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Tough conversations are a given in cancer rehab – there’s truly no way out of them.
From the diagnosis of cancer to chronic impairments to financial toxicity, there’s a plethora of challenging topics that we MUST discuss with our patients. But why is it so hard???
In short, nobody likes delivering bad news. We got into health care to HELP people, not to make them feel bad.
So why not just avoid tough conversations altogether? Because it actually hurts our patients in the long run.
Here’s the perfect example: a patient is at risk of developing lymphedema. Instead of discussing this risk & what lymphedema really means for a patient, the clinician skirts around this conversation because it’s uncomfortable.
Fast-forward a few years, the patient has stage 2 lymphedema, had no idea they were at risk, had no idea what lymphedema really meant, & didn’t know that they would be dealing with this the rest of their life.
Worst of all, they’re upset, angry, frustrated that the health care system has let them down once again.
We cannot allow this to continue any longer – & that’s why I’m thrilled that Dr. Lori Boright is on the podcast today to discuss her upcoming APTA-CSM session called Navigating the Complex Situations and Tough Conversations of Working With the Cancer Population.
Here’s what we covered in today’s interview:
- Having difficult conversations with patients is an important aspect of working with the cancer population.
- Authenticity and being your true self are key in having these conversations.
- Confidence and practical skills are essential in delivering difficult news to patients.
- The session at CSM aims to provide clinicians with tools and resources to improve communication and help patients navigate the challenges of cancer care.
Mark your calendar for ON-17496 – Navigating the Complex Situations and Tough Conversations of Working With the Cancer Population!
This APTA-CSM session will take place on Saturday, February 17, 2024 from 8-10am.
This session will not be available on-demand.
About Dr. Lori Boright
Dr. Lori Boright is an Assistant Professor at Oakland University in the Doctor of Physical Therapy Program. She received her DScPT and Graduate Certificate in Oncology Rehabilitation from Oakland University, DPT from AT Still University, MPT from University of Michigan Flint, and BS in physiology from Michigan State University. She is a Clinical Cancer Exercise Specialist, credentialed by the University of Northern Colorado Cancer Rehabilitation Institute. Her research agenda focuses on primary and secondary disease prevention inclusive of prehabilitation for a variety of cancer diagnoses and upstreaming initiatives for community and population health promotion.
Email her at boright@oakland.edu
Follow her on X (formerly Twitter) @BorightLori
Check out Oncology Rehabilitation: A Comprehensive Guidebook for Clinicians
Transcript:
Elise – @TheOncoPT (00:00.682)
Hey, Onco PT and welcome back to this episode of the Onco PT podcast. Now we wrapped up the holiday season, but we are entering almost a second holiday season for me as a physical therapist. Because if you’ve been around here for any length of time, you know that conferences are my jam. And CSM is like second Christmas to me. So we are kicking off our CSM preview sessions with another dynamic guest who has been on the podcast previously and I’m so excited to have back
to talk about her very exciting CSM session. Welcome back Dr. Lori Boright to the Onco PT podcast.
Lori Boright (00:37.576)
Thanks Elise, this was wonderful, good fun. Call me Lori.
Elise – @TheOncoPT (00:41.586)
Okay, I love it. So Lori just mentioned to me right before we hit record that she’s never been to Boston. So Lori, I’m gonna go off script momentarily. What are you most excited about for Boston as a first time Boston traveler?
Lori Boright (00:57.8)
So I’m a humongous history buff, so I wanna see some sites. I don’t know that I’ll have a lot of time, but whatever time I get, I’ll be on foot and looking for the, you know, main historic sites.
Elise – @TheOncoPT (01:13.67)
If you want a 17 mile walk path, I was in Boston a couple of years ago, and I’m also like a history nerd. And so I went from our hotel and I went over to like some of the historical sites. I ended up at Old North Church and then I came back and like managed to because I really love I love history, but I also really love seafood and especially like the seafood in Boston. So highly recommend. Anyways, like we’ll have to talk more about that off air because I
Lori Boright (01:20.455)
Yeah.
Lori Boright (01:33.317)
Me too!
Elise – @TheOncoPT (01:41.998)
who love Boston. I’ve been there a few times and I’m so excited to go back. So I’m really excited that you get to experience Boston for the first time, Lori. It’s gonna be such good fun.
Lori Boright (01:48.968)
Yay, yes. Yeah, I’m a rookie. I think, I can’t recall off the top of my head, but I did write it down. There were two restaurants that were highly recommended for seafood specifically. So yeah, we’ll have to compare notes and maybe even meet up for a meal. That would be fun.
