PT, OT Evaluation Codes Get an Upgrade – New Therapy Caps

2017 Changes: Double Check Your Code Status

Physical Therapy Billing Updates: New Therapy Caps. New Evaluation Codes.

Physical Therapy Billing Updates: New Therapy Caps. New Evaluation Codes.

By now, your billers should be thoroughly familiar with the four new PT and/or four new OT codes for 2017. If not, you may be seeing an increase in rejections, denials, and—possibly—collections.

The new codes replace the somewhat vague “PT evaluation” and “OT evaluation” with more specific evaluation types, including the length of time the evaluation took. In this post, we’ll outline the new codes and the codes they replaced, then offer some suggestions on evaluating your progress on the new rules.

New PT and OT procedure codes

Here are the codes that should have been replaced:

  • 97001 – PT evaluation
  • 97002 – PT re-evaluation
  • 97003 – OT evaluation
  • 97004 – OT re-evaluation

Here are the PT replacement codes:

  • 97161 – PT evaluation low complexity, 20 min
  • 97162 – PT evaluation moderate complexity, 30 min
  • 97163 – PT evaluation high complexity, 45 min
  • 97164 – PT re-evaluation est. plan care

Here are the OT replacement codes:

  • 97165 – OT evaluation low complexity, 30 min
  • 97166 – OT evaluation moderate complexity, 45 min
  • 97167 – OT evaluation high complexity, 60 min
  • 97168 – OT re-evaluation est. plan care

Use of discipline-specific modifiers when billing Medicare

GN (speech language pathology), GO (occupational therapy), and GP (physical therapy) modifiers have been in effect since September 1, 2016. Therapy codes aren’t payable without one of these modifiers.

Thus, the GP modifier applies to the four new PT codes, indicating services delivered under an outpatient physical therapy plan of care. The GO modifier applies to the four new OT codes, indicating an outpatient occupational therapy plan of care.

New therapy caps

Medicare rules regarding therapy caps have also changed for 2017. There’s a $1,980 cap for PT and speech language pathology combined (up from $1,960 in 2016 and $1,940 in 2015, so in keeping with the $20-rise-per-year trend). There’s also a $1,980 cap for OT.

Note that deductible and co-insurance amounts count toward the amount applied to the limit. Also, there’s an exemption process through the end of 2017 for when medical necessity requires services beyond the cap. However, a manual medical review is required once expenses reach $3,700.

To bill under the exemption, modifier KX must be used. According to CMS, when you use the KX modifier, you are attesting that the services you provided are reasonable and necessary and that there is documentation of medical necessity in the beneficiary’s medical record.

Gaining efficiency

Here are a few ways to evaluate your progress on the new rules.

  1. Run procedure reports for dates of service post-January 1 to ensure claims don’t include any old codes (97001, 97002, 97003, 97004).
  2. Run procedure reports to identify any for which no GO or GP modifier was assigned.
  3. Review claims that were denied or rejected for reasons related to absence of modifier on evaluative procedure codes.
  4. Use your software to set procedure-code macros for evaluative procedure codes to automatically assign the right modifier.
  5. Leverage any therapy-limit calculators and alerts that are built into your medical billing application.

Hopefully, your practice’s transition to the new codes was smooth. If you have suggestions or tips you’d like to pass along to others on this topic, email your ideas to info@freept.com. We’d love to feature you as an expert or have you contribute to one of our Therapy Tips articles.

As you know, these codes and regulations are subject to change, and the details for how to use all of the codes and modifiers are dependent on specifications from the individual payers. References for this article and additional helpful resources are below:

Rehabilitation to prevention and education

Dr. Alexis Sams is the owner and lead physical therapist of ANS Fitness and Physical Therapy, which specializes in providing total injury care for dancers – from rehabilitation to prevention and education.

We recently asked Dr. Sams about her experiences treating different types of performance artists. Here’s what she shared:

Tell us about your practice. What sets you apart from other practitioners in your area?

