tasks for patients. I have > spoken > to them on several occasions, went into the staff office and told them to > get > in the gym and recently have gotten two complaints from patients. They > are > not doing documentation - I allow blocked time for their documentation. > Our > tech supervisor is ready to scream and the techs are also very frustrated > - a > mutiny in the making! > So, my idea is to build a documentation island/counter in the gym and do > away > with the staff office. I would be able to create one desk for > professional > staff for private situations ie. phone calls to physician's offices. The > island that has been designed will allow for patient confidentiality and > their is plenty of room in the treatment area. > Has anyone been through this or used an island? I would appreciate the > feedback. My only other option is to say, " See ya " to the PTs. > > Ann > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - > Rochester Michigan. Register at today. > > Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > > LAMP Summit 2000. July 23-25, 2000 Register at . > > Visit our EStore at www.RehabBusiness.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Ann, You could also inform the PTs that they are putting their license at risk by not directly supervising the tech's. Also, if they are documenting and billing Medicare for a directly supervised treatment -- and they are not in the gym supervising the tech's -- then they are fraudulently billing. With Medicare, the fines as I understand them, are $10,000 per incident -- with treble damages. Thus, for fraudulently billing for just three treatments the fine would only be $90,000. Perhaps, having the corporate attorney or compliance officer speak with the PTs would make them aware of the gravity of the issue. If they were all active APTA members they would probably already be aware of these issues. See you all in Indy! H. PS: Could you identify yourself more fully in your email **************** Hansen, PhD, PT Fircrest Physical Therapy Fircrest, WA FircrestPT@... At 10:57 AM 6/9/2000 -0400, you wrote: >I am having problems in our facility with our PTs disappearing into the staff >office and allowing the techs to perform tasks for patients. I have spoken >to them on several occasions, went into the staff office and told them to get >in the gym and recently have gotten two complaints from patients. They are >not doing documentation - I allow blocked time for their documentation. Our >tech supervisor is ready to scream and the techs are also very frustrated - a >mutiny in the making! >So, my idea is to build a documentation island/counter in the gym and do away >with the staff office. I would be able to create one desk for professional >staff for private situations ie. phone calls to physician's offices. The >island that has been designed will allow for patient confidentiality and >their is plenty of room in the treatment area. >Has anyone been through this or used an island? I would appreciate the >feedback. My only other option is to say, " See ya " to the PTs. > >Ann > > > >Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - >Rochester Michigan. Register at today. > >Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > >LAMP Summit 2000. July 23-25, 2000 Register at . > >Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Positive move typically to do away with office atmosphere. At the same time, you must study eval and paperwork forms for reduction. In todays market, paperwork must be clear, concise, and brief. Steve Passmore Evergreen Rehab Re: documentation island > I am having problems in our facility with our PTs disappearing into the staff > office and allowing the techs to perform tasks for patients. I have spoken > to them on several occasions, went into the staff office and told them to get > in the gym and recently have gotten two complaints from patients. They are > not doing documentation - I allow blocked time for their documentation. Our > tech supervisor is ready to scream and the techs are also very frustrated - a > mutiny in the making! > So, my idea is to build a documentation island/counter in the gym and do away > with the staff office. I would be able to create one desk for professional > staff for private situations ie. phone calls to physician's offices. The > island that has been designed will allow for patient confidentiality and > their is plenty of room in the treatment area. > Has anyone been through this or used an island? I would appreciate the > feedback. My only other option is to say, " See ya " to the PTs. > > Ann > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > > Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > > LAMP Summit 2000. July 23-25, 2000 Register at . > > Visit our EStore at www.RehabBusiness.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 One more motivational factor for those PTs who are not supervising their techs... [not that this group hasn't come up with plenty already] If they check their professional liability insurance [AKA Malpractice Insurance} they may note that they are not covered for activities that involve violation of laws. In addition, they seem to be violating your facility policies, so they may be subject to subrogation even if there were a covered claim of some sort. So they are also putting their personal assets on the line. At 08:19 AM 06/09/2000 -0700, you wrote: Ann, You could also inform the PTs that they are putting their license at risk by not directly supervising the tech's. Also, if they are documenting and billing Medicare for a directly supervised treatment -- and they are not in the gym supervising the tech's -- then they are fraudulently billing. With Medicare, the fines as I understand them, are $10,000 per incident -- with treble damages. Thus, for fraudulently billing for just three treatments