I’ve been in the emergency department twice as a patient – zero stars, would not recommend. I was enormously fortunate in that I left the same day both times, & both issues were resolved completely.
This is not the reality for many of our patients.
In fact, the emergency department is the safety net of American health care. Think about this: how many patients do you have who…
- Were diagnosed with cancer in the emergency department?
- Wound up in the emergency department due to side effects or complicating factors?
- Were unable to access care with their normal medical team & had to seek care at the ED?
I’ve learned over the past few months that OncoPT & emergency department PT are not that different – in fact, we both see a variety of diagnoses, age groups, experiences, & complex circumstances.
And what today’s guests have really figured out is how to approach any complex patient population with a dependable framework, no matter the circumstances.
Drs. Rebekah Griffith, Jenna Segraves, & Mark Magdaleno stopped by TheOncoPT Podcast to discuss their upcoming CSM session, “Keep It Simple — Management of the Complex Patient in the Emergency Department.”
Now let me reassure you: you will benefit from listening in on this conversation, no matter the setting & patient population you encounter. No ED experience required.
So pop in your favorite earbuds & get ready to take some notes!
You can tackle any patient case – you just need the right tools
Emergency departments can seem scary, overwhelming, complicated, & hard to navigate…& that’s coming from a PT. Now imagine how your patient feels.
So instead of getting lost in the weeds, our guests today discuss how you can truly tackle anything with a dependable framework.
This framework is like the foundation of a house: from a solid foundation, you can literally build a mansion. Or you could build a cozy cottage. Both required a solid, dependable foundation first though.
“Physical therapy should not be a luxury, should not be something people have never heard of, and it should be something that gets to the patients who need it.”
Controversial opinion: I think emergency department PT might be what actually “saves our profession.” Ponder this quote from Dr. Rebekah Griffith:
“Physical therapy should not be a luxury, should not be something people have never heard of, and it should be something that gets to the patients who need it.”
With top of scope physical therapy delivered in the emergency department, PT impacts health care on multiple levels. Not only is the patient exposed to PT, but family members & caregivers are too.
Beyond the patient & caregivers, emergency department PTs work with a variety of health care professionals, including physicians, nurse practitioners, physician assistants, respiratory therapists, social workers, case managers, & beyond. And what a more perfect opportunity to demonstrate high quality care for our patients AND the value of our profession?
These factors can contribute so positively to the public perception of physical therapy – which is exactly why I think emergency department physical therapy might just be what turns the tides for PT.
Mark your calendar for Keep It Simple — Management of the Complex Patient in the Emergency Department!
This APTA-CSM session will take place on Thursday, February 15, 2024 at 11am.
This session will be available on-demand after the conference.
About the Speakers
Dr. Rebekah Griffith is a physical therapist who specializes in care in the Emergency Department and ICU settings. She believes that physical therapy should not be a luxury and should be accessible to everyone, particularly in life’s most critical moments. Dr. Griffith is the founder of the ED DPT, a business focused on making Emergency Physical Therapist practice well-known and well-practiced. She also serves her profession as APTA Colorado President Elect. A believer in life-work flow, she is a dedicated mother of 3, wife of 22 years, an avid reader, writer, and photographer, and also holds a Black Belt in Taekwondo. Dr. Griffith firmly believes that we rise by lifting others, which is at the core of being a physical therapist and human.
Jenna Segraves is an Assistant Professor and a Board Certified Neurologic Clinical Specialist in Physical Therapy. She graduated with her Masters in Anatomy and Clinical Health Sciences from the University of Delaware in August of 2014 and her Doctor of Physical Therapy in December of 2014. Her clinical practice involves a wide variety of settings and populations including outpatient orthopedics, outpatient neurology, and acute care with a focus on neuro/trauma diagnoses, critical care, the emergency department, and inpatient obstetrics. Dr. Segraves is passionate about expanding physical therapy services to the emergency department to optimize patient function/safety and reduce overall hospital costs.
Mark graduated from Northern Arizona University in 2010 with a BS in Exercise Science and earned his DPT from Chapman University, in Southern California, May of 2013. He has worked his entire career in the hospital setting and prides himself in being a generalist. For 8 years, he has managed patients across the continuum of acute care, outpatient therapy, inpatient rehab, and emergency care. With a particular passion for the complex trauma patient population and emergency physical therapy, Mark is interested in practicing at the top of his scope and advancing physical therapy into a prominent role in primary care.
