~Move It~The New Professionals Collaboration Blog

A time of transitions

2011-05-25T21:21:00.000-04:00

Hello All,

I apologize for the long delay between posts around here! It has been a very, very busy year. APTA elections are just around the corner and I've been devoting a good deal of time to my efforts on that front. And of course, with elections come this year's House of Delegates which marks the gathering of the highest governing body of our profession.

I'm very proud to be a part of this year's House. Just to name a few, we will be tackling issues such the profession's role in end of life care, the possibility that it's time for PTs to bring on additional extenders beyond PTAs, and reflecting on how Vision 2020 is evolving and could be changed. The House is a place of great passion and enthusiasm. It is endlessly satisfying to see so many PTs and PTAs lively advocate for what they feel is the right course.

This blog has always been about questioning what is known, be that assumptions regarding new PTs, philosophies about where we are headed as a profession, or even just the present state of health in society. The microcosm of ideas, musing, and rants here on Move It represent a different way of viewing our profession and reflections on common situations that New Professionals seem to find ourselves in.

So it is with great appreciation and admiration for all of Move It's readers and contributors, that I must make a confession. My New Professional card has been revoked. Ten days ago I officially eclipsed the 5 year mark. From this point on, I hope to serve as a guest author only for the blog. Fresh perspectives will be coming soon! Stay tuned and thank you again for your readership!

Cheers,

Ben

Disrupting something sacred

2011-04-27T21:13:00.002-04:00

Tim Richardson has done a nice job of introducing aspects of disruptive innovation to the PT blogsphere. I read Christensen's book in 2009 and think back to it often. A big question for me has always been, "How can we do the work we are setting out to do smarter?"

Without a doubt, the need and demand for our services will increase in the coming years. If we don't seek to disrupt ourselves, someone else will.

Innovation is about capitalizing on areas in which newer, quicker, cheaper, and better options exist. In many ways, PT evolved to disrupt the western medical model in place for the hundred or so years prior.

If we fail to see that as part of our pedigree, it's a sad state of affairs. Sad for us because we will lose ground in the next shake up. But it would be great for the next generation of lower cost, more consumer-savvy providers.

If we want to stay on top, here are my suggestions:

Step one: Acknowledge that not every problem requires a PT.

We have a diverse and widely applicable skill set but we can't be everywhere all the time. There are some jobs that ATCs, exercise physiologists, health coaches, and nutritionists may do better. If you can't handle hearing that, okay, but be ready to have our association spread too thin across too many uphill battles... This means looking at PT-PTA relationships and PT-XYZ relationships as well. As a profession, and rightly so, we are anti-kick back. But as demand increases we will need to put the lab back in collaboration. Which brings me to-

Step two: Forge alliances with the individuals next in line to "disrupt" the system.

This is no small list. Point of care is moving out of the hospital and out of the Doctor's office. For us, it's moving out of the clinic... Nurses were set up to be big winners in Health Care Reform. That is certainly a strategic alliance that needs our attention. PTAs, ATCs, SPTs, Massage therapists, and a laundry list of others deserve constructive consideration as well.

Step three: Re-evaluate which jobs we set out to do.

If an ATC proves they can rehab an ACL better than we can, sigh, maybe we should get out of that business. Do I expect that to happen? No. Is it possible? Perhaps?? If we aren't asking ourselves the question, we open ourselves to being blindsided by unexpected answers. As I've said in the past, comparative effectiveness studies are exciting opportunities to prove our expertise and rally public support behind endeavors in which we choose to take on a leadership role. Could the APTA registry in the works be used for the greater good? I certainly hope so. Why not fund it and fast track it?

Step four: Innovate. Move "to where the puck is going to be."

If PTs seek to 'own' just two major areas in the health care arena, they should be obesity and aging related neuromusculoskeletal deterioration. Soon 80% of Americans would qualify for PT intervention based on one, the other, or both categories. Where are our community based intervention courses for aging and physical therapist interventions? Where is the hot bed at which PT and Public Health intersect?

  As always, thanks for reading! There's been a brief hiatus as I've been managing some family issues and gearing up for APTA elections. This is a cross post with the EIM Blog. But there will be some Move It exclusives up soon.

   Cheers,
   Ben

Keeping up with Research

2011-03-31T16:07:00.002-04:00

I think we can all agree that RESEARCH ROCKS . . . but how do we keep up with it all?!?! As a physical therapy student, I vowed to myself that I would “always” keep up with the latest research once I entered the working world. Journals, continuing education, conferences . . . I was going to do it all. Once classes, exams, papers and group projects were done, I thought I would have plenty of time to keep up with the research world. How could I possibly be busier than I was as a physical therapy student?!?!

After five years of working as a physical therapist, these thoughts make me laugh :-). I have come to realize that staying up-to-date with the latest research findings is a very personal and challenging journey for each of us. Finding a balance between family, friends, recreational activities and work can be demanding. With so many people, responsibilities, and activities filling each day, finding time to stay in touch with the research world can be difficult. It has taken me a few years of trial and error to figure out what works best for me. Here’s what I do:

· Skimming journal cover pages (JOSPT for example) as soon as I get them and highlighting the articles that are most relevant to the patients I am seeing currently. This helps me prioritize me reading/learning.

· Reading journal articles two days a week during lunch . . . often while riding a recumbent stationary bike. Starting to do this really helped me keep up with my journal reading.

· Attending continuing education courses and PT conferences as regularly as I can given time and $ constraints.

o Looking up journal articles cited by presenters at courses and conferences

o “Open Door” which is available to all APTA members is a great resource for finding journal articles in publications that you don't already receive

· Journal club – I work as one of two physical therapists at a university student health center. Putting together a journal club took some extra planning because our “Sports Medicine” journal club includes physical therapists, an athletic trainer, and primary care physicians. We meet once a month to discuss new articles and to work on our overall system of patient care.

· Talking “shop” with PT friends . . . sharing what we have learned

So fellow NPs, how do you do it? How do you keep up with the latest research while balancing family, friend, work, etc? I'd love some new ideas!

Exploring Our Future

2011-03-07T21:42:00.000-05:00

Something is always lost in translation when you summarize a summary. But I intend to try. On Saturday I had the honor of attending and presenting in Emory University's "Exploring the Future of Physical Therapy Symposium." We set out to bridge and contextualize two seminal APTA events, the Physical Therapy and Society Summit(PASS) and the Vitalizing Practice Through Research and Research Through Practice(VRTP) Conference. The symposium though not officially sanctioned by APTA was certainly peopled with many of its luminaries. Similarly to PASS, at which I was the youngest PT in attendance, I was surrounded by NIH grantees, journal editors, and progressive thinkers from academia and the clinic.

Emory's event built upon and went beyond past efforts. PASS imagined the future. VRTP established strategic goals. On Saturday, with the help of an APTA lobbyist straight from D.C. and with the Chief Disability and Health Officer from the CDC, we began to compare the current state of affairs with our goals as a profession. To borrow from Capitol Hill, this was a big "frickin" deal... ahem. (Not bad for what was initially a simple Alumni weekend and Foundation Fundraiser.)

Exploring the Future was about initiating change in the PT world. Ivory towers, silos, bloated curricula, exorbitant debt, disconnected scientists, and disinterested clinicians were all on the chopping block. The audience was engaged and asked to reflect on how change can happen and where change is needed. Topics ranged from ACOs to regenerative medicine to innovative co-pay incentivization schema. Comments ranged from "Translational clinicians need to be honored within APTA." to "If you don't donate to the Political Action Committee, at least marry a congress person."

The seemingly obligatory product of Symposiums these days is the White Paper. While such a paper is in fact forthcoming, there was a strong call throughout the event to take action beyond the keyboard. Hopefully bloggers are granted free license in this regard. No blog of any readable length could do this day long event justice. So I want to share a personal perspective that grew out of PASS and was strengthened over the weekend.

Physical therapists must come to lead community initiatives. Our skill set has expanded in many helpful areas but the need for our skill set has exponentially out accelerated that growth. Patient demographics have become population statistics. As clinicians, researchers, and just professionals, our reach needs to extend further now than ever. My personal mission, having attended PASS and presented in Exploring the Future as young leader, is to promote a skill acquisition model for leadership development within APTA. The sooner we identify the societal needs of 2020 and beyond, the better we will be able to "skate to where the puck will be" by preparing our clinicians and leaders to meet those challenges. Where do you think the puck is going?

cheers,
Ben

Clinical practice is Research (and Research is Practice)

2011-03-01T22:20:00.000-05:00

Research is the March theme on ~Move It~

Once upon a time, a time long, long ago, when I was only contemplating sitting for my NCS and not counting down the days until I would take the most expensive and difficult test of my life, I registered for a preconference course at the Combined Sections Meeting. The course was entitled "Laying the Foundation for Expert Practice in Neurological PT". A prominent theme of this course was differentiating between "intuitive" and "systematic" processing. We were taught that experts were able to synthesize information intuitively without investing cognitive resources in differentiating between plausible and implausible hypotheses. This ability was thought to improve efficiency and allow an expert to focus on an individual's complaints.

I'll be honest. I found this distinction frustrating in its over simplicity. Experts will inevitably be more efficient in processing information gathered from their patients. (If they weren't, we'd have a problem.) But in the world of Physical Therapy, everything is data collection, every touch, every question. Saying that something is intuitive makes light of the empirical process going on beneath the surface. New grads think in terms of T-tests, whereas experts conduct ANOVA.

So granted, there is a difference in the way information is processed. But whether it's an expert clinician performing an evaluation or an NP assessing gait, hypothesis testing is the bread and butter of physical therapy. Anything that obscures this fact contributes to the unfortunate divide between research and practice in our field.

Researchers assess whether or not a particular practice works. They are "practicing" to see if it works. Clinicians test hypotheses with every modification to a treatment plan. Why, then, is there such an inexplicable divide between clinicians and researchers? My hypothesis: the methodological family tree split too long ago. The clinical language is different because there hasn't been an IRB looming in the background. Standardization wasn't required. But in the context of the emerging health care paradigm, in which comparative effectiveness and clinician scorecards will evolve, a common bench/bedside language will be indispensable. Our branches must re-form a central trunk.

Where do you see the Clinic and Lab colliding? And for the future, if we don't strengthen those connections, how will we survive?

Cheers,
Ben

Becoming Component Secretary as a New Professional

2011-02-28T22:17:00.001-05:00

Since my first Physical Therapy interview at New York University, being an active member in the American Physical Therapy Association has been an interest of mine. During the interview is when I first meet Dr. Marilyn Moffat. I was fortunate to have her as a source of knowledge and guidance during my graduate school experience and my continued develop as a new professional. As a student, I regularly attended district and Chapter meetings increasing my interest in the governance process. While I was a student, I was selected to be a student Delegate at New York’s Delegate Assembly which is a smaller version of the APTA House of Delegates (HOD). This allowed me to attain firsthand experience on how our Chapter makes decisions on important issues.

Our New York Chapter has made it easier for students to get involved at the district and Chapter levels. We recently started a new pilot program called the “Student Interns,” which allows one student from each PT school to attend a Chapter BOD meeting where they are paired with a district director to help mentor them.