Elise – @TheOncoPT (02:00.779)
Nice.
Elise – @TheOncoPT (02:05.47)
Oh my God. Yes, please. That would be amazing. Okay, so we’re of course talking about Boston because CSM is being held this year in Boston, which again, we’re very excited for. Can you tell us about one of your sessions? Yeah, y’all I did say one of. We’re gonna focus on one of Lori’s sessions today and then we’ll tease the other ones at the end of this interview. But Lori, can you tell us a little bit about your session?
titled Navigating the Complex Situations and Tough Conversations of Working with the Cancer Population.
Lori Boright (02:40.092)
Certainly, Canelis. I know that you want to know when it is, and I did write this down, February 17th. It’s the eight to 10 a.m. session on Saturday. Myself and Dr. Chris Wilson are collaborating on presenting the material. Dr. Deb Doherty has also collaborated with sort of like the dynamic trio of projects. And I will say this is the extension of a project that we have done in…
Elise – @TheOncoPT (02:44.767)
I definitely do.
Elise – @TheOncoPT (02:49.526)
Mm-hmm.
Lori Boright (03:07.96)
you know, a variety of different ways at our state level. And so we wanted to kind of repackage it a little bit and spruce it up. I conceptualize it as our social determinants of health and also providing clinicians with very tangible ways to improve communication, to feel more comfortable delivering difficult news.
Elise – @TheOncoPT (03:12.907)
Nice.
Lori Boright (03:33.784)
Um, so myself and Dr. Doherty kind of collaborated on the social determinants of health. We pull out financial toxicity as something that we, um, you know, delve much more deeply into as a social determinant of health. So those are sort of like the, if it’s a three-parter, it’s, you know, a broad overarching, um, explanation and working your way through trying to solve and help.
Elise – @TheOncoPT (03:47.575)
Mm-hmm.
Lori Boright (03:59.664)
be present through some of those social determinants of health. And I’ll talk a little bit more about that in greater detail. But then again, we pull out financial toxicity as sort of a standalone because it is so super impactful. And then the last really half of the session is the navigating those tough conversations that we have to have with patients. It’s really a given in the oncology space. So.
Elise – @TheOncoPT (04:11.927)
Yes.
Elise – @TheOncoPT (04:24.366)
Mm-hmm.
Lori Boright (04:28.012)
And that’s really Dr. Chris Wilson’s purview. He does a lot in his entry-level DPD curriculum courses and actually teaches in the graduate certificate program at Oakland University as well on those specific topics. So there are those three sort of subsections. I will say it really, the aim is to prepare clinicians to help.
Elise – @TheOncoPT (04:37.134)
Mm-hmm.
Lori Boright (04:56.676)
patients manage a multitude of social, emotional issues, again, helping them to find resources. And again, I don’t ever purport that we can solve all of the problems, right? We have our purview, but it is within our responsibility realm to resource with patients, for patients, and help them get to navigate, is the word.
our colleagues who have specialty, you know, areas of expertise in financial toxicity specifically. So, you know, and this presentation doesn’t necessarily give you all the tools because again, it’s sort of out of our purview, but things to think about, and then some real practical ways to resource for patients and to help you network as a clinician to develop.
Elise – @TheOncoPT (05:33.543)
Mm-hmm.
Lori Boright (05:55.368)
the network that you need so that you can confidently refer. When, because it’s really, again, not in its such situation, we’ve talked about this before, it’s not if you’re gonna see a cancer patient in your practice, I don’t care if you wanna specialize or not, it’s when, and truly where many of these social determinants of health are concerned, especially financial toxicity, it’s not if it’s when. It’s rare that, you know.
Elise – @TheOncoPT (06:00.275)
Mm-hmm.
Elise – @TheOncoPT (06:20.573)
Mm-hmm.
Lori Boright (06:22.768)
someone will transition from diagnosis through survivorship without a copay or impactful deductible, right? So, you know, being forced to make some of those difficult decisions in terms of, do I pick this? Do I pay the bills this month or do I get my chemotherapy? I mean, those are real, real situations. And so it is, I would say good fortune to be in a health system that has financial navigators,
Elise – @TheOncoPT (06:28.718)
Mm-hmm.
Lori Boright (06:52.624)
that will solve and help resolve issues, find money through grants, community resources that involve multiple levels, faith-based, secular, those kinds of things to help provide resources that patients might need at any given scenario. So again, it’s not necessarily our job to do all of that, but to help them.