Transcript
Elise – @TheOncoPT (00:02.185)
Hey, Onco PT and welcome back to this episode of the Onco PT podcast. We are continuing our APTA CSM 2024 preview sessions with our next exciting session. And I am so excited to welcome some three very dynamic speakers to this episode. So first up, let’s welcome back Dr. Rebecca Griffith, the EDD PT to the Onco PT podcast. Rebecca, welcome back.
Mark Magdaleno (00:18.743)
And that’s how we can do it. So if you’re interested in the second half, you can go to the second half of the video before we go to the third half. And we’ll be showing you how we do it. And if you’re interested in the third half, you can go to the third half of the video. And if you’re interested in the fourth half, you can go to the fourth half of the video. So that’s how we can do it. And we’ll be showing you how we do it.
Rebekah Griffith, The ED DPT (00:26.818)
Thank you, I’m so happy to be here, but I have to tell you, like, in this company, I’m not the EDDPT, because we are all EDDPTs. So, I mean, I am one of many today, and I’m really excited about that.
Elise – @TheOncoPT (00:38.441)
Oh my God, I love that. So we’re gonna need you to change your little handle here. You can’t be the EDDBT anymore in this conversation.
Rebekah Griffith, The ED DPT (00:47.658)
Well, I’m not smart enough to fix that, so we’ll see.
Jenna Segraves (00:47.793)
Thanks for watching!
HAHA
Mark Magdaleno (00:50.97)
I’m going to go.
Elise – @TheOncoPT (00:52.65)
That’s okay. We’ll let it slide this time. I love that. So then following Rebecca, we have a brand new speaker to the Onco PT podcast, Dr. Jenna Segraves. Jenna, welcome to the Onco PT podcast.
Jenna Segraves (01:05.093)
Thank you so much. I’m happy to be here. Just to give a little background about myself, I am a board certified neurologic clinical specialist. So I’m very passionate about working with patients that have various neurologic conditions. And I am so excited to be talking more about having PT in the emergency department.
Elise – @TheOncoPT (01:25.617)
That is so exciting. And then our next speaker of the evening is Dr. Mark Magdaleno. Mark, welcome to the Onco PT podcast.
Jenna Segraves (01:26.489)
Yay!
Mark Magdaleno (01:34.01)
Yeah, so good to be here. Thank you so much for having me. I’d love the opportunity to be able to speak about our CSM presentation. So a little bit about myself is that I’m, I’ve been a bit of a generalist for my entire career. So I’ve had most of my career, which is 10 years now, in some combination of outpatient, inpatient, acute rehabilitation, and just kind of a broad generalist mentality, I would say, which…
which is what draws me to the emergency room. And I’ve been here at UC Health in Aurora for about seven years and been in the emergency room for most of that time.
Elise – @TheOncoPT (02:05.141)
Mm-hmm.
Elise – @TheOncoPT (02:13.961)
Okay, I’m gonna go off script. I’m gonna ask a question. So I know Rebecca’s kind of backstory into this, but Jenna and Mark, how did you find yourself in the emergency department as a physical therapist? Because that is, when I graduated PT school, that was not on my PT bingo card. And I didn’t know it was a thing, honestly, until I saw Rebecca on social media. So I have a lot to learn about this topic.
Mark Magdaleno (02:40.642)
Yeah, I would say standing on the shoulder of giants, right? It was not an opportunity that I had much of an awareness either until I started working here coincidentally. And would you believe it, Dr. Rebecca Griffith had started an ED program that was something that I showed some interest in and fell in love with it.
Jenna Segraves (02:55.075)
Look at that.
Rebekah Griffith, The ED DPT (03:00.938)
Yeah, Mark has been stuck with me that whole time, that seven years that he’s talking about and he’s still standing. And I have to tell you, he’s one of the best clinicians I’ve ever worked with. So if you have need to learn particularly about vestibular, about how to simplify the complex, like that is why Mark is part of this presentation because he takes this like calm methodical approach and can take anything that feels really serious and complicated and break it down systematically to the point where it feels like a no brainer.
So he’s absolutely gonna crush this presentation.
Elise – @TheOncoPT (03:35.189)
I love that. All right, Jenna, same thing.
Jenna Segraves (03:37.178)
Yeah, yeah, absolutely. So I got into the emergency department because when I was actually applying for an acute care position, they had a growing need because they were well aware that having our services in the emergency department was so important. They were just starting to have too many calls for PT to come down to the ED. And so…
I actually interviewed for a position that would require a significant amount of my time to go down there. And I had never done it before, but my background with outpatient and also acute care, that nice blend, it really, I think, set me up for success working in that department.
