Sharpen Your Saw: My Top 3 Takeaways from CSM 2017

Sometimes you have to take a break from the “work” of your work to hone your skills and take your game to the next level. After returning home from this year’s APTA Combined Sections Meeting (CSM) in San Antonio, I feel like that statement rings particularly true; after all, it takes stepping outside your office—and the comfort zone you’ve created inside those walls—to learn new ideas and approaches that will help you become more effective and efficient at work. Now, condensing three days’ worth of rehab therapy-related information into easily-digestible tidbits is no easy task. But, while I made it to a number of superb presentations, three in particular really stood out and piqued my interest. Let me give you a taste of some of my key takeaways.

Everyone is looking for mentorship.

Get the most out of these opportunities.

There’s power in connecting with other like-minded people in your line of work. And whether you’re a seasoned professional or fresh out of PT or OT school—and, believe me, throngs of students attended CSM—you may be looking for a mentor to help shape your experiences in, and understanding of, the clinical landscape. But, as experts explained during a session titled, “Mentoring – A Requirement or Added Bonus in Today’s Physical Therapy Practice?,” you can’t expect to find a mentor—and get all your questions and issues addressed—simply by raising your hand. You have to actually seek them out.

As Beth Sarfaty, PT, MBA, put it, you have to make yourself mentorable by taking responsibility for your career. “Think of mentorship as your own personal board of directors,” she said. “These are the people you have ID’d as role models, coaches, and general resources in your career.” From there, endless opportunities await both you and your mentor; after all, mentorship is a two-way street in which both parties learn from one another in order to:

• Build a shared passion of learning
• Share in a commitment to success
• Adapt in the changing world of health care
• Advance patient care
• Share best practices
• Build upon new or existing skills

Create a program with measurable ROI.

Alternatively, as a rehab therapist with plenty of knowledge and experiences to share, you may want to institute a mentoring program of your own that will allow you to:

• Create a congenial nurturing process
• Promote professionalism and personal development
• Boost retention and recruitment rates
• Keep your existing staff engaged
• Share best practices in clinical care

So, how can you “sell” the idea to your organization? According to Sarfaty, not only should a bona fide mentorship program allow both the mentor and mentee to grow professionally, but it also should allow all participants to demonstrate measurable ROI on the program’s success. To that end, you’ll want to establish mentorship program goals, determine how it might lead to improvements in your practice (increased visits and referrals, for example), and strategize how you’ll evaluate success. “Mentorship programs should help clinicians and administrators feel more invested and develop camaraderie in the system,” said Carlton Glover, PT, DPT.

Always know the legal and ethical standards you must meet.

Put the patient at the center of your decision-making.

As with any other profession, rehab therapists come from a variety of backgrounds—and they may have different values and beliefs than their patients. This variation may lead to conflicting beliefs about the “right” way to deliver treatment. Still, according to Aliya Chaudry, PT, MBA, J.D., APTA/ELI Fellow, four basic concepts of medical ethics should always guide your decision-making:

• Beneficence (i.e., acting in the patient’s best interests)
• Non-maleficence (i.e., not intentionally inflicting harm on patients)
• Respect for patient autonomy
• Justice (i.e., always acting in fairness)

During a presentation titled, “The Interface of Ethics and Law in the Clinic for Best Practice,” Chaudry said care delivery best practices are not always so cut-and-dried. For example, you may decide upon a particular discharge date—and your patient may disagree with that decision. In this scenario, your job is to advocate for—and act in the best interest of—your patient (i.e., exercise beneficence). And, with regard to the concept of “informed consent,” you must always provide your patients with the best possible information about their healthcare options, including the risks and benefits of each possible treatment. Furthermore, you should always adhere to the rules set forth in your state practice act. And remember that you always must provide clear and defensible documentation of any treatment you decide to administer. That way, if you ever find yourself in a legal dispute, you will be able to support your decision-making process. “As long as you back your decisions with data and evidence, your documentation will hold up to any scrutiny,” Chaudry said.

Recognize your rights and responsibilities as a practitioner.

You’re not always going to agree with your patients about treatment options—and some patients might even take steps to stop seeing you and instead find a new practitioner altogether. While you may vehemently disagree—the patient’s reasons might not make any sense to you—you must recognize that patients have that right. Conversely, you may want to stop treating a patient who continually fails to comply with his or her treatment plan—including prescribed home exercises. Under this scenario, Chaudry said the ethical thing to do is to refer the patient to a new provider. “It’s not sufficient to simply close the door on a patient you don’t want to see anymore,” she explained. “It’s actually your duty to help them find a new practitioner or facility.”

You can’t understand or experience what you don’t know.

Practice better cultural sensitivity.

Rehab therapists have very close relationships with their patients. After all, promoting better mobility and function often means providing hands-on treatment. Beyond providing treatment, however, PTs and OTs also serve as their patients’ advocates. But, it can be hard to understand—and empathize with—a population of patients with whom you’re not very familiar. And according to two experts who spoke during a session titled, “Sexuality, Race, and Transgender Health: Sexuality in Marginalized Populations,” transgender and other gender minority patients can feel just as uncomfortable, particularly when being touched or addressed with incorrect gendered terms.

As such, they may forgo essential treatment and services due to embarrassment or frustration with a system that doesn’t understand their unique needs. “It can be difficult to feel comfortable in your gender and sexual identity when the rest of the world is unaccepting,” said Uchenna Ossai, PT, DPT. “We must recognize the impact of our clients’ marginalized identities and provide spaces of affirmation. Otherwise, we’re failing as providers.”

Create inclusive office practices.

So, what’s the path forward? How can providers help to remove stigmas? Most people see gender and sexual orientation as a simple issue, but it’s more complicated than that. As Ossai explained, gender identity and expression can be fluid. These issues can also be ambiguous if a patient hasn’t formed a clear definition of himself or herself.

But, rather than assume you know everything, Ossai said, providers should simply “show up and shut up” and let these patients do the talking. Additionally, Ossai said there are a number of relatively simple things that can be done to make transgender patients feel more comfortable, including:

• Asking patients which pronouns they prefer (i.e., he/she or him/her)
• Creating gender-neutral bathrooms
• Offering a “transgender” or “other” option on intake forms
• Using gender-neutral language (e.g., “partner”) when asking about a patient’s sexual or relationship history

As therapists, you can’t rest on your laurels and expect to provide the best possible results for your patients. There’s always something new to learn. So, I hope you’ll take some of these ideas to heart. Learning new skills and approaches not only opens the door to new possibilities, but also helps set you apart from your peers. Still looking to relive a bit of CSM? Catch up on everything you missed by searching for #APTACSM on Twitter.