Re: Enhancing the public's perception of PT

[Guest guest]

Doug:

Great points! We also need to remember that anytime we identify

ourselves to anyone as PT's we contribute to the public's perception, good

or bad. Several years ago, while doing some legal research, I came across

an article in the National Disability Law reporter. To make a long story

short, a PT had written in requesting a legal opinion about the need for

automatic doors in a local store. The opinion reprinted the letter,

unedited, which was full of jargon, inappropriate abbreviations, poor

grammar and punctuation and generally gave the reader the impression that

the writer never finished high school. I use it as an example to my

students. Admittedly, this article addressed a small audience, but I think

we need to remember that we contribute to the public perception of PT

anytime we identify ourselves as PT's.

Laurie Walsh

Daemen College

>Dale:

>

>The perception of the medical community and the general public is do to

>our lack of effective marketing and our own behaviors.

>

>Here is a perception to think about.

>

>If I am a physician and I have had almost zero education about PT and I

>constantly get phone calls and documentation stating: Dr. White can use I

>hot packs on Ms. ? Dr. White is it OK to do estim on Ms. . Dr.

>White Ms. has improved w/ treatment but she would would benefit

>further treatment, please advise.

>

>or

>

>Ms. the doctor only ordered 4 weeks of therapy. Therefore you have

>to go back to the doctor to see if you need more PT. Ms. did you

>bring a prescription/orders from the doctor?

>

>Instead we need to be saying: Dr. White, thank you for the referral. I

>appreciate the opportunity to consult on your patient Ms. . I have

>evaluated her and my diagnosis is ?L5 radiculopathy. I will follow Ms.

> biw for the next four weeks. My Rx is for HP and ther. ex. If her

>radicular sxs do not improve in the next 10 days I will refer her for a

>MRI of the lumbar spine. I will keep you apprised of her progress. Please

>sign the enclosed referral form for insurance purposes.

>

>Dr. White: Ms. has improved since my initial consultation. The

>following are the results of today's physical examination. ............

>She requires an additional two weeks of treatment at which time I will d/c

>her from my care with instructions to contact me should she have any

>questions.

>

>Ms. did you bring a referral from Dr. White? Ms. you are

>improving with treatment and I think you need two additional weeks of

>treatment. I will contact Dr. White's office to get the paperwork squared

>away for the insurance company.

>

>My point being if we talk and document like technicians who are not sure

>what we should be doing for the patient or for how long and that we need a

>permission slip to go to the mens/ladies room (pardon the sarcasm) then

>how can we expect to be treated any differently.

>

>

>Dale Avers wrote:

>

>> I am most grateful for the discussion and candidness of the responses

>>concerning the advantages and disadvantages of additional certifications

>>outside the traditional realm of PT. It has been most enlightening for me.

>>

>> Underneath this issue is the all important issue of the public's

>>perception of PT. Do you agree that the PT profession has a mixed bag of

>>public awareness and knowledge of the scope of our interactions? Is this

>>a problem not only with our public but also ourselves and third party

>>payers? If public perception is too narrow, not wholly positive or even

>>negative....what ideas do the members of this listserv have for enhancing

>>the public's perception of physical therapists/physical therapy?

>>

>> My personal perception is one of routinely hearing about patients and

>>clients who have tried PT and been very disappointed in the lack of

>>results, lack of professionalism and lack of clearly articulated goals

>>and outcomes. As a result, they have judged the entire profession by

>>these interactions, and been unwilling or reluctant to try PT again.

>>Several clients recently have told me they have " believed " in PT, but

>>haven't been able to find a " good " one, defined as competent based on

>>results, and professional that included full informed consent and clearly

>>articulated goals and outcomes. This personal perception prompts my

>>question to you. Thank you for your responses.