My active involvement as a student served to increase my involvement as a New Professional (NP). After graduation, I was asked by my district to attend their Executive committee board meetings, where I got to see more of the deliberating processes. After a year, a vacancy in the position of Vice Chair at the Greater New York District of the NYPTA became available and I was elected to position of Vice Chair of our district. During the same time I submitted my name to our Leadership Committee where I got named to that committee. That same year I also was elected as a NY delegate to the HOD where I got to meet a lot of our influential Chapter delegates and gained more valuable experience.

Last summer our NY Chapter Secretary got elected as Vice President which left a vacancy at that position. Shortly after, I got a call from the NY Chapter President and he was acquiring about my interest in serving on the Executive Committee. With excitement I spoke to a few members of my District to get their insight about me serving as our Secretary. One member whom I valued their opinion informed me I was too young and did not have enough experience to do a good job at the Secretary position. They explained the normal progression was to serve as a district delegate or as a Committee Chair first to get a better understanding of the Board and its structure then persuade an Executive Committee (EC) position.

After a few lengthy discussions with the President and stating my concerns he ensured me I would do a great job and I was only filling the position for one year. With some hesitation and nervousness I accepted the position not fully understanding what it would entail considering I have never been to a BOD meeting let along serving on the Executive Committee. One of the reasons the president wanted me to become part of the EC was what I could bring to Chapter. Our current President wanted our Chapter to take a new direction and one way to reach this was to get younger members with a fresh perspective. One thing as a NP I can bring to the Chapter is a younger thought and new approach to help bring positive change to our Chapter. Our EC is open to everyone’s’ opinions which allows for discussion because at the end of the day we all want what is best for the Chapter.

Fortunately for me I knew that past Secretary and she continues to mentor me along with the other EC members. This past year has been a little nerve racking yet continues to thrill me as time progress and I gain enough confidence and knowledge. So much so I am running for reelection for the position of Secretary this upcoming April.

Looking back on this past year, I have been very fortunate to have accomplished so much professionally already and hope I can continue to mentor other NPs. I think being involved with a big Chapter like NY offers many advantages because of our size as well as the many opportunities for leadership and involvement. My advice to other NPs would be try to get involved at much as they can commit to; first starting at the district level, then at the Chapter level, and finally at the National level. I was fortunately to bypass the normal progression and go straight to the EC. I am only thankful for the opportunities I have been given so far. As NPs we are the future of the profession and it’s up to us to make the difference.

Jeremy Crow, DPT, SCS, NYPTA Secretary, NY Delegate to APTA House of Delegates

4,000 to 1

2011-02-20T12:38:00.000-05:00

A little over a week ago I had the chance to speak to a group of PT and PTA students in New Orleans. The Student Assembly leaders held a caucus to give their members a better understanding of involvement, governance, and engagement within APTA. During my talk I brought up the fact that there are about 4,000 Americans for every APTA member. I wanted to make the point that our profession's mission, enhancing societal health and function, requires their generation to be impassioned, involved, and willing to acquire new skill sets.

I single out the up and coming generation for a number of specific reasons. Needless to say, no PT or PTA, regardless of talent as a clinician, is prepared to directly influence thousands of consumers. And yet, that is our goal, an excellent and appropriate goal given our skills and ambition in the emerging health paradigm!

So strategically, how can physical therapy move to meet this challenge head on? Looking back to the ratio, we certainly can't expect the number of Americans to decline (nor would we want it to). However, influencing the right side of the ratio, APTA membership, presents an opportunity to shift things in the profession's favor. Clearly, I'm a big proponent for APTA involvement but it's not out of blind zeal. Upon leaving the bubble of academia, it is essential that PTs and PTAs maintain some line of communication with the professional world. Otherwise, as we do not sit for re-licensure, it's easy to become removed from all but the most local issues. If today's students don't feel a visceral connection between our mission and staying involved, complacency, disinterest, apathy, and a shrinking vision are on the horizon. But with a proper foundation and greater investment in leadership development pathways, this risk can be minimized.

Getting back to our societal goals, soon-to-be clinicians and those with several more decades to practice can and should cultivate some special talents. Community outreach must become a focus! Many of us are comfortable with social media and technology. This is a great place to jump off. How can we hook up groups of clinicians with teams of people seeking improved health? (This speaks to Carpe Sanitas and the "Team Wellness" concept that I should probably devote a whole blog to at some point.) And by extension, how do we pick out the smallest, most effective group of clinicians to assist a given team demographic? Who else will be in the group? Exercise Physiologists? ATCs? Dietitians? Nurses? Chiropractors?

PTs can create a program but for it be consumer-centered we must continue to earn our seat at the table. That will mean disrupting our standard practices, collaborating in new ways, and trying new things. If we don't disrupt ourselves, someone else surely will. (For a great read on this theme try The Innovator's Prescription.) What are your ideas for shaking up the status quo or for getting the benefits of PT to a big audience? I would love to hear them.

Cheers,
Ben

A generation with challenges, vision, and Debt

2011-02-07T18:54:00.000-05:00

{This post also appears on the Evidence in Motion Blog. If you don't already know about these guys, check them out!}

We are inundated with speculation about what Health Care Reform (HCR) may bring. Though the outcome remains uncertain, having practiced less than five years, the long term consequences of HCR will have a profound impact on my career. Our profession will undoubtedly change as health care evolves. In order to be prepared for what things may come, each new generation of PTs and PTAs must be more conscientious and more prepared to take action than the last. As stated in EIM’s mission, we must elevate the profession if we want to meet new challenges. This leads me to reflect on my own generation’s readiness to step up to the plate. Are there unique qualities that work for or against our preparedness?

It’s reasonable to say that I was part of the first big wave of DPT graduates. When I started looking at PT programs in 2002, it was far enough after the Balanced Budget Act to be optimistic and close enough after the adoption of Vision 2020 to have big dreams. Physical Therapy was and remains a hot career. I do remember hearing that reimbursement was better before 1998 but I never experienced that reality. I only knew that things were changing and, like many of my peers, I wanted to have a front row seat for the new paradigm.

For me, that meant pursuing the only doctoral degree then available in my state. I set my sights on Emory University and have never regretted the course that landed me there for three years. What has given me pause, however, is the wide variability in financial burden I learned about amongst my peers. Leon Johnson Jr., the excellent and frequent speaker on student finances for APTA, once mentioned that, given our starting salaries, PT students should avoid accumulating debt greater than $40,000. This was not welcomed news.

Flash forward, my peers and I live with student loan debt ranging from minimal to six-figures and payment for our services is hardly in a golden age. More payment changes are on the horizon. Surely this impacts our preparedness to be involved in professional endeavors. Are we too busy focusing on repayment to see the importance of advocacy? Is there apathy? Or are we more prepared but less inclined to take action? Each of these is likely in play within the ever growing new PT workforce.

Debt may constrain us, but certain things work in our favor as well. Most importantly, we came into a profession with vision. The adoption of Vision 2020 was an incredibly important step in our evolution. For my generation, it framed our academic pursuits and our relationships with consumers. So even as average debt burden went up, professional aspirations did too. Combined with our technological savvy, we seek to address professional challenges in new ways. Move It, HoboHealth, NewProfessionalPT, and PTHaven are just a few examples of young PTs and PTAs using technology to bring together our peers. The next step is to successfully integrate these networks and harness them for professional advocacy.

Our profession needs a place for new members to go to discuss experiences and opportunities. Investing in these emerging social networks has the potential to significantly influence the next decade of PT and PTA graduates. As Health Care Reform begins to roll out, this is the first great challenge for my generation. How can we expand social networks like Move It while benefiting from established, progressive voices like EIM? What ideas do EIM readers have to share with New Professionals and how can we best collaborate?

Cheers,

Ben

Professional Involvement is this month’s theme on Move It. Please check us out on the blog and follow us via twitter.

Professional Leadership, my friendly wake-up call from the APTA

2011-02-07T01:15:00.005-05:00

I recently had the opportunity to attend a leadership development program run by the APTA staff at my Chapter office. At first I thought . . . ugh, I have better things to do on a Saturday morning . . . but it turned out to be one of those events that gave me a wake up call to improve something that wasn't even on my radar. It was a great reminder of the work it takes to be a leader, as well as the work it takes to be led. At the time of my last APTA leadership event, I defined myself as a "green/gold" leader and communicator, and I still thought of myself this way. Does anyone else define themselves as a color (or two)?

For people not familiar with the color code, a very rough description is as follows: (1) Orange: Action-oriented, fast-acting, and flexible; (2) Blue: Expressive, group-oriented, encouraging; (3) Green: Visionary, analytical, high expectations; (4) Gold: Thorough, organized, structured

As time has progressed, so has the leadership message from the APTA. The speaker had 2 messages that hit home that I thought would be good to share/discuss with this group of other young leaders.

First, the speaker presented the results of retrospective qualitative analysis of strong leaders. She described a book (forgive me because I can’t remember the name) that summarized the qualities shared by prominent, successful leaders. They boiled down to: (1) Challenge the Process; (2) Inspire a Shared Vision; (3) Enable Others to Act; (4) Model the Way; (5) Encourage the Heart.

We rated ourselves on these 5 characteristics, but didn’t just pick 1 or 2. This new rating method helped me to see my leadership communication style along a multidimensional spectrum, instead of an absolute. Maybe “encouraging the heart” is still not my strongest area (I think this would fall on the blue spectrum), but it is not absent from my leadership repertoire. Thinking about leadership in this more dynamic way helped me to think about how to progress my leadership skills and to think about what avenues of involvement fit my strengths.

The second new message was about how to utilize volunteers. This topic is important in recruitment of new active members, as well as making sure that current volunteers (including myself) don’t become burned out. The speaker pointed out that each of our volunteers will have different skills, leadership abilities, and interests. Sometimes we assign volunteer tasks to others (or ourselves) based on the one characteristic we know. For example, one could assume that a private practice manager/owner may be a great treasurer. However, maybe that volunteer would be happier with a position that allowed them to take a break from business-oriented tasks. Avoiding our own burn-out, and the burn out of our volunteers will lead to a much more productive professional community.

These 2 new messages gave me a better perspective on my own active involvement and how to grow. Does anyone else have any tidbits of wisdom from your own leadership experiences, a book you read, or different leadership development event?

Miriam

Residency Pros and Woes for the Soon to be New Grad…

2011-01-26T08:54:00.003-05:00

I have to admit that when Ben asked me to participate in posting on the Move It blog website, I was flattered and a little (ok a lot) intimidated. I spent a lot of time reading other posts, found them fascinating and then thought… “What in the world am I going to say before I’ve even entered the :Real World:?” (I am a 3^rd year PT student preparing to graduate in May.) But, alas, true to my extroverted personality, I realized I have a LOT to say, and even more to ask. I am honored to be in the presence of these amazing new professionals, and it gives me a lot of encouragement and inspiration as I embark on my journey into the professional world coming up here in May. It is exciting to see all of the opportunities available to me as a new graduate, between residency programs, research fellowships, and multitude of settings and specialties.

Again, however, that intimidating feeling returns. I have had many discussions with classmates of mine about our near (much nearer than we believe) future in this profession. We have spent 3 years of blood, sweat, and tears (well at least some tears for sure) pouring our brains and hearts into this profession we feel passionately about. Now our caffeine riddled, sleep deprived bodies face the reality: How do we put all of this information we’ve learned to its best use for our professional lives?Many students, including myself, are concerned with being “stuck” in an area of PT once they start out in it. What if we (Gasp!) don’t know if that’s definitely the track we want to be on for our entire professional career? While the opportunity for specializing in areas (NCS, OCS, WCS, etc) offer amazing enhancements to the profession, it also adds some pressure to decision making process. Should I specialize right away? If I do, what if I want to change career paths? If I don’t, am I not advancing my career the way I should? Many of the same questions arise regarding residency programs. Several friends of mine are pursuing residencies because of the unique and beneficial opportunities they present.