ANSFPT was created in 2014 to answer the fitness and wellness needs of performance artists including dance, music, gymnastics, cheer, ice skating and martial arts. I combine years of clinical physical therapy practice with my experience as a dancer and instructor to assist other artists through the injury experience. We provide rehabilitation following injury and specialize in programming and education for injury prevention and wellness for young artists, parents, professional artists and instructors.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

Most of my patients are referred via word of mouth. This particular patient was a dancer who I came to know while teaching at her studio. At a community fair performance she sprained her ankle and had to be carried off stage. She was in pain, her ankle was swelling, and she was nervous about how this injury would effect her dancing, particularly the competition she had six weeks later. In just three weeks she was back to dance without pain and by the day of competition she was ready to dance with no problem.

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

1. Don’t doubt their knowledge when they first start their career. They’ve passed the licensing exam so they know something. Don’t be afraid to practice what you know.

2. Be resourceful – don’t worry about knowing all the “right” answers immediately, but start to know where you can locate them when you need to.

3. It’s not about making mistakes; that’s inevitable. It’s about how you resolve them and what you learn from them.

Please talk about any ways you are trying to impact the community you’re a part of:

Mentoring/Teaching? I accept volunteers for high school and college students interested the the PT profession.
Community involvement/awareness? I support area dance studios, dance companies and fitness gyms through injury prevention screenings and seminars.

Anything (that you care to admit) that you would never do again?

I will NEVER believe someone who tells me that I’m not a good therapist.

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Physical therapy

Mindy Simon is a Clinic Director with The Center for Physical Rehabilitation (CPR), which serves a wide outpatient population in the Grand Rapids, Mich. area. She is both an Orthopedic Clinical Specialist and a certified athletic trainer.

Tell us about your practice. What sets you apart from other practitioners in your area?

I have had the benefit of specializing in orthopedic and manual therapy with CPR for the past 12 years. This has allowed me the opportunity to work with a very wide patient demographic, treating patients from a few weeks in age all the way up to patients in their 90s.

During their treatment sessions with me, my patients typically will have some sort of manual or hands-on therapy (depending on their presentation and our therapy goals, which we develop based on the patient’s input) and therapeutic exercise. I also focus heavily on patient education because it is my goal to help patients help themselves going forward from their time with me. Our clinics are all very bright and inviting, with an upbeat and positive atmosphere being of utmost importance to us. Our patients appreciate that, even though they are often in pain, the process of getting back to their previous functional level can be an enjoyable experience.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

One of our many success stories was referred to our office from his primary care physician with low back pain that was also referring to the patient’s upper groin and testicle. In addition to his pain symptoms, he was having some swelling in the affected area. He shared that he and his wife had been trying to conceive their first child without success for the past year and he was concerned that his current complaints might be contributing to this.

After taking a thorough history, the next and most important step was to determine if this patient belonged in my clinic (were his complaints not of musculoskeletal origin?). I was able to perform a mechanical assessment of the patient’s spine using the McKenzie method. The importance of this was to determine if his symptoms could be impacted by spinal movements, thus helping me answer the all important question, “Can physical therapy help him?”.

Within his first few visits, we were able to significantly lessen his referred pain pattern with end range extension exercises and also educate him on how to maintain his improvements. He also no longer reported swelling in the impacted area. He was very relieved that his original complaints were mechanical in nature (i.e., coming from his low back) and best of all, when I ran into him and his wife at a restaurant about a year later, I was introduced to his beautiful baby daughter!

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

The best advice I can give someone pursuing a career in physical therapy is to realize that the body of knowledge is always changing in healthcare. If you want to provide the best possible care for your patients (and this should hopefully be your ultimate motivation), you have to be ready to dedicate yourself to becoming a lifelong learner. This is more than just reading an occasional journal article; it’s also surrounding yourself with knowledgeable professionals who are energized by sharing new treatment ideas with each other.

I have learned so much over the years by gleaning information from those around me, including professionals from other disciplines. It is extremely easy to think about how much knowledge you have gained in your three-plus years of graduate school and become complacent … challenge yourself to be better than that!

Please talk about any ways you are trying to impact the community you’re a part of.