>>

>> Dale Avers

>>

>> Dale Avers, PT, MSEd

>> Mount St. 's College

>> 12001 Chalon Road

>> Los Angeles, CA 90049

>>

>> FAX

>>

>> Doctoral Candidate

>> Instructional Systems Technology

>> Indiana University

>>

>> ------------------------------------------------------------------------

>>

>> eGroups.com home: /group/ptmanager

>> - Simplifying group communications

>

>

>------------------------------------------------------------------------

>

>eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>

>Content-Type: text/x-vcard;

> charset= " us-ascii " ;

> name= " douglaswhite.vcf "

>content-disposition: attachment;

> filename= " douglaswhite.vcf "

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[Guest guest]

In a message dated 08/18/1999 8:18:10 PM Eastern Daylight Time,

douglaswhite@... writes:

<< If her radicular sxs do not improve in the next 10 days I will refer her

for a MRI of the lumbar spine. >>

This is phrase I have difficulty with. I would love to do this but will the

3rd party pay for my MRI referral???

Steve Marcum PT

Kentucky

Pattie A. Clay Hospital

[Guest guest]

Dale:

The perception of the medical community and the general public is do to our lack

of effective marketing and our own behaviors.

Here is a perception to think about.

If I am a physician and I have had almost zero education about PT and I

constantly get phone calls and documentation stating: Dr. White can use I hot

packs on Ms. ? Dr. White is it OK to do estim on Ms. . Dr. White Ms.

has improved w/ treatment but she would would benefit further treatment,

please advise.

or

Ms. the doctor only ordered 4 weeks of therapy. Therefore you have to go

back to the doctor to see if you need more PT. Ms. did you bring a

prescription/orders from the doctor?

Instead we need to be saying: Dr. White, thank you for the referral. I

appreciate the opportunity to consult on your patient Ms. . I have

evaluated her and my diagnosis is ?L5 radiculopathy. I will follow Ms. biw

for the next four weeks. My Rx is for HP and ther. ex. If her radicular sxs do

not improve in the next 10 days I will refer her for a MRI of the lumbar spine.

I will keep you apprised of her progress. Please sign the enclosed referral form

for insurance purposes.

Dr. White: Ms. has improved since my initial consultation. The following

are the results of today's physical examination. ............ She requires an

additional two weeks of treatment at which time I will d/c her from my care with

instructions to contact me should she have any questions.

Ms. did you bring a referral from Dr. White? Ms. you are improving

with treatment and I think you need two additional weeks of treatment. I will

contact Dr. White's office to get the paperwork squared away for the insurance

company.

My point being if we talk and document like technicians who are not sure what we

should be doing for the patient or for how long and that we need a permission

slip to go to the mens/ladies room (pardon the sarcasm) then how can we expect

to be treated any differently.

Dale Avers wrote:

> I am most grateful for the discussion and candidness of the responses

concerning the advantages and disadvantages of additional certifications outside

the traditional realm of PT. It has been most enlightening for me.

>

> Underneath this issue is the all important issue of the public's perception of

PT. Do you agree that the PT profession has a mixed bag of public awareness and

knowledge of the scope of our interactions? Is this a problem not only with our

public but also ourselves and third party payers? If public perception is too

narrow, not wholly positive or even negative....what ideas do the members of

this listserv have for enhancing the public's perception of physical

therapists/physical therapy?

>

> My personal perception is one of routinely hearing about patients and clients

who have tried PT and been very disappointed in the lack of results, lack of

professionalism and lack of clearly articulated goals and outcomes. As a result,

they have judged the entire profession by these interactions, and been unwilling

or reluctant to try PT again. Several clients recently have told me they have

" believed " in PT, but haven't been able to find a " good " one, defined as

competent based on results, and professional that included full informed consent

and clearly articulated goals and outcomes. This personal perception prompts my

question to you. Thank you for your responses.

>

> Dale Avers

>

> Dale Avers, PT, MSEd

> Mount St. 's College

> 12001 Chalon Road

> Los Angeles, CA 90049

>

> FAX

>

> Doctoral Candidate

> Instructional Systems Technology

> Indiana University

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

Attachment: vcard [not shown]

[Guest guest]

It depends on the state and the ins co.

PacRock@... wrote:

> In a message dated 08/18/1999 8:18:10 PM Eastern Daylight Time,

> douglaswhite@... writes:

>

> << If her radicular sxs do not improve in the next 10 days I will refer her

> for a MRI of the lumbar spine. >>

>

> This is phrase I have difficulty with. I would love to do this but will the

> 3rd party pay for my MRI referral???