Mark Magdaleno (04:04.163)
Thank you. Have a good one.
Elise – @TheOncoPT (04:24.749)
Oh my gosh. So again, I think this is a really great intro into this topic because again, even in oncology, I didn’t know that oncology was a thing in physical therapy until I got to school and then happened into a CSM session that was on oncology. And so I’m hoping that maybe this is going to be like someone else’s origin story of wandering into your session and maybe like.
Mark Magdaleno (04:33.309)
I think that’s what we’re going to be talking about in the next few minutes. So, if you’re interested in learning more about the
Mark Magdaleno (04:50.45)
So, I’m going to go ahead and read it. Thank you so much for coming. So, if you like the video, you can subscribe to the channel. If you haven’t already, you can subscribe to the channel. If you want to see more videos like this, you can go to the link in the description.
Elise – @TheOncoPT (04:52.845)
Five years from now, they’ll tell the same story. So let’s dive into your CSM session, which is titled, Keep It Simple, Management of the Complex Patient in the Emergency Department. Tell me all about it. This is so exciting.
Elise – @TheOncoPT (05:11.268)
Rebecca, you’re muted.
Rebekah Griffith, The ED DPT (05:15.51)
to a certain extent, every patient that comes into the emergency department is complex, right? There’s a reason they’re coming to the ED. Sometimes it’s socially complex, they may not have access to any other care. Sometimes it’s medically complex. Sometimes it’s psychologically complex. Sometimes it’s…
Elise – @TheOncoPT (05:26.102)
Mm-hmm.
Rebekah Griffith, The ED DPT (05:33.27)
just a really tough time in their life. So I would say that we try to approach every patient as the whole complexity of who they are as a human. But the rationale for this presentation really is there’s been a lot of programming at CSM about here’s how you get into the ED, here’s kind of what you can do there. This is what the research shows about the benefits. But for those physical therapists who practice in the ED, we wanna help you level up.
So the purpose of this presentation would really be to allow you to grow in your practice, to be able to take anything and anyone with any circumstances that walks through the door and to know how to approach that in a comfortable, reasonable, and easy to manage way.
Mark Magdaleno (05:57.442)
Thank you.
Mark Magdaleno (06:16.153)
Yeah, I think there’s just so much going on in the ED with respect to, you know, biopsychosocial different diagnoses, lots of crossovers with, you know, acute care and
outpatient and different populations such as oncology, you really get tossed into this buffet of patients and complex situations. So I think it’s easy to overthink it a lot and really get stressed out. So I think that was a great title that Rebecca, I think, created, Keep it Simple, in that it’s a really good way to streamline a thought process and not to get stuck with paralysis of analysis.
Elise – @TheOncoPT (06:50.997)
next.
Elise – @TheOncoPT (06:58.209)
Mm-hmm.
Jenna Segraves (06:58.805)
Ooh, I like that paralysis of analysis. Yeah, and just to sort of add to that, I think that Rebecca and Mark have both just done a phenomenal job really of just kind of giving us a great nutshell of like what this presentation is going to be about. But we also have to remember that within the emergency department, the collaboration that takes place, the interdisciplinary communication is different than on other floors of acute care. And so,
I think it will also bring a deeper understanding and also a deeper appreciation of what that really looks like and how to really navigate that for those that are currently working in the emergency department. How can they make their time down there more efficient?
Elise – @TheOncoPT (07:45.525)
Mm-hmm. So then what was the motivation behind putting together this presentation? I really love, I’m gonna pull something out that Rebecca said earlier, which is there’s been programming on how to get started or how to get into this. And this is something I kind of see of an oncology too of there’s kind of a gap between here’s what oncology PT is and then there’s like way up here.
and sometimes I need in the middle. So I wanna know what inspired you to present on this topic at this CSM in particular.
Mark Magdaleno (08:16.834)
the need to present the best of me and the most effective way to do it. I wish you all a happy New Year’s Day. And I hope that you all have a wonderful year. I wish you all a happy New Year’s Day. And I wish you all a happy New Year’s Day.