the fine would only be $90,000. Perhaps, having the corporate attorney or compliance officer speak with the PTs would make them aware of the gravity of the issue. If they were all active APTA members they would probably already be aware of these issues. See you all in Indy! H. PS: Could you identify yourself more fully in your email **************** Hansen, PhD, PT Fircrest Physical Therapy Fircrest, WA FircrestPT@... At 10:57 AM 6/9/2000 -0400, you wrote: >I am having problems in our facility with our PTs disappearing into the staff >office and allowing the techs to perform tasks for patients. I have spoken >to them on several occasions, went into the staff office and told them to get >in the gym and recently have gotten two complaints from patients. They are >not doing documentation - I allow blocked time for their documentation. Our >tech supervisor is ready to scream and the techs are also very frustrated - a >mutiny in the making! >So, my idea is to build a documentation island/counter in the gym and do away >with the staff office. I would be able to create one desk for professional >staff for private situations ie. phone calls to physician's offices. The >island that has been designed will allow for patient confidentiality and >their is plenty of room in the treatment area. >Has anyone been through this or used an island? I would appreciate the >feedback. My only other option is to say, " See ya " to the PTs. > >Ann > > > >Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - >Rochester Michigan. Register at today. > >Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > >LAMP Summit 2000. July 23-25, 2000 Register at . > >Visit our EStore at www.RehabBusiness.com Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com *********************************************** Janice Kuperstein, PT, MSEd Assistant Professor University of Kentucky College of Allied Health Professions 121 Washington Avenue Lexington, KY 40536-0003 Telephone: 606 - 323-1100 ext 261 Fax: 606 - 257-1816 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 At one facility I worked at, we had a type of documentation area that you describe and it worked well. I have encountered this same problem over the years, and keeping the charting area out of an office has worked well. Dave Kujawa, PT, OCS >>> abatc@... 06/09 10:57 AM >>> I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Ann, The way that you have described it, it appears that you have some therapists on your staff that are neglecting their responsibilities. They are not supervising their patients and techs as per their license, they are not doing other constructive tasks during this time, such as documentation. Furthermore, it appears that they are not paying much attention to you as their supervisor. At least for now, I would save the money you plan to spend on building an island, and follow the suitable disciplinary action with those not doing their job. If they continue to neglect their responsibilities, get rid of them and hire some PTs who will do the job. I'm sure there are enough therapists around to replace them. n Callachor PT Sup. MacNeal Health Network Berwyn IL Re: documentation island At one facility I worked at, we had a type of documentation area that you describe and it worked well. I have encountered this same problem over the years, and keeping the charting area out of an office has worked well. Dave Kujawa, PT, OCS >>> abatc@... 06/09 10:57 AM >>> I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Ann - I could not have said it better than Cheryl Talamo! These " professionals " have a choice - get out of the office or get out of the facility. Go to Human Resources and find out what procedures you have to follow to institute disciplinary action, take action and let them know what you are doing. If nothing else you are functioning as an advocate for the patients referred to your service for care. Tell these folks to wise up - this kind of behavior should be long gone! C. Sinnott, M.Ed.,PT Acute Care Section President Re: documentation island > > > > I am having problems in our facility with our PTs disappearing into the > > staff > > office and allowing the techs to perform tasks for patients. I have > > spoken > > to them on several occasions, went into the staff office and told them to > > get > > in the gym and recently have gotten two complaints from patients. They > > are > > not doing documentation - I allow blocked time for their documentation. > > Our > > tech supervisor is ready to scream and the techs are also very frustrated > > - a > > mutiny in the making! > > So, my idea is to build a documentation island/counter in the gym and do > > away > > with the staff office. I would be able to create one desk for > > professional > > staff for private situations ie. phone calls to physician's offices. The > > island that has been designed will allow for patient confidentiality and > > their is plenty of room in the treatment area. > > Has anyone been through this or used an island? I would appreciate the > > feedback. My only other option is to say, " See ya " to the PTs. > > > > Ann > > > > > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - > > Rochester Michigan. Register at today. > > > > Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > > > > LAMP Summit 2000. July 23-25, 2000 Register at . > > > > Visit our EStore at www.RehabBusiness.com > > > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > > Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > > LAMP Summit 2000. July 23-25, 2000 Register at . > > Visit our EStore at www.RehabBusiness.com > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I agree with this answer. There are plenty of therapists out there dying to work. My staff are happy to have jobs and put out 110% every day. And they are proud to be PTs and offer PT to the pts