Pro Bono Physical Therapy – Essential to Physical Therapy Education
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Volunteering time to provide pro bono physical therapy reminds us why we want to be PTs in the first place – to help people.
I started out volunteering in a student-run pro bono clinic 1 Saturday per month, serving the homeless population.
I cannot emphasize enough the incredible experiences that have sprouted from my participation.
I began as a clinical volunteer, with the opportunity to not only put into practice what I was learning in school, but to collaborate with professors, students of other health disciplines, and to become more comfortable interacting with a vulnerable patient population.
By the end of my second year of volunteering, I was more than just a clinical volunteer. I had opportunities to take on leadership positions, participate in a small grant, create an art project, give professional presentations, and design educational programs.
One of the most significant skills I developed was deeper compassion for individuals from every background and life situation, which is crucial for patient-centered care and attention.
The clinic experience not only served as a place to help those without access to physical therapy, but also to develop my skills as a future clinician and professional.
There are many personal benefits associated with volunteering at a pro bono clinic, but more importantly, pro bono care is an essential part of community health. Pro bono clinics often serve the most vulnerable community members, those without resources or the freedom of other health care options.
Service to the community demonstrates the altruism of physical therapy, and reminds us that helping others is fulfilling and rewarding. It is a community responsibility unique to health care providers that is an honor and privilege to hold.
Pro bono clinics offer the opportunity for physical therapists and students of physical therapy to participate in population health, increasing access to care and eliminating financial barriers. This gesture uplifts our most in-need community members and serves as an opportunity for physical therapists and students to get creative in a unique practice setting.
At Northern Arizona University, we have an interdisciplinary clinic called the Student Health Outreach for Wellness (SHOW), which integrates programs from all 3 state universities. Medical, nursing, occupational therapy, social work, physician assistant, and physical therapy students collaborate together to treat patients experiencing homelessness. Patients receive treatment that caters to their specific needs, and the collaborative environment facilitates a better understanding of the scope of practice across all disciplines for students.
Treating patients in this setting gives students the opportunity to gain invaluable experience and reorients them to the service-based career they chose as health care providers.
This is just 1 example of a pro bono clinic model, each institution will have different resources and needs associated with providing pro bono care to their community.
Starting your own student-run pro bono clinic is no small task. It often takes years to get free clinics off the ground.
Like any clinic, it requires space, funding, infrastructure, modems for sustainability, and support. At the university level, it will likely require a team of very dedicated students and faculty to build a clinic. Often times, rent-free space at the university is ideal, or "borrowing" already established space after hours. Funding may come from grants; for instance, the Pro Bono Incubator grant program from Move Together exists to support the development of pro bono clinics.
Clinic infrastructure includes anything day-to-day that would make a normal clinic operational: protocols for patient appointments, roles and responsibilities for staff and volunteers, documentation and medical record guidelines, a clear chain of command, and more. Sustainability often falls to faculty who can help transition the next year's students to leadership within the clinic.
Pro bono care is an essential part of physical therapy education. It reminds us that physical therapy is our gift to others, and a way in which we can achieve more altruism: practicing the selfless concern for the well-being of others. It brings our focus back to where it should be—on our patients, regardless of their life situation or ability to pay.
Serving individuals experiencing homelessness at the SHOW Clinic has been an invaluable experience. Below are some personal and incredible stories from our time as volunteers.
My very first shift at the SHOW Clinic was the summer after my first year of physical therapy school. I was working on a team with a first-year medical student and a nursing student.
We were given a patient who came in complaining of bilateral shoulder and hip pain. I was asked to perform the evaluation, as we assumed initially that it was a musculoskeletal issue.
After going through performing an assessment on the patient, we quickly realized that we were wrong. After examination and ruling out other causes, we came to the conclusion that the patient had a rare disorder called temporal arteritis. A physician who was our preceptor concurred with the diagnosis, and the patient was referred to the closest hospital.
While it wasn't a pathology that can be addressed with physical therapy, we were told that if we hadn't seen the patient that day and he didn't seek treatment elsewhere, there was a good chance that he would have completely lost his vision.
- Naveed Shan
One of my favorite memories from working at the pro bono clinic resulted in excellent patient care and experience, collaborating with other health professional students. A patient presented to our clinic with multiple complaints: urinary tract infection (UTI), chronic low back pain, and chronic vertigo. Not only was the vertigo causing the patient nausea and discomfort, but it had prevented her ability to drive for 2 years. A medical student and I evaluated her. I found it extremely valuable to observe the medical student take a patient history to diagnose UTI, and confirm that treatment was available at the clinic. I was able to practice taking patient history and performing a lumbar screen to address the patient's low back pain. The medical student, an audiology student, and I made a joint effort to tease out the vertigo the patient was experiencing, which was positional in nature. The audiology student and I performed a Dix-Hallpike test to confirm benign paroxysmal positional vertigo and were able to completely eliminate the patient's dizziness with an Epley maneuver. I learned 2 things that day. The first was that although health professions have many differences, we all have the responsibility of taking a patient history, building rapport with patients, and embracing where our scopes of practice overlap; and second, it opened my eyes to the fact that students' energy and volunteerism is one of the crucial components of pro bono care and why it can be so successful. Our communities need people like us to show compassion and treat patients because we sincerely want to better the health of the entire population.
- Maggie Delaney
Thinking about starting your own pro bono clinic at your university? Each school may shape a clinic to fit their needs and luckily, the Widener University Physical Therapy program outlined their process in detail for the benefit of others hoping to start pro bono clinics. Within their outline you'll find resources such as clinic model examples, student experiences, and more. APTA also has a valuable resource on pro bono practice, which provides clarification of practice guidelines concerning pro bono care.
Not ready to start a pro bono clinic, but still want to do service? Consider pledging to serve on Global PT Day of Service to be held on October 14, 2017. This is a global day in which PTs, PTAs, students, and APTA staff serve their communities in a variety of ways, whether it is clinical work or simply volunteering locally. You can pledge to participate or sign up to be an ambassador and grassroots organizer in your state.
Finally, if pro bono work is an interest of yours and you have the means to attend a conference, consider the Physical Therapy Pro Bono Network Conference. This conference serves as an opportunity to engage with other physical therapy students, faculty, and professionals pursuing pro bono work, or hoping to begin their own clinics. Encourage your program to join the Pro Bono Network to discover more resources, and connect with programs around the country.
Maggie Delaney, PT, DPT, and Naveed Shan, SPT, Northern Arizona University