I myself am/was considering doing a Neurology residency. It would provide me with a wide knowledge base in advanced skills that would not have had the opportunity to master in PT school. I would be exposed to a variety of patients with many different neurologic diagnoses, and it is also attractive to think of being able to sit for my NCS after one year and seemingly “fast track” my career. However, some more practical notions come into my considerations that make me hesitant. This particular residency I am considering, for example, does not start until January. I graduate in May. Though I would be perfectly fine (and happy) to wait until July to begin working, I cannot wait until January secondary to financial pressures (student loans anyone?) and the desire to put my degree into practice! It has been offered as a suggestion to work prn somewhere, but I fear my own personal anxiety of not having a very stable work schedule/ income would make that 6 months quite tumultuous. In an ideal world, I would love to find a place where I could work full time, gain neuro experience, practice my skills, do the residency, and come back to my position. (I know, I’m a dreamer J ). Then there is the question of value for the profession. Residencies are fairly new to Physical Therapy, and have already been met with skepticism, not just from students, but from seasoned therapists. I have listened in on, and endured many “What’s the point?” conversations and have not myself had a very good answer to provide. Any thoughts and feedback (HELP!) would be very much appreciated for this soon to be new graduate DPT.

Pushing Practice

2011-01-09T17:11:00.003-05:00

I've always been a little indecisive. When I was a kid and someone would ask me what my favorite color was I would say "All of them. No, wait, purple. No, shiny metallic blue. No, no purple with shiny sparkles! Final answer." Well, I guess I haven't changed much in the past 26 years, because it has dawned on me that this is the exact quality that is beginning to shape me as a physical therapist. And, I'm realizing that isn't such a bad thing. Throughout school I loved EVERY topic we covered... even the practice areas I never thought I'd be interested in. I always had trouble choosing sections to be a member of, courses to attend at conferences, and don't even get me started on considering a residency after graduation!

As we went through school, I kept thinking that I'd figure it out before graduation. Well, it didn't happen. So, I decided to create my own little unique experience for my first year of work (now that I think about it, its kinda funny that I was an interdisciplinary major in undergrad... ha ha... I never quite realized how in line that was with my personality!) Anyways, for my first year of work I worked 4 days a week in an outpatient orthopedic private practice, where I was given the opportunity to take my interests and run with them. Little did my boss know what he was getting himself into! The calm quiet orthopedic clinic in a very affluent Atlanta suburb was suddenly filled with dizzy people, kids scooting around on the scooter board that had only ever been used for the occasional balance exercise, Spanish being spoken across the gym, and the occasional screaming baby who just wasn't in the mood for therapy that day (in the newly converted baby treatment room in the back of the clinic.) Outside of my 4 days a week at the outpatient clinic, I worked PRN 1 day a week (theoretically just one day...) at a pediatric acute care hospital, where I got to cover ever floor from ortho to neuro to trauma to oncology to cardiac and even some wound care. I managed to weasel my way into just about every practice area I was interested in.

It was the hardest thing in the world for me when I decided to uproot my life and jobs that I loved to take a new opportunity recently that just kept clawing its way into my thoughts until I gave in. So, I put all of my stuff in storage, said a teary "see ya in a year!" to my wonderful friends in Atlanta, and headed out to Vegas to live the life of a showgirl!!! Well, sort of. I took a job as a physical therapist on a traveling Broadway show.... And we are currently in Vegas for a few months. I work nights, eat in the casino underground dining hall for employees every night, have crazy roommates (a pirate in the treasure island show, an acrobat in cirque du soliel, and a go go dancer!), and still don't believe that this is all actually happening. I've had alot of time to think out here... mostly cause I spend alot of time lying around resting my sore hands!!!! So, I've been reflecting on all the great experiences I've had already in my almost two years of practicing. I've started to realize that I may never fit clearly into a section or a clinical specialty or even any specific job that is out there.... and this has now started to create an idea in my head that keeps clawing its way into my thoughts! And we know how that goes! I know its a little ways off, but I now have this concept growing in my head of what I may want my own clinic to be someday. Somewhere that combines physical therapy, wellness, community, laughter, and life; a clinic I can make my own and push the normal practice patterns that are divided up for us in school.

I'd love to hear if any of you have ideas for pushing practice patterns, as well!!! I'm fascinated with this at the moment. Anyways, to conclude, I'm quite happy to say that once I set myself free of worrying about boundaries and of needing to decide in which area I belong, I am finding myself very much at peace with my identity as a physical therapist. And, also, quite happy that purple with shiny sparkles is still my favorite color. =)

Clinical Contemplation on Christmas

2010-12-25T13:53:00.000-05:00

Just killing some time between inpatient visits at the hospital on Christmas afternoon and I began envying my private practice friends who are laying comfortably at home, probably enjoying various broiled meats and season-appropriate nogs. The question popped into my head, "When did I stop caring about working exclusively in outpatient?"

The truths are, it doesn't bother me all that much that I'm in the clinic on Christmas Day, I recently realized that the PT in my head that previously thrived on athletic injuries has found joy in a variety of areas, and my vision of my long term career path may be less clear than ever.

My first job out of school was with a private practice, my bread and butter. I never really assessed whether I would be happy in other practice areas. Private practice was what I always envisioned doing, and ultimately someday, I would work for my own private practice. Then, I started as a traveling PT. Originally I took all outpatient assignments but somewhere along the way I fell into assignments in other settings. Now, I haven't had an exclusively outpatient assignment in over 2 years. Somewhere in those two years I learned a lot about myself, here's a list of things I never expected:

-I like home care. Not necessarily the clinical side of it, but I like the lifestyle, the freedom, and being outdoors during the day.
-Prosthetic training is cool. Many of those people are highly motivated and won't reach their fullest potential without intensive physical therapy.
-Urgent Care is a life-changing experience. You will see stuff happen in an ER that you won't see anywhere else on earth.
-Inpatient has taught me a lot about every aspect of surgery, even if I don't do acute care long term, I've learned a lot from it.

I don't have a conclusion. Maybe I have attention deficit issues and what I really like isn't any one thing, but a constant variety. But, through trying different things, I've broadened my own personal scope of practice. Some day I think I'll have to focus a little and put more effort into one portion of the PT spectrum, but for now I like seeing it all.

Time to head back to the floor. Maybe my patient will get to go home for Christmas night because of what I do this afternoon, that's pretty cool.

James

Congrats to 2 of our own

2010-12-19T09:47:00.002-05:00

Recently got a promo for this upcoming exciting course down at Emory U. Congrats to Nate and Ben for being speakers. Who better to discuss the future than two guys who will truly be paving the way along with some of the biggest names in the PT world. Wish I could make it down.

https://secure.www.alumniconnections.com/olc/pub/EMR/event/showEventForm.jsp?form_id=65281

Specializing

2010-12-15T16:09:00.004-05:00

Firstly, obvious congrats to Ben for the nomination and all things moving forward.

Now my question to all of you... why specialize?

I will be taking my OCS exam, Ben will be taking his NCS and I know a few of the other NP's have already taken one of the specialist exams.
As NP's is it too soon or just the right time to etch out a specialty?
The field that we are in is so broad and diverse it can create a jack of all trades and a master of none situation. For me it was a simple choice because ortho/sports is where my passions lie and are so interspersed (plan to do SCS at some point). I am taking it to force me to sharpen my knowledge base and hopefully serve to make me more marketable in an otherwise saturated NYC market.
I am very curious what all your experiences have been. Has it made you more marketable? Did it actually help sharpen your skill set or was it just an affirmation of what you already knew?
The SCS is the only way a PT can legally (to my knowledge, or also having your ATC) cover sporting events on the sideline, has anyone taken advantage of that? Do other specialties provide you with other 'benefits'?
What was your approach for studying (obviously very personalized question, but good info for us in this boat)?

I apologize for just asking a lot of questions but I feel like this is the right group to ask and hopefully this will stimulate some good convo...
GO!

Ambitious Changes for Move It

2010-12-12T22:08:00.000-05:00

Greetings NPs and all others! A new post is once again overdue and I apologize. I've been trying to get all of my ducks in a row for some changes to the blog. The reasons are threefold. One, I need to spend more time in the coming months a) preparing for the upcoming election and b) studying my butt off for the NCS exam. Two, my days as a New Professional are numbered and I need to find a mix of newer grads and experienced voices to carry the torch. And three, during the candidacy phase of the election cycle, it is important that Move It not come across as a campaign vehicle.

To that end, I have contacted a dynamic, diverse group of potential co-authors. Each of these individuals has the potential to contribute meaningfully in a vast number of ways. What I hope to see happen is an enriching of the online community for New Professionals. By expanding the scope of potential topics and by increasing the geographic range of word-of-mouth communication, more authors should lead to a better Move It.

Another change is the introduction of monthly themes. Though still under discussion regarding sequence and details, Practice, Training, Involvement, and Research will be the broad categories for the months of December through March. Posts on other subjects and events will very likely be woven in. But each month will have a theme and there will be weekly posts on some aspect or variation of that concept. For instance, Practice may include posts about Wound Care as an NP, Travelling, or how being an ATC or CSCS influences your clinical skills and decisions.

I would love to hear your feedback on this redesign. And I greatly look forward to seeing the concept behind Move It evolve and grow.

Cheers,
Ben

The Big News: New Professional slated for National Office

2010-12-03T18:38:00.000-05:00

... and incidentally, it's me.

With the announcement of the slate today, I can finally, officially divulge that I am a candidate for APTA's Nominating Committee. I've been trying to wrap my head around what that really means for the better part of two weeks. So far I've made it just past "Yippee!" or something to that effect that sounds a bit more appropriate coming for a 29 year-old. I'm thrilled for myself, intimidated and nervous too, yes. But most of all I'm excited at the prospect of an NP (New Professional) serving the Association in a significant role during a time of change and growth. If successful, I may get to set a precedent for how dedicated and progressive the NP crowd can be. While happy for me, I'm pumped for us!

I have lots of thoughts on what the process may hold. Recently I've come to see the NomCom's mission as bringing ideas (specifically people with ideas) and skills (specifically people with skills) to the table. Members of APTA then get to decide which combination will best suit the needs of our profession. It's an exciting, though a bit daunting, opportunity to help facilitate this process. Sink or swim, how I perform in the election cycle will have a bearing on the expectations for and the perceived readiness of the New Professionals as a whole. I'm looking forward to representing our demographic well. Please let me know what you think and please considering participating on Move It!

Cheers,
Ben

The Fountain of Youth

2010-11-24T22:17:00.001-05:00

Unfortunately, I have nothing new to report on the election front. Stay tuned! But I have been ruminating on a blog for quite some time. You lucky readers, you.

I was reminded of the idea tonight when suggesting a continuing education course about the impact an overweight population has on the practice of physical therapy. By this, I do not mean "bariatric physical therapy". Bariatric PT is a great specialty, or would be, if the APTA made it one. I could easily digress into why it should be a specialty alongside Prevention, Metabolic Regulation, and Community Centered PT, but that is not what's calling me tonight.