Rebekah Griffith, The ED DPT (08:23.07)
For me, it was last year I went to all of the EDPT content, which was great. There were people who were really like showing what they were doing, how they were doing it, how they had become successful. But for me again, it was just like, I need to learn what to do next and how to be a better clinician in this space. And I think when you’re speaking to that gap at CSM, is CSM the place to be teaching advanced skills? I don’t know, right? Like, I don’t know. Is CSM a tasting menu?
Mark Magdaleno (08:47.921)
So thank you for joining us. And we’ll see you next time. Have a great day. Bye.
Rebekah Griffith, The ED DPT (08:51.118)
Or is CSM where I’m going for my CEUs to advance my skills? Is a two-hour lecture really enough? I don’t know. But the other issue that exists is this gap in continuing education for physical therapists who practice in the emergency department period. So right now, we are filling the space in the space that’s available. And that’s why this really works.
Jenna Segraves (08:51.333)
Thank you.
Rebekah Griffith, The ED DPT (09:13.594)
this lecture should be such a nice follow-on to the content that was provided last year. So if you went last year to the EDPT or EDPT content and you were like, this is amazing, we are now ready to bring you to that next step.
Elise – @TheOncoPT (09:26.26)
That’s so exciting.
Jenna Segraves (09:27.849)
Something that, yeah, and something that kind of inspired me really had to do with when I was at that previous hospital that I was talking about where I was there and was working much more often in the emergency department. We were trying to train some new grads to actually be able to go down there as well. And they were often getting very just overwhelmed, you know, very overwhelmed. And so this…
Mark Magdaleno (09:27.98)
I love that.
Elise – @TheOncoPT (09:54.529)
Yeah.
Jenna Segraves (09:57.145)
this actual session I think is really going to help tease it out to where it doesn’t feel so overwhelming. It’s easy to get lost in the complexities but how do you pull yourself out and come back to sort of a framework to walk yourself through?
Mark Magdaleno (10:02.427)
Thank you.
Elise – @TheOncoPT (10:03.905)
Mm-hmm.
Mark Magdaleno (10:05.35)
Yeah.
Mark Magdaleno (10:10.48)
with time and time. Thank you.
Mark Magdaleno (10:14.998)
100% it’s that gap that everyone’s talking about, right? There’s not enough content to fill that gap to bring you from entry level or new grad to a fully functioning emergency room PT. So it’s a lot of on the job training and I would say several years of on the job training when we noticed that we have interest in our new grad population. So it’s just the content has not yet been developed to.
Elise – @TheOncoPT (10:18.973)
Mm-hmm.
Elise – @TheOncoPT (10:30.227)
Mm-hmm.
Mark Magdaleno (10:41.146)
develop these young budding PT’s with a lot of passion, but maybe a lack of confidence or a lack of certain skill sets.
Elise – @TheOncoPT (10:42.453)
Yeah.
Elise – @TheOncoPT (10:49.949)
Mm-hmm. And I really like the acknowledgement that y’all have of, because this is something I don’t think I’ve really explored of, you know, how much can you really do in a two hour session at CSM? But it’s a start, right? And I think that’s really important. And I think that’s something that sometimes even in oncology, I really like this approach of kind of what Jenna said of, sometimes it’s really complex and it’s really complicated. It’s very multi-layered.
But what kind of a framework can you come back to make sure that, okay, I can rest in my assuredness of this framework as a basis or a foundation for me to then build upon no matter what I see in the ER, because I imagine you’ll probably see a lot in the emergency department.
Rebekah Griffith, The ED DPT (11:36.91)
Well, at least I’m gonna tell you too that if anybody’s listening to this and they’re like, I’m absolutely not an EDPT, this presentation is still for you because we’re gonna take that same framework, we’re gonna apply it to any complicated patient no matter what setting you’re in. So if you’re like, I’m a home health pediatrics PT, this is absolutely not for me, it is. Because the framework we’re going to provide to you is really through the lens of an EDPT.
but it’s applicable to any complex patient population. Anytime you’re confronted with a patient and you’re like, I’m not sure what to do, this framework will help you navigate your way through that. I think we’ve tried to make it so that you can really take your tool set and apply it with the right top of scope mindset and then get that to the patient to get the patient the best that they need. So anybody, it really would benefit from this presentation.
Mark Magdaleno (12:04.689)
that’s not the best way to do it. So, I think that’s a good way to do it. I think that’s a good way to do it. So, I think that’s a good way to do it.
Elise – @TheOncoPT (12:27.413)
So why is it so important, and you kind of answered this, but I’m gonna keep asking this, why is it so important for attendees to go to your session versus someone like a different one? Because we know this is a good topic, but tell me why.
