Building a Strong PT-PTA Relationship: What One Award-Winning Team Has to Say
From left to right: Jodi Maron Barth, PT; APTA President Sharon L. Dunn, PT, PhD; and Gincy Lockhart Stezar, PTA, at NEXT 2018
Jodi Maron Barth, PT, and Gincy Lockhart Stezar, PTA, co-owners of the Center for Facial Recovery in Rockville, Maryland, received the 2018 APTA Outstanding PT-PTA Team Award. They also are clinical instructors and members of the Maryland Physical Therapy Association House of Delegates. #PTTransforms interviewed Barth and Stezar for their insights into building a strong PT-PTA relationship.
#PTTRANSFORMS: Jodi, to start off, how and why did you became a PT?
Jodi Maron Barth: I was a high school athlete and really wanted to do something with sports medicine. My cousin was a physical therapist, and he said, "You don't want to be an athletic trainer, you want to be a physical therapist, because you can do a lot more." I graduated from Ithaca College and started out at an acute care hospital, Albert Einstein, in the Bronx, where because of rotations I had great exposure to all areas of service.
Later on, I was still geared to the sports medicine side of things and got bored. I started doing more with spines and manual therapy. When I was working with low back patients, I noticed that their feet were a problem, and I started specializing in orthotics assessments. Later, I began evaluating the jaw.
Currently I specialize in treating temporomandibular joint (TMJ) disorders. About 10 years ago one of my referring docs asked me if I could do anything for a patient who had an acoustic neuroma and developed facial palsy. I had to do some research and training, and Gincy and I combined the skills and techniques we learned with our background in manual therapy to develop our own technique using neuromuscular reeducation.
#PTTRANSFORMS: Gincy, what was your journey to becoming a PTA like?
Gincy Lockhart Stezar: I have a degree from the University of Maryland, and I was fitness director for NASA. When I was working with the employees, they were always coming in injured and complaining about one thing or another. And I was always going to my anatomy book and saying, "If it hurts when you're doing this and this is the muscle involved, you probably shouldn't be doing this; you should be doing that."
I realized I loved solving those problems, so while I took time off to raise my 2 children, I decided to pursue a PTA degree. There was a program at Montgomery College, which was close to where I live. I decided that I wanted to work with patients, and it was something where I wouldn't have to go back for 4 years of training. I interviewed in 2004 at MedStar National Rehabilitation Hospital (NRH). Jodi became my mentor.
JMB: I was a regional director and ran a couple of clinics. At the same time, I was trying to see a fairly full load of facial palsy and TMJ patients that nobody else knew how to treat. I thought Gincy had great hands-on skills and the potential to become a super PTA. It was a perfect opportunity to train Gincy on what I was doing, and she acted as an extender of my treatment to allow us to see more patients and give them more quality time.
#PTTRANSFORMS: How did you come to found the Center for Facial Recovery?
JMB: The center was formed out of passion. I was heading toward the administrator track at NRH, and I didn't want to do that. Gincy was running one of the clinics. We both love patient care—that's why we went into this profession—and we knew there was a need for treatment for facial palsy patients. Not too many therapists have an expertise in facial palsy and, honestly, not many therapists want to work with this population. But we do. Of all the patients we have treated through the years, facial palsy patients are the most cooperative. All they want to do is get better, and it's such a team approach between us and the patient.
#PTTRANSFORMS: So do you only treat patients with facial palsy or do you see other patients as well?
GLS: We also see former patients from time to time who come to us for treatment for cervical, low back pain, and other orthopedic dysfunctions.
JMB: Most of our patients are kind of head-to-toe patients. There's not just a jaw problem. It's not just a shoulder problem. But our specialty, and where we feel we shine, is treating facial palsy and TMJ patients.
#PTTRANSFORMS: When you were nominated for the APTA Outstanding PT-PTA Team Award, several people mentioned your mutual trust and respect. If I were to see you in operation as a team, how would I see that manifested?
GLS: Jodi does the evaluation and she sets up the plan of care. We've worked together for so long that once she sets the plan of care, we just take it from there.
JMB: We treat the patient together. I'll start with one patient and she'll finish with that patient, or she'll start treatment with one patient and I'll finish with that patient. We believe patients should get the best of both worlds.
One of our patients said once—because when we "hand off" we physically hand off—that it was such a smooth transition, he didn't even realize that Gincy's hands were on him versus my hands until he saw me talking to someone else.
GLS: Even though Jodi is doing the evaluation, I'm recording a lot of the information and hearing as much as Jodi is about what the patient's aches and pains, complaints, and concerns are. I'm not starting treatment with a patient without knowing anything about them other than what's written down. I get to know them from the very beginning—and they also get to know me.
#PTTRANSFORMS: You both also are clinical instructors, is that right?
#PTTRANSFORMS: It's so funny that you answer at the same time!
JMB: It happens all the time.
#PTTRANSFORMS: Has your working relationship like always been as strong and collaborative as it is now, or has it grown over time?
GLS: I definitely think it's congealed. The attraction in the beginning was that we had a very similar philosophy of care. I liked the way Jodi treated her patients—I thought that was the way patients should be treated. As time went on it came into a natural ebb and flow of treatment. She doesn't have to tell me all the time: "You need to do this. You need to do that." I know this is what needs to be done, and what the next steps will be. We've worked together long enough that we know what each other is thinking.
JMB: I would say also that our work ethic is the same. So no one is working harder than the other. And, even though she has a PTA degree, [when we first started working together] Gincy was diligent about looking things up and asking a lot of questions. She worked hard to get up to her current performance level.
GLS: The other thing that's helpful is that we take classes together. We come back with the same knowledge, and that reinforces our collaboration.
#PTTRANSFORMS: Do you also conduct research together?
JMB: We do. With the help of some great supporters, we've established a nonprofit foundation geared toward research for facial palsy and TMJ. We've published articles together. Many years ago, we actually went to Italy to teach therapists there how to treat facial palsy.
We also teach workshops with the performing artists at schools such as the University of Maryland and Penn State and have presented at conferences for the National Association of Teachers of Singers.
#PTTRANSFORMS: What would you say is the most important element in building a healthy strong PT-PTA collaboration?
GLS: Communication and respect. I feel respected by Jodi even though I don't have a physical therapist degree. She instilled in me that, just because I don't have that degree, it doesn't mean I can't think.
JMB: I think, [for a PT], the willingness to learn from a PTA. And for the PTA to realize [he or she] is not a technician. Many PTAs I've worked with were happy with putting on the hot pack, doing electrical stimulation, doing some massage, teaching some exercises, and sending the patient on their way. Gincy wanted to learn more. She wanted to be the best that she could be.
#PTTRANSFORMS: Jodi, what advice would you give another PT who might be struggling to form a better more effective or supportive relationship?
JMB: PTs should go into the relationship open-minded and take each person as an individual. If that PTA is there for them, the PT should be responsible for getting them up to the level of care that the PT is providing.
#PTTRANSFORMS: Gincy, what advice would you give a PTA?
GLS: Show what you have to offer, and show your interest. Find someone you have a good rapport with, and who respects you, and will listen to you—and build on that.
Your PTA brain is equal to any PT's brain. You just have limitations on your evaluation and discharge, and that sort of thing.
JMB: But I do think the PTA needs to do due diligence: You have to do reading, you have to do research, get into continuing education. Going to classes with the PT is very helpful, because we learn those new skills together. There has to be a give and take, but there also must be respect—and that, I think, has to come from the PT.