Tonight I just wanted to point out the fountain of youth. We've all seen it. It's the short one, the one next to the taller one that we all tend to drink from. So yes, I'm talking about water fountains. Stay with me here and feel free to point out wheelchair accessibility, biomechanical issues, and the vertically challenged, if you absolutely must. But the point I'm trying to make is that, when given a choice between an easy option and a minutely more difficult one, we tend to take the easier of the two.

I won't argue that you burn more calories by stooping for the lower water fountain. But I will say that a conscious, symbolic dedication to a more effortful why of doing things would help lessen our societal waistband. Am I wrong? It's not that people are lazy necessarily. I think it's the same poetic sensibility inherent to our brain's motor planning ability. We don't think about it. We just see, and take, the path of least resistance. A brilliant strategy for the serengeti, less so for a perpetual office safari. Perhaps there is a time to tell our clients, "Work harder not smarter!"

But exerting more effort will only get our society so far. Many people have dealt with weight related musculoskeletal issues so long, their anatomy no longer responds typically to stressors. And then they have their stroke, COPD diagnosed, diabetic event, heart attack, fall, car crash, or come to Jesus moment. That's where we come in. Except, wouldn't it be great to have prevented it all in the first place? To slap the proverbial Big Gulp out of their hand ages ago? To push for the short fountain while the short fountain was still an option? I think so. Where do you stand and where does your state measure up?

Cheers,
Ben

Why "Move It", why read it, and why now?

2010-11-15T18:46:00.003-05:00

So, one thing I think this blog suffers from is a lack of context. You would have to dig pretty far back to learn about its origin or to get a feel for the range of topics it has covered. As such, new readers may find it tricky to figure out what to read and where different topics may be found. To put it more and less succinctly, the better blogs get buried and while Memento was a good set up for a movie, reverse sequenced blog story lines are not very readable. Christopher Nolan I am not.

Who I am is a New Professional, or NP as I like to shorten it. Much of the time this blog has been a font for the random thoughts, experiences, and musings I've had at the beginning of my career. The title, Move It, is a play off of the new APTA slogan Move Forward and is meant to evoke a common PT phrase, "Move It or Lose It." But also, at the risk of being un-PC, it is a message directly to New Professionals, "Move your ass!" No one is going to do it for us. And if we don't move our profession forward, then quite certainly, we will lose it.

I'm one of a cohort of past student leaders that, upon leaving my role within APTA's Student Assembly, found myself in the vacuum of general membership. Luckily, the New Professional moniker had just been created and gradually more attention has been given to getting our demographic involved. Many times over, this fortuitous timing has benefited me greatly.

"But what is this blog about?" Despite being a self-affirmed APTA nerd and often blogging about experiences specific to that avenue of professional involvement, Move It has included universal themes for PTs and PTAs trying to find their calling. I've blogged about career indecision, visionary meetings of forward thinking, physical therapy steering and governance, and often times just my own perspective on where PTs and PTAs can and should be going.

I try to be pointed but fair about the problems that I and we face. Sometimes it's interesting... sometimes it's not. But I think it is important that there is a record of the types of things we go through. And more so, that NPs begin to form an empowered sense of self and direction within our profession. Move It is my idea of what might, in some small way, help kick start that process.

The most recent blogs are about my recent nomination for APTA office at the national level. I'm blogging about the process and, eventually, either the excitement or disappointment this amazing experience will afford. My number one goal, as a blogger and as potentially the youngest person ever slated(fingers crossed) for national office, is to inform and bring together new PTs and PTAs. Follow Move It or just wish me luck but spread the word and tell me what we can do to accomplish this goal.

Cheers and look for more additions and functions on the blog soon,

Ben

It doesn't take long

2010-11-13T19:12:00.002-05:00

It's so easy to get busy towards the end of a week and feel rushed before switching to "relax" mode. So I apologize to anyone offended by a less than spiffy blog last night. And tonight, unapologetically, I'm taking the night off to go see some great live music. Work-Life balance people, we could all probably use more of it!

A slightly better designed survey should now be up. Please take the time to fill one out! I was not happy with the formatting from the post last night and couldn't believe I missed that typo. Whether you saw it or not, thank you for visiting the site, reading a bit, and hopefully contributing!

Have a great Saturday night!

Cheers,

Ben

So much to do, so little time, and just as much certainty

2010-11-11T22:56:00.000-05:00

I found out today that in order to qualify for election, one must have been a "physical therapist member in good standing for at least five years immediately preceding their election or appointment..." Therefore, student physical therapist membership does not count. will have five years and one month of PT membership on the day of the election! How's that for a close call?!?
While relieved personally, it does bring to my attention, for the first time, the realization that New Professionals are explicitly prohibited from serving on the Nominating Committee, Board of Directors, or other high office. Seems a bit hypocritical from an organization perpetually at odds with "arbitrary limits" placed on us by the likes of CMS and others... This means pushing the New Professional envelope further will necessitate a bylaw amendment down the road. (Note to self)
So here I sit, formally, unequivocally able to be slated, with just nine or ten days before I'll know more and not bound by the rules and code of conduct for candidates. {I would post a link to that document but it's only accessible to Chapter and Component Delegates within APTA. odd.} Well, as the title of this post suggests, there are loads of things I would like to do before anyone can tell me "That's not allowed." Things I'd like to do while juggling a relatively new job and all the expectations and efficiencies expected therein. ... sleep when you're dead? ... meh. We can handle it. If we weren't good at juggling, we wouldn't have made it through school.

Here's what I think I should do. What else would you all suggest?
--Blog Daily on Move It
--Use the NP Facebook group for the evils of shameless self-promotion
--Post Blog link and thoughts to every other NP and PT blog I can think of (here's looking at you Bo)
--Invite other bloggers to comment on the process thus far
--Continue to contact past mentors of mine to solicit suggestions and feedback (3 of 3 are in support of an almost NP on the NomCom so far)

--Don't forget that the benefit to be had of the process, this pre-slate/might-not-ever-be-slated process, is in preparing other emerging leaders to improve upon my performance

Let's be honest, until a critical mass of nontraditionally thinking PTs & PTAs are calling the shots, be that at the House of Delegates level or within the Board of Directors, change will be gradual. I want to be one of the ones that helps to "plug the intersection" and let people through, to usher in new debate and renewed enthusiasm for big, blue sky thinking. To make even the slightest headway there is to succeed!

It's challenging for me to work in all the concepts I would like. Each blog post, much like the multitude of trajectories our career paths might take, could evolve in many different ways. I want to pace myself with the next ten or so days and not grow weary of, or boring with, the blog. Additionally, I want to be realistic about the probability of my being slated. I want to structure my experience to inform the emerging generation of leaders. And as much as all of these, I want to be engaging to all of you and to hear your thoughts, challenges, and the strength of our collective voice!

Cheers for now,
Ben

Opportunities and Inquiry

2010-11-08T21:14:00.000-05:00

Well, the process is starting to make a bit more sense, if not the role I am to play. I now understand that a Nominating Committee 1 (NC1) form is mailed by a person or persons, group or groups to the Nominating Committee recommending an individual for a particular office. In my case, the National Assembly, leaders of the PTAs within the association, recommended me. This is interesting, and I really hope I am not committing any faux pas here by blogging about this, because at times I have voiced the opinion that PTAs might best be served by forming an independent, though allied, association. In conversation, this has not always been an endearing argument. My best guess is that they see advantages to having a "non-traditional thinker" on the Nominating Committee(NomCom). I would like to think that is true too.
(A quick aside on the appropriateness or inappropriateness, as the case may be, of blogging about behind the scenes happenings. I'm for it. And hopefully that will not come back to haunt me. I realize that, at times, I toe the line between what should and should not appear on a publicly accessible forum. I always try to let professionalism and learning be my guide. If I cross the line and get burned, at least others will know where the line is. Wish me luck or recommend a good wound specialist.)
Right so, the NC1 form is received by the NomCom and an NC2 form is mailed to the individual. This second form ascertains "Consent to Serve" for the suggested position and all other nationally elected positions. Once returned, the NC2 form and support statements submitted with the NC1 form guides the NomCom as a whole to determine a slate of candidates for all positions to be elected in a given cycle. Of note, the NomCom is not under any obligation to slate you, at all or for the position to which you were directly nominated. Now, I haven't gotten that far yet but, once the NomCom has determined if/where to slate you, you must again consent to serve in that capacity. (I might have to come back and correct that though.)

For me, the whole process raises some interesting questions. In what national position would an NP best serve? We could bring new energy, new ideas, and willingness to be bold to the NomCom. But perhaps the national scope and "contact list" isn't there yet. If it's not, is that a strength or a weakness? NomCom is a committee and each membership benefits from the collaborative effort of the whole. That sounds good for an NP. Would the same thing not also be true of the Board of Directors though? What unique benefit would be instilled in a Board that included an NP? What would be the detriment?

These are all things on my mind and I would love to hear your thoughts! But for now, cheers and have a nice evening. More to come as the process continues...

ben

POPTS/RFP

2010-11-08T14:52:00.006-05:00

Thank you Ben for keeping up with this and encouraging participation.

I wanted to touch on a subject that I think lies at the heart of the future of healthcare that possibly we as New Pro's can affect.

In NY there are a lot of mills. Many "PT clinics" that partake in poor ethics with a focus on profit. I know of clinics that pay patients to come in and then submit claims making money this way. The "treatments" (if they are even performed) tend to consist of heat, ice and maybe even massage. Bottom line is these patients are not going to get better. They drain the healthcare resources (money and possible quality clinicians) and patients who have actual pathology will deal with a condition that does not improve correctly because they most likely do not know any better. Long term these patients drain further resources when they need total joint replacements or spine surgeries, etc. It is a vicious cycle with the owners of these clinics having the last laugh. Sometimes they get caught, but is there more we can do?

At the recent National Student Conclave task panel on transitioning from Student to New Pro, where 20% of the GOXV was on the panel, Allen Eshmoili warned the students to avoid the tempting paycheck that may be offered with working in a mill. We certainly need to try to stop it at the source because they cannot run these clinics without a licensed PT. Furthermore, with the idea of branding our profession this is all a step backwards and the image we have to fight to get quality PT to the forefront.

In my experience reporting these clinics does very little becausehttp://www.blogger.com/img/blank.gif a large investigation has to be undertaken. It seems there is some monitorinhttp://www.blogger.com/img/blank.gifg of these clinics and it does take years before they are brought down. Here is an article from my state on how to report misconduct, your respective states likely has a similar process.

Also, be sure to check out the APTA's RFP center.

So I would like to hear what you all think CAN be done and if you have had experiences with these types of clinics.
--
Stay Healthy (personally and professionally :)

It's funny sometimes the way energy cycles around...

2010-11-06T10:22:00.001-04:00

Hi Peeps,

Once again there was a longer pause between posts than I would like. Does anyone else find that having a smart phone pushes your visits to an actual, real computer further and further apart? That's been my observation and I definitely think it impacts the blog. Convenience can be a double edged sword at times.