Elise – @TheOncoPT (07:08.471)
Mm-hmm.
Elise – @TheOncoPT (07:16.429)
Mm-hmm.
Lori Boright (07:21.304)
resource and find those resources.
Elise – @TheOncoPT (07:27.238)
When I first started practicing, I was very unprepared and frankly naive about just how many of these conversations I would be having with my patients. And I think it comes from a few different reasons. For me, an outpatient, as an outpatient physical therapist, I spend a lot of time with my patients. I usually am very privileged. I get to see my patients for about an hour at a time.
And I mean, we are talking, right? We’re doing our interventions, of course, but I mean, like, I get to hear all about the things. I get to hear about their lives. I get to hear about their kids and their grandkids and their pets. And we also talk about some not so fun topics like the financial implications and like how much of a struggle it is. You know, I’m thinking back a really like, more drastic example of just some of the financial toxicity that one of my patients faced is.
This patient of mine was in his seventies and he was couch surfing between his adult children’s homes because he could not live at home by himself. And so he was sleeping on either a sleeping bag or like a blowup mattress. And that, unbeknownst to me at the time, but like months of working with him, it finally came to light of just how bad his sleep was. And that was absolutely affecting his capability to participate in our rehab sessions.
Lori Boright (08:34.503)
Thank you.
Elise – @TheOncoPT (08:50.87)
So I just tell this, Lori, because I know there’s probably someone out there listening who is like, is it really my place as a physical therapist to have these conversations about finances with patients? What would you tell that person?
Lori Boright (09:07.388)
So I love what you’ve done here actually, because we’re talking about like a three-part presentation or education session, right? And the last of which is having difficult conversations in the cancer context, but we’ve dovetailed it into, the second part, which is that very specific social determinant of health we’ve kind of pulled out to highlight. What I will say is this.
conversation and being your authentic self and being very, you know, open and willing to discuss things with patients varies from person to person. I don’t want to go the lengths of saying you either have this or you don’t, but it does come much more naturally to some than others. I’ve never struggled having a conversation really with anyone. I can have a conversation in the drive-through at Starbucks. Like my kids get really frustrated when I’m, you know.
Elise – @TheOncoPT (09:56.078)
Mm-hmm.
Lori Boright (10:04.188)
telling them my life story and where we’re off to, blah, blah. So I haven’t struggled in this domain, but working with students over the years, you do see the gamut of individuals that will struggle in this domain. So my best advice is to be your authentic self, because if you’re trying to act the part or…
Elise – @TheOncoPT (10:07.278)
Absolutely.
Elise – @TheOncoPT (10:20.183)
Mm-hmm.
Lori Boright (10:30.14)
Fake it till you make it. Some, again, I can’t do blanket statements because some people are successful in that way. But I have found when, you know, I’m working with students, we’ll just give an example of, you know, their very first practical examination and they are having a hard time communicating, asking important questions, you know, taking the history. Other students are, you know, making small talk along the way. And so again, there’s those two, you know,
different sides of the spectrum. In coaching students in terms of having even just regular conversations with people, it’s being your authentic self, pulling from things that have meaning to you, finding common ground between you and your patient. And so when you were talking about how this individual was couch-serving for several months and you didn’t know it, you had to develop that relationship.
Elise – @TheOncoPT (11:20.382)
Mm-hmm.
Lori Boright (11:28.764)
first, right? So these really, these really aren’t conversations that you’ll probably have on day one unless they unless you ask, is there anything else you’re concerned about or, you know, are there other things outside of PT that, you know, might be bugging you that you might want to put on my radar because I can help you, you know, find who you might need to help with, right? So if you have those open ended types of things as part of your, you know, just normal approach.
Elise – @TheOncoPT (11:31.032)
That is true.
Elise – @TheOncoPT (11:37.607)
Mm-hmm.
Elise – @TheOncoPT (11:52.118)
Mm-hmm.
Lori Boright (11:58.62)
great, because people might bring that out. But my sense is those are more the naturally, you know, comfortable, more conversant clinicians, right? So I think that, you know, being your authentic self, and then there’s lots of strategies, and we will bring a lot of that through in terms of having these difficult conversations where you’re delivering difficult news or…
Elise – @TheOncoPT (12:10.752)
Mm-hmm.
Elise – @TheOncoPT (12:24.138)
Mm-hmm.
Ooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo
Lori Boright (12:27.256)
You know, you’re having conversations related to preparing for the end of life I mean when I think about the difficult conversations in the cancer context is that and When is it a good time to start introducing that because you don’t want to wait too long you and I have talked about Hospice and palliative care quite a bit and Introducing that is probably one of the most and I would call it a courageous conversation that I’ve ever had with patients, right?
Elise – @TheOncoPT (12:37.149)
Mm-hmm.
Elise – @TheOncoPT (12:45.355)
Yes.
Lori Boright (12:56.94)
It’s even if you are in a situation where it’s an incurable cancer and you know, there are issues related to quality of life. We’ll just lump it into quality of life. Wanting to maximize that.
Elise – @TheOncoPT (13:11.786)
Mm-hmm.
Lori Boright (13:19.36)
It is, I will say, it’s not easy for anyone, but being your authentic self, and I always focus on what we can do to help or make things better. I don’t like to use negative terminology, so trying to keep things as positive as possible, but you always wanna be truthful too. So Dr. Wilson will talk at length about
Elise – @TheOncoPT (13:44.862)
Mm-hmm
Lori Boright (13:48.428)
a few different techniques. Motivational interviewing is one that is used often, a little bit less, I would say, in the palliative care and hospice domain potentially. For compliance and again, just to have a general understanding, give the patient some autonomy and ownership of the process of…
Elise – @TheOncoPT (13:55.318)
Yeah! Mm-hmm.
Elise – @TheOncoPT (14:13.004)
Mm-hmm.
Lori Boright (14:16.324)
decision making, you know, you’re trying to provide as much information as possible in a very truthful way so that they can make informed decisions. But there are programs out there. Vital Talk is one that Dr. Wilson will talk about. I think Memorial Sloan Kettering also has a wonderful online course that those who, you know, get the taste and gist of what we’re offering with this education session.
Elise – @TheOncoPT (14:37.73)
Thanks.
Lori Boright (14:44.624)
potentially need or want more, there are other avenues that they can seek for additional guidance and a little more of the hospice palliative care tone is the word that’s coming to mind because I think it does have a little different sound, flavor, choose your word.
Elise – @TheOncoPT (14:48.462)
Mm-hmm.
Elise – @TheOncoPT (15:03.147)
Yeah.
Elise – @TheOncoPT (15:09.626)
Mm-hmm. And even as someone, you know, like I’m obviously looking forward to this session and I have not attended it yet because it’s clearly not February at this point. But one of the things, you know, I do have waves of patients where I feel like I have a very heavy load of patients who are in the more end of life stages, right? So I definitely go through those phases, but a difficult conversation that I think I have way more commonly, I’m curious your thoughts on this, Lori.
is around lymphedema. And a lot of times, I unfortunately get patients who come to me who have very unfortunately like wrong information about lymphedema. Like let’s just call it what it is. Where, you know, they may not, they may actually have no information whatsoever. Like they may have been told this is not gonna be an issue for you. You hear that a lot. Even if you get it, you know, it’s not that big of a deal. You’ll wear a sleeve and like, it’ll be fine.
Or if you do what you’re supposed to and you wear your sleeve, I throw it back on the sleeve because that’s what I hear most often. You’ll wear your sleeve for a bit and then it’ll be gone. Each of these are very wrong of just different kind of phases of where they’re at with their information regarding lymphedema. This is sometimes even from people within the medical field. This is not they’re going to Google and looking this information up.
this is a conversation that I have with many of my patients, unfortunately. And so if you’re someone who’s listening to this conversation right now and you’re thinking, you know, I don’t really work with a lot of end of life patients. It’s probably not super pertinent to me. I would bet that the techniques and like the motivational interviewing that Lori is talking about that Chris Wilson is going to do would really help me out in that situation because that hands down, Lori is one of the most common conversations.
that I ended up having to have with patients about, no, this is a chronic condition that we are gonna have to manage for the rest of your life. And that is hard news. That is hard news to receive. That is hard news to deliver in a like aware and compassionate, but also truthful way. And I really love the emphasis that you’ve had so far on truthful with all of this.
Lori Boright (17:29.994)
Right, right. And I think that’s a really good example. So again, you know, the palliative care and end of life hospice types of conversations, certainly not the only ones you will have. I pulled that out as, you know, an extreme example. But we have these, these kinds, these similar kinds of issues that you’re having with, you know, these patients who have been.
Elise – @TheOncoPT (17:44.671)
Of right, of course.
