A landmark event in the history of Texas physical therapy and consumer advocacy nationwide is upon. HB 637 – Patient Direct Access To Physical Therapy – has moved to the public hearing stage for the first time. Texas HB 637, authored by Rep. Craig Eiland, has made it’s way to a public hearing with the House Public Health Committee. The public hearing is scheduled for April 20, 2011 at 8:00 am.

This bill is a significant one for health care consumers in Texas. The bill does not change or alter the scope of practice of physical therapists in Texas. It simply removes the referral requirement for treatment by a PT. As the law stands right now in the state of Texas, a physical therapist can perform a patient evaluation without a referral, but must then attain a referral from an authorized referral source (i.e physician or chiropractor) regardless of insurance plan. HB 637 would allow patients to have direct access to a physical therapist for evaluation AND immediate treatment without a referral. This will be a significant cost savings for consumers and will provide greater access to appropriate and necessary care.

The hearing provides an open forum for the public to provide testimony, which is limited to three minutes per person. Those present who are not wishing to speak can fill out a “card of support” in favor of the bill. The presence of consumers and physical therapists affected by this bill is hugely important. This is an opportunity for Texans to gain access to care and decrease the cost of care.

If you are unable to attend the public hearing but wish to support consumer direct access, please email one of the Representatives on the Public Health committee.

More information on Direct Access to Physical Therapy can be found here. The following articles will also provide further information on the importance and meaning of direct access to physical therapy:

Direct Access To Physical Therapy: You Have It, Or You Don’t

Patient-Centered Health Care Begins With Access To Care

Direct Access To Physical Therapy (from 2009 Legislative session)

Photo credits: Wikipedia

That was the headline of the full page ad on page A6 of Monday’s Austin American-Statesman. I’ve seen the ad before – I do still read the print version of the newspaper with my morning coffee – but for some reason, on that particular day it grabbed my attention.

It was like playing the game where you look at the image and see the picture of the old woman or the young lady – or any number of visual puzzles. I read on with intrigue.

I’ve been a physiotherapist for 23 years. I have reviewed a few MRIs over the years. Out of curiosity today, I took a look at the MRI image in the ad. At first glance, it was a mild herniated disc. Lo and behold, the first line of the ad stated such: “Do you see it? It’s called a herniated disc, a painful condition that can cause severe sciatic nerve pain”.

It only took two sentences, and I was on a rant.

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I have to admit – I think I am suffering from PMMSD: Post-March Madness Stress Disorder. I am sure there are millions of college basketball fans that are suffering from this malady. I think it might be time to go to the doctor. Or the Internet. I understand that both options can elicit similar results on many diagnoses these days.

While I am in my post-March Madness recovery program, the world moves on. There is one thing we can always count on: more Rhubarb – NCAA tournament or otherwise. I don’t think I am the only one suffering from an illness these days. Just look to the legislative branch of our democracy for further examples.

1. Today’s first illness is the one that occurs when you become a legislator. Ye of many great ideas to save the world, or your little part of it, morphs into the legislator that can’t seem to see the forest for the trees.

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The debate rages amongst clinicians and students alike. Which is better - manual therapy (in all of its myriad of forms) or mechanical therapy (otherwise known as MDT, or the McKenzie Method)? For some reason, clinicians seem to be very polarized when it comes to their approach to orthopaedics. This makes for some rather entertaining dialogue between the factions involved.

At the entry-level of education and beyond,  students continually ask faculty which is "better". I have had physical therapy students sit in a classroom and debate, with great passion I might add (given their lack of experience), that one approach is better than the other. This extends to practicing clinicians that are also struggling with where to spend their continuing education dollars. It seems like it has evolved into an "us versus them" mentality. At best, it is an entertaining dialogue; at worst, a fine example of ignorance amongst well-educated clinicians.

One must be better, yes? Isn't that the way it has to be? Someone has to lose, no?

Is the great debate – manual therapy or mechanical therapy – just a great perceptual divide?

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There are many distinctive sounds in sport. The swish of a basketball through a hoop, touching nothing but net. The explosive tink of a golf ball as it is hit with a driver off the tee. The banshee wail of a Ferrari F1 engine at 18,000 rpm. All of these are exquisite sounds that signify good things in sport.

And then there is the sound of a basketball, bouncing off the rim. They call it a “brick”, and it produces quite the hideous sound as the ball goes “clank” off the rim. In my opinion, it might be one of the worst sounds in sport.

We got to hear that a lot this past Monday night. The sound was resonating, reverberating, echoing around Reliant Stadium during the NCAA men’s basketball final. What looked to be an exciting match-up between #8 Butler and #3 Connecticut turned into an event that only a brick mason could truly appreciate.

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In our time on the planet, we experience moments that can instigate joy and happiness, or pain and sorrow. It could be a moment of love, or anger, or frustration, or exhilaration. Each of of these moments will take us down a path in our mind’s eye, a path which is dependent upon how we perceive that moment at that specific point in time. The same issue, at different times of our lives, may lead to totally different responses, different reactions, and different actions. One day, a benign response; the next, a response that wreaks havoc on our soul, and creates disharmony and insecurity in us.

The power of the mind can take us into uncharted waters and places we’ve never been. The mind puts its own spin on everything. We could be emotionally labile – or emotionally volatile – and the mind spins its tales and weaves its webs and conjures up the net effect to our psyche and to ourselves.

The challenge is to stay in the moment, to accept the moment as it is, to reflect, and to act mindfully. No easy task, indeed.

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“In my professional opinion, I don’t think you should be running.”

It was the early 1980s. The words still ring loudly in my mind. I had experienced some knee problems during my growth spurt as an adolescent. I had my share of knee surgeries – and probably your share as well. I had a well-respected orthopedist who told me I should never run, but that it would be alright to swim or bike. How could I ever doubt “the expert”?

Not long after that, I became a physiotherapist. I focused my career on orthopedics and sports injuries. Countless patients over the years have been told the same things that I was told. They have put their faith in conventional thinking, in traditional medicine, much as we have been taught to do over the years. Many haven’t asked enough questions. All have come to me feeling frustrated and hopeless. I understand the feeling well, having been there myself.

But today, I stand here having just completed my 10th consecutive Capitol 10K in Austin. That’s 100K of running in one event alone over the past decade - not bad for a guy that shouldn’t be running at all, according to the experts. So how did this happen?

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