I have some really big news but first the happy news to share is that I was re-elected GA Delegate. I was one of three NPs to be elected, the third being an alternate. Hurray NPs!!! Nearly inconceivable is the fact that by the time the 2011 House rolls around I will no longer be a New Professional. Five years go by quickly when you're trying to take over the world. And to be honest, I've had the thought on more than one occasion recently that I did not play my cards very well in those years. I guess it's human to second guess the course of one's actions. But with the dual disappointments of thinking I had a shot at PTAG President and later thinking that I would be asked to serve as Georgia's Chief Delegate, perhaps the youngest PT in either role, my APTA energy was pretty low. It's not that I begrudge anyone their reasons for withdrawing their support or changing their plan. I choose the word 'disappointed', well, pointedly.

Through a combination of my own experiences, both good (the Physical Therapy and Society Summit, presenting at a CDC symposium on Heart Disease and Stroke Prevention, and being at the House of Delegates with "junior" Chief responsibilities) and bad (discovering my own ineptitude in the Georgia Membership Secretary role, struggling with acceptance of the idea of a Preventative Health specialty at the APTA and University level, and crashing and burning on a post-PASS website initiative), I had begun to question how truly ready our organization was to bring my generation of young leaders out onto the stage. Which is why a recent email caught me completely off guard...

Someone has nominated me for the APTA Nominating Committee. That's a huge honor. I'm not sure where the process will go. I imagine it would take a seriously progressive Nom Com to allow me to be slated. Back when I was a new NP, my plan was to have a certain other NP run for APTA Board of Directors in his first five years. Unfortunately, he went and messed it up by becoming staff. Punk. I never saw myself as the one to try to break through that barrier. I'll have to let everyone know what develops. My thought is, "Why not have a run at it?". If nothing else, what better way to learn about the process and test my 'true readiness' theory, right? I'll definitely be looking for feedback and support from all of you. Let's see if a New Professional can shake up the election process!

Be excellent to each other and cheers,

Ben

Rekindling

2010-10-15T08:52:00.000-04:00

To say the least, I've skipped a chapter or two of my 'new job' story. Things are going well and the environment offers a lot of opportunities that I didn't have previously. But as with all busy times, refocusing is a necessity and I've looked forward to turning my attentions back to this project. In the beginning, this blog was an opportunity to espouse my thoughts, spell out some arguments for or against issues facing healthcare and physical therapy, and especially, to give a voice to new professionals looking for their place within a changing health paradigm. I continue to wish my efforts to bring in other opinions had met with greater success. But, the blog continues and things of great interest are on the horizon.

I head later this morning to the Georgia Fall Physical Therapy conference. With programing and meetings today, I hope to make enough of an impression on members to be re-elected as a Georgia Delegate tomorrow. It's very exciting (and intimidating) to see the slate I'm running against. A CEO, a past PTAG president, two past vice-presidents, a nationally experienced PT advocate, an out of state past-delegate, and 3 recently graduated, enthusiastic rock stars. I suppose it becomes a conceit of being a "not so new" New Professional, new faces are good for 'us' but perhaps not for 'me'... It is going to be a tough re-election. It's great to know PTAG has so many great people pursuing the role though. Without a doubt, the association will be in good hands next year. But now I suppose I should go clean myself up a bit and polish my networking skills!

More blogging to come soon! Of particular interest, Emory is putting together an event in March which sets out to shape the future of practice. It will synergize themes from the Physical Therapy and Society Summit and the Vitalizing Practice through Research Conference in a progressive, focused environment. I have the good fortune of being a panelist for the event and will have much to report!

Cheers,

Ben

Accelerando and Decrescendo

2010-06-18T15:32:00.000-04:00

As I type from a coffee shop next to the Berklee School of Music, I can't help but inflict a musical theme or two. So for the non-music buffs, that's an increase in tempo with a decrease in volume. I think it's an apt description of the end of the House. Things began to move very, very quickly but then many of the "hot topic" motions were withdrawn prior to a vote. In fact, the House ended hours earlier than expected. Contrast that to last year when there was speed reading and a frenetic pace up to the last minute. But for now I'll move to the coda and share my thoughts.

While the House process always leaves behind some frustrations and lingering questions, there was at least one common theme that I found encouraging... mostly. There were two groups seeking to "find their voice". One was the PTAs as they continue to push for greater voting rights within the States. And the second was New Professionals. To me, "voice" was the central theme of essentially every bylaw amendment before the House. While it was more explicit in the PTA initiative, the 'block' of bylaws addressing APTA executive leadership related, both directly and rhetorically, to New Professionals.

If you weren't there, I'll spare you a description of the 150+ possible combinations of new rules the APTA almost had. I say almost, because none of them went to a vote and thus, nothing changed. Three different states brought forth initiatives to facilitate more rapid turnover of APTA leadership. Again, I'm oversimplifying to spare you the minutiae. Discussion went on but the entire issue (transcripts attached) was punted to the Governance Review Task Force, a group which probably didn't expect to take center stage in House activities this year. Best of luck to them as they try not to step on any toes now...

Good things that came from this year's House: APTA will be guiding us to better address the obesity epidemic. (Even if it's peds alone, we have to start somewhere.) APTA is more explicitly saying that torture is bad. (Despite it being inherent in our Code of Ethics, if our governing body wants it spelled out, so be it.) Extender language was discretely withdrawn. (I applaud the Private Practice folks for rousing a little rabble in the process.) And my personal favorite, the APTA is going to try to do a bit more of the "League Building" which I'm such a big fan of with other primary care provider organizations. (And I would like to politely take a little credit for that "other" being in there.)

Cheers to all!

Ben

ps~ Wish me luck being a mentor tonight at the Student Assembly mixer! And please, please, PLEASE, share with me what you all want this blog to be about!!! Coming soon: Passing the OCS, prepping for the NCS, Why lobbying is more effective if you're under 30, and a New Professional asking why we aren't on the APTA board yet! New Energy, new authors, and your topics!! (if you just email me them)

House Update

2010-06-15T10:34:00.000-04:00

For those that are Twitter savvy (though, I'm only pretending to be), I'll be giving updates with the hashtag #hod2010.

~ben

Thoughts from Day 2

2010-06-15T09:35:00.000-04:00

My biggest take away from today is that this year's House Motions justify the governance review process. What I mean by that is that we need to change the way we do business because we're doing the wrong business. It's not necessarily that I disagree with our process. I just think the resource allocation (human capital and financial) could be better allocated. For instance, this year there are a number of bylaw amendments being proposed because "It's a bylaws year." when in fact bylaws can be, albeit more difficulty, heard in any year with the right amount of support and prior warning. That may be a bit jargony but the point is that we're running on tradition over reason. I hope this theme won't persist. Instead of waiting to see what an appointed group recommends changing, we are debating, at great length, what changes should be made...

In other news though, a good group of New Professionals and current student leaders socialized, mentored, and networked over several tall, tasty pints at Pour House. Wish you all could have been there! More to come tomorrow.

Cheers and Good night,
Ben

Early thoughts on this year's House

2010-06-14T08:34:00.003-04:00

My biggest take away from today is that this year's House Motions justify the governance review process. What I mean by that is that we need to change the way we do business because we're doing the wrong business. It's not necessarily that I disagree with our process. I just think the resource allocation (human capital and financial) could be better allocated. For instance, this year there are a number of bylaw amendments being proposed because "It's a bylaws year." when in fact bylaws can be, albeit more difficulty, heard in any year with the right amount of support and prior warning. That may be a bit jargony but the point is that we're running on tradition over reason. I hope this theme won't persist. Instead.of waiting to see what an appointed group recommends changing, we are debating, at great length, what changes should be made...

In other news though, a good group of New Professionals and current student leaders socialized, mentored, and networked over several tall, tasty pints at Pour House. Wish you all could have been there! More to come tomorrow.

Cheers and Good night,
Ben

Boston, Boston

2010-06-13T08:07:00.001-04:00

Well, I'm unemployed and on my way to Boston. I suppose, actually, I have a job waiting for me next Monday, but it still feels like limbo. The blog has been down for I while, but I'm hoping for a nice little spike in activity for the House of Delegates(APTA's governing body).

There are a couple nice things on tap for New Professionals at this year's House. Among other things, Laura Doskocil and I are trying to pull together all of the NP delegates for a caucus. In the past, and this isn't a criticism, new delegates were primarily exposed to members of their own delegation, those sitting nearby, and perhaps a regional caucus. This will be the first time a group of us convenes based on the New Professional demographic. I am very curious to see how the opinions of this small group defer from those of the group at large, or if they do for that matter.

I am also going to try gprs tweetcast from the House. I've never done that before, so we'll see how it goes. The two big issues worth bringing up in advance are a) should PTAs have full voting rights in each state chapter? and b) how should APTA term limits change to improve participation in leadership? I've been accused of over simplifying the issues. But, sometimes I find that help in order to see how people develop support or opposition for the underlying concept. That, or I just over simplify...

Cheers and more to come (hopefully note from my phone in the airport), Ben

I have moved (well, at least vocally)

2010-05-12T23:25:00.000-04:00

Considering the name and intent of this blog, I apologize for there not being much online action of late. I'm glad to have the readership and participation that we have and I'm always hoping to build on it. Surely you guys come back hoping for someone else's rants than my own!

Right, so, on that note, I have officially resigned for my first time ever. Hopefully this goes some distance in explaining the last month of downtime for the blog. Loan debt being what it is, I couldn't really risk being let go to far ahead of schedule. I listened to a lot of advice about what is too much or too little notice and opted for 5 weeks. I "tenured my resignation" on Monday, provided a formal letter on Tuesday, and started telling coworkers today. I have only 21 more work days with my first professional employer. The following week will see PT nerdiness and shenanigans in Boston and then it's on to Job #2. I will be the float PT (full time) between teams that specializes in Brain Injury (Stroke and Traumatic).

I am definitely excited about that but I'll save my best case scenarios for another blog. A few thoughts on resigning. One, everyone tells you something different about "appropriate notice". Two, even if you don't intend to turn in "the letter" on the day you give verbal notice, it helps to have it written. Three, your employer will ask where you are going. Four, they will not like your answer (but will tell you what they wish you were doing instead). Five, at least one coworker will always claim they 'saw it coming.' And six, you will end up feeling like you should have told more people at once to avoid repetition and gossip.

What have you all notice about resigning? How much notice did you give? Any horror stories?

yours,
Ben

Money vs. minutes, the trade off for NPs

2010-04-14T22:12:00.000-04:00

What's more important: higher pay or reasonable hours?

Given that many of us have a crazy amount of loan debt, I'm curious where the scale tips. Certainly everyone is different, but what's the spread? I have a relatively low cost of living in Atlanta. I would be happy to work fewer hours for proportionally less money. But other people may be trying to eliminate their debt more quickly or may be placing a higher premium on having more time later in their careers. What's the ideal take home for an NP after paying bills and loans each month? 1k, 2k, 5k (in my dreams)... Okay, okay, too many questions. I would love to get some discussion going though!

Cheers, ben

Dealing with Different

2010-04-08T22:45:00.000-04:00

Some times you get the best case scenario and some times you get reality. Right now I have reality. But for a brief moment things were looking well above my expectations.

Within the last week I was offered a job at a higher salary than I expected, with the expectation that I mentor new professionals, and with a choice of which team to be on. And, not incidentally, I thought I stood a real chance of being the next President of the Physical Therapy Association of Georgia (and therefore the youngest component president in APTA history). And then there was reality...

I won't say my opportunities have disappeared but the framing has changed...