Mark Magdaleno (12:29.796)
So, we’re going to have a little bit of a break. And then we’re going to have a little bit of a break. So, we’re going to have a little bit of a break. And then we’re going to have a little bit of a break. So, we’re going to have a little bit of a break.
Mark Magdaleno (12:42.899)
I think it’s the experience in this room. I would find it hard to duplicate the amount of ADPT that is within this wall during this session.
Elise – @TheOncoPT (12:53.745)
Mm-hmm. Ooh, I like that. Good answer, Mark.
Rebekah Griffith, The ED DPT (12:57.022)
tell you it’s going to bring all the EDPTs to the yard also I think. And so I think you’re going to have this room full of experts in this area and I anticipate a robust discussion from like all of the EDPTs that come to CSM and I cannot wait for that.
Elise – @TheOncoPT (13:13.936)
exciting.
Jenna Segraves (13:15.737)
Yeah, and I think too that the topic itself and what we’re talking about is also gonna draw a lot of interest for students who are currently just learning about how to be a physical therapist and maybe they’re currently in a class about complex cases and this is really going to set them up for success throughout their curriculum, but also to be thinking about a new and novel area that maybe they haven’t learned about in school.
Elise – @TheOncoPT (13:33.354)
Mm-hmm.
Jenna Segraves (13:42.793)
It’s not very often that this is even covered in the curriculum. And so I think that it could really spark some, you know, new frontier, passionate therapists to come back to their school and say, listen to this talk I just went to. Why did we not learn about this in school? We absolutely should be in the emergency department.
Elise – @TheOncoPT (14:04.275)
Oh my God.
Jenna Segraves (14:04.293)
Let’s spark change. Let’s do it.
Mark Magdaleno (14:07.69)
Yeah, I love that now that I’m thinking about that because there’s so many clinicians that you know, they have that passion, that fire when they realize that this is something new and novel that they want to take on. Even experienced clinicians who have been doing outpatient therapy their whole career and they jump into something new, you can kind of see that fire that’s been ignited. So I think it just takes a little bit of exposure sometimes to say, wow, that is cool.
Rebekah Griffith, The ED DPT (14:10.062)
Thank you.
Elise – @TheOncoPT (14:26.398)
Mm-hmm.
Elise – @TheOncoPT (14:40.477)
It really does only take once. Again, like I went to one oncology talk. It was the very first session of CSM 2016 in Anaheim and like there was Elise before CSM and there was Elise after CSM. And Elise after CSM has never been the same because of this. So again, like I love what Jenna said about, let’s spark change. Literally this could be the, again, five years from now, this could be the reason that someone has like a whole.
interest and excitement and passion and like department they’ve built out. Oh my God, that makes me so excited.
Jenna Segraves (15:10.513)
True.
Rebekah Griffith, The ED DPT (15:17.41)
I mean, that’s my mission, right? Like my mission is to have a PT in every ED in the United States and urgent care. So if anybody walks out of this session with that as a goal, I’m 100% like behind that and here to help.
Jenna Segraves (15:18.459)
That would be so cool.
Elise – @TheOncoPT (15:32.557)
Oh my God. I just love CSM for so many reasons, but that in particular is one of them. Oh my God. Okay, so let’s say that someone is coming into your session and they’re like, okay, I’m gonna learn a lot in here. I’m gonna overload my brain, but what is one takeaway that you want someone to walk out of your session with confidently and say, I feel really good about this thing?
Rebekah Griffith, The ED DPT (16:02.954)
have the skill set and the mindset and I can really handle this as a doctor of physical therapy. This is my role, this is my place, and this is a space that we need to be in. And I think that also I want anybody who comes to leave realizing we need to go where the patients are and we need to fill some of the gaps in healthcare because we’re the right provider at the right time to do that and as hope-bringers, as professionals that make hope visible
Mark Magdaleno (16:24.667)
I am a
Rebekah Griffith, The ED DPT (16:31.33)
the emergency department has to be a space that we’re in.
Jenna Segraves (16:36.589)
Rebecca, do you know how powerful you are when you speak? I just, I love your words. I just want to say ditto. Move past me.
Mark Magdaleno (16:40.696)
I’m sorry.
Mark Magdaleno (16:46.767)
Thank you.
Rebekah Griffith, The ED DPT (16:47.523)
Can you tell I feel really strong about this? I feel like a broken record, but this is important.