>

> Steve Marcum PT

> Kentucky

> Pattie A. Clay Hospital

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

Attachment: vcard [not shown]

[Guest guest]

Doug,

thanks for the thoughtful reply, and I whole heartedly agree. I would add one

scenerio that I used to use rather frequently......Dr. White...I noticed you

ordered PT 3x week for 3 weeks for Mrs. ....but you know, I think she is

making excellent progress and will only need to see her for one more week, and

just once in that week. Thanks for referring her.

But what do we do with all the PTs who see patients 3x/wk for 6 weeks because

that is what is ordered, because that's what they can bill for and may get

reimbursed for.....or the PTs that don't really evaluate and don't really have

expectations about outcomes? It's like a cancer in our profession, and one of

the reasons I started teaching full time. How can we hold ourselves accountable,

even when our state licensing boards wimp out, don't mandate any kind of

expectation about continuing education, don't pull licenses when the evidence is

clear of violations, etc. We are all part of the problem, when we see this kind

of stuff going on and aren't part of the solution. Ok, Dale,...off your soap

box. I've been hearing to much negative stuff about this profession I love so

much.

Dale

Dale Avers, PT, MSEd

Mount St. 's College

12001 Chalon Road

Los Angeles, CA 90049

FAX

Doctoral Candidate

Instructional Systems Technology

Indiana University

>>> " M. White " 08/18/99 05:14PM >>>

Dale:

The perception of the medical community and the general public is do to our lack

of effective marketing and our own behaviors.

Here is a perception to think about.

If I am a physician and I have had almost zero education about PT and I

constantly get phone calls and documentation stating: Dr. White can use I hot

packs on Ms. ? Dr. White is it OK to do estim on Ms. . Dr. White Ms.

has improved w/ treatment but she would would benefit further treatment,

please advise.

or

Ms. the doctor only ordered 4 weeks of therapy. Therefore you have to go

back to the doctor to see if you need more PT. Ms. did you bring a

prescription/orders from the doctor?

Instead we need to be saying: Dr. White, thank you for the referral. I

appreciate the opportunity to consult on your patient Ms. . I have

evaluated her and my diagnosis is ?L5 radiculopathy. I will follow Ms. biw

for the next four weeks. My Rx is for HP and ther. ex. If her radicular sxs do

not improve in the next 10 days I will refer her for a MRI of the lumbar spine.

I will keep you apprised of her progress. Please sign the enclosed referral form

for insurance purposes.

Dr. White: Ms. has improved since my initial consultation. The following

are the results of today's physical examination. ............ She requires an

additional two weeks of treatment at which time I will d/c her from my care with

instructions to contact me should she have any questions.

Ms. did you bring a referral from Dr. White? Ms. you are improving

with treatment and I think you need two additional weeks of treatment. I will

contact Dr. White's office to get the paperwork squared away for the insurance

company.

My point being if we talk and document like technicians who are not sure what we

should be doing for the patient or for how long and that we need a permission

slip to go to the mens/ladies room (pardon the sarcasm) then how can we expect

to be treated any differently.

Dale Avers wrote:

> I am most grateful for the discussion and candidness of the responses

concerning the advantages and disadvantages of additional certifications outside

the traditional realm of PT. It has been most enlightening for me.

>

> Underneath this issue is the all important issue of the public's perception of

PT. Do you agree that the PT profession has a mixed bag of public awareness and

knowledge of the scope of our interactions? Is this a problem not only with our

public but also ourselves and third party payers? If public perception is too

narrow, not wholly positive or even negative....what ideas do the members of

this listserv have for enhancing the public's perception of physical

therapists/physical therapy?

>

> My personal perception is one of routinely hearing about patients and clients

who have tried PT and been very disappointed in the lack of results, lack of

professionalism and lack of clearly articulated goals and outcomes. As a result,

they have judged the entire profession by these interactions, and been unwilling

or reluctant to try PT again. Several clients recently have told me they have

" believed " in PT, but haven't been able to find a " good " one, defined as

competent based on results, and professional that included full informed consent

and clearly articulated goals and outcomes. This personal perception prompts my

question to you. Thank you for your responses.