Lori Boright (17:52.816)
kind of misdirected and misinformed about their issues with lymphedema, just in the general context of oncology rehab, right? Recently, a breast cancer patient who had radiation, no prehab, nobody told her she should be ranging her shoulder, even just regular range of motion through treatment comes with a frozen shoulder. So there’s just…
Elise – @TheOncoPT (17:56.727)
Mm-hmm.
Elise – @TheOncoPT (18:12.705)
Ugh.
Lori Boright (18:20.596)
is so much wrong with, you know, again, the whole referral process and prehab. I’m not going down that rabbit hole today because it’s my favorite rabbit hole, but that’s not why we’re here. But those kinds of conversations are difficult because you certainly don’t want to undermine your medical, your colleagues in medicine, right? They are very obviously not up to par in terms of, you know,
Elise – @TheOncoPT (18:31.17)
Hehehehehehe
Lori Boright (18:48.844)
current evidence and what patients should be doing to minimize those issues. It’s not to say that they’re doing anything wrong. We’ve talked about this too. It’s the silo effect, right? They’re in the business of saving lives. So they’re doing that with radiation. But the manifold consequence to the…
Elise – @TheOncoPT (18:51.682)
Mm-hmm.
Lori Boright (19:11.136)
lack of proper information dissemination is that we have these quality of life issues. So yeah, I mean, that’s impactful too. And you stop short of saying, if you saw me three months ago, we could have prevented this whole thing because that’s a major undermining of your medical colleagues. But there again, you have to be truthful. Okay, now what we’re dealing with is a very fibrotic joint capsule, whatever the case may be. And this takes a long time to rehabilitate and it’s quite a bit of work.
Elise – @TheOncoPT (19:23.475)
I mean, right?
Lori Boright (19:40.552)
Um, you know, and again, you impart, you know, as much of your physical as well as emotional self, you know, as, as you’re capable of doing, um, within the bounds of, you know, your capacity to be empathic and, um, that weighs on you too. Having these difficult conversations on a regular basis is, is impactful. We’ve talked about that. Um, I think.
you know, at least a little bit the impact. So there is something to be said for having to have, you know, the sort of divesting and offloading conversations with non-patients and, you know, if it’s colleagues, if it’s friends and family, to make sure that you’re, you know, caring for yourself in that way as well.
Elise – @TheOncoPT (20:33.41)
Yeah. Ooh, that’s a ooh.
Elise – @TheOncoPT (20:39.87)
Is that something that you’re going to talk about in this session? Because I feel like that’s a really, really big deal. Because I do think, you know, a lot of us here in Onco PT have such a heart and a passion for this. And I feel like we wear that so like openly of just how much we care for these patients to our detriment sometimes that we take on maybe a little or a lottle too much.
when we need to like, okay, here is a boundary and this is, you know, this is outside of that boundary for me because, oh, well, you just said on something, Lori, that I’m like, oh my God, really important stuff.
Lori Boright (21:18.044)
So we need to play Scrabble, because a ladle is a great word.
Elise – @TheOncoPT (21:21.491)
GHAHAHAHAHA!
Lori Boright (21:23.984)
I did catch what you did there. I will say there will be, there’s time for collaborating and practicing a lot of these techniques. So I can’t really necessarily say that we’re going to impart that like on a global scale, but through small group facilitation, some of those things might come up. I will say it is an area of mind that.
Elise – @TheOncoPT (21:35.99)
Very nice.
Elise – @TheOncoPT (21:42.242)
Mm-hmm.
Cool.
Lori Boright (21:50.3)
is of significant interest because I feel like we do not dedicate enough time to it. And it’s not just in the oncology rehab clinical space. It’s in the post COVID every healthcare worker space, right? So maybe we’ve just planted a seed on a future idea to collaborate on for a CSM session in 2025.
Elise – @TheOncoPT (22:03.086)
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Elise – @TheOncoPT (22:13.418)
Oh my God. This leads really nicely into my next question because this is going to be what we reflect on and point back to when I ask that question in the future. What was the inspiration behind coming up with this session? Because there’s so, like, I mean, we know there’s so much to talk about in cancer rehab. Why this? Why at CSM?
Lori Boright (22:38.576)
I think the why is my general why. And again, this was a collaborative with two colleagues that we work very well together, we do a lot of work together. Through the development of our textbook, we have some wonderful space in the textbook dedicated to a lot of these concepts. But it was something I feel like we came out of that experience and…
Elise – @TheOncoPT (22:59.691)
Nice.
