Selected Podcast

The Inside Story on Outpatient Rehab

Daniel Finn, PT, DPT, OCS, MBA, discusses the outpatient rehabilitation services offered by The George Washington University Hospital, including physical therapy, occupational therapy, and speech language pathology. Finn shares details about the specialized branches that fall under the outpatient umbrella, such as aquatics, dance rehab, hip preservation, lymphedema, oncology, pelvic health, sports medicine, and concussion programs, as well as GW Hospital's expertise in conditional concerns for mid-life and elderly populations.
The Inside Story on Outpatient Rehab
Featured Speaker:
Daniel Finn, PT
Daniel Finn, PT, DPT, OCS, MBA is the Lead Therapist OUTPATIENT REHABILITATION SERVICES and a member of the medical staff at George Washington University Hospital and
 is affiliated with The George Washington University Hospital and GW Medical Faculty Associates.

Learn more about Daniel Finn, PT
Transcription:

Mike Smith, MD (Host): Welcome to GW HealthCast. I’m Dr. Mike Smith. Today’s topic is the inside story on outpatient rehab. My guest is Daniel Finn. He is the lead therapist of outpatient rehabilitation services at the George Washington University Hospital and is affiliated with The George Washington University Hospital and GW Medical Faculty Associates.. Daniel, welcome to the show.

Daniel Finn, PT, DPY, OCS, MBA (Guest): Thank you.

Dr. Smith: So, let’s start with a nice overview of what outpatient therapy is. What do the patients do? Who works with them? And how long does it usually last?

Daniel: Well, in outpatient therapy, patients with physical limitations come to our facility for 45 minutes – one-hour treatments once to twice a week. Courses of therapy can last anywhere from one month to six months depending on the person’s injury or condition and someone could work with one of three different rehab disciplines. And disciplines include physical therapists, occupational therapists and speech/language pathologists.

Dr. Smith: And who can benefit from this the most or maybe another way of asking it; how do you know if somebody is a good candidate for outpatient therapy?

Daniel: Well, when a physician refers a patient to physical therapy; usually the two most distinct reasons are pain level or a functional limitation. So, the person is having some difficulty performing their daily routine, perhaps they might not be able to go to work because of pain or difficulty walking or sitting for prolonged periods of time at a desk and during our initial assessment; we can screen for patients that would benefit from physical therapy as well as screen for non-musculoskeletal problems that might indicate that they would need a diagnostic workup from another type of physician specialist.

Dr. Smith: Right. It’s interesting. So now can patients just go themselves to an outpatient therapy program or do they have to be referred?

Daniel: Now in many states in the United States, depending on the Practice Act of each separate state: patients might be able to have direct access. Which means from a legal standpoint, they can come to a physical therapist directly off the street, report their problems and be examined. For occupational therapists and speech/language pathologists; such documentation, such regulation is not available at this time. So, in most states, physical therapists do have some form of direct access.

Dr. Smith: So, I know that the George Washington University Hospital offers really what you might call specialized programs. I understand there is dance and then there is sports medicine and pelvic health. Tell us a little bit about those specialized programs and when it comes to the therapist, is there extra training for them to do those types of specialized therapies?

Daniel: Absolutely. So, in the last two years, our staff has grown by almost double and with the increase in the number of staff, we have been able to allow therapists to develop a special interest area. Most or all of these areas do require continuing education, certification and sometimes or cases board certification for the specialty. Right now, we have available to patients an aquatics program, a dance rehabilitation program that is for novice up to professional performers. We have a hip preservation program where we work with patients either conservatively to avoid surgery or post-surgically to ensure that a minor arthroscopic procedure doesn’t lead to a total hip replacement down the line.

We also have a lymphedema program where we treat people with upper extremity or lower extremity lymphedema swelling. We have an oncology program, so patients who are beginning chemotherapy, radiation or have had surgery to treat cancer can come in at any point in their cancer recovery process, even 10 or 20 years later and still have significant benefits in pain and function. We have a pelvic health program and we have a seating and mobility clinic where two specially certified clinicians can customize a wheelchair for a patient with mobility needs. We also have a sports medicine program and a vestibular and concussion program. So, we have a certified therapist who has gone through some extensive training to work with patients with vestibular or sometimes dizziness issues as well as people who have had concussions through sports injuries or motor vehicle accidents.

Dr. Smith: You know as the population Daniel, gets older and older, we know the baby boomers are getting into the retirement age now; is there anything to address just an older population, maybe like balance, just being more active, anything along those lines in what you do?

Daniel: Of course. We have conditions that are more common in an older population, just as we have conditions more common in younger populations. In our older populations, orthopedic problems are more common and they typically involve arthritis and some balance issues. So, we have therapists on staff that are well-trained and very comfortable and quite successful working with people to either avoid joint replacement surgeries or rehabilitation after a joint replacement surgery. The other less common but certainly important area in an older population are neurological conditions, particularly stroke and a group of neurological therapists comprised of physical therapists, occupational therapists and speech therapists work closely with our neuro physicians to coordinate care to improve balance, function, cognitive issues, memory, swallowing and speech and language, reception and expression.

Dr. Smith: So wow, there is a lot that you obviously you are offering at the George Washington University Hospital and I think you made a good point that all of these specialized programs are being managed, the therapists have had some extra education and training in those areas. What questions should people ask, or what things should they consider when selecting a program for their rehab?

Daniel: Well I think the comprehensiveness of a program is very, very important. There is plenty of evidence to suggest when someone is getting or receiving physical therapy from one office and then has to go to another office to be assessed for a wheelchair and then even another office to work with an occupational therapist, that the coordination of care is sacrificed in that situation. And the outcomes from the therapies, even with very qualified therapists in each location, is also significantly less optimal than when the clinicians can coordinate in the same area.

Dr. Smith: So, in summary, Daniel, what would you like people to know about outpatient rehab?

Daniel: I would like people to know that even if they have had a condition that is persistent, even if they have a condition that they recall that their parent or their grandparent had and feel that it is something that is just part of their fate; that we see miracles happen every day here. People who didn’t think they could get better, start seeing improvements in as little as two weeks and the independence that people get has a direct effect not only on their ability to do things, but on their outlook in life. So, I would like people to know that some effort on their part and the efforts that we make every day achieve significant benefits.

Dr. Smith: That’s great Daniel. I want to thank you for the work that you are doing and also thank you for coming to the show today. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Finn or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment.

This is Dr. Mike Smith. Thanks for listening.