>

> Dale Avers

>

> Dale Avers, PT, MSEd

> Mount St. 's College

> 12001 Chalon Road

> Los Angeles, CA 90049

>

> FAX

>

> Doctoral Candidate

> Instructional Systems Technology

> Indiana University

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

------------------------------------------------------------------------

eGroups.com home: /group/ptmanager

- Simplifying group communications

[Guest guest]

I believe that the " medical community " as well as the general public have

formed their perception of what we do based on their individual and

collective experiences with physical therapists and the outcomes they have

been able to produce. In my observations over twenty years of clinical and

administrative experience, I believe we have, unfortunately, been our own

worst enemies.

As PT's we are entitled by our respective practise acts to treat a very

broad array of musculoskeletal , neuromuscular and pathophysiological

impairments. That is not to say we already " know it all " but that our

academic preparation should have taught us when we need to learn more and

where to find the answers. A guiding principle I learned early on and have

tried to convey to students and staff was this: YOU SHOULD HAVE A DEFENSIBLE

RATIONALE FOR EVERYTHING YOU DO. The very fine PTs I have known and often

refer to know what they are doing, know why they are doing it and are able to

articulate this to both the patient and the medical community. These same

very fine PTs have dedicated the resources (both time and monetary) to join

professional organizations, attend continuing education programs, purchase

and actually read books, at times seek advanced certifications,- yes, and

spend countless hours following listservs!

Until more grass roots PTs take seriously their roles as lifelong learners

and seekers as well as articulate educators, I fear we will continue to be

misunderstood and underestimated. I think that is the challenge for all the

educators as well as the leaders of the various professional organizations

within our profession. A string of letters after our names won't do it for us

but the advanced study that goes into attaining those letters may provide the

additional knowledge and skills to be more articulate and effective in

certain areas of practice.

Pat Walaszek,PT

[Guest guest]

I, too, have enjoyed the dialogue around this issue. L. Walsh's post

frames the concern about public relations and physical therapy. The old

maxim is that if you do a great job your client (patient) will tell 5

people about it, but if you do a bad job 15 people will learn about it.

The public's perception of the physical therapy profession is essential

to our growth and success. Yet, as Dr. Hack points out, WE can not

agree on our role. She wrote:

Should we be assuring our place as THE providers of exercise as

a valuable intervention? Or should we be leaving the in-depth

information on exercise to other credentials and instead assure

our students know something about lots of different kinds of

practice? If we are to do the latter, what is the unique, unifying

factor to our practice? Or are we to do both - which is most difficult

task, indeed.

The APTA has been developing a vision statement- I recommend that this

is needed as a compass to unify us and guide us towards common abilities

(though I certainly do not want to be adding " veterinary " competencies

into my curriculum). We can not 'do it all'- what (specifically) is

that unifying factor going to be? Once we have that education programs

like Temple Univ. will surely produce competent graduates.

I, too, am surprised that the credentialing process is perceived by some

to be more useful/effective than the education process to become a

physical therapist. I speculate that for some issues this may be due to

our emphasis on pathology (to the neglect of the healthy or athletic

population). I also suggest that physical therapy educators' reliance

on a research-supported conclusions often leaves graduates with a broad

base of knowledge and few absolute answers. This better prepares

graduates for their career, but leaves them asking many questions about

the single best method to achieve strength or conditioning. Some

credentialing programs apparently have the answer to that question.

However, credentialing may not be not necessary for the competent PT who

effectively keeps current with new research in this arena. For others

credentialing may provide the framework, or the incentive, necessary for

them to study and to integrate new evidence/information into their

practices.