Lori Boright (23:06.312)
Maybe in an unrecognized way. It’s something we want to evolve and Contribute a little bit more in this space potentially for the second edition of the textbook I think you know that was sort of an unspoken rationale But you know, it’s just something When you work well with colleagues, you just kind of vibe and I think you know, dr Wilton and dr. Doherty and I do that very well so I’m
Elise – @TheOncoPT (23:20.356)
Mm-hmm.
Lori Boright (23:33.908)
very, very fortunate to have such great colleagues and support in that way. But that it all directs back to our overarching why is to improve survivorship for really everyone who’s touched by cancer. And, you know, our little seed planting with, you know, potentially talking about the importance of cell care and all of that in the future, that’s care of the clinician who is affected by cancer, right? Because we’re working in this domain.
Elise – @TheOncoPT (23:46.722)
Mm-hmm.
Lori Boright (24:03.264)
um, including, you know, in, in the mission of, of APTA Michigan oncology rehab SIG, we have, um, I can’t reiterate it verbatim right now, but we’ve talked about all persons affected by cancer and that includes, um, improving survivorship. It involves improving the support that, um, people who are supporting the survivor, right? So the carers.
Elise – @TheOncoPT (24:31.711)
Mm-hmm.
Lori Boright (24:32.344)
We might even term it exactly that way. And then, you know, the obvious person, you know, diagnosed with cancer is at the center of that. And that’s the obvious, obvious why. But I feel also compelled to mention just briefly that historically, bless you, again, we can’t ignore the underserved and underrepresented.
Um, and so that’s, you know, the, those social determinants of health that adversely affect some more than others is just, you know, not where any of us want to practice. So it’s, it’s bringing those obvious things to light, um, giving the clinicians some practical tools to resolve some of the minor things, right? Again, not all of it is within our
our scope of practice or purview. But I am always of the mindset, and this is one of my mantras, even with my entry-level DPT students, you know better, you do better. So if you know someone that could help this person, you connect them. And so whether or not that’s part of your job or not, knowing better and doing better is the mainstay of my practice, and certainly I extend that into my…
teaching life as well.
Elise – @TheOncoPT (26:06.518)
We didn’t plan it this way, but this episode has kind of been like a full circle moment for me, like on air, while I’m not sneezing, obviously, like off mic. But I opened with talking about my patient who was couch surfing, and you pulled out something, Lori, that like genuinely I had never thought of, of that maybe that patient wasn’t comfortable enough to talk to me about that. Like this was a point that you made earlier in the episode, and I’m sitting here like, huh, I never thought about it that way before.
And then something that you just said, like just now, again, full circle, of you know better, you do better. And so after that experience with that patient of learning that, oh, they are couch surfing and they don’t have a mattress to sleep on, that is not a blow-up mattress, because we’ve all slept on a blow-up mattress and we know the kind of sleep that we get on that. Now I know that I need to be talking to my patients about this, and I never would think, as someone who has a mattress, that I get to sleep on,
every single night, I never would have considered that was not the reality for all of my patients, right? And that’s not something I default to thinking about, I need to ask about this. And so again, like Lori said, you know better, now it is your responsibility to do better. And I think that sleep situation for me was a great example of that, of moving forward, I know to ask my patients those kinds of questions.
And again, it stemmed from a, what I until today genuinely thought was a very innocuous conversation. That may have actually been a really hard conversation for my patient to have with me, and maybe I wasn’t ready to receive that information. And so I do think maybe being a clinician who is more proactive in maybe…
laying the foundation to have some of these maybe more uncomfortable and vulnerable, difficult questions and conversations with patients will open up opportunities to show up better for our patients in the long run. Anyways, I’m having this on-air realization, Lori, that I’m just like, wow, this is a really big learning moment for me. I’m really appreciative of that.
Lori Boright (28:21.808)
wonderful. It’s wonderful. And I’m similarly learning from you. We are all constantly evolving. I think if you can extend that, you know, again, I feel like the word you pull out or I’m pulling out of that is authenticity. You need to be vulnerable with your patients so they can be vulnerable with you. It’s the human in you meeting the human in them and walking with them, not
Elise – @TheOncoPT (28:44.098)
Yeah.
Lori Boright (28:51.684)
dragging them through or following them through. You are walking with them on this journey.
Elise – @TheOncoPT (28:59.726)
Chills, chills, Lori. Oh my God. Oh, okay. I feel like we’ve already answered this, but I want to know what your answer to this is. Why is it so important for CSM attendees to go to this session on Saturday, February 17th at 8 a.m.?
Lori Boright (29:02.497)
I love when I do that.