Mark Magdaleno (16:50.034)
Ha ha ha!
Jenna Segraves (16:50.781)
You’re very passionate. Yes. No, but I love that. And I just I couldn’t agree with everything that you said anymore. Something else though, just to add to it, because everything you said, I agree with tenfold. You know, I really, I just I also want everyone to walk away understanding the importance of our role. So
you know, everything that you just said, but also that like we should be on the team. We should be part of the actual team members because we identify things that others don’t even know either how to look for it or they don’t know what to ask. And so we spend that additional time with patients to where we can really get a deeper dive on some social determinants of health that could really impact their recovery.
Mark Magdaleno (17:32.347)
And that’s the end of the video. Thank you for watching. I hope you enjoyed it. Please like, comment, and subscribe to my channel. I’ll see you guys next time.
Jenna Segraves (17:47.393)
And then we know who to go to refer them to if there are additional needs outside of our scope that we can’t help with at that time. We need to be there.
Elise – @TheOncoPT (17:51.538)
Yeah.
Mark Magdaleno (18:00.255)
I hope people come away with the same passion that everyone here is speaking to because I think it’s sometimes easy to not be motivated if you’re only seeing a certain patient population or
Elise – @TheOncoPT (18:05.581)
Mm-hmm.
Mark Magdaleno (18:13.658)
you know, only confined to these certain interventions that you’re able to provide. But here in the ER, it’s, you know, basically everything from social situations to manual therapy, and you get to really flex all those skills and become competent in each one of them. So you can walk away with this sense of confidence of like, I can manage any patient and I can help anyone no matter what their diagnosis or chief complaint is. It’s really a rewarding.
and I hope that is like a contagious feeling that we can make known in our presentation.
Elise – @TheOncoPT (18:51.721)
I feel like EDPT is such a new frontier as someone who’s not in it. So let me be clear. I feel like this is very much a new frontier of physical therapy because of what each of you said as far as what an incredible opportunity to meet people where they’re at. Because when Rebecca was on the podcast previously, one of the things that she talked about a lot that has really stuck with me is emergency departments are kind of the safety net of American healthcare.
There is no further downstream that I’m aware of as like, that is it. That is the hopefully catching the net of patients. And so what a tremendous opportunity and privilege to be able to show up in arguably what is probably one of the most distressing and vulnerable periods in some patients’ lives to then provide that hope and to be that beacon who can show up and say, I know that with my skillset,
Rebekah Griffith, The ED DPT (19:25.422)
Thank you.
Elise – @TheOncoPT (19:51.293)
and my mindset, I can help this person. No matter what they have, I may not know exactly what’s going on, but I’m gonna find out and I’m gonna find other people, and listener, the three people who I’m interviewing on this podcast right now, who can help me with that. And gosh, that is so exciting. I mean, this is so much bigger than I think.
Mark Magdaleno (20:02.217)
and the other people. That’s what we want.
Mark Magdaleno (20:12.774)
you
Elise – @TheOncoPT (20:15.273)
we think it is right now. I really do. Like this has the opportunity to like totally transform American healthcare. And that is really, really exciting.
Mark Magdaleno (20:26.722)
Yeah, you can feel it when you’re in it. The analogy I use is that just a little bit off course leads that ship into a completely different place, right? So if you make this change and you point this patient in the right direction from the starting point.
Jenna Segraves (20:26.837)
It is exciting. Yeah.
Rebekah Griffith, The ED DPT (20:29.038)
Thank you.
Elise – @TheOncoPT (20:38.321)
Yes!
Mark Magdaleno (20:44.646)
then they have the ability to make that follow-up that changes their life or improves their outcome in the long run, as opposed to just following through that safety net.
Rebekah Griffith, The ED DPT (20:55.55)
I think we’re impacting healthcare on multiple levels also, right? So Mark speaking to that patient, that patient’s family member might be getting exposure to PT. But when you also think about it, our interactions with the nurse practitioners, the physician assistants, the physicians, the residents, the interns, the respiratory therapists, the social workers, the case management workers, for them to be able to see what we can do.