I am extremely blessed to both live and work in the same community. More importantly, I am lucky to be employed by a company that appreciates the importance of being an integral part of the community that we strive to serve. The owners of our company, who are all PT’s providing patient care in our clinics, have always supported many community charities. Most recently, we are conducting our annual in-clinic food drive to benefit a local community center for homeless and low income individuals in the Grand Rapids area. We, as a company, have also provided pro bono health and wellness classes to a local elementary school for both students and parents. The Center for Physical Rehabilitation also has several contracts with area high schools; we provide an hour of complimentary injury consultation by a physical therapist directly in these schools each week.

From a personal standpoint, I have loved serving as a preceptor to students studying a variety of disciplines, including exercise science, athletic training and physical therapy, for the past eight years. Students motivate me to become a better clinician; the best ones are filled with questions that I need to be prepared to answer (whether by clinical reasoning or by a quick research review!). I also have been a long-time member of the American Physical Therapy Association and Michigan Physical Therapy Association, , which exist to serve the physical therapy community.

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Physical therapy

Britton Taylor is President and Founder of Taylor’s Touch, a revolutionary physical therapy practice in Portland, Ore.

We recently checked in with Britton to learn more about his philosophy on physical therapy and how he helps his patients. Here’s what he had to say:

Tell us about your practice. What sets you apart from other practitioners in your area?

I believe that laughter is the best medicine! With this core belief in mind, I’ve developed a groundbreaking, nontraditional approach to physical therapy that utilizes humor to diagnose and treat my patients’ most pressing ailments and maladies.

For proprietary reasons I can’t go into too much detail, but I can tell you that humor creates new neural pathways in the brain and can also retrain the central nervous system to work more economically. My patients heal quickly and have a rip-roaring time in the process!

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

I would say that I’m very proud of my success with a patient named Allen.

Allen came to my office with severe pelvic pain. He was extremely depressed, and I was determined to help him get him back on track.

It sounds hard to believe, but humor can be incredibly revealing. In Allen’s case I used a variety of jokes as diagnostic tools, using the vibrations of his laughs to detect anomalies. Through this technique I was able to diagnose severe inflammation and tension in his pelvic bowl.

In addition to a vigorous and regimented set of exercises, I give all of my patients a “comedy prescription” that is personally tailored to their medical needs. In Allen’s case I recommended two Richard Pryor albums and one Jeff Foxworthy TV special, followed by an episode of “The Big Bang Theory.”

The impact of the treatment was nothing short of miraculous! Allen has regained full control of his bladder and has a completely new outlook on life!

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

Don’t always believe what the textbooks tell you! Find an approach that honors your voice and your unique personality. Everyone has something special to give. Be the change your want to see in the world. Also, follow your dreams. In my case, it’s combining healing and humor to make the world a better place.

Please talk about any ways you are trying to impact the community you’re a part of

I used to mentor veterans and teach the disabled, but frankly I don’t get out in the community much any more because I don’t want people stealing my proprietary methods. However, I do perform standup on the weekends, and this is a great way for me to share my therapeutic methods with the broader populace.

Anything (that you care to admit) that you would never do again?

Oh boy. This one is embarrassing. I used to dress up as a clown when I first started seeing patients. I thought it would make them laugh, but it honestly terrified most folks. For aspiring therapists, I don’t recommend this approach.

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Sherry McLaughlin is the President and Founder of the Michigan Institute for Human Performance, innovators of MoveWell® (The Pain-Free Corporate Solution).

Sherry recently checked in with us to talk about her practice and share one of her favorite patient success stories. Here’s what she had to say:

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

An ultra marathon runner who was complaining of knee pain at mile 15 of his runs. The problem was he was training for a 50-mile run.

Why did this patient come to your practice? What problems were they experiencing?

He had heard about us from another athlete.

How did you go about diagnosing him or her?

We always do a full-body biomechanical assessment. Many times the problems at the knee stem from issues in other joints. In this case, there were limitations in hip and ankle mobility.

What treatment course did you decide on?

Normalized muscle function and joint mobility at the hip and ankle with manual therapy and a functional movement-based exercise program.

What was the impact your treatment had on the patient? How did you help him or her?

