Today in PT

Cloak of Invisibility

I have always loved the logical nature of physical therapy practice. As therapists, we’re trained to evaluate and treat, measure and palpate, and observe the responses of multiple body systems from a research-based perspective. But just as giving a successful treatment is based on science, PT is also an art form that requires us to adapt our knowledge to fit the individual variation of each human body and the lifetime of experiences stored within it. It’s all very challenging, yet deeply rewarding.

But pain can be elusive, at times difficult to pin down through observation and testing, and we don’t always find the responses we expect. Many patients are in bad moods because they are suffering from chronic pain, and are frustrated because their condition is seemingly invisible to their loved ones, bosses, and friends. It’s terribly invalidating — there are so many ailments that lie hidden without deformity, gait deviation, or accompanying assistive device to herald their presence. Here, the cloak of invisibility isn’t anything to do with superheroes or Harry Potter, but instead is the dark cover of feeling all alone in the daily fight for wellness.

Part of the PT's job is to validate the patient’s state of being, find the source of their pain, and then empower them to conquer it. So next time you greet your patients with the question, “How are you today?” and they reflexively respond, “I’m fine,” go on to ask how they really feel, and then be prepared to do something about it.

Are you ready to look beyond the cloak?

Anne Ahlman, MPT

Small Stuff

You always hear the expression, “don’t sweat the small stuff,” and most of the time I am in full agreement. But lately, it seems like the list of aggravating little things is ganging up on me and throwing me off balance. For example, just over the past 48 hours:
•    I was awakened at 4:30 am by the chirpy little smoke detector letting me know at regular 30-second intervals that its battery was running low (why does this never happen in the evenings when I’m awake, instead of during the usual 2:00 am to 5:00 am window of time?)
•    My back-door neighbors decided to ignore the rules of the homeowner’s association and painted their house, in plain view of the rooms I use the most frequently, a revolting shade of purple
•    The weather stripping on the top of my car door pulled away, draping festively down into my peripheral field of vision, which forced me to temporarily secure it with duct tape until I can go and buy some appropriate glue this weekend
•    Our grumpiest cat threw up on the keyboard of my recently-purchased laptop computer, causing it to short circuit — now the computer is possessed by random commands, changes in font and view, and rapidly jiggling folders that are impossible to read, not to mention a perverse insistence on sending the people in my address book random emails containing my private information
•    And this morning? As I was driving into work, I noticed that the car started pulling to the right during the final leg of my journey — sure enough, the right front tire was going flat but I had no time to fix it before patient care, leaving me stranded.

Am I being secretly filmed for a reality TV program? <Sigh.>

Each item of aggravation by itself is nothing, especially when placed in the context of important events like mourning the recent death of a beloved member of the family, but it’s all starting to wear me down and deepen my misery, making me almost afraid to leave the security of my bed in the mornings. During times like these, I’m really not in the mood to treat patients … but an amazing thing happens when I turn up for work anyway: I start to feel a little bit better.

There’s nothing like focusing on someone else to help take you out of your own head. Sure, I still need to get a new battery for the smoke alarm, plant screening bushes along my back fence, glue the car’s weather stripping back into place, repair or replace my computer, and fix my tire, but none of that stuff is actually all that important, is it?

Take care of the big stuff.

Anne Ahlman, MPT

Perspectives on Policy

**Spoiler Alert!** Although extremely important, this is rather a dry topic.

I don’t know how many of you have seen the APTA’s position paper on healthcare reform, but it makes interesting reading. In the paper Health Care Reform: 2009 — A Physical Therapy Perspective, the APTA states that it “strongly supports” healthcare reform from the perspective of enhancing insurance coverage, increasing patient access to care, and reining in unnecessary costs. Sounds good, doesn’t it?

Detailed points include guaranteeing patient access to affordable healthcare from their provider of choice, ensuring that rehabilitation services are part of standard insurance benefits packages, instituting direct access throughout the nation, repealing outpatient therapy caps, securing PT reimbursement for wellness and chronic care programs, and expanding health information technology incentives to include PT practice. Again, it all sounds good … but is there any hope these points will actually be included in the bill currently being fought over on Capitol Hill? There seem to be as many ideas of what healthcare reform should include as there are people in this country.

With so much rhetoric, information, and disinformation flying around, now is the time to discuss the facts and make our voices heard to protect our patients and our profession. Whether or not we choose to be members, the APTA is making an effort on our behalf, and that is much appreciated. But it’s time to put aside personal political affiliations and think about what will be the best way for everyone to receive quality care without restriction and without breaking the bank. Now is the time to talk among ourselves, forward ideas to senators and members of Congress, and think seriously about the future. What are the most important aspects of healthcare to you, as a PT or PTA? As a citizen? As a patient? As a taxpayer? As a family member?

The topic is too important to ignore.

Anne Ahlman, MPT

Do All Fish Smell?

There has been a lot of flap this week in the various forms of media about a recent White House statement concerning healthcare reform. In reference to tracking potential disinformation and rumors about the developing plans to reform America’s health insurance system, the White House Blog writes, “Since we can’t keep track of all of [these rumors] here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.” (Source: www.whitehouse.gov/blog, August 4, 2009).

It seems innocent enough — or is it? Although it is always important to ensure that accurate information is being circulated out there for citizens to base their informed decisions on, the statement smacks of Big Brother — watch what you think, say, and write, or the secret police will come and get you. Perhaps the statement was just poorly worded … but is it no longer OK for patients and PTs to exercise their right to freedom of speech as they discuss the specifics of a plan yet to be fully developed? I think a spirited debate over the pros and cons of a healthcare plan that will affect more than 300 million people is just what we need right now, rather than blind assent.

What are your thoughts?

Anne Ahlman, MPT