Lori Boright (29:20.588)
I think that the topics we will discuss span beyond the oncology domain. So that’s importance number one. This is for all clinicians, not just oncology clinicians. I mean, there’s a lot that is, I mean, it’s going to be under the auspices of oncologic physical therapy, but savvy clinicians will realize that these scenarios exist outside of oncology rehab. So that, it will help everyone.
Elise – @TheOncoPT (29:28.118)
Love.
Elise – @TheOncoPT (29:38.254)
Mm-hmm.
Elise – @TheOncoPT (29:46.05)
Mm-hmm.
Lori Boright (29:49.868)
And it will do that by giving resources and practical information and allowing for practice of some of these skills that you will develop. So it’s almost like a full knowledge translation experience. And that will allow you to return to the clinic when you return, ideally Monday morning, sometime early in the week.
Elise – @TheOncoPT (30:10.413)
Mm-hmm.
Lori Boright (30:19.196)
and be able to use these strategies. So practical information, knowledge translation, skill building, again in the oncology space that I think you can extrapolate to any clinical conversation.
Elise – @TheOncoPT (30:38.85)
What is one takeaway that you want for attendees to walk away from their session, your session, and walk into their hospital or their clinic on Monday morning and be like, I got this?
Lori Boright (30:53.336)
with confidence, having practiced the skills, I think that’s the word, confidence, and being able to use those skills right away.
Elise – @TheOncoPT (31:06.158)
I love that. Well, you know our, yeah, go ahead.
Lori Boright (31:06.896)
Potentially, you know, go ahead. I was just going to say potentially even in your personal life, right? I mean, we all have to have difficult conversations. These are skills that I think are life skills, not necessarily just work skills. So that’s another little pearl.
Elise – @TheOncoPT (31:23.906)
I would agree with that. Listen to Mother Lori, she’s giving you life advice here. What I was going to say, Lori, is you know that our motto here at, or like our tagline here at the OncoPT is helping physical therapists treat oncology patients confidently and competently. So like the confidence thing, I am all about that. So this is perfect. One last time, where can people, or I should say when is your session so that people can be on the lookout for that when they’re signing up and
Lori Boright (31:45.192)
That’s a great word.
Elise – @TheOncoPT (31:53.666)
planning out their CSF.
Lori Boright (31:56.384)
February 17th, so that’s that Saturday morning, 8 to 10 a.m. Typically, in my experience, things are pretty straightforward in the app. And you can star sessions and add them to your little calendar. And that’s kind of how I stay organized, because it really is information overload. So that you are doing this to help people kind of parse out what might be of special interest to them is really a good service. So thanks, Elise.
Elise – @TheOncoPT (32:06.039)
Mm-hmm.
Elise – @TheOncoPT (32:09.951)
Yup.
Elise – @TheOncoPT (32:20.822)
Mm hmm. Yeah, that’s I mean, and again, Lori and I were talking off air. This is exactly why I do this, because even today, like I know, because I was already looking at the CSM schedule of how am I going to prioritize what I want to attend to, because I need like in the Harry Potter books, Hermione has a has a time turner. And so she can go back in time and attend the classes, attend all the classes. I need that for CSM, because this three day
extravaganza is just not enough for me. Like I really need it to be a week, but also not a week long. So last question, Lori, which will also help people kind of say, OK, where am I going to go? When I’m going to go to it? Is your session going to be on demand? Like after. OK, good to know. Good to know. OK, let’s give a little time. Tell us about your poster. When are people going to be able to go and see that?
Lori Boright (33:06.617)
This particular session will not be offered on demand.
Lori Boright (33:20.092)
So the poster presentation I’ve been assigned to is Saturday, it’s that same day, Saturday afternoon, 1 to 3 p.m. Typically the posters are in the exhibit hall, so that’s a little easier to find, and they’re like divided by section. The title of the poster is Perceptions and Outcomes of Older Adults Following a Cancer Prevention Educational Seminar. And it is a project that I worked on with four very talented DPT students. They actually helped
Elise – @TheOncoPT (33:26.782)
Okay, nice.
Mm-hmm.
Elise – @TheOncoPT (33:47.35)
Hee hee.
Lori Boright (33:49.768)
myself, Dr. Chris Wilson and Dr. Sarah Arena, develop a cancer prevention education module and it was delivered to older adults in person. And we did a survey of their perceptions and knowledge and much of what we discovered was we were pretty effective in delivering the content. So little spoiler alert, but lots of significance in terms of outcomes.
Elise – @TheOncoPT (33:58.243)
Oh my God.