He not only called to tell us he ran his 50-mile race, but also that he was now on par to run a 100-miler in Hawaii in a couple of months and he was so excited that he would be able to do it. He finished that race a couple of months later without any knee pain.

That case was just the beginning of our journey here at MIHP. Since then, we have helped thousands of people return to normal pain-free living through our method of full-body assessment. In fact, our MoveWell program was launched based on our clinical work in an attempt to prevent injury and help people find solutions to their pain problems at work.

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

I would advise PT students to think outside of the box. To always ask “why?” until they come to a solution. Pain doesn’t just happen because of age. There are problems to be solved and our education as PT’s lines us up to be the experts in musculoskeletal health. In order for us to be a valuable part of the health team, we can’t forget the basics of how the body is designed.

Please talk about any ways you are trying to impact the community you’re a part of:

Mentoring/Teaching?

I have taught Kinesiology and Musculoskeletal PT to PTA students at Macomb Community College since 1994. I launched seminar series called The Missing Link and Real World PT to educate other therapists on how the body is designed to move and work.

MIHP regularly accepts student interns and volunteers and our doors are open for budding and seasoned clinicians who want to shadow us for a day or more. Our staff is very amicable to teaching the things we have learned in our journey.

Community involvement/awareness?

I sit on the board of a local nonprofit called Back Alley Bikes where we take donated bicycles, fix them up or teach others how to fix them up and then allow them to have the bicycles for transportation. I love working with the youth in the Youth Earn-a-Bike program. Though not PT related, I enjoy helping others maintain an active lifestyle.

I have also spoken to area church groups, delivering our Five Key Facts About Your Body’s Design seminar. Helping people become aware of how their body works is very empowering in their quest for a pain-free life.

Working with veterans or the disabled?

I have lectured to PT’s at West Point Military Academy, Camp Lejeune, Onslow Memorial Hospital and Portsmouth Naval Hospital.

What is the funniest thing, if any, that has happened to you in practice?

We use this manual technique, muscle spindle massage, to facilitate muscles that might not be working correctly. It involves stroking a muscle in a certain direction and is very effective in activating a muscle. We once had a runner who had a lazy gluteal muscle, so one day he was doing squats and realized his gluteal muscles weren’t working. He yelled, “Hey Sherry, can you come over here and rub my butt?”

Anything (that you care to admit) that you would never do again?

I could never again do PT the old-fashioned way. It is impossible for me to evaluate a joint in isolation without taking into consideration the entire biomechanical chain.

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Therapy and balance

Danielle Gross a physical therapist at FYZICAL Therapy and Balance Wellness Center in Rockville, Md. She specializes in Vestibular Rehabilitation Therapy and Balance.

Here she shares one of her favorite patient success stories, offers advice to students and discusses how she tries to help in her community. Read on:

Tell us about your practice. What sets you apart from other practitioners in your area?

Aside from our full suite of physical therapy services, FYZICAL Therapy and Balance Wellness Center is very unique in our area due to our comprehensive balance program. Our practice has a combination of cutting edge balance technology and highly trained specialists who are able to efficiently recognize the area of dysfunction, and create a highly individualized plan of care that directly addresses the patient’s cause of the problem, whether it be vertigo, imbalance or other symptoms.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

Our clinic is very proud of our many success stories that our patient’s take away with them once they are discharged from treatment. One of our more recent patients came to FYZICAL directly from the hospital with severe vertigo.

Why did this patient come to your practice? What problems were they experiencing?

This particular patient woke up one morning with severe dizziness/vertigo. He began vomiting due to the dizziness and became very dehydrated. He was admitted to the hospital for three days where doctors ran tests and were able to get the patient to stop vomiting. All of his tests were negative and he was given medication to help with the dizziness. However, upon leaving the hospital, he continued to feel very dizzy and could no longer walk without the assistance of a cane. He was a previous patient of our clinic for back pain, and remembered that we also worked with balance and dizziness patients.

How did you go about diagnosing him?