The whole scope of it, it really blows their mind from whatever stereotype it is they have in their head about what a physical therapist is and what a physical therapist does. And so that opportunity to educate those providers to work in partnership and collaboration with them has ripple effects to care that multiple thousands of patients will experience over their lifetime. So I think that’s a benefit too. And I think the other thing that
that Mark and I have noticed, particularly with our last pilot program, is we had to do patient satisfaction as one of our outcome measures. And we know patients are pretty satisfied in the ED, and it made us nervous to have to be like, here’s a patient satisfaction survey, I need you to realize this is just about me, this has nothing to do with anything else in the ED. And even the times when I felt like we didn’t help somebody, like they left the same way they came in, those were sometimes the best patient reviews, and it was the comments.
Elise – @TheOncoPT (22:13.165)
Oh my God.
Rebekah Griffith, The ED DPT (22:14.346)
It was like, God bless Mark and all of his progeny. It was like, the physical therapist made me feel like a human. First medical provider to touch me. Actually listened to me. Explained things in a way I could understand. I feel so much less scared now. Like, those are the things. So, I mean, when we talk about, like, we’re making, like, patient changes, even if all we’re doing is adding some humanity into that experience, that’s enough for me.
Mark Magdaleno (22:17.939)
Thank you.
Elise – @TheOncoPT (22:18.763)
Oh
Jenna Segraves (22:21.922)
aww
Jenna Segraves (22:41.969)
Hmm. Mm-hmm. Wow. You know, Rebecca, I love that. And one thing to, that you just made me think of is that they’ve actually done research on those that have experienced trauma. And some of the, one of the biggest, I guess, reasons for people that feel as though they’ve experienced trauma is that they, in the healthcare system, so this is specific to within the healthcare system.
Mark Magdaleno (22:55.026)
So, I’m going to say that I’m going to say that I’m going to say that I’m going to say that I’m going to say that I’m going to say that I’m going to say that I’m going to say
Jenna Segraves (23:11.957)
is feeling like they were not heard. And so what you just said, we can actually allow them to share their voice, share their thoughts, their fears, and to just feel like they have been heard. We listen.
Elise – @TheOncoPT (23:27.581)
Mm-hmm. Oh my god.
Mark Magdaleno (23:31.346)
Yeah, I think a lot of patients like the reassurance that’s associated with our evals as well in that if a standard emergency room diagnosis might be low back pain and they’re discharged with still no understanding of what’s causing their low back pain. No.
Elise – @TheOncoPT (23:32.582)
Oh my god.
Mark Magdaleno (23:50.378)
estimate or prognosis on, is this going to be the rest of my life? Am I going to be paralyzed? Is this something that’s serious and incurable? Or do you have the therapist go in and speak with them for 20 minutes about the inherent stability of the spine and how all of these things are bound to improve just based on your youth and your lack of comorbidities? This is something that’s going to get better with graded mobility. It’s really, I think,
just educate the patient in terms of like at ground zero instead of waiting several weeks until they end up in a primary care clinic or outpatient physical therapy clinic until they’ve had all these fear of avoidance behaviors and all of these misconceptions. So they’ve had that opportunity to make this terrible scenario in their head or you can just tell them right now and everything’s gonna be all right.
Elise – @TheOncoPT (24:48.049)
Oh my God. I might just go to the session for the quotables that y’all are dropping. I mean, we’re in this 30 minute interview already just mic drop after mic drop.
Rebekah Griffith, The ED DPT (24:59.606)
It was because we have the coolest job.
Mark Magdaleno (25:02.967)
Yeah, I would agree.
Elise – @TheOncoPT (25:03.818)
must be it.
Rebekah Griffith, The ED DPT (25:03.822)
I’m just gonna assert that.
Jenna Segraves (25:04.25)
It is.
Elise – @TheOncoPT (25:07.097)
Oh my God. Okay, when is the session? Like, when can I register? Where do I like when do I need to see y’all? Because come on now. Let’s go.
Jenna Segraves (25:17.751)
It is Thursday, February 15th at 11 o’clock.
Elise – @TheOncoPT (25:23.117)
Oh my gosh, how exciting. That was my next question. That is so exciting. Oh my gosh. Okay. So again, y’all, their session, Keep It Simple, Management of the Complex Patient in the Emergency Department is going to be happening on Thursday, February 15th at 11 a.m. They will be announcing the room assignments, I’m sure, very shortly. But oh my gosh, you guys, that was fabulous.
Rebekah Griffith, The ED DPT (25:23.37)
and it will be available on demand after CSM. So they are gonna record that session as well.
Elise – @TheOncoPT (25:52.465)
Okay, I’m going to go off script again and ask one more question of each of you. What is something for the clinician out there who is listening to this and thinking, this may be where I’m supposed to end up? I think I’m supposed to be in the emergency department practicing, but I’m kind of scared about it. What is one thing you would just leave them with that would be encouraging, motivating during this uncertainty time?