Jim , PT, MA

Director, PTA Program

Naugatuck Valley C-T College

750 Chase Parkway

Waterbury, CT 06708

> Re: Enhancing the public's perception of PT

>

> Doug:

> Great points! We also need to remember that anytime we identify

> ourselves to anyone as PT's we contribute to the public's perception,

> good

> or bad. Several years ago, while doing some legal research, I came

> across

> an article in the National Disability Law reporter. To make a long

> story

> short, a PT had written in requesting a legal opinion about the need

> for

> automatic doors in a local store. The opinion reprinted the letter,

> unedited, which was full of jargon, inappropriate abbreviations, poor

> grammar and punctuation and generally gave the reader the impression

> that

> the writer never finished high school. I use it as an example to my

> students. Admittedly, this article addressed a small audience, but I

> think

> we need to remember that we contribute to the public perception of PT

> anytime we identify ourselves as PT's.

>

> Laurie Walsh

> Daemen College

>

> >Dale:

> >

> >The perception of the medical community and the general public is do

> to

> >our lack of effective marketing and our own behaviors.

> >

> >Here is a perception to think about.

> >

> >If I am a physician and I have had almost zero education about PT and

> I

> >constantly get phone calls and documentation stating: Dr. White can

> use I

> >hot packs on Ms. ? Dr. White is it OK to do estim on Ms. .

> Dr.

> >White Ms. has improved w/ treatment but she would would benefit

> >further treatment, please advise.

> >

> >or

> >

> >Ms. the doctor only ordered 4 weeks of therapy. Therefore you

> have

> >to go back to the doctor to see if you need more PT. Ms. did

> you

> >bring a prescription/orders from the doctor?

> >

> >Instead we need to be saying: Dr. White, thank you for the referral.

> I

> >appreciate the opportunity to consult on your patient Ms. . I

> have

> >evaluated her and my diagnosis is ?L5 radiculopathy. I will follow

> Ms.

> > biw for the next four weeks. My Rx is for HP and ther. ex. If

> her

> >radicular sxs do not improve in the next 10 days I will refer her for

> a

> >MRI of the lumbar spine. I will keep you apprised of her progress.

> Please

> >sign the enclosed referral form for insurance purposes.

> >

> >Dr. White: Ms. has improved since my initial consultation. The

> >following are the results of today's physical examination.

> ............

> >She requires an additional two weeks of treatment at which time I

> will d/c

> >her from my care with instructions to contact me should she have any

> >questions.

> >

> >Ms. did you bring a referral from Dr. White? Ms. you are

> >improving with treatment and I think you need two additional weeks of

> >treatment. I will contact Dr. White's office to get the paperwork

> squared

> >away for the insurance company.

> >

> >My point being if we talk and document like technicians who are not

> sure

> >what we should be doing for the patient or for how long and that we

> need a

> >permission slip to go to the mens/ladies room (pardon the sarcasm)

> then

> >how can we expect to be treated any differently.

> >

> >

> >Dale Avers wrote:

> >

> >> I am most grateful for the discussion and candidness of the

> responses

> >>concerning the advantages and disadvantages of additional

> certifications

> >>outside the traditional realm of PT. It has been most enlightening

> for me.

> >>

> >> Underneath this issue is the all important issue of the public's

> >>perception of PT. Do you agree that the PT profession has a mixed

> bag of

> >>public awareness and knowledge of the scope of our interactions? Is

> this

> >>a problem not only with our public but also ourselves and third

> party

> >>payers? If public perception is too narrow, not wholly positive or

> even

> >>negative....what ideas do the members of this listserv have for

> enhancing

> >>the public's perception of physical therapists/physical therapy?

> >>

> >> My personal perception is one of routinely hearing about patients

> and

> >>clients who have tried PT and been very disappointed in the lack of

> >>results, lack of professionalism and lack of clearly articulated

> goals

> >>and outcomes. As a result, they have judged the entire profession by

> >>these interactions, and been unwilling or reluctant to try PT again.

> >>Several clients recently have told me they have " believed " in PT,

> but

> >>haven't been able to find a " good " one, defined as competent based

> on

> >>results, and professional that included full informed consent and

> clearly

> >>articulated goals and outcomes. This personal perception prompts my

> >>question to you. Thank you for your responses.