During his first visit, the patient spent an hour one-on-one with a vestibular therapist. His initial evaluation consisted of multiple tests including a functional gait exam, balance testing on different surfaces, special tests involving the eyes and inner ears, and vestibular testing with special infrared goggles. The goggles used were extremely helpful in watching involuntary eye movements that were being produced by the dysfunction in his inner ear. With his reported symptoms and special testing, it was determined that the patient was suffering from an acute form of Vestibular Neuronitis in his right ear, but this wasn’t the end of the story! After performing positional testing with the infrared goggles, the patient also had a severe case of Benign Paroxysmal Positional Vertigo (BPPV) in his right ear. Not only did the patient have an acute vestibular disorder, but he had two!

What treatment course did you decide on?

The treatment plan that was created consisted of two parts. The vestibular issues that the patient was experiencing are both treated very differently. Fortunately, BPPV is a disorder that has great success rates with simple in office maneuvers. We were able to perform an Epley maneuver during the initial evaluation to resolve the BPPV. He no longer experienced vertigo with sudden changes in position. However, he continued to feel very off balanced, and dizzy constantly due to the Vestibular Neuronitis. The course of treatment for Vestibular Neuronitis involved two treatment sessions per week over a four to six week period. In that time, we initiated gaze stabilization exercises, exercises on a balance shuttle, computerized force-plate technology to measure different aspects of the patient’s balance, and exercises to strengthen his legs.

What was the impact your treatment had on the patient? How did you help him or her?

By the end of the treatment, the patient no longer experienced dizziness or vertigo, he was able to walk without using a cane, and he was able to embark on a service trip overseas for a month without symptoms of dizziness or imbalance.

What advice would you give PT/Chiro students today? For instance looking back at your own career is there anything you would do differently?

My advice to PT/Chiro students today is to be aware of the vestibular system, and the common conditions that many patients experience due to vestibular dysfunction. Over the course of my time treating patients, I have seen patients for various other orthopaedic conditions who have undiagnosed BPPV that has contributed to falls and other injuries. Many patients think that their dizziness is a normal part of aging and that they can’t be helped. However, with the knowledge of a simple Dix-Hallpike Test and an Epley maneuver, you can greatly improve a patient’s quality of life! It is important to screen and educate your patient’s about balance and potential fall risks.

Please talk about any ways you are trying to impact the community you’re a part of.

We are always trying to impact our community by providing the best possible care for our patients and Wellness members. First, we believe in honoring God and serving others in all areas within the clinic; patient care, human resources, business ethics and corporate finances. At FYZICAL Therapy and Balance Wellness Center, our patients’ needs are our first priority, deserving our greatest attention and resources. We believe patient care is best delivered in a friendly atmosphere where caring for patients and staff is more important than the bottom line. Our “Team” approach is fundamental to building a basis for superior patient care. Overall, our excellence in patient care and patient relations is the norm at FYZICAL Therapy and Balance Wellness Center.

In our clinic, we as a staff are either mentoring or teaching on a daily basis. We have many volunteers and students that come in to shadow therapists. Our aides are also learning from each other and the therapists about different aspects of physical therapy and patient care. All therapists also excel in different areas of treatment, allowing therapists to learn from each other whether it’s regarding orthopaedic physical therapy, pelvic health or vestibular rehabilitation.

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Wellness

Susan C. Clinton (PT DScPT OCS WCS FAAOMPT) is the co-owner of specialty physical therapy private practice Embody Physiotherapy & Wellness LLC, international instructor and co-founder of the Global Women’s Health Initiative.

Tell us about your practice. What sets you apart from other practitioners in your area?

We founded Embody Physiotherapy & Wellness, LLC as a practice that focuses on client-centered care in an atmosphere that would allow each individual to explore the changes they seek in an environment that quiet, relaxing in a nontraditional medical setting. The practice follows evidence-based parameters for pelvic health, persistent pain, pregnancy and post partum, spinal and extremity injuries with a focus on post-treatment wellness in movement classes, yoga, balance, dance, music and fitness.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did she learn about your practice?

This 1 year post-partum patient was a mother of one that had a difficult birth and had complications post-partum of pelvic organ prolapse, stress urinary incontinence and diastasis rectus abdominus (DRA). She found our practice from a link on a website after trying to take care of her issues on her own. She had been looking at various websites that provided patient education and exercise programs to purchase regarding her health conditions and became worried that she may be doing herself more harm than good since she wasn’t making any progress to her own goals.

