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  • New Tool for Managing Arthritis Focuses on Prevention and Management in Primary Care

    Nearly 1 in 4 adults in the United States has arthritis—some 54 million people, according to the US Centers for Disease Control and Prevention. Chances are more than good that many of your patients and clients are among them. A new tool developed by the Osteoarthritis (OA) Action Alliance, the US Bone and Joint Initiative, and numerous experts in the field—including a representative from APTA—can expand your knowledge of OA. In addition to provider-facing information, the Osteoarthritis Prevention and Management in Primary Care Toolkit also includes patient handouts and resources that you can use to empower your patients and clients to engage in self-management strategies that complement your clinical care.

    October 12 is World Arthritis Day—spend some of it educating yourself on OA by visiting APTA's arthritis webpage, which links to the OA toolkit and other resources such as community-based programs that can extend the benefits of your treatment and help patients and clients maintain their movement and independence.

    Biased? Me? PT in Motion Magazine Takes a Look at Unconscious Cultural Attitudes

    Want to get an up-close glimpse at a person with cultural biases? Follow these instructions:

    1. Grab a mirror.
    2. Look into it.

      That's one way to summarize the starting point for "Battling Bias's Distorted Images," the cover story for the October issue of PT in Motion magazine. The article makes the case that while unconscious bias—also known as implicit bias—is very much a part of the human condition, it's something that can be acknowledged and managed in ways that minimize its impact on relationships. For health care providers including physical therapists (PTs) and physical therapist assistants (PTAs), that's an important step to take in effective patient care.

      Through interviews with PTs in a variety of settings, author and Associate Editor Eric Ries explores how implicit bias—and these PTs' recognition of it in themselves—has impacted and changed their lives, particularly at the professional level. Several describe the journey as a path that's not always easy, but absolutely crucial to providing the best possible person-centered care.

      The article also delves into how you can uncover implicit biases through self-tests such as the Implicit Association Test series, and what to do after they're identified. PTs interviewed for the article provide insight on how physical therapy education programs can respond to the challenges of implicit bias, and provide practical tips on making behavior changes that may in turn lessen, if not eliminate, a particular bias.

      According to Hadiya Green Guerrero, PT, DPT, interviewed for the story, efforts to counter implicit bias are necessary for PTs and PTAs because the stakes are high.

      "Do your best to think about your biases and check them at the door," Green Guerrero says in the article. "Seek to learn and understand each patient or client to the clinic, what constitutes his or her biggest health concerns, and what barriers that person faces to optimal well-being and needed interaction with the health care system."

      "Battling Bias's Distorted Images" is featured in the October issue of PT in Motion magazine and is open to all viewers—pass it along to nonmember colleagues to show them 1 of the benefits of belonging to APTA.

      Stay Inspired, Motivated, and In-the-Know With These APTA Podcasts

      APTA continues to assemble a collection of free, easy-to-download podcasts that deliver plenty of variety, from personal stories that remind you of why you love what you do, to nuts-and-bolts information that could be crucial to your professional survival.

      Where to start? Here are some suggestions—but you can also check out APTA's podcasts webpage to browse an extensive list of offerings.

      Podcasts that inspire
      A recent example: "A Journey Out of Pain and Addiction, and a PT's Crucial Role"

      What it's about: In his keynote address for the 2019 APTA NEXT Conference and Exhibition, US Army Master Sergeant (Retired) Justin Minyard recounted the injuries he received during rescue attempts first at the Pentagon during the 9-11 attacks and then while on a mission in Afghanistan. But the heart of Minyard's story is about what happened afterward: the multiple fusion and other surgeries, the intense pain, his slide into addiction, and his eventual freedom from opioids. He readily acknowledges that his recovery was thanks in large part to the work of an interprofessional team that included a dedicated physical therapist (PT).

      Why you should listen: Minyard's brutal honesty and his ability to tell a story with both humor and pathos pull you in from the start. And the gratitude he has for his PT—he describes her as not just his physical therapist "but my psychologist, my sounding board, my marriage counselor, my educator of my options, and my kick in the ass"—will remind you of why you love the profession.