we serve. Sounds like you need some fresh blood. Diane Aja, MS, OTR Work Enhancement and Rehabilitation Center Fletcher Health Care Williston, VT Re: documentation island > > I am having problems in our facility with our PTs disappearing into the > staff > office and allowing the techs to perform tasks for patients. I have > spoken > to them on several occasions, went into the staff office and told them to > get > in the gym and recently have gotten two complaints from patients. They > are > not doing documentation - I allow blocked time for their documentation. > Our > tech supervisor is ready to scream and the techs are also very frustrated > - a > mutiny in the making! > So, my idea is to build a documentation island/counter in the gym and do > away > with the staff office. I would be able to create one desk for > professional > staff for private situations ie. phone calls to physician's offices. The > island that has been designed will allow for patient confidentiality and > their is plenty of room in the treatment area. > Has anyone been through this or used an island? I would appreciate the > feedback. My only other option is to say, " See ya " to the PTs. > > Ann > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - > Rochester Michigan. Register at today. > > Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! > > LAMP Summit 2000. July 23-25, 2000 Register at . > > Visit our EStore at www.RehabBusiness.com > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 Why are we assuming that the therapist are at fault? It is hard to believe that all your professional staff would behave in this matter. If this is the case, the island would not solve the problem. Reyna Colombo Director of Physical Therapy Beaumont Hospital- Troy >>> " Pomatto, " 06/09/00 11:12AM >>> Ann, I believe that you are being more than generous if you schedule blocked time for documentation. That is a luxury that not many therapists have. An island for documentation is a good idea, but I am afraid it will not solve your problem. I would recommend that you establish objective and measurable goals for changing your therapists behavior, have them sign the goals and action plan with the understanding of the consequences if their behavior does not change. Just my 2 cents. Pomatto, PT Dir Rehab Services Ransom Memorial Hosp Ottawa, KS Re: documentation island I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com ! ! ! ! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I was hired from the outside 2 years ago to come in and manage a SNF rehab department. The department had been supervised by a non-therapy manager for years. The PT department had a very similar situation going on as the one described by Ann as well as other behavioral issues. We tried team meetings, individual counseling, review of policies, etc. It took some time, but basically what it took was an individual conference with each professional. Each one was given the opportunity to take a " day of decision " . (Of course, we did each conference on a different day so as not to empty the department on a single day.) Each one was to take a day off to think about the issues that were discussed and were told to return the day after for an 8:00 meeting ready to " get on the bus " or with resignation in hand. Each was given in writing an interim evaluation and a list of non-negotiables (behaviors that would no longer be tolerated) before their " day of decision " began. Interestingly enough, every one of them came back ready to get on the bus and those issues were cleaned up in short order. That was 9 months ago and the department averages 75% productivity now (that includes the lead therapist who has a lower productivity expectation), works together like a team and there are no more ethical/legal issues over supervision. It worked here but we had support from upper management to handle it this way. Good luck. Tammy PT tkelly1@... Re: documentation island I am having problems in our facility with our PTs disappearing into the staff office and allowing the techs to perform tasks for patients. I have spoken to them on several occasions, went into the staff office and told them to get in the gym and recently have gotten two complaints from patients. They are not doing documentation - I allow blocked time for their documentation. Our tech supervisor is ready to scream and the techs are also very frustrated - a mutiny in the making! So, my idea is to build a documentation island/counter in the gym and do away with the staff office. I would be able to create one desk for professional staff for private situations ie. phone calls to physician's offices. The island that has been designed will allow for patient confidentiality and their is plenty of room in the treatment area. Has anyone been through this or used an island? I would appreciate the feedback. My only other option is to say, " See ya " to the PTs. Ann Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com ! ! ! ! Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 This subject seems to have struck a nerve here, and I don't doubt that a number of members are glad to see that their's isn't the only professional staff behaving in this fashion. I cannot relate personally in that I have a solo practice without any assistants or techs, but as I travel and teach I see this sort of thing with some regularity. I'm fairly certain that for every complaint about the absence of a therapist that the supervisor actually hears, there are countless more that go unreported. Kind of like that termite thing, if you know what I mean. I don't know that changing the furniture in the department will help. The " mother of the problem " as some management consultant might say, is the absence of passion for the work of therapy itself. Without an opportunity to bring their own creativity to the job, many highly trained individuals will retreat from the protocols that dominate their day and restrict whatever they once thought would be their individual way of practicing. We should remember that productivity can be coerced, measured, rewarded and, to some degree, expected. Creativity responds to very little of this, and it will emerge only within an environment that encourages the internal conversation that precedes it. A PT gym is rarely if ever like that, and staff expected to act in a manner commensurate with their original intent when they chose this career will often grow complacent when they are told just exactly what to do for every diagnosis. Allowing the techs to take over is not acceptable, but it's understandable. I also think it's very, very common. Ultimately, it's a management problem that requires a manager still passionate about clinical problems and willing to invite new solutions. At least, that's what I think. Barrett L. Dorko, P.T. " The Clinician's Manual " <http://barrettdorko.com> Also at <http://rehabedge.com> And http://prorehabonline.com> And <http://physicaltherapist.com> And<http://Rehabmax.com> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 This subject seems to have struck a nerve here, and I don't doubt that a number of members are glad to see that their's isn't the only professional staff behaving in this fashion. I cannot relate personally in that I have a solo practice without any assistants or techs, but as I travel and teach I see this sort of thing with some regularity. I'm fairly certain that for every complaint about the absence of a therapist that the supervisor actually hears, there are countless more that go unreported. Kind of like that termite thing, if you know what I mean. I don't know that changing the furniture in the department will help. The " mother of the problem " as some management consultant might say, is the absence of passion for the work of therapy itself. Without an opportunity to bring their own creativity to the job, many highly trained individuals will retreat from the protocols that dominate their day and restrict whatever they once thought would be their individual way of practicing. We should remember that productivity can be coerced, measured, rewarded and, to some degree, expected. Creativity responds to very little of this, and it will emerge only within an environment that encourages the internal conversation that precedes it. A PT gym is rarely if ever like that, and staff expected to act in a manner commensurate with their original intent when they chose this career will often grow complacent when they are told just exactly what to do for every diagnosis. Allowing the techs to take over is not acceptable, but it's understandable. I also think it's very, very common. Ultimately, it's a management problem that requires a manager still passionate about clinical problems and willing to invite new solutions. At least, that's what I think. Barrett L. Dorko, P.T. " The Clinician's Manual " <http://barrettdorko.com> Also at <http://rehabedge.com> And http://prorehabonline.com> And <http://physicaltherapist.com> And<http://Rehabmax.com> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I was interested in your comment about the PT gym not being conducive to creative thinking. Ours definitely is. With PT's, PTA's, PT and PTA students present year round, every day is a virtual think tank around here, where everyone has the opportunity to observe what others are doing and offer suggestions. It's the " no one has a bad idea; or asks a stupid question " philosophy. Area Prosthetists and Orthotists are here frequently and join in as well. We recently had a clinical intern who turned down a full time job to work here per diem in hopes of something full or part time opening up later. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I was interested in your comment about the PT gym not being conducive to creative thinking. Ours definitely is. With PT's, PTA's, PT and PTA students present year round, every day is a virtual think tank around here, where everyone has the opportunity to observe what others are doing and offer suggestions. It's the " no one has a bad idea; or asks a stupid question " philosophy. Area Prosthetists and Orthotists are here frequently and join in as well. We recently had a clinical intern who turned down a full time job to work here per diem in hopes of something full or part time opening up later. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I'm sure your gym is as you suggest, and that there are others like it elsewhere. Perhaps I should have emphasized that it isn't the gym that's the problem, but the attitudes of the people in it. Such a thing begins at the management level, and yours is obviously a reflection of your presence there. Barrett L. Dorko, P.T. " The Clinician's Manual " <http://barrettdorko.com> At 04:34 PM 6/9/00 -0500, you wrote: >I was interested in your comment about the PT gym not being conducive to >creative thinking. Ours definitely is. With PT's, PTA's, PT and PTA >students present year round, every day is a virtual think tank around >here, where everyone has the opportunity to observe what others are doing >and offer suggestions. It's the " no one has a bad idea; or asks a stupid >question " philosophy. Area Prosthetists and Orthotists are here >frequently and join in as well. We recently had a clinical intern who >turned down a full time job to work here per diem in hopes of something >full or part time opening up later. > > > > >Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - >Rochester Michigan. Register at today. > >Coming Soon - Rehab Pro - The New Way...A Better Way to Rehab Success! >LAMP Summit 2000. July 23-25, 2000 Register at . > >Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2000 Report Share Posted June 9, 2000 I'm