Why did this patient come to your practice? What problems was she experiencing?

She made the decision to come into our practice after speaking with me on the phone. She expressed great concern and fear that any of her movements, trial at exercise and simply lifting and carrying her young child were making her diastasis and pelvic organ prolapse worse. She was afraid to move and was very worried that she would not regain previous pre-pregnancy function, much less pursue a second pregnancy. She also had a recent history a fall when her child was a baby with a fractured patella and reported she was also not walking, kneeling moving well because of this.

How did you go about diagnosing her?

I was able to help her connect the pieces of her physical problems with a thorough evaluation which included everything from her pelvis, pelvic floor, abdominal canister to her breathing strategies, movement strategies and dominant strategies of alignment for holding her child, playing the violin and general standing/walking. Through the conversations on the phone and in the clinic, it was clear that she was very afraid of anything that would make the diastasis worse – and spent much of her time posturing with her hands holding her abdomen.

What treatment course did you decide on?

Her goals to return to normal movement, running, lifting/carrying and good improvement of her prolapse, DRA and incontinence were the driving pieces of the intervention.

Patient education was the first course of treatment – although she was not in pain, she had a very heightened fear avoidance pattern preventing her from engaging in normal life and activities. She would not sit straight up, nor lean over a table or bed or get on her hands and knees for fear of “her organs falling out”. Time was spent really helping her understand her anatomy, physiology and what was safe and OK for her to pursue. Along with ongoing education was changing her breathing strategies and getting her to recognize how much breath-holding was occurring with even the simplest of tasks. We progressed steadily changing the abdominal/pelvic floor strategies and load transfer with laughing, coughing, sneezing, talking, singing. The movements in all postures and positions became more complex and she eventually gained the confidence to reach, lift, hold and carry without fear of her DRA worsening.

What was the impact your treatment had on the patient? How did you help her?

She quickly became continent again and the pelvic organ prolapse returned to a minor stage 1 position without symptoms. The ability to really believe her DRA was stable and non-threatening took a bit longer, but eventually she returned to all of her activities without symptoms or fear. She told me upon her last visit that she was pregnant with her second child and was thrilled to be in this position when she originally thought it wouldn’t be safe 6 months earlier. She regained her life, her dreams and her movements with education, guidance and the belief that she would recover.

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

The best advice I would give to students today is something that I learned in the mid to later part of my career. First of all, seek out a mentor, even if it over the phone or by Skype, as there is nothing that will equal having someone with greater experience help you develop your clinical reasoning and your intervention paradigms. Secondly, do not grow complacent that the knowledge you have gained will not change. It will change! Update your knowledge as regularly as possible as our field is in rapid growth. Finally, do not ever let a job or life’s circumstances keep you from defining and living your passion! Find it, live it and do not forget to take care of yourself every day!

Please talk about any ways you are trying to impact the community you’re a part of, such as:

– Mentoring/Teaching?
– Community involvement/awareness?
– Working with veterans or the disabled?

My community work has come in several forms through the years. My passion is teaching both at the University level but mainly in post-professional education. Sharing knowledge amongst colleagues has been the most sustainable form of energy in my professional life. I have been blessed to do this on an international stage and this has shaped my practice more than any other avenue I persue.

I have also fueled community awareness through various organizations and foundations within my field. I have been active in the American Physical Therapy Association with leadership positions in the Orthopedic and Women’s Health Sections. I am serving on the Board of Directors for the Association of Pelvic Organ Prolapse Support (APOPS) and I am a founding Board Member of the Global Women’s Health Initiative (GWHI).

Finally, my clinical work takes me into many venues including backstage at dance/theatre performances, dance studios and in musicians practice arenas.

What is the funniest thing, if any, that has happened to you in practice?

The funniest thing that has ever happened to me in practice was during a dance performance, one of the dancers went down with a foot injury. The funny part was hiding behind and moving the scenery to get to her without the awareness of the audience. The rest of the performers had to suddenly alter their patterns of movement and their acting skills to change the scene suddenly to help her to safety. The dancer did not have a fracture or a tear and the show was saved! We all had a great laugh for weeks!