      More inspiration: APTA's "Defining Moment" podcast series is the audio companion to PT in Motion magazine's regular feature of the same name, which highlights stories from members about those moments when they felt that special—often life-changing—connection to the physical therapy profession. [Editor's note: If you want to share your defining moment, contact Associate Editor Eric Ries at ericries@apta.org.] For inspiration you can share with your patients, the popular Move Forward Radio is your go-to option: an interview series that features patients, PTs, and physical therapist assistants (PTAs) discussing physical therapy's role in a wide range of issues. Recent podcasts include explorations of physical therapy and people with Alzheimer's disease, foot health, and the treatment of pelvic pain in people who are transgender.

      Podcasts that energize
      A recent example: Just about any podcast from the APTA Pulse series

      What they're about: Some of the liveliest discussion in the profession is taking place at the student level, and the APTA Pulse series of blogs and podcasts brings that energy to you. The Pulse podcast series features mostly students, with the occasional more-seasoned PT, PTA, or other expert. Notable podcasts include "Failure Is a Bruise, Not a Tattoo," "Stereotype Threat," and "Healthy Mental Living: Tips From a Counseling Psychologist."

      Why you should listen: It's a great way to re-charge your enthusiasm for the profession.

      More energy: Want more insight on the PT and PTA student perspective? APTA's Student Assembly records its "#XchangeSA" live chats, which have ranged from discussions about performance therapy and training to building your professional brand. And if you haven't read or heard it already, APTA President Sharon Dunn's address to the 2019 APTA House of Delegates will put some wind in your sails when it comes to the challenges of taking on the high cost of PT and PTA education, dismantling the productivity mindset, and making involvement in the association accessible to all.

      Podcasts that inform
      A recent example: "Ordering of Diagnostic Imaging by Physical Therapists: A 5-Year Retrospective Practice Analysis"

      What it's about: In this interview for APTA's journal PTJ (Physical Therapy), Editor-in-Chief Allan Jette, PT, PhD, FAPTA, interviews researcher Aaron Keil, PT, DPT, about his groundbreaking study on civilian PTs who are able to order imaging.

      Why you should listen: Don't be scared off by the academic-sounding title. With the growth of direct access to PT services comes more serious discussion about the PT’s role in primary care—and the importance of the PT's ability to order diagnostic imaging as a crucial part of that primary care role. It's an issue that needs to be on your professional radar.

      More information: Each month PTJ produces podcasts, like the one highlighted above, that help you get a first-person perspective on some of the latest research in the profession, making the PTJ podcast page worth a regular stop. Another helpful research-oriented podcast: easy-to-follow expert tips on finding evidence and research on APTA's PTNow Article Search and Rehabilitation Reference Center.

      And even more information: If you're interested in keeping up with fast-moving world of payment (particularly related to Medicare and Medicaid), don't miss APTA's "Insider Intel" recordings of its live phone-in series. You won't find Insider Intel on the association's podcast page—they're collected separately—but they're definitely worth tracking down. MIPS, SNF payment, home health rules, new payment models, the physician fee schedule—it’s all there. And you can register for upcoming live events while you're checking out the recorded ones.

      Help Highlight the Importance of 'Safe and Sound' Workplaces in August

      One way to achieve the physical therapy profession's goals of a healthier society is to help that society avoid sickness and injury to begin with. That's why physical therapists (PTs) and physical therapist assistants (PTAs) should consider taking part in an upcoming week focused on workplace safety and health.

      The US Department of Labor (DOL) Occupational Safety and Health Administration’s (OSHA) "Safe and Sound" week is set for August 12-15 this year, and now's the time to prepare to help bring attention to the initiative, and highlight the role the profession can play in a healthier, injury-free workforce. APTA is an official partner of the program.

      Both DOL and APTA offer resources that can help you highlight the week. Visit the DOL’s Safe and Sound webpage to sign up, get ideas for how to participate, and download resources to recognize your participation. APTA can help you understand the profession's connection to the issue through its webpage on the PT's role in promoting a productive and healthy workforce. That page includes a variety of resources, including tips on initiating discussions with employers about what PTs and PTAs have to offer and the APTA Academy of Orthopaedic Physical Therapy Occupational Health Special Interest Group. In addition, the association offers a webpage exclusively devoted to OSHA resources.