Mark Magdaleno (26:16.926)
Just like you, I’m the president of the United States, the president of the United States.
Mark Magdaleno (26:24.686)
That’s a great question. I would encourage them to use the sort of systematic approaches that we have applied in this setting. And then we’re going to teach these principles in our talk and just start to use this framework and kind of mold your perception of these patients. It’s not just like a biomedical patient. Treat each patient as its own.
Jenna Segraves (26:26.07)
It is.
Mark Magdaleno (26:51.77)
you know, IFC model in that it’s, or ICF model in that it’s, you know, everyone is a biological system. They have a psychological health, they have behavioral health needs, and that they need a support system in place. So being able to think of each patient as its own little body, and then address each of those needs.
Jenna Segraves (27:17.265)
Yeah, I think that I would ask them first, you know, like, tell me exactly what it is that you’re fearful of. Are you scared about the complex case? Are you scared about having to communicate with a lot of different healthcare providers? Are you scared about talking to your manager and trying to start a program? Because maybe it doesn’t exist yet. What exactly are you nervous about? But let’s say it’s the complex case because they’re just really worried about that.
Elise – @TheOncoPT (27:39.752)
Mm-hmm.
Jenna Segraves (27:45.113)
Well, I like to, we will be utilizing a lot of case-based scenarios throughout our session. And so I think if they, if you attend the session, that will really help you understand even some of the most complex that we will present, we will break it down into its, its more simple parts. And hopefully that will help kind of put someone at ease to realize, oh, maybe it’s not as complex as I think it is.
Elise – @TheOncoPT (27:52.514)
Nice.
Rebekah Griffith, The ED DPT (28:16.782)
I would just say if you’re thinking about it, if you’re like, you heard this and you’re like a little bit inspired and you’re like, gosh, there’s so much opportunity there, I would say, yes, you can. Bring your brain, bring your heart, bring your guts and like, let’s go because the need is so great. And we need you, we just need you, the patients need you. As long as we’re practicing in this payer centered care model, like patients are never gonna get that care that they really need.
Jenna Segraves (28:25.21)
Hmm.
Mark Magdaleno (28:29.593)
And I think that’s a very important part of the mission.
Rebekah Griffith, The ED DPT (28:42.61)
and we have to start being that change, and we have to start going to where our patients are, because physical therapy should not be a luxury, should not be something people have never heard of, and it should be something that gets to the patients who need it. And this is one way where we can get upstream at the bottom of the waterfall. So we need you. Welcome, let’s go. Let’s go, like full send, as my 14 year old would say, full send.
Mark Magdaleno (28:43.164)
and we have to do it in a way that’s not true. So that’s why we’re going to do it in a way that’s not true. We’re going to do it in a way that’s not true.
Jenna Segraves (28:51.244)
Uh huh.
Jenna Segraves (29:03.67)
Let’s go!
Elise – @TheOncoPT (29:05.947)
I love that.
Elise – @TheOncoPT (29:11.737)
Oh my gosh, again y’all, right? Kind of at the end. Ha ha.
Jenna Segraves (29:11.989)
So let’s go. I think we should all do that. Yeah.
Mark Magdaleno (29:15.579)
team.
Rebekah Griffith, The ED DPT (29:17.742)
We’ll have to practice that before the presentation.
Elise – @TheOncoPT (29:20.089)
There you go. There you go. I like that. Oh my gosh, you guys, this was phenomenal. Again, you can catch their session happening Thursday, February 15th at the second session of the day. It is going to be so impactful. I’m so, so excited for this and thank you so much for making time to come on the podcast. This has been a really educational and enlightening interview and I’m really, really excited to see where this goes and what becomes of it.
Jenna Segraves (29:20.235)
Yes.
Elise – @TheOncoPT (29:46.945)
and what future PTs are going to be at that session who are like, this is it. This is where I’m supposed to be. And that’s really exciting to me. So thank you so much, y’all. I really, really appreciate it.
Mark Magdaleno (29:52.786)
Thank you.
Mark Magdaleno (30:00.527)
Yeah, thank you for having us.
Jenna Segraves (30:00.881)
Thank you, Elise. Thank you so much.
Rebekah Griffith, The ED DPT (30:02.53)
Thank you. And we can’t wait to see your presentation at CSM either.