> >>

> >> Dale Avers

> >>

> >> Dale Avers, PT, MSEd

> >> Mount St. 's College

> >> 12001 Chalon Road

> >> Los Angeles, CA 90049

> >>

> >> FAX

> >>

> >> Doctoral Candidate

> >> Instructional Systems Technology

> >> Indiana University

> >>

> >>

> ----------------------------------------------------------------------

> --

> >>

> >> eGroups.com home: /group/ptmanager

> >> - Simplifying group communications

> >

> >

> >---------------------------------------------------------------------

> ---

> >

> >eGroups.com home: /group/ptmanager

> > - Simplifying group communications

> >

> >

> >

> >

> >Content-Type: text/x-vcard;

> > charset= " us-ascii " ;

> > name= " douglaswhite.vcf "

> >content-disposition: attachment;

> > filename= " douglaswhite.vcf "

> >content-description: Card for M. White

> >content-type: text/x-vcard; charset=us-ascii;

> > name= " douglaswhite.vcf "

> >content-transfer-encoding: 7bit

> >

> >Attachment converted: Macintosh HD:douglaswhite.vcf 50 (TEXT/ttxt)

> (0000F9D2)

>

>

>

>

> ----------------------------------------------------------------------

> --

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

[Guest guest]

Pat,

You are correct in identifying PTs as the cause of the decline in physical

therapy's reputation. I am in the process of marketing a new PT clinic and

I run into the poor image of PT everyday. It seems that every physician I

talk to has tales of problems with PT. These problems usually involve

patients being seen for months of ineffective or unskilled treatment. For

example, physicians describe patients having " hot packs, ultrasound and

massage " (HUM) for months (with no progress), doing simple exercises in the

clinic, such as quad sets and straight leg raises for weeks (with no

progress and no home program), or doing a general conditioning program in

PT, when the patient also works out at the YMCA five days per week!

But the biggest complaint, and the hardest one to overcome, is that PT is a

waste of time and money. I hear this from physicians that I visit, from

the RN drawing my blood at the blood bank, from folks I talk to at the

park. These individuals have experienced the HUMmer and the worthless

exercises and realized how worthlessness of the expensive treatments.

I agree that a positive approach wherein we promote the benefits of -- and

do -- quality PT, is the best approach. But at the same time there are

practicing PTs who are damaging our profession by using PT primarily to

milk patients of their money. So my follow up question to your email which

identified PTs as the source of the decline in the public's image of

physical therapy is; How do we gracefully rid our profession of the PTs who

misuse the public's trust in our skills?

Hansen, PhD, PT

One of the PTs with a string of letters after his name

Fircrest Physical Therapy

Fircrest, Washington

At 08:50 AM 8/19/99 -0400, you wrote:

>I believe that the " medical community " as well as the general public have

>formed their perception of what we do based on their individual and

>collective experiences with physical therapists and the outcomes they have

>been able to produce. In my observations over twenty years of clinical and

>administrative experience, I believe we have, unfortunately, been our own

>worst enemies.

>

> As PT's we are entitled by our respective practise acts to treat a very

>broad array of musculoskeletal , neuromuscular and pathophysiological

>impairments. That is not to say we already " know it all " but that our

>academic preparation should have taught us when we need to learn more and

>where to find the answers. A guiding principle I learned early on and have

>tried to convey to students and staff was this: YOU SHOULD HAVE A DEFENSIBLE

>RATIONALE FOR EVERYTHING YOU DO. The very fine PTs I have known and often

>refer to know what they are doing, know why they are doing it and are able to

>articulate this to both the patient and the medical community. These same

>very fine PTs have dedicated the resources (both time and monetary) to join

>professional organizations, attend continuing education programs, purchase

>and actually read books, at times seek advanced certifications,- yes, and

>spend countless hours following listservs!

>

>Until more grass roots PTs take seriously their roles as lifelong learners

>and seekers as well as articulate educators, I fear we will continue to be

>misunderstood and underestimated. I think that is the challenge for all the

>educators as well as the leaders of the various professional organizations

>within our profession. A string of letters after our names won't do it for us

>but the advanced study that goes into attaining those letters may provide the

>additional knowledge and skills to be more articulate and effective in

>certain areas of practice.

>Pat Walaszek,PT

>

>------------------------------------------------------------------------

>

>eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>