sure your gym is as you suggest, and that there are others like it elsewhere. Perhaps I should have emphasized that it isn't the gym that's the problem, but the attitudes of the people in it. Such a thing begins at the management level, and yours is obviously a reflection of your presence there. Barrett L. Dorko, P.T. " The Clinician's Manual " <http://barrettdorko.com> At 04:34 PM 6/9/00 -0500, you wrote: >I was interested in your comment about the PT gym not being conducive to >creative thinking. Ours definitely is. With PT's, PTA's, PT and PTA >students present year round, every day is a virtual think tank around >here, where everyone has the opportunity to observe what others are doing >and offer suggestions. It's the " no one has a bad idea; or asks a stupid >question " philosophy. Area Prosthetists and Orthotists are here >frequently and join in as well. We recently had a clinical intern who >turned down a full time job to work here per diem in hopes of something >full or part time opening up later. > > > > >Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - >Rochester Michigan. Register at today. > >Coming Soon - Rehab Pro - The New Way...A Better Way to Rehab Success! >LAMP Summit 2000. July 23-25, 2000 Register at . > >Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2000 Report Share Posted June 10, 2000 This documentation island has been an interesting dialogue to watch. If I may I'd like to throw in my two cents - There are two points that I feel are worth thinking about and should, hopefully, cause to ask ourselves more questions which is where our life and our careers become enhanced. First - if we use the " 5 Whys " to Root Cause Analysis we will see that we need to go farther before we come to a conclusion. i.e. The PT's aren't performing up to standards - why? because unless they are in the open they don't do their work - why? they have poor attitudes - why? because in the past working harder led them to frustration and not being respected by management at some level...(for example - no insinuation intended.) - Why?..... I think we have to get to the root cause before we offer solutions, otherwise we only solve symptoms - not the real problem. (just like treatment) Secondly, you can't manage people -- people are unmanageable! We can't even manage ourselves if we are honest about it! You manage systems and processes and you develop people - I believe that is much more than just semantics. Gerber (author of The E-Myth (means the entrepreneurial myth)) states that in businesses and organizations we have to create a game worth playing -- which boils down to two things - 1. Only people who like our game will be attracted to it enough to stay and play, and 2. every game has rules. Rules are necessary and provide the structure and order but do not stifle the participants. ( Jordan did his creating, performing, and enjoying all within the rules of the game he was attracted to.) Are we asking enough " whys " in this case, in our case and in our profession? And are we creating a game worth playing and if so are the current players a fit for your game? Again in this situation, our situations and in our profession? So much for my two cents - I look forward to feedback and more questions -- since answers are dead. Jeff Hathaway, PT, CEC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2000 Report Share Posted June 10, 2000 This documentation island has been an interesting dialogue to watch. If I may I'd like to throw in my two cents - There are two points that I feel are worth thinking about and should, hopefully, cause to ask ourselves more questions which is where our life and our careers become enhanced. First - if we use the " 5 Whys " to Root Cause Analysis we will see that we need to go farther before we come to a conclusion. i.e. The PT's aren't performing up to standards - why? because unless they are in the open they don't do their work - why? they have poor attitudes - why? because in the past working harder led them to frustration and not being respected by management at some level...(for example - no insinuation intended.) - Why?..... I think we have to get to the root cause before we offer solutions, otherwise we only solve symptoms - not the real problem. (just like treatment) Secondly, you can't manage people -- people are unmanageable! We can't even manage ourselves if we are honest about it! You manage systems and processes and you develop people - I believe that is much more than just semantics. Gerber (author of The E-Myth (means the entrepreneurial myth)) states that in businesses and organizations we have to create a game worth playing -- which boils down to two things - 1. Only people who like our game will be attracted to it enough to stay and play, and 2. every game has rules. Rules are necessary and provide the structure and order but do not stifle the participants. ( Jordan did his creating, performing, and enjoying all within the rules of the game he was attracted to.) Are we asking enough " whys " in this case, in our case and in our profession? And are we creating a game worth playing and if so are the current players a fit for your game? Again in this situation, our situations and in our profession? So much for my two cents - I look forward to feedback and more questions -- since answers are dead. Jeff Hathaway, PT, CEC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2000 Report Share Posted June 10, 2000 Reid, I find your comments interesting and sad at the same time. I believe we have to start asking the hard questions beginning with " who am I " and " Who are we as a profession " and stop defending who we have been all this time. By being too focused on who we've been, we miss the opportunity to become what we can be in the healthcare arena. What are the rules of the game? What are the new rules we need to reach