Health care reform appears to be stumbling and bumbling its way along these days. Many of the solutions proposed are much like putting a band-aid on a gaping flesh wound. It might provide a short term fix, but the long-term solution is lacking.
We have a lot of smart people in this country who could provide us with many solutions for health care reform. What is perhaps more important is that most of them are not directly a part of the monolithic medical machine and all of its raging tentacles. There are a lot of great ideas out there that could serve as the foundation for truly epic and effective health care reform.
Here are five books for those who are looking for solutions to the health care dilemma.
Humans have always found ways to communicate. It may have started with etched drawings on the wall of a cave, but it has evolved into language, penmanship, and now, the digital world we live in. All forms of expression, be they images, music, and both the spoken and written word, can all be represented digitally now.
The ability to communicate effectively has a direct effect on our capacity to solve problems. That could be at the clinical level – or the personal level. The digital era presents us with countless ways to connect and communicate. But there are times when I think that it has done us more harm than good.
Has the digital era made us more effective in communication? Or did Led Zeppelin have it right when Robert Plant sang the immortal words to “Communication Breakdown”?
I think it is fair to say that in just about every trade or profession, there is a desire to be reasonably reimbursed for one’s level of expertise and the ability to provide a good product to the consumer. It’s not any different if you are a mechanic, a plumber, a physician, or a physical therapist. I think that most consumers want to be able to pay someone appropriately for the work they’ve done – at least in principle.
One of the differences is the presence or absence of a third party payer.
It can become highly frustrating and economically challenging as a clinician to receive dwindling reimbursement from third party payers. So many clinicians will opt for a cash-based approach where they feel there is a direct relationship between the customer and the service provided.
Sounds good, right? Not exactly. The incentives are still not conducive to systemic success. The solution lies in the paradigm used, not how the reimbursement occurs.
Some people will find that when the cold, blustery weather hits, triathlon training may be the last thing on their minds. For others, it will be just the ticket to get them through another long winter.
The holiday season is upon us, religious beliefs notwithstanding. So to all those triathletes out there, I ask you: what gifts would your coach have for you this holiday season? But first, if you don’t have a coach, check your Christmas stocking – he/she might be in there!
On a day like 12-12-12, it seems only fitting to use the Twelve Days of Christmas as a starting point. So with a little fanfare, here is my rendition of a Christmas favorite – The Twelve Days Of A Triathlon Christmas – with coach’s comments included.
You’ve probably heard the phrase used many times. “Take what the day gives you”. Or there is also the infamous “When life gives you lemons, make lemonade”. Or any of countless variations on a theme.
It gets to the point where at times, these phrases sound a little old or cliche. But I can tell you that it is one of the most common discussions I have with the athletes that I coach.
Sport is a microcosm of life as we know. In sport, much as in life, you never really never know what the day holds for you. You will be faced with many challenges and many joys. This could take place over the span of a 5K or an Ironman triathlon.
Ironman Cozumel recently reminded that “take what the day gives you” is a good mantra for athletes.
There are many issues in which the perceived problem isn’t really the same as the mechanism underlying the issue. Oftentimes it will require peeling away a few layers of the onion to get to the core issue at stake. Joint mobilization – be it performed by a physical therapist or physical therapist assistant – illustrates one of these issues.
As I mentioned in my previous post, “Joint Mobilization And The PTA: Much Ado Over Nothing?”, there are plenty of reasons to indicate that PTAs are, or certainly have the capacity to be, qualified to perform joint mobilization. Let’s face it - patients take their joints to end range daily, oftentimes with sustained loading and frequently with greater maximal end range loading than a PT or PTA will ever utilize. So why be concerned about the PTA?
With that said, there is an emotional debate brewing. Why? Time to peel away a few layers of the onion to find the source. Unfortunately, while debating the minutiae of kinematics, educational degrees, and manual skills, the critical importance of autonomy is overlooked – to the detriment of the profession as a whole.
It has become a hot topic in the world of physical therapy: the role of the physical therapist assistant (PTA) in joint mobilization. It appears to be a growing point of contention and divisiveness within the profession. Surprised? Not I.
Physical therapists will claim that joint mobilization requires advanced training and clinical skills that are not, nor should be, a part of PTA practice or education. I find this whole issue, and the roots to it, annoying at best. The profession once again finds itself facing an issue that drains energy from the unity and clarity of vision that our profession both needs and deserves.
Let me give you some real-world examples of why this debate has become mildly ridiculous – and how the voice of reason can return some sanity to the equation.
Up to 60% of runners will sustain an injury within any given year. Poor running mechanics, in conjunction with poor, ineffective and outdated training methods, can pose a significant injury risk. "RunSmart" was written to address these issues in the running community.
"Running Injuries: Etiology And Recovery- Based Treatment" (co-author Bridget Clark, PT) appears in the third edition and fourth editions of "Clinical Orthopaedic Rehabilitation: A Team Approach" by Charles Giangarra, MD and Robert C. Manske, PT.
Allan Besselink, PT, DPT, Ph.D., Dip.MDT has a unique voice in the world of sports, education, and health care. Read more about Allan here.
Top 5 finalist in three categories: "Best Overall Blog", "Best PT Blog" and "Best Advocacy Blog".
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