      Members-Only Webinar Will Focus on Demonstrating Value in New Home Health Payment System

      Physical therapists (PTs) and other providers who furnish services through home health agencies that bill Medicare will face an entirely new payment system beginning in January, 2020—one in which demonstrating the value of a particular intervention will be key. A new multidisciplinary webinar that includes experts from the US Centers for Medicare and Medicaid Services (CMS) can help you prepare for the shift.

      APTA has joined with the American Occupational Therapy Association, the American Speech-Language-Hearing Association and CMS to offer a free members-only live webinar on how therapy providers can best navigate the new Medicare Patient-Driven Groupings Model planned to go into effect January 1, 2020. The collaborative presentation is set for August 5 at 2:00 pm ET. Advanced registration is required.

      A recording of the webinar will be made available at later date. For more information on the presentation, contact advocacy@apta.org.

      [Editor's note: want to get up to speed before the webinar? This  PT in Motion News story summarizes the biggest elements in the CMS proposed home health rule, and an APTA webpage devoted to the PDGM includes recordings of presentations held earlier in the year.]

      From PT in Motion Magazine: Regenerative Medicine and the PT

      Patient, heal thyself.

      Maybe that's not exactly what regenerative medicine is all about, but it's close: with its emphasis on enhancing the body's own genetically driven capabilities to repair damage and reestablish neural connections, regenerative medicine is pushing the boundaries of what we know about the healing capacities hidden in our own DNA. And physical therapists (PTs) are bringing an important perspective and set of unique skills to the field.

      "PTs on Rehab's Leading Edge," in the April issue of PT in Motion magazine, takes a look at the current state of regenerative medicine, robotics, and genomics in physical rehabilitation, and finds a growing appreciation for what PTs bring to the table and the ways movement and exercise can affect health at the cellular level.

      The article covers current approaches including the use of platelet-rich plasma and neural retraining through the use of robotic exoskeletons, but also explores what the future may hold as researchers such as Richard Shields, PT, PhD, FAPTA, and Steve Wolf, PT, PhD, FAPTA, work to better understand the science of regenerative medicine and prepare the next generation of PTs for what will one day be a very different health care environment.

      "As the field of medical regenerative medicine progresses, so too will physical therapy," Shields tells PT in Motion. "How are you going to manipulate the genetics? You're likely going to do it through various forms of technology that allow us to apply loads and movement, whether through robotics or just plain exercise. Understanding how to dose for cellular response is going to be the new frontier."

      "PTs on Rehab's Leading Edge" is featured in the April issue of PT in Motion magazine and is open to all viewers—pass it along to nonmember colleagues to show them one of the benefits of belonging to APTA.

      From Move Forward Radio: Motivated by Physical Therapy Experience, Woman Is Inspired to Give Back

      Sometimes physical therapy doesn't just heal an injury, it changes the course of a patient's life for the better. Colleen Rapp, a press operator for the Denver Post, thought her physically demanding job was exercise enough—until she got a wholistic view of her health status from her physical therapist (PT) after a shoulder injury. Her experience even inspired her to raise funds for doctor of physical therapy students at the University of Colorado.

      Now available from APTA's Move Forward Radio: an interview with Colleen Rapp and her PT Tami Struessel, PT, DPT, a board-certified clinical specialist in orthopaedic physical therapy. "I wasn't taking care of my body the right way," said Rapp. "I thought exercise was my work."

      One day at work, Rapp slipped on some water on the press floor and injured her back so badly that she couldn't stand, walk up stairs, or get out of bed without pain. That brought her to Struessel, who "wove in" education about sleep hygiene and nutrition. "[Rapp] needed to come to a place where she realized she needed to do the hard work, because making lifestyle changes is not easy," Struessel said.

      Rapp said her "aha!" moment came when she realized "this was an opportunity to make this count in my life, and [become] the person I needed to be when I was older." In addition to changing her diet, getting more exercise, and sleeping better, she achieved a better work-life balance. "I learned I want to be the best I can be and do the best I can do, but I don't want to do it incorrectly," she told Move Forward Radio. "Physical therapy has taught me a broad spectrum of things—it changed my life."

      Move Forward Radio is hosted at MoveForwardPT.com, APTA's official consumer information website, and can be streamed online or downloaded as a podcast via iTunes, Google Play, or Spotify.