Anything (that you care to admit) that you would never do again?
We all have regrets in life – alas, most of mine do not involve my professional career, but instead making a perceived choice that music and physical therapy would not fit in my life together.

PT students
Dr. Negin Jalayer is the owner of Marathon Physical Therapy – a long standing and well-known physical therapy practice in Great Neck, N.Y.

Here, she discusses her practice, her favorite success stories and offers her advice to PT students. Read on:

Tell us about your practice. What sets you apart from other practitioners in your area?

Our practice is unique. You quickly recognize this once you step foot in our door. We know you by name – not by your visit number. And our No. 1 goal is to give each and every one of you the very best physical therapy care possible.

We are a small, boutique physical therapy practice, not a large center where you are lost in the chaos of a high volume, large practice. We provide excellent physical therapy care using our highly effective manual therapy techniques – that means you get hands-on care from us. And what we really do well at Marathon Physical Therapy is that we take the time to understand your condition, so that we can treat the root cause of it and not just its symptoms – this way you get better, and STAY BETTER!

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

I had treated a patient who was diagnosed with advanced bilateral shoulder osteoarthritis. She was told by her orthopedist that extensive surgery was her only treatment option. Before considering surgery, she found out about us through a friend who we had helped. She began a regimented course of physical therapy with me, and not long after, was able to elevate her arms above shoulder height with more ease and much less pain.

Her case was especially important to me, especially being an orthopedic clinical specialist (OCS), that I was able to improve her pain and use of her arms in order to prevent her from having surgery. She had severe difficulty and pain with doing basic activities using her arms. I was able to properly diagnose the tendonitis accompanying her rotator cuff syndrome, and to effectively treat it at each stage so that she could resume basic activities and initiate some light recreational activities.

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

My advice to PT students today would be to follow your passions and to treat each patient with compassion and respect. I always tell my students to treat each patient like they are a family member.

Looking back at my career, no, I would not change anything. I am a true believer that every experience makes you stronger and helps to build a foundation.

Can you please talk about any ways you are trying to impact the community you’re a part of?

I went into private practice because a great opportunity came my way and I realized that I could make a significant impact on the community I am in by taking it. Being that I am fluent in Farsi/Persian – I knew that I would be able to serve the Great Neck community of older Farsi-speaking adults. I feel that it was my duty to take this opportunity in order to better the quality of care they deserved, and to bridge the language barrier gap.

In addition, I have a great privilege in being able to mentor PT students from local graduate programs. I really enjoy the mentoring process and feel it is especially important for these students seeking outpatient experience, to come to a place where the physical therapist(s) has a specialty in orthopedics.

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Patient success

Todd Smith, owner of Rochester N.Y.’s Procare Physical Therapy and PXC Sports Performance, has nearly 20 years of experience as a Physical Therapist. We recently asked him about his practice and one of his favorite patient success stories. Here’s what he had to say:

Tell us about your practice. What sets you apart from other practitioners in your area?

I have had the opportunity to work with some highly skilled clinicians as well as some amazing clients and athletes throughout my career. In 2005, I opened a sports performance training center in an unfinished basement in a small outpatient clinic where I worked as a staff PT.

In 2011, I finally decided it was time to move on and open my own PT practice and sports performance center. My current facility offers clients and athletes 10,000 square feet for rehab, training and sports simulation activities. We are located in a town with nine PT clinics, so having the specialized, well-equipped facility to be able to offer what others cannot is a significant piece of what separates us from our competition.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

Preparing for this interview, I was thinking of all the athletic success stories I have witnessed, both from the rehab side as well as the sports performance side. But as it came time to put my thoughts on paper regarding one patient success story that I was especially proud of, my thoughts continued to go back to one of the real-life heroes I had the privilege of working with.

The success story I wish to share involves a serious motor vehicle accident, where a police officer who was broad-sided on his motorcycle, sustained a complex crush injury to his lower leg. This patient arrived in significant pain, unable to bear weight. While the accident resulted in a small chip fracture, most injuries were related to soft tissue trauma.

