Health care has a huge impact on our country’s economic status, accounting for 17+% of the GDP and growing steadily. As the baby boomer generation gets older, we are faced with an even bigger drain on health care resources. But wait for it – wait until the youth of today, Generation Z as they are called – get a little older. If you think the problems are big now, wait for another 10 to 15 years.
Obesity (and a generalized lack of fitness) is taking its toll on the youth of America.
Ross Perot said it quite nicely back in his first election infomercial: “In America, we have a problem”. I just don’t think that Perot realized that this is where the problem would really exist.
The numbers are simply astounding. Perhaps “depressing” would be a better term.
Childhood obesity is rising. Based on data from the Centers For Disease Control and Prevention [1], 16 percent of children (over 9 million kids) aged 6-19 years are overweight or obese - a number that has tripled since 1980. Another 15 percent were considered at risk of becoming overweight. But it gets worse.
The storyline in far too many sports these days goes something like this:
Athlete A sets a record of some form or another in Sport B. Athlete A has never failed a drug test mandated by his/her sport. The general public can’t believe that a performance like this is possible without the use of performance-enhancing drugs. Questions start to accumulate, and people start to wonder if their much-beloved Sport B has been tarnished by a drug cheat.
The governing body of Sport B doesn’t have very good drug testing policies, or perhaps doesn’t enforce them very stringently, or perhaps just doesn’t really care when everything is said and done. Those that run Sport B are pleased that tickets are being sold, or TV contracts are being negotiated – or both.
Performance-enhancing drug use in Sport B is only illegal based on the rules of Sport B, not the fact that they are illegal to use in the United States. Now we introduce Group C – those with their own agendas that don’t want Sport B to be soiled - try to dig up the dirt on suspected drug cheat Athlete A.
Anything sound familiar here? Name the sport – and read on. The storyline has just begun.
If there was ever a reason for Direct Access to Physical Therapy to exist – in ANY state of the US or country of the world – it would be back pain. There is no doubt that back pain could become the poster child for this consumer initiative. It also provides plenty of evidence-based reasons to counter the claims of physician naysayers.
First things first – back pain will affect 50 - 80% of the population at some point in their lives, and 40% of the population will have an episode of back pain within any given year. This amounts to about 31 million Americans that are afflicted with low back pain at any given point in time, or approximately 10% of the population.
The estimated costs of back pain in the US exceed $170 billion annually. Yes, that is BILLIONS of dollars.
In the world of back pain, evidence-based practice (via clinical practice guidelines) is going to be critical in order to increase access to care and to decrease the cost of care. I would like to think that physicians, chiropractors, and physical therapists alike would agree on this. So let’s try to weed out “conjecture” from “data” as it applies to the claims regarding back pain and patient direct access to physical therapy.
History was made on Wednesday, April 20 as HB 637 went to a public hearing in the House Public Health Committee. This is the first time in eight years that a direct access bill has made it to a hearing. But it didn’t come without it’s challenges throughout the day.
The initial meeting was scheduled for 8:00 am with a long agenda full of various bills addressing issues ranging from raw milk to EMS services and all points in between. By 10:00 am, our bill had not been heard, but committee members needed to return to the House for debate on other bills. Many of those wishing to provide testimony on HB 637 stood strong and patient throughout the day, waiting for the meeting to resume.
At 7:00 pm, the meeting finally resumed. Though our numbers had decreased slightly, many clinicians and patients were still in attendance to provide support for the bill.
After hours of testimony on raw milk products and the cottage food industry, physical therapists in Texas finally had their opportunity to speak out on behalf of their patients and their profession.
April 20, 1931 was an important day in history. But perhaps it wasn’t important for the reasons that you think.
This is the date of birth for one Robin McKenzie, a physiotherapist from New Zealand. Mr. McKenzie’s astute clinical observations lead him to develop the McKenzie Method of Mechanical Diagnosis And Therapy. In 1981, he published his first text on MDT as it applies to the assessment and treatment of the lumbar spine, and since then has released books on MDT applied to the spine and extremities. He has contributed a unique and innovative approach to patient classification (and focus on self treatment) which has continued to gain research support over the years.
Not only has McKenzie laid the foundation for an assessment and treatment paradigm, he has provided the world with the first true “patient-centered” competent self care approach for musculoskeletal problems.
This didn’t come without great challenges and resistance from many angles, from outside his profession and from within.
A landmark event in the history of Texas physical therapy and consumer advocacy nationwide is upon. HB 637 – Patient Direct Access To Physical Therapy – has moved to the public hearing stage for the first time. Texas HB 637, authored by Rep. Craig Eiland, has made it’s way to a public hearing with the House Public Health Committee. The public hearing is scheduled for April 20, 2011 at 8:00 am.
This bill is a significant one for health care consumers in Texas. The bill does not change or alter the scope of practice of physical therapists in Texas. It simply removes the referral requirement for treatment by a PT. As the law stands right now in the state of Texas, a physical therapist can perform a patient evaluation without a referral, but must then attain a referral from an authorized referral source (i.e physician or chiropractor) regardless of insurance plan. HB 637 would allow patients to have direct access to a physical therapist for evaluation AND immediate treatment without a referral. This will be a significant cost savings for consumers and will provide greater access to appropriate and necessary care.
The hearing provides an open forum for the public to provide testimony, which is limited to three minutes per person. Those present who are not wishing to speak can fill out a “card of support” in favor of the bill. The presence of consumers and physical therapists affected by this bill is hugely important. This is an opportunity for Texans to gain access to care and decrease the cost of care.
If you are unable to attend the public hearing but wish to support consumer direct access, please email one of the Representatives on the Public Health committee.
More information on Direct Access to Physical Therapy can be found here. The following articles will also provide further information on the importance and meaning of direct access to physical therapy:
Direct Access To Physical Therapy: You Have It, Or You Don’t
Patient-Centered Health Care Begins With Access To Care
Direct Access To Physical Therapy (from 2009 Legislative session)
Photo credits: Wikipedia
That was the headline of the full page ad on page A6 of Monday’s Austin American-Statesman. I’ve seen the ad before – I do still read the print version of the newspaper with my morning coffee – but for some reason, on that particular day it grabbed my attention.
It was like playing the game where you look at the image and see the picture of the old woman or the young lady – or any number of visual puzzles. I read on with intrigue.
I’ve been a physiotherapist for 23 years. I have reviewed a few MRIs over the years. Out of curiosity today, I took a look at the MRI image in the ad. At first glance, it was a mild herniated disc. Lo and behold, the first line of the ad stated such: “Do you see it? It’s called a herniated disc, a painful condition that can cause severe sciatic nerve pain”.
It only took two sentences, and I was on a rant.
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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