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Special Monterey SJAPTA District Meeting Summary October 12, 1999
by Bruce Beekley
On October 12th at the Community Hospital of the Monterey Peninsula,
a special district meeting was held. The idea was to restart the
tradition of having an annual district meeting "over the
hill" from San Jose in order to allow APTA members and
prospective members to attend a district meeting at a conveniently
located site. H-Wave Electrical Stimulation was the sponsor and
raffled of a $50 gift certificate to a lucky attendee (Ellie
Buckley). Wendy Pugh, PT was the lucky winner of a $50 gift
certificate raffled of for donating to the PAC. Dr. Martha Jewell,
Chair of the PT Program at Samuel Merritt College was the guest
speaker blending well the role and value of the APTA into the
APTA¹s Guide to Practice, The Normative Model for Clinical
Education and the concept of Diagnosis by the Physical Therapist. The
presentation was extremely timely and informative regarding the
current standard of practice of PT, the importance of creating and
documenting the PT diagnosis and the prospect of practicing in the
truly autonomous situation via direct access. A very interactive
discussion was held and all attendees felt the meeting was
beneficial. Plans are to have possibly two meetings next year in the
Monterey-Santa Cruz area. Please plan to attend.
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District Meeting Summary from September 14, 1999
by Bruce Beekley
The September SJAPTA District meeting was held on September 14, 1999
with the clinical topic being a discussion on the opportunities to
effectively provide Physical Therapy for the blond and visually
impaired. The speakers were Sandy Rosen, Ph.D., PT and Katherine
Hevener. Dr. Rosen is a specialist in Orientation and Mobility at San
Francisco State University. Kitty Havana is blind and a blind
rehabilitation specialist for the VA in Palo Alto. Both of these
great speakers presented the audience with helpful tips and
strategies to enhance and respect the needs of the blind and visually
impaired. They presented specific ways to greet the blind patient and
orient them to specific treatment environments. They additionally
explained communication opportunities designed to provide clear and
effective understanding. Please do not hesitate to contact Kitty
Hevener at (650) 493-5000, ext. 64540 if you have any questions.
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Panel Tackles Tough Issues
by Chris Murphy, PT
On July 20, members of the district were treated to a lively
discussion about the future of physical therapy when we were joined
by John Mattox, Rick Ritter, PT and S.J. Salfen, MD. The panel,
moderated by Stuart Katzman, PT, talked about changes in the health
care continuum. Following is a review of the meeting by focusing on
one of the most prevalent dilemmas with which we are faced today: how
to provide quality care with shrinking reimbursements.
To effectively deal with this multifaceted problem, we must look
beyond our own perspective and understand the perspective of the
other parties involved in the equation. It is crucial that we
understand that, because very few individuals actually select their
health insurance coverage from more than a handful of possibilities
provided by their employer, there are actually four parties involved
in the equation. I have identified these parties and their
motivations as follows:
The insurer who desires to minimize the financial cost of
achieving acceptable outcomes.
The provider who desires to realize a reasonable profit for
providing quality care that allows the patient to achieve his desired outcome.
The patient desires to achieve a desired outcome in the most
economical fashion (in terms of time, effort and financial cost).
The employer desires to minimize expense and maintain a
healthy workforce. Employers also use benefits, such as health care
insurance, as a means to attract and retain valuable employees.
In addition to understanding the motivations of the parties involved
it is beneficial to understand their interactions:
The insurer provides reimbursement to the provider and sells its
services to employers, but has very little interaction with the patient.
The provider interacts with the insurer in regards to reimbursement
and with the patient in regards to treatment, but has very little
interaction with the employer.
The patient seeks professional consultation from the provider and
primarily consults with his employer's human resource department for
questions about health insurance benefits. The patient rarely
interacts with the insurer.
The employer negotiates the best price for contracted services with
the insurer and presents those options to the patient in an effort to
make him a happier and more productive employee, but has very little
interaction with the provider of those services.
So, given these understandings, it becomes imperative that we, as
providers, continue to provide insurers with outcomes research, which
documents the efficacy of quality care. Additionally, however, we
need to make a greater effort to educate the patient in his role as
health care consumer. We must continue to provide services that
patients feel are valuable. If we are successful in achieving
these goals, the patient will achieve his desired outcome in the most
economical fashion. Then, patients will accept an increased burden of
the cost of these services and will be more willing to fight when
those costs become unfairly effected by the whims of the insurers.
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Surface EMG
Presented by Jonathan Holtz
May 11, 1999
Physical Therapists need to be looking for new ways to distinguish
themselves as clinicians as well as objectively document the
condition of their clients. We need to be looking for ways to
demonstrate the efficacy of interventions. Surface EMG (sEMG) is a
unique way of combining the knowledge base of physical therapy with
recent innovations that can achieve these objectives. Whether you
practice in the OP arena, in neuro rehab or in pediatrics, sEMG is a
powerful tool you can use in the assessment and treatment of movement dysfunctions.
Jonathan Holtz, MA, PT has used sEMG in the OP and industrial
settings for the past eight years. He has presented at the
Biofeedback Society of America and has contributed to the literature.
At the district meeting, Jonathan will review sEMG fundamentals and
demonstrate the application for OP problems. He will also present a
review of the current literature and other sEMG applications.
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Bob White, PT, CHT "The Role of Physical Therapy in Hand Therapy"
February 9, 1999
After a stimulating discussion on the concepts of planning for the
future through financial investments presented by our district
meeting sponsor, Richard Blum, MD, Bob White, PT, CHT stepped calmly
to the podium to present his inservice. This was no easy feat as he
had just spent the previous one and one half hours becoming familiar
(and lost) on the streets and byways of Santa Clara, San Jose and
Sunnyvale. Never to be denied the opportunity to speak to the
ever-growing anxious crowd, Bob enlightened us on the world of hand
therapy as seen through the eyes of a physical therapist. He
described the general job description of the Certified Hand Therapist
(CHT) as one who sees a variety of diagnoses and implements a
plethora of interventions including modalities splints, ergonomics,
functional training, adaptive equipment, mobilization and education.
To sit for the certification, an OT or a PT must have at least 2,000
hours of experience working with hand patients and must be practicing
for a minimum of five years.
Bob then talked of world united, blending the strengths of both the
Occupational and Physical Therapy professions. He highlighted that
the OT's academic preparation emphasizes a greater psychosocial
background, an increased ADL, activity and functional training, an
adaptive equipment experience and splint training and tend to be more
holistic. Physical therapists bring to the field of hand therapy
expertise in modalities, exercise and conditioning, manual therapy
and joint mobilization, physics principles and the desire to break
down the physical components of movement and pathology.
The desire or opportunity to utilize OT's and/or PT's in the hand
clinic depends on the decision by the particular clinic according to
Bob. Many clinics actually have both OT's and PT's on staff who is
Certified Hand Therapists. Bob concluded his talk by reminding us of
the fact that PT is an extremely potentially demanding profession
physically. Life as a CHT does have its rewards also in the realm of
energy conservation and minimal joint mobilization efforts due to the
relatively smaller joints and soft tissues addressed.
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