His therapy was complex, involving soft tissue work, joint mobilization, stretching, kinesiotaping and a progressive strength program. The patient was very eager to try and return to his previous role with the police department, but more specifically wanted to be back on to the motorcycle for the police department.

After months of rehab, progressive increase in strengthening, agility and eventually a running program, this officer was able to return to full active duty, including riding his police motorcycle. The gratitude expressed from this particular patient made all the effort worth every second. He was thankful for achieving a successful return to all the roles he cherished in his life: police officer, husband and father.

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

My advice for younger PT students is to take each patient as a person first and foremost, and an injury or condition second. Remember, every person you work with is someone’s son, daughter, mother, father, etc. and is relying on your expertise to return them to their full life activities.

If new PT’s have any interest in pursuing private practice, make sure to spend time working on your business skills, not just your clinical skills. As a private practice owner, you will be responsible being competent in both areas in order to be successful.

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Dr. Andrew Zang

Dr. Andrew Zang is the owner of Zang Physical Therapy, a new model concierge therapy practice seeking to deliver Unmatched Personalized Attention for all his patients.

Here he discusses his approach to Physical Therapy and shares one of his favorite patient success stories. Read on:

Tell us about your practice. What sets you apart from other practitioners in your area?

I began this practice to be able to treat patients the way I feel they should and most patients desire but is very difficult in the healthcare world we live in today. What patients will experience at Zang Physical Therapy is 1:1 treatment without distractions and no hand-offs to support staff to direct treatment. Patients will also be treated by Harrisburg’s only FAAOMPT (a doctor’s fellowship training for physical therapists); this designation is only achieved by 1 to 2 percent of physical therapists. Dr. Rodeghero et al JOSPT 2015 put forth results showing increased patient outcomes in fewer visits when patients were treated by a FAAOMPT.

The therapy experience will become a partnership where I work for the patient to assist them achieving their functional goals, returning them to the activities they were unable to complete due to pain. Patients will not waste time doing exercises they can do on their own. We will maximize our time together to work on items the patient cannot do on their own including hands-on treatments as well as patient education.

Often times patients will only need to be seen one or maybe two times per week at most vs. two to three times per week in a traditional model. The best part is, most patients are able to come learn how to feel better, function better and live with less pain without the hassle of waiting for a doctors appointment first. Also, our goal is to help you avoid injections, medications, or being told you need surgery.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?

One of the best patient stories I have to share is about a mother to three kids who, after giving birth to her third child, had to be placed into a medically induced coma for four weeks due to contracting a respiratory infection that nearly killed her. When she came to see me, she was weak and severely deconditioned using a walker for mobility (she was 33 at the time). She was unable to assist in caring for her newest child and struggled to perform simple daily tasks like dressing herself. Over the course of several months working together two times per week, she was able to then care completely for all her children including running around to numerous events that her two older children participated in.

This is nowhere near the typical patient I treat. Most of what I treat are the chronic neck, back, knee, and shoulder pain patients who have sought care from numerous providers elsewhere but were no better and looking for a solution to their problem. Many just want to improve their quality of life and that is what I seek to provide for the patients I treat. Helping patients return to a higher level of function with less pain is the ultimate goal.

What advice would you give PT/Chiro students today? For instance looking back at your own career is there anything you would do differently?

For future or current PT students: seek out a mentor who can facilitate your growth as a therapist. Guidance throughout the process is vital to your progression in this profession. Learning does not stop when you finish PT school. Continued thirst for knowledge helps to set oneself apart from the rest.

Please talk about any ways you are trying to impact the community you’re a part of:

When not treating patients, I am involved with teaching at the entry and post-professional levels. I am on staff for South College in Knoxville, Tenn. as part of their entry level program. I also am an active member of the Evidence in Motion (EIM) team, which provided blended learning (online and onsite) for working professionals seeking to further their professional development in various domains. In any free time I have left, I routinely offer free injury screens and put on at least one seminar per month on health/wellness/injury prevention topics. With whatever time is left I enjoy my time with my wife and daughter.

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