      Other recent Move Forward Radio episodes include:

      NASCAR and the Role of Physical Therapy
      Jena Gatses, PT, DPT, was the first full-time female PT and strength coach in NASCAR. She discusses her experiences with these specialized athletes and other high-profile clients, including actor Mark Wahlberg.

      Still Dancing: A Woman's Story of Doing What She Loves While Living With Spinal Cord Injuries
      Marka Rodgers envisioned spending her life in the world of dance, even after sustaining and working hard to overcome not 1 but 2 devastating spinal cord injuries. With the assistance of a wheelchair, a service dog, and some primo leg braces, Marka not only continues to dance but also to teach dance.

      Headaches and Physical Therapy
      There are headaches, and then there are headaches. Denise Schneider, PT, DPT, discusses the causes and red flags for more serious headaches, how physical therapy may help, and when referral to another health care provider is the best option.

      Young Woman Shares Experiences With Juvenile Arthritis and Physical Therapy
      Christina Iversen shares her experience with juvenile arthritis, having dealt with it since the age of 2. Now a young adult, she knows well what it's like to contend with the physical, emotional, and social effects of growing up with a condition that's typically associated with older adults.

      Retreat for Injured Veterans and Families Adapts Activities and Helps Them Reconnect With Each Other
      Since 2017, selected veterans who have been injured in active duty or as a result of their service have come to Maine in the summer, along with their families, for an all-expenses-paid vacation courtesy of the Travis Mills Foundation, founded by a veteran who experienced amputation and directed by Kelly Roseberry, PT, DPT.

      From PT in Motion Magazine: Health 'Consumerism' Is Changing How PTs Think About Care

      Call it the Amazonification of society, or a signifier of the shift toward "value-based" models, or simply a logical response to the pressure of ever-growing insurance deductibles and copays, but one thing's for certain: patients are increasingly extending their consumer savvy to choosing health care providers—and that includes physical therapists (PTs).

      In its March issue, PT in Motion magazine offers a primer on what's known as the "consumerism movement" in health care. The article explores how some PTs are responding to an environment in which patients take a more active role in selecting a provider and making informed choices about pathways of care.

      The movement is associated with the rise of online provider rating systems, but it's broader than that—according to author Chris Hayhurst, it's a mindset in which "would-be patients are the drivers of change, leveraging the power of their limited health care budgets to push providers to better meet their needs." And if they're not happy with the result? You (and anyone else with Internet access and a smart phone) will hear about it.

      In addition to providing the fundamental concepts behind health care consumerism, "PTs and the Consumerism Movement" also shows how some PTs are recognizing the new realities and making changes to their practices to stay competitive.

      Kathryn Stenslie, PT, DPT, one of the PTs interviewed for the article, puts it bluntly. "The fact is, people are shopping around for care," she says. "And as much as we PTs don't like to think about it, not every practice is equal."

      Stenslie and other PTs featured in the piece offer up multiple examples of changes they've made to improve patient satisfaction—everything from routinely walking patients to their cars to offering Saturday hours and more extensive home-exercise regimens to keep clinic visits (and copay totals) as low as possible. The PTs interviewed agree that while the changes can require that more effort be applied to developing team approaches and dedicating more time to discussing patient expectations and treatment options, the payoffs can be significant.

      And those payoff aren't just limited to business results. Janet Bezner, PT, DPT, PhD, FAPTA, a professor in the Department of Physical Therapy at Texas State University, says the changes can help promote what she sees as a much-needed evolution in the way society approaches health care in general.

      "The idea that I don't have to blindly take what my health care provider tells me and just do it is part of the notion that 'I'm in charge of my own health,'" Bezner says in the article. "It's the idea that I, the patient, know what's best for me. I may appreciate you, the health care provider, telling me what my choices are, and explaining them to me. But in the end, I'm the one who gets to decide."

      "PTs and the Consumerism Movement" is featured in the March issue of PT in Motion magazine and is open to all viewers—pass it along to nonmember colleagues to show them one of the benefits of belonging to APTA. Also don’t miss the issue’s other articles that cover the use of hippotherapy in PT interventions, perspectives from PTs who have disabilities, a look at CPT codes beyond the 97000 series, a PT who continues “rescuing” people after retiring from military service, and an ethics scenario around responding to a critical online review.