My follow up questions to the job offer (sign on bonus for starting early, more time off for professional endeavors, rate of time off accrual, etc.) all came back with negative answers. Then I met with my mentor, the one that at CSM suggested enthusiastically that I run for president. He was less than enthusiastic. He was equivocal. And perhaps he was so for good reason, but, Dah!

My confidence in my ability to win the election has faltered. My desire to try anyway has not.

Life and my plans for the next few years seem less rosy. Admittedly, some of that is just the letting of wind out of my sails. This situation makes me wonder how close other NPs have come to making big career changing decisions and then either gone for it, consequences be damned, or backed off and acquiesced quietly.

I think it's time for a change and I'm not prone to run for challenges. It would just be nice to feel that a) a company is willing to bend rules to bring me on board, and b) that I had a strong advocate in my corner for running for a milestone position for an NP to achieve.

More on that come. And certainly, a blog on my nonexistent negotiation skills will follow.

Cheers,
Ben

How quickly things can change

2010-04-06T21:48:00.000-04:00

Since returning from Belize, things have happened rapidly! To get to the crux of it, I have interviewed for a job and been offered a position. I am now having the "should I stay or should I go" theme play out with a very real set of consequences. I could leave my "comfy" 40 hour a week job which is... not 100% fulfilling. Or, I could take a salaried job that involves many more hours but also much more stimulation. (And they have better toys.) The initial offer was better than I expected salary-wise but there is little promise of adequate professional time for leadership activities outside of the facility... Salary is not my motivator. Time is.

So I asked a series of questions, and it's a good thing I did. Essentially every question I asked came back with a negative response. Literally, I had a written out best-case-scenario and not a single condition was met. That being said, the opportunity is so good that I'm not eager to jeopardize it with my shoddy negotiation skills. Although a blog on how not to negotiate could be highly entertaining, for everyone but me. ... ... nah, not worth it.

More to come on the negotiations and why I might need more professional time tomorrow night!

Cheers,

Ben

The cure for all New Professional ills... Belize

2010-03-23T22:18:00.000-04:00

Hello all,

As the title would suggest, the blog has hit a lull because I have been taking some much needed R&R, three nights to be specific. It would have been longer, if only NPs accumulated PTO a little faster or did not have to use it quickly on things like conferences, job interviews, and hangovers...

Joking aside, I do not want to turn this into a travel blog. That is what my nonproductive blog is for. But I will say that meeting people with incredibly different lifestyles, cultures, and perspectives can do wonders for your resolve and productivity. It turns out to be a funny contrast between making me want to run from responsibility (most notably to tropical destinations) and reminding me how passionate I am about my reasons for putting my nose to the grindstone. I cannot say that the appeal of 6 months or a year of travel did not hit me hard, but I really do see the importance of working for change within our profession and culture more clearly.

So if you want to read some travel ramblings, read from the link above. And if you're waiting for the next NP blog, keep waiting. It should happen soon and be about a concept on the horizon within the House of Delegate to promote NP involvement in APTA leadership on a non-voting level... I hope enumerate the reasons I believe this to be a horrible idea.

Cheers, or perhaps Kampai, Ben

A challenging situation and a dangerous subject matter

2010-03-11T20:36:00.000-05:00

I imagine some of the other NPs out there have more experience on this one than I do. I've been with the same employer for going on 4 years, ever since I graduated. So now I'm weighing my options and considering moving to a different company. How on earth do you discretely have conversations with your potential "next" employer when you're at work 8:30-5? I have a 30 minute lunch break, a student, and about zero privacy. Don't get me started on my utter lack of paid time off, in the event I actually make it to the interview stage. Does one call in sick? Schedule a day off without explanation? Lie? I have a knee-jerk, honesty response which could get me in trouble soon. Not to mention there are all sorts of inadvisable things about writing this type of blog in the first place.

I see the risks of putting this information out on the interwebs. I'm banking on the benefits outweighing those risks. But in fact, I'm happy to report it's getting a bit more treacherous! The Move It Blog is up to 75 visitors and counting. It's even getting some attention from APTA staff, and no, not just my ex-roommate ;o)

My philosophy is that we are in an age where there is no sense in not having a commonality of resources and shared experiences. I love being a PT, especially a neuro-PT! I take the opportunities before me for advancing my clinical expertise and trying to foster leadership cred, but that isn't always enough. As New Professionals, we have unique stressors. I would like to think that this blog will eventually give voice (and not just my own) to remedies for, or at least ways to handle, that kind of stress.

Something that would help me would be a periodically updated list of PT negotiation skills and advice for job hunting in a depressed economy. Any know any? ... Bueller?

Back to the resumé ~ ben

A Blog on Beginnings

2010-03-04T23:31:00.000-05:00

So, I believe a simultaneous advantage and disadvantage of being an NP is the concept of a fresh start. Perhaps it's a byproduct of being a "not burnt out" PT. We are in a field with huge opportunities. The strength of our position is that each new thought, each emerging initiative is an invitation to recreate our careers. For me, PT nerd that I am, that's an exciting idea. I think I may be coming to the realization, though, that that ability to change paths might also be a contributor to physical therapy burn out.

We have these opportunities, we're exposed to these new ideas and we either incorporate some parts, ignore it all, or, potentially, change everything... So on some level, our choices become a) become insular, b) become flippant, or c) add something to an ever-shrinking plate. oy!~

So because this blog, admittedly, has become self-centered, what are my beginnings? What is out there to to be ignored, incorporated, or added? Clearly, the supervisor position I've talked about in the past is not working out. (Hurray! for a door closed :o) To begin or not begin: Last night I hosted/moderated a panel discussion on 'what's wrong with rehab..." The title was obviously a bit different but the objective was clear: Talk about the problems-> discuss what should be done. The panelists, all at once stimulating, challenging, and intimidating, spoke clearly on 3 themes:

Theme 1) The way we validate what we do, does not validate what we do.
Theme 2) The lack of validation, however unintentional, is jeopardizing everything we stand for, e.g. improvements in health, clinical consistency, and, well, beneficence (the idea we are good--in fact better--than substitutes).
Theme 3) Advocacy is our shot at redemption. And I chose the word redemption carefully. We went wrong. As a profession, yes, but within a flawed industry, emphatically yes, we went wrong. To not protest is to consent by acquiescence. The fight was never downhill, or really even level, but the longer the status quo holds, the steeper our path to correcting the wrongs.

The beginning I now face, once again, is the question of how to address a demonstrated need for change. I would like to build a resource center for patients and professionals who are not satisfied with the status quo. I want to empower people to identify the flaws, articulate the arguments, and champion the cause of process improvement in health care/rehabilitation. How do we tackle the huge problems as New Professionals? I know it's wrong to wait on others to take action! It's just so hard to take a breath and make the leap when we have soooooo many possible roads to travel.

I would like to end with a fantastic quote from Mark Twain that I worked into the panel: "All large political doctrines are rich in difficult problems -- problems that are quite above the average citizen's reach. And that is not strange, since they are also above the reach of the ablest minds in the country; after all the fuss and all the talk, not one of those doctrines has been conclusively proven to be the right one and the best."

word. Ben

Catching up on catching up

2010-02-28T21:35:00.000-05:00

I would be remiss to let a full week go by after CSM without a follow up blog! The event itself was a whirlwind with lots of learning, networking, and a great deal of fun. True to NP form, we rush to prep for it, we cram in as much as humanly possible, and then we drag ourselves through the following week. Basically, in spite of that pesky fatigue business, it's as fast-paced, stimulating, and PT-geeky as a week can be. I had a blast. The following 5 work days, though, oye! Stress almost seems more intense until the next 'real' break. I needed to catch up on sleep and read a distracting book just to reset my brain. I'm afraid I don't have much else to contribute tonight. I am prepping for a panel discussion taking place on Wednesday. More on that after the event, "Is Our Dynamically Changing Health Care Environment Jeopardizing Successful Rehabilitation Outcomes?". Yours truly will be serving as moderator. Good times...

Cheers,
Ben

An expert profession versus a profession of experts

2010-02-20T17:57:00.000-05:00

One of the themes from the NCS prep course was that expert clinicians run towards difficult patients not away. Embracing challenge was touted as a sign of excellence. Over the next few days that theme jumped out in a number of other talks. Interestingly, some of the parallels were not actually linked to clinical skills. Specifically, I attended Incubating Innovation which was about coming up with new ways of solving problems, thinking laterally, and overcoming barriers. The thought occurred to me that in some ways we are our own barrier. Specialization in physical therapy is coming and it’s a wonderful thing! But the challenge we face as a profession is to specialize ‘smarter’ than the MDs.

This means two things to me:
1) We should strive to address emergent, growing health issues by “cutting them off at the pass” (i.e. obesity, diabetes, sedentary lifestyle).
And 2) We should focus our expertise around symptom complexes and the skills necessary to address a given constellation of impairments (i.e. bariatrics, metabolic syndrome, community-centered, activity-based wellness).

Our current system, through the APTA/ABPTS, is superb at imparting knowledge but is far from svelte. Where is our Prevention specialty? How about Obesity? Metabolic syndrome? These demographics are where we, as a profession, should be running! PTs should own obesity. We should champion prevention!

Perhaps I’m naïve. Perhaps the profession would go bankrupt because no one is paying us to move in that direction yet. But I am willing to bet that our market share, public image, and evolving skill set would be larger, better, and more relevant if we take ourselves there, instead of being led.

We are the movement experts. We should tackle the hardest, most prevalent movement disorders within our scope of practice. Here’s the exciting thing, everyone moves. And movement, framed as exercise or not, changes gene expression and brain structure. We have the capacity help these people change who they are, mentally and physically, for the better, just by doing what we love to do. Our depth of knowledge puts us in a position to have a significantly impact societal needs, if we rise to proactively meet the challenge.

Welcome to Move It

2010-02-19T18:49:00.000-05:00

Just wanted to thank everyone that has expressed interest in the blog here at CSM. I'm happy to have some more readers. And I am also looking forward to seeing how this initative evolves with more feedback and suggestions. While it has become an avenue for me to express personal ideas and stories, I really hope that this will be a step towards an established, collaborative community of New Professionals.

Cheers, Ben

ps~ Topics on the horizon include Technology and Vision 2020, Disrupting the Status Quo, what students should be learning from NPs, and what an NP organization would look like. Please add to the list or become a contributor to the blog yourself!

Intuition shmentuition

2010-02-18T03:39:00.000-05:00

I must say that I thoroughly enjoyed my first ever pre-conference course! While it admittedly had a lull here and there, so does my attention span on warm sunny days. I will, briefly, take issue with one assertion from the course. A differentiation was made between "Intuitive" vs "Systematic" decision making. I just want to say that I do not believe in intuitive decisions. (Please argue with me if you disagree.) I believe that all decisions that we make are systematic. We may not have the words, or perhaps the evidence, to support that decision, but in the end, a decision, any decision, is a hypothesis. It is a guess based on something. A gut feeling (the intuitive's cliche) is more than nothing. Perhaps our language has not yet evolved to explain the decision making process, but somewhere, on some level, data is being analyzed and a hypothesis is being tested. Our goal as a profession, for the good of our clients, is to make these hypotheses progressively more standardized. That standardization was the strength of the NCS prep course and I think has important implications for all aspect of practice!

Well, for someone 3 hours 'ahead' of East Coast time, this is the best I can do for one night. I hope anyone coming across Move It for the first time after CSM will find something relevant to themselves. Please comment, contribute, or, by all means, heckle.