our next potential? What does being a Physical Therapist really mean? What is quality care? How do we get there from here? Etc., etc. One last thought about working environment -- Motivating Therapists is a Myth. Rather than attempting to motivate people to be productive so the environment is better isn't the opposite true, that a productive environment is more motivating? So the question is how do we make the environment more productive? Jeff Hathaway, PT, CEC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2000 Report Share Posted June 10, 2000 Reid, I find your comments interesting and sad at the same time. I believe we have to start asking the hard questions beginning with " who am I " and " Who are we as a profession " and stop defending who we have been all this time. By being too focused on who we've been, we miss the opportunity to become what we can be in the healthcare arena. What are the rules of the game? What are the new rules we need to reach our next potential? What does being a Physical Therapist really mean? What is quality care? How do we get there from here? Etc., etc. One last thought about working environment -- Motivating Therapists is a Myth. Rather than attempting to motivate people to be productive so the environment is better isn't the opposite true, that a productive environment is more motivating? So the question is how do we make the environment more productive? Jeff Hathaway, PT, CEC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2000 Report Share Posted June 10, 2000 Thank you for your reply to the listserve. I was bothered by the tendency to " blame the staff PTs " and label them as " unprofessional " but I wasn't able to identify exactly why I felt the way I did about it. I think you hit the nail on the head....people will act professionally when they feel like professionals...I have been struck over the past several years by the deprofessionalization of health care. When I started in PT about 15 years ago I dictated evals that were ussually about two pages long and that tried to break down problems into component parts . Now I do PRN work for 3 different places and the evals are forms that you check off. I honestly don't think you have to go to 6 years of college to be able to identify that a person needs moderate assistance with transfers....I think most of the CNAs could fill out these " eval forms " and come up with about the same information. Another issue I have considered along these same lines is the adoption of technology by rehab personnel. I worked for a home health company one time and I was trying to convince my supervisor that we should obtain manual muscle testers...you know... those digital readout things that give a specific force production. My reasoning was that about 40% of what the therapists were identifying as their treatment plans had to do with strengthening and, besides improvement in functional tasks, the only way they were assessing strength was with manual muscle testing which we know is not reliable. Of course we didn't get them...but there was always money to buy the latest infusion pump or another software package. It struck me that most of the " newer " technology used by PT is about 50 years old ( e-stim and ultrasound for example ). Most of the exercise equipment I have used in PT gyms is made of rubber or sand. If the other departments in health care organizations used technology this dated, the accountants would be using paper and pencil ledgers, and nurses would be using hot water bottles. In short, I have to count myself as one who doesn't feel as much of a professional as I used to. Reid Hanson PT MSA Re: Re: documentation island This documentation island has been an interesting dialogue to watch. If I may I'd like to throw in my two cents - There are two points that I feel are worth thinking about and should, hopefully, cause to ask ourselves more questions which is where our life and our careers become enhanced. First - if we use the " 5 Whys " to Root Cause Analysis we will see that we need to go farther before we come to a conclusion. i.e. The PT's aren't performing up to standards - why? because unless they are in the open they don't do their work - why? they have poor attitudes - why? because in the past working harder led them to frustration and not being respected by management at some level...(for example - no insinuation intended.) - Why?..... I think we have to get to the root cause before we offer solutions, otherwise we only solve symptoms - not the real problem. (just like treatment) Secondly, you can't manage people -- people are unmanageable! We can't even manage ourselves if we are honest about it! You manage systems and processes and you develop people - I believe that is much more than just semantics. Gerber (author of The E-Myth (means the entrepreneurial myth)) states that in businesses and organizations we have to create a game worth playing -- which boils down to two things - 1. Only people who like our game will be attracted to it enough to stay and play, and 2. every game has rules. Rules are necessary and provide the structure and order but do not stifle the participants. ( Jordan did his creating, performing, and enjoying all within the rules of the game he was attracted to.) Are we asking enough " whys " in this case, in our case and in our profession? And are we creating a game worth playing and if so are the current players a fit for your game? Again in this situation, our situations and in our profession? So much for my two cents - I look forward to feedback and more questions -- since answers are dead. Jeff Hathaway, PT, CEC Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Coming Soon - Rehab Pro - The New Way...A Better Way to Rehab Success! LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
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