Elise – @TheOncoPT (34:07.572)
Mm-hmm.
Elise – @TheOncoPT (34:12.879)
Yay!
Lori Boright (34:19.404)
statistically, but I feel like the best outcome, and I will just say this because my students won’t be joining me to present, unfortunately, but the best outcome of all was watching them grow as students and talking about confidence, putting together a mini PowerPoint and delivering it to a room of older adults is pretty anxiety-provoking. All four students did an exceptional job, enjoyed every minute of it.
Elise – @TheOncoPT (34:19.56)
Mm-hmm.
Elise – @TheOncoPT (34:36.855)
Mm-hmm.
Lori Boright (34:48.124)
the older adults just, you know, oohed and awed over the wonderful experience that they provided. And so I’m really proud of this project.
Elise – @TheOncoPT (34:54.446)
Oh!
Elise – @TheOncoPT (34:57.878)
That is so exciting. Oh my gosh. First of all, congrats to those students. That is such like a monumental accomplishment to do. And I’m really, really excited to see that poster. So wonderful on that. And then you also have another session at CSM. Is that correct?
Lori Boright (35:13.456)
Yep, I’m part of another collaborative session. A group of us were asked to contribute to this particular presentation and larger project. It is the how-to manual for including oncology rehab and entry-level DPT curriculum. Shana Harrington and Chris Wilson for the last several years have been working on information sourcing data gathering related to what’s being currently taught.
Elise – @TheOncoPT (35:30.668)
Mm-hmm.
Lori Boright (35:41.624)
across the country related to oncology rehab and put together a really exceptional Delphi study, the outcome of which was not much. And we need to up the ante a little bit in terms of what we’re providing because they are required to know certain things for entry-level board practice or passing the boards for entry-level practice rather.
Elise – @TheOncoPT (35:42.087)
Mm-hmm.
Elise – @TheOncoPT (35:58.517)
Mm-hmm.
Elise – @TheOncoPT (36:06.775)
Mm-hmm.
Right.
Lori Boright (36:11.648)
So, you know, the work to come is involving working with CAPTE. We do not currently have CAPTE standards for oncology, for DPT curricula, but this how-to manual will really help to kind of ramp up what programs might have existing or fill gaps that maybe is not there. Yeah, exactly. So.
Elise – @TheOncoPT (36:24.041)
Mm-hmm.
Elise – @TheOncoPT (36:36.93)
are needed.
Lori Boright (36:40.412)
that we are preparing an entry-level workforce. Because I know as a listener of your podcast, many episodes do stem on the volume of cancer patients to the lack of qualified clinicians. So if we can narrow that gap through entry-level preparation, all the better, at least to help triage and get things moving.
Elise – @TheOncoPT (37:11.95)
So there you have it y’all. Some very exciting topics and conversations that are going to be had at CSM. Very, very excited about this. Lori, where can people connect with you? I mean, obviously we’re going to be at CSM, so that’s number one. But where can people connect with you after listening to this podcast episode? They’re like, I’m obsessed. Where can I learn?
Lori Boright (37:33.188)
I am on faculty at Oakland University. So email address, Bill Wright at oakland.edu for direct messaging. I’m very accessible. I’m on Twitter. I don’t remember what my handle is. You might have to put that in the show notes. Yeah. And Instagram too. Yeah. Either of those two places. I will say Twitter is a lot of fun in the oncology rehab space. So if you’re not on Twitter, you should be. Yeah.
Elise – @TheOncoPT (37:48.066)
I can find it. I’ll find it. That’s not a problem. Ha!
Elise – @TheOncoPT (37:55.304)
Perfect. And then I…
It’s a lot of fun. I agree with that 100%. And I was just going to leave one little tidbit with, she mentioned it, but I just want to make sure that was acknowledged. She is also part of the amazing oncology rehab textbook team that we had on the podcast like a year ago or so. So that’s also going to be linked in the show notes because if you are considering diving into oncology rehab in any capacity, you need this textbook on your bookshelf. So
Lori, thank you so much for coming on the podcast again. This was such fun. And I’m really, really excited about this session because it’s very needed, obviously in the oncology session, you know, like world, but also just, I think, being a better clinician, it’s going to be really, really impactful. So make sure y’all, if you’re going to CSM, mark your calendar, the navigating complex situations and tough conversations of working with the cancer population is happening on Saturday, February 17th at 8 a.m.
and we will see you there. So Lori, thank you so much for coming back on the podcast to talk about this today.
Lori Boright (39:05.864)
Thanks for having me.