Cheers,
Ben

Mid-air musings

2010-02-16T16:10:00.000-05:00

As I write this, I’m somewhere between here and there. On my way to San Diego and also trying to figuring out what it takes to be an expert clinician. The reason for my early departure from Atlanta is a preconference course, Neurologic Practice Essentials: Clinical Decision Making as a Foundation for Expert Practice. As a NP I've practiced in a Geriatric Hospital as an LTAC and outpatient PT and in an Acute Rehabilitation Hospital as a PT on the general rehab floor. The NCS seems like my best choice for advanced certification, should I go for it. It also, of course, matches my obsession with neuroplasticity (seriously, read that book).

So with the goal of adding 3 letters behind my name, and with a year and change left on the NP shot clock, I am rolling the dice on a career focus. While I’m a little behind some of my peers and while I won’t be able to sit for the exam until after I lose my New Professional status, it feels like the right move. The whole process seems like a huge undertaking both from a financial and from a time management standpoint. Nonetheless, getting certified seems like one of the best ways to maximize your clinical skills during the initial stages of our practice. I’m hoping to get a contributor or two to blog on their experience with the Board Certification process from an NP perspective in the near future (ahem, KATE).

I finished an article on the flight about characteristics of expert practice amongst role-model PTs. It makes me wonder what the parallels would be between those individuals and, for instance, NPs that pursue residencies and early (relatively speaking) board certification. Are we “future experts” with pre-existing, similar philosophies or does the philosophy develop concomitantly with the expertise? Maybe this course will let me know.

I’m curious what the makeup of the course will be. I hope to see some other NP faces in the crowd. This type of course really captures an aspect of the “Move It” mentality that I would like to develop within our cohort. One day I hope there will be a clear post-academic track for new professionals seeking involvement, opportunity, and excellence.

Cheers and much more to come as the week goes on!

Ben

CSM excitement and a nice idea from Bo

2010-02-15T08:36:00.000-05:00

Hello all,

For a little while this morning I am blogging instead of packing. I have about 10 hours before my flight to San Diego, good times!!! I just wanted to share an idea and a website with all of you. Change.org which I just learned about from Bo's blog has a very interesting initiative going on. Anyone can submit an idea for positive change within our society. The top 10 most popular ideas will then be presented in Washington to members of the Obama administration. You can go and read my suggestion or vote for it over on the right. Feel free to let me know what you think. And definitely make your own suggestions! This is the kind of participatory governance that democracy is founded on! Finally our technology is catching up to the scale of our population.

Cheers and much more to come in the next few days~ Ben

Sweet, sweet (frustrating) simplicity

2010-02-09T00:01:00.000-05:00

So, seemingly HR thought better of approving my qualifications. I received today what appeared to be the negative counterpart to their original communication. Rather than confirming that I met the minimum job requirements, this one disputed that prior assertion. No explanation, no personalization, just a recantation. Go figure. I will chalk it up to a second read through by a less open-minded reviewer. (That, or they are one of the dozen or so people to read my blog in the last few weeks.)

Well, It never hurts to take a long shot, well, maybe a little. :o) I'll be prepping for CSM in the next 7 days and hope to post some new hopes before my departure.

Cheers and let me know if anyone has had a similar experience!

Ben

The Waiting game and Valuating our time

2010-02-04T23:11:00.000-05:00

A friend of mine recently found out a coworker's salary is nearly 100% more than their own. Should we feel worth 50% less? Do we contribute 50% less, bring in half as much business? How far does salary.com go when we are asking questions like these? We all feel we have special traits that make us particularly marketable. We think we know where we should fall within that bell curve. But how do we decide how much to ask for our time? I think this is a frequent question for New Professionals and it's certainly not an easy one. Nor can we be sure that we all gravitate to the appropriately deserved income. Some of us are just better at haggling, negotiating, and schmoozing than others.

Here's what I think. As new professionals we are inherently undervalued. But my reasons for thinking this are a little nontraditional. I don't think we're doing the right jobs. Generally an NP's talent in patient care is developing but we have other immediately helpful, untapped skills. We are coming through a period where critical analysis, studying, and technological resource savvy are paramount. I think that those skills could often be put to use early in employment in meaningful ways across a variety of practice settings. What if we respected those skills enough to allow NPs some time to collaborate on and potentially initiate programmatic change? New grads could be seen as consultants and fresh eyes. To me, that's powerful.

The situation reminds me of politics. The status quo is such that by the time an individual is in a position to enact change, they are so thoroughly vested in the traditional way of working that the risks are too great to rock the boat. Clayton Christensen has talked a lot about this phenomenon as it relates to business and later health care. When someone else is committed to cyclic, ongoing innovation, those less willing to be disrupted always lose in the end.

I would like to think NPs could and should be that injection of creative thinking and of unbiased appraisal without predilection. But perhaps this whole blog is all shallowly subconscious supposition about my worthiness for the Rehab Supervisor position. Regardless, I think valuation of our time and expertise should extend beyond current clinical contributions and incorporate the capacity we have for disruptive innovation. I would like to see what more NPs rocking boats would do to our health care climate, PT and non-PT alike.

To finish, I would like to share an anecdote, courtesy of my mother, about our demographic's potential contribution to society if we were valued a little more highly. During a discussion about stimulus packages a few months ago, my mother made the clearly brilliant suggestion that forgiving graduate student loan debt would be an exceedingly effective way of boosting the economy. This is why my mother might have made a better Senator than Social Worker. She observed that people in their late twenties are usually in the process of accumulating 'stuff' and are often constrained in their purchases by lingering loan debt. I couldn't agree with her more. I, for one, would take many more trips across the country and purchase more goods and services if I weren't climbing out of a giant pit of Emory loans. I'll keep you posted if she decides to come out of retirement and run for office.

Cheers,
ben

New Hotness and furthered possibilities

2010-01-31T23:30:00.000-05:00

It has been a technophiliac week for this NP. I type this blog from my living room on a brand new Netbook I picked up today. I'm hoping that having something new, faster, and even more portable will increase the regularity of my blogs. That being said, it was not the only improvement, advancement, or discovery of the week.

I have added Google Analytics to my repertoire of things I possess pseudo-knowledge of. That's right. I now officially know the readership of this blog: approximately one viewer every 10 days.

I remain undeterred. If anything, at least I know now that it is highly unlikely any of my coworkers are reading. (The viewer was in Alaska... or crafty like a fox.)

On the subject of people around the office, and given the perceived unlikeliness of any cats escaping, I will happily announce that I have made it through the first phase of pursuing the level 4 position where I work. No, no, not the "Resume updating for the first time since my first job after grad school" phase (though that merits a blog in and of itself), nor the "Cover letter circulation amongst your brainiest friends" phase either, this was much bigger.

The job description indicated that a minimum of 5 years work experience with at least 2 in supervisory/management capacities were required. [Note: Depending on how you frame that, I could have neither.] Well, and here is a testament to what working with the Student Assembly will get you, I made it through! They stated in an email that I met the minimum requirements! At least now, if I do not get the position, it will be someone that has actually met me making the decision and not someone rejecting a paper likeness. I would not be applying for the position if I didn't think I could do the job. But, somehow the fear of rejection is worse for me when it is based exclusively on selectively documented qualification.

On some level I just feel awkward and uncomfortable putting achievements down on paper. Is anyone else in our group like that? And beyond being awkward, it is downright hard to decide: what goes where, what to keep in from college, what to leave out from social'ish endeavors, who's format to use, complete or incomplete sentences, punctuation, bullets, and on, and on, ad nauseum. I worried that my voice was not the one on the page by the time it was tweaked hither, tither, up, down, and sideways.

Well, I hope it was not not my voice that got me this far.

Cheers and wish me luck! I will try to flesh out a little more of my thought process on the decision to pursue the supervisor position over one of the other endeavors when I have a little more time. The tiny little keyboard is getting to me tonight ;o)

Ben

A Blog, a #2 pencil, and Musings from a barstool

2010-01-16T23:30:00.000-05:00

Or, my options runneth over...

As if, at last blogging, my choice were not convoluted and difficult enough, the plot has thickened. My supervisor has resigned effective mid-February. This creates two additional potential options: 1) vault, inconceivably, from level 2 PT to level 4 inpatient PT manager, or, more realistically, advocate for one of the level 3 PTs to get the level 4 spot for semi-self-interested reasons. Both options keep me "in the system", which I am presently, enthusiastically opposed to. But arguably, I'd be insane not to pursue the 4 position. At 28, from an outsider's perspective, to not show the initiative in applying/interviewing would be a bigger hit to my "in system" career than flat out leaving for a better opportunity.

Speaking of which... there are more.

But first, in a world of real problems, in which global attention is rightly centered on the decimation in Haiti, this blog must read as the trifles of a spoiled brat. When forced to step back and contextualize my "difficulties", life is gloriously good, idyllic in fact. My pitfall, I suspect shared by others feeling the need to Move It, is micro-focal worries. One day I will learn to make decisions in the macro-mindset... maybe when I grow up, that is.

But yes, on to more. A peer suggested business opportunities on the horizon in a technology related PT field. "Dynamic" and "Innovative" were also thrown about just to press all of my nerdy, over exuberant buttons. Add to that a friend of a friend heading up some part of the Health initiative at Google and my imagination is a whirl.
So what does this all mean to my largely inchoate plan? No going down to 32 hours! That's probably not a move they would look for in an aspiring manger... or could it be a brilliant piece of strategy. Promote me or lose me.!?... In another system perhaps that would/could be understood by the powers that be. Here I fear it would be missed. Unsurprisingly, I'll leave the hours drop on the table, surely no one would expect me to narrow my options, right?
An aside, I discovered today that I made less money in '09 than in '08. 'Huh?', you say? 'Huh?', I echo. Within a small company, in a slow economy, that's plausible. "In system", I feel duped. To reiterate, spoiled brat = me.
So where, in all of this, does decision theory come about? How do you compare disparate options on an ordinal scale? Therein lies a problem. New Professionals don't compare options, we compare hypothetical, parallel futures. If that's not treacherous, I'm not sure what is. Why are we better at weaving baskets than divvying up eggs? (Weaving, which I am clearly better at than coming up with analogies.)

While that seems a reasonable stopping point for a blog, I'll attempt to implement the Hemingway'ian method of 'stop while you are writing'. That seems counterintuitive in the age of blogs. We stop at a sound bite; we stop with a theme. Reward, not provocation, is the endpoint. Is that an evolution of prose or a byproduct of our shrinking attention spans? If I answer that question, do I perpetuate the cycle? In all fairness, I should concede that, also Hemingway'esque, I couldn't stop quite yet because I was not finished with my drink and didn't want to leave my spot at the bar.

Cheers,
Ben

Contemplation

2009-12-23T01:15:00.000-05:00

Hopefully I’m not the only NP that can’t fathom how 2 weeks can flash by so quickly. I can’t say that anything has changed dramatically since I resolved to more seriously pursue professional change. Concrete steps I have taken: Contacted a coworker about trading work schedules come February (switching down to 32 hours and working a Wednesday-Saturday rotation). I’ve also taken on a slightly greater leadership role at my current job by heading up a group that will try to integrate different educational initiatives within the building (i.e. Grand Rounds, Journal Club, Inservices, Evening CEU courses, ‘Travelling’ CEU courses, and a group I started last year to discuss practice innovations.)

