I started as the main shoulder and elbow orthopedic surgeon at the VA in Dayton back in September.  Things are going great.  the patients are really cool.  many of them have phenomenal stories about the places they’ve been all over the world.  If it weren’t for patient privacy, I would have enough to fill my blog everyday for years…maybe I’ll get their permission and write a book.  So many dreams so little time. 

I like to teach and interact with all of the other staff , therapists, residents etc.  So I started a weekly conference with the residents and another separate one with the therapists.  The therapists and I meet once per week for 15  minutes or so to go over any interesting or “problem” patients and I think this helps quite a bit.  So much of medicine (life?) is communication.  Answer a few questions early and you head off large issues down the road.  One day per month instead of the usual Q and A we’ll do an educational topic: we switch off, one month I’ll do a shoulder or elbow topic from the surgeon perspective and the next the therapists will do a topic from their perspective.  It’s been great. Admittedly residency does not cover physical therapy topics in enormous depth, so it’s a good education for all of us.

One of the therapists gave me a link to a site that produces educational materials for health professionals and patients.  The company is called VHI.  I really like it, because they have a monthly newsletter with a therapy topic that is supported by a mini review of the evidence.  They then showcase some of their many animations of therapy exercises- computer generated 3-D human figures performing exercises that can be viewed by patients as educational tools.  The link is above for anyone interested.

We were brainstorming an idea about using tech to enhance the PT experience for patients.  It occurred to me that right now PT is being done in 2 main ways: one-on-one monitored therapy with a licensed therapist in an outpatient facility or at home using a self guided program that one was taught by a therapist and then “discharged” and sent to do on one’s own.  The advantage of the outpatient visits is the attention and monitoring.  The disadvantage is inconvenience due to travel, time and lost work.  The advantage of the home program is independence, which of course is it’s main disadvantage - no oversight / encouragement.  What if there was an in between?

Take web cam technology ( I think the folks at Nintendo are doing something like this with some of their products) and a series of instructional links on your PT website.  Once your patient has graduated to a home program have them log in every so often to check in with the therapists.  Have them produce a 2-3  minute video once per month and submit it to the therapist who can then download it, review it and send back some corrections/encouragement via email or video chat.

Maybe it’s already being done, I don’t know.  I know it’s not widespread and not currently “reimbursable” by the current system.  But I know it’s the future and probably good service.  

Maybe we’ll pilot it here.  Will keep you posted…