      From PT in Motion Magazine: Recognizing—and Beating—Burnout

      Being a physical therapist (PT) or physical therapist assistant (PTA) can be fulfilling, but it also can be demanding and challenging—so demanding and challenging that those feelings of fulfillment seem out of reach at times. The result: burnout, a condition being experienced by an increasing number of PTs and PTAs, sometimes before they even know it's happening to them.

      In its February issue, PT in Motion magazine takes an in-depth look at clinician burnout through the eyes of PTs and PTAs who experienced burnout firsthand, PTs who've been looking at ways to stop burnout before it starts, and PT researchers looking into the topic. The article is part of a PT in Motion special theme issue on trauma and stress in the physical therapy profession. (Other articles in the series are “It Can Happen Anywhere: Protecting Your Workplace From Public Safety Threats” and “Combatting Sexual Harassment and Inappropriate Patient Sexual Behavior.”)

      "Beating Burnout" is anchored in the stories of APTA members Meredith Castin, PT, DPT, and Sean Hagey, PTA, who found themselves feeling increasingly unable to find a sense of satisfaction in roles that demanded too much and seemed to put patient-centered care in the backseat.

      Both found a healthier, happier career path, albeit in different ways: Hagey sought counseling and convinced his employer to decrease productivity demands (and in the process, move to a more user-friendly electronic health records system); Castin left clinical practice entirely and started up a website that explores nonclinical roles for PTs and PTAs.

      According to the article, some of the major contributors to PT and PTA burnout are the usual suspects, including some employers' unreasonable productivity demands and the cloud of student debt that puts additional pressures on many in the profession. But there are other, less-obvious factors that can lead to burnout, too, including a lack of mentorship, feelings of being undervalued, and the letdown that inevitably results when unrealistic career expectations as a student aren't met upon joining the workforce.

      But the topic isn't left there. The PTs and PTAs interviewed for "Beating Burnout" also offer strategies for making positive changes to defeat burnout, or stop it before it starts. Those ideas include seeking out strong mentors, having "hard conversations" with employers about productivity demands, and getting involved with APTA and the surrounding community to maintain a sense of connection to peers and the world beyond the clinic.

      "Beating Burnout" is featured in the February issue of PT in Motion magazine and is open to all viewers—pass it along to nonmember colleagues to show them one of the benefits of belonging to APTA.

      New Anthem UM Vendor in 5 States May be the Beginning of a Wider Shift

      Physical therapists who bill Anthem Blue Cross-BlueShield (BCBS) in California, New York, Indiana, Wisconsin, and Louisiana, get ready for a change: there's a new utilization management (UM) vendor in town.

      APTA has learned that Anthem BCBS is migrating to a new UM vendor, starting with the 5 states listed above. The new UM group is a subsidiary of Anthem known as AIM Specialty Health and replaces previous UM vendor OrthoNet in Medicaid states

      The migration will begin March 1, 2019, for Medicaid patients in New York, Indiana, Wisconsin, and Louisiana. The shift won't happen in California until March 15, 2019, and will include all commercial enrollees. But the migration isn't likely to stop there, according to Elise Latawiec, PT, MPH, APTA lead senior practice management specialist.

      "Anthem also operates in Colorado, Connecticut, Georgia, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, and Virginia, and manages specialty plans in several other states. From the information received thus far we expect the migration to impact all lines of business in the coming year," Latawiec said, adding that APTA has asked Anthem to notify the association as far in advance as possible so that we may alert membership to the change.

      The new UM system also includes occupational therapy and speech-language-hearing services, and applies to any outpatient place of service, including both on- and off-campus hospital facilities. Anthem BCBS will require that the new UM be applied for patients with all diagnoses for which treatment is delivered in the outpatient setting.

      AIM is holding a series of initial training sessions January 24, January 30, February 24, and February 26, and says it will reach out to invite current Anthem providers to the webinars. Anyone unable to attend a scheduled session will be able to access a recorded version following the 4 trainings.

      APTA will meet with AIM representatives for a follow-up conversation after the initial rollout.

      Want to get a better understanding of the ins and outs of UM? Check out APTA's Utilization Management Toolkit, a members-only online resource with tips, common challenges, and strategies of addressing UM issues.