Ideally, I would like to work less and study more in 2010. I love my clinical work but feel that my calling is in areas with a more macro focus. So to the end of working less, going down to 32 hours in February and leaving my employer in June seems to strike the nicest balance between responsibility and innovation. [Note to self: Tell no one at work about this blog.] The next 6 months would give me the opportunity to save more money, complete more projects at work, and prepare to begin down another path. June would mark 4 years of traditional clinical work before “branching out”. I just wish I new what that was going to look like! More to come on that later. Now for a beer and, hopefully, back to back wins at trivia night!

Cheers,
Ben

A modest agenda

2009-12-08T22:36:00.000-05:00

So, for no particular reason beyond having not much to do tonight, I'll continue my blog-athon with a list of options/opportunities/ideas worth developing in my life right now.

>Start my own LLC: Disruptive Physical Therapy (DPT, get it, ehn? ehn?)
>Develop newPTs.com: follow up on PASS with a cross-discipline collaboration builder
>Work on a blog/online presence for NPs: promote the 'Move It' brand (if you can label it as such)
>Develop an app for new professional collaboration and consensus building
>Quit working and get an MPH
>Quit working and get an MBA
{Continue working and do either of the above}
>Enroll in next year's MIT New Media masters class (starting 2011)
>Develop an open source component for John Moore's project at MIT's New Media lab (technology enabled remote rehab program compliance monitoring)
>Promote the development of Fellowships in Prevention (within Ortho/Cardiopulm)
>Pursue a nationwide practice analysis (part of a PhD?) to form a Prevention specialty

Do none of these things, live like a hermit until my loans are gone (2012 if I commit to serfdom), and then start innovating...

My favorite way to look at this list is as a 'surplus' of opportunities. How could I do all of these if they weren't partially combined or integrated? Could starting DPT, LLC enable me to pursue an MPH or even MPH-MBA while building newPTs.com? Or would that be overloading myself by taking on too much? I'd like to think not, but need to be rational.

My loans are at low interest rates (sub 5% fortunately enough). How much of my saving would a start up company take? Could I expect any return on invest? If so, how soon?

Enough for one night. More musing to come. ~ben

Pizza and cogitation

2009-12-08T19:26:00.000-05:00

As I sit in a pizza shop trying to organize my thoughts, I'm not quite sure where to begin. This blog may ramble on. It's been a crazy 5 months and I'm trying, as I imagine many New Professionals are, to appreciate what I've accomplished in my time since PT school as well as to assess what I can still do with my remaining year and half of 'newbie' status.

Many salient quotes come to mind:

"What we have to remember is that we are really, very young. We have time to recreate ourselves as professionals many times over at this point." ~James Spencer

"You have 30 days to make this website happen." ~Steve Wolf, regarding a project I proposed in February [note: it hasn't happened yet]

"I'm pushing really hard to get approval for another Level 3 position to open up. If it does, I think you should be one of several people to interview for it. [read: You want a carrot? Who's a good boy? Carrot? Carrot? Roll over. Roll over.]" ~my boss

"Systems are rarely disrupted from within the silo. Generally, innovation happens at the intersections of multiple disciplines by upstarts with novel ideas." ~paraphrased from Clayton Christensen in pretty much everything he's ever written about Disruptive Innovation

I guess a part of what I'm struggling with here is the desire to step out of the mainstream. The fear, of course, is getting swept in the wrong direction or being a failure. Escalators aside, it's not in my nature to be a risk taker, so getting swept away looms large in my list of activities to avoid. There is a point in life, however, when I think someone has to decide to risk sinking, abysmally, or 'stay in line' in perpetuity.
For most New Professionals it's just not in the cards to take significant risks. This problem will only get worse as PT school continues to become more expensive and as available health care reimbursement dollars decline. While it makes leaving the mainstream more difficult, this may be the best thing that's ever happened for Physical Therapy. Back in February, I listed as an 'inspirational thought' the idea that payment is a "shrinking pie" (fewer available dollars, smaller pieces to go around, etcetera). I ask, what could be better for an evidence-based, articulate group of Professionals than a resource war?
But I digress, this Blog is about..., ..., knowing when to change directions in your first 5 years. In keeping with my quote theme, it's immediately apparent that I'm not meting Ghandi's call to "Be the change you want to see in the world." (Darn Indian philosophers and their tall orders!) We are on the receiving end of so much information and subject to so many masters, decision making can be very difficult. Stepping back to survey the situation, and, even more intimidating, stepping out on our own is daunting.
I hope that my next few blogs will reflect the thought process of one new professional trying to do just that. Come what may, I plan to document the thoughts, discussions, negotiations, and possibly a resignation that follow. I hope you guys will read along!

~ben

Books read and blogs to come

2009-12-04T11:34:00.000-05:00

Hello all,

I've just finished a really interesting book on Health care "The Innovator's Prescription". I highly recommend it. I have note cards full of potential blogs! (Exciting for me anyway) I want to finish my other book, which I've been reading in parallel, "Predictably Irrational" by a behavioral economist, before I write the blogs. Some really interesting perspectives between and across these books. I look forward to getting some ideas out there and hopefully firing Move It back up.

Ciao for now ~ben

2009-06-28T19:23:00.000-04:00

Carpe Sanitas

2009-05-08T00:08:00.000-04:00

Seize Health.

At the risk of this blog becoming just a font of my own personal diatribes, here's another one. But first let me just say that having a new professional forum is a great opportunity to discuss and critique our perceptions of the field. I hope people come to post their own thoughts and opinions, or at least occasionally heckle the bejesus out of mine.

Sorry to beat a dead (language) cliche but now for Carpe Sanitas or Seize Health!

If life and happiness, both intrinsically health-related, are unalienable rights, I would like to see a little more "pursuit" in the methods of the American health care consumer.

That's why I'm here to deliver an invective on why the concept of "health care delivery" is utterly deplorable. It seems to imply that if you just wait long enough, health care will come to you. Just wait right there on the couch... "It's not delivery. It's diabetes."

And to be honest, the way our system is currently arranged, that's not far from the truth. Wait. And it comes. Help arrives in the form of an ambulance on the fast track to reactionary, emergency care. The problem is long established before any 'care' is given.

It's kind of like using a smoke alarm instead of an oven timer. Then as a society we bemoan how many burnt meals we've been having lately, how the price of smoke alarm batteries is skyrocketing, and how the alarms seem to malfunction more than they once did. (Let's not even mention the cost of providing smoke alarms to the uninsured. They don't even have a wall to hang it on.)

Physical Therapists have great potential to draw public attention to timers over alarms. Not only can we clearly explain how fast the clock is ticking and why, but often we can actually add time to the countdown.

Which brings me back to the latin, I am enthusiastic about the phrase "Carpe Sanitas" for 2 reasons. Number one, the 'seize health' message is relevant and timely as explained above. And number two, Sanitas could also be perceived or interpreted as "sanity". Frankly that's a useful double entendre. On the one hand you have the logical 'Seize Health' and on the other you have the more imploring 'Seize Sanity'.

The sane approach is the pursuit paradigm. Reactionary health care is bloated and unsustainable. It's begun to set off alarms and warnings of its own. Realizing this, PTs can and should pursue an aggressive oven timer agenda!

That's enough for one night from me. But anyone have thoughts on how to structure our agenda? Speak now or forever be subjected to more late night blogs from Ben.

to be continued...

ben

Gonig Green or Going Healthy

2009-04-26T21:46:00.000-04:00

The House of Delegates (Physical Therapy's highest governing body) has two pieces of legislation coming forward this year about environmental issues. While good initiatives at heart, I believe they both miss the mark by not aiming higher. The environment, be it built or natural, is inextricably linked to health and mobility. As physical therapy is directly concerned with these two issues, PTs and PTAs must form a comprehensive, progressive stance on environmental health.

I will be the first to admit that by most standards, I'm as 'crunchy' as they come. I dragged friends and family to An Inconvenient Truth and I ride a bicycle to work. But when it comes to American Physical Therapy Association (APTA) policy, the language should not be about climate change. Our focus would best be placed on asthma not ozone, and on obesity over emissions. Our profession has unlimited potential to impact health not climate. Therefore I hope to see the APTA develop a detailed position that puts us in the leadership role among health care providers advocating for healthy environments for the sake of supporting health. To me, this means the APTA has a vested interest in everything from air quality to sidewalk quality.

In general I would say that New Professionals are aware of this issue more so than the general public. However, I believe that we have an ethical obligation and huge opportunity to rally behind this cause. It will undoubtably push us further along the path towards becoming preventative practitioners. But more importantly, it will express to our clients that we care about their health as much as we are concerned about their injuries. After all, health is contextual. PTs must come to vigorously advocate for the context that best supports a kinesiophilic or movement loving existence.

I have an as yet unfinished joke about "where the sidewalk ends..." I'm not sure how to get there but the punch line is "diabetes."

What do you think? Can PTs frame "going green" as "going healthy?"

And can we do that at a national level?

Ben

NYC New Pro Mixer

2009-04-12T23:52:00.000-04:00

Start Time:	Thursday, April 23, 2009 at 7:00pm
End Time:	Friday, April 24, 2009 at 1:00am
Location:	Place: Taj Lounge (tajlounge.com)
Street:	48 West 21st Street Between 5th and 6th Ave
City/Town:	New York, NY

New Professionals and Students of the world of Physical Therapy come together for this great event to get to know each other and have a good time. You work hard for your patients, now enjoy some time for yourself.
Time: Thursday, April 23rd @ 7:00pm
1.5 Hour Vodka Open Bar (7:00 - 8:30PM)

Along with great drinks, Taj has a great food menu.

Cover is $15 for anyone on "PT Networking" list (that would be all of you!)

Above is the Facebook invite info, let me know what you guys think. Because it was short notice I will be making it more open to other groups, but this is more a test run to see what kind of NYC motion we can get going with this group and take it from there.

Seamless Web

2009-03-21T12:50:00.000-04:00

I am sure this will fall into place eventually, but is there a way we can make this blog, the google group, the facebook group, the e-mails all link up to create a more seamless share of info?
What is everyones preferred method for checking this info?
I know we can get updates on the blog through our email or rss feeder, including getting an update on the comments as they come through as well.

I did just find about a service called basecamp, which may an option for us if we want to setup a much more thorough website: http://grouphub.com/#/
You can take a tour of what they offer... may not be worth it, just one idea.

NYC NewPro Event

2009-03-21T12:45:00.001-04:00

I am fairly certain this is in the spirit of this site... I would like to announce that I am going to be planning a Social event in NYC. I have yet to determine the date or exact venue and am willing to take suggestions. I realize we are all over the country, but I hope some of you can make it out here. I will announce any details as they become available. I am going to aim to get this event in by May 1-ish... I figure if I put it here, it has a much higher chance of getting done

I am still considering beginning a New Pro SIG here in NY through the NYPTA. So any thoughts would be greatly appreciated as always.

I have one more thought but will make it a separate post as it may generate a whole different talk...
Have an awesome weekend!

The First of Many

2009-03-19T18:53:00.000-04:00

Hello to the group formally known as the GoXV. The Group of 15 was really never intended to be so confined. Hopefully this blog will further our avenues of expansion and collaboration. I hope we find it useful in whatever capacity it takes on.

Sincerely,

Ben