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Re: CASE 1
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Re: CASE 1 - January 13, 2006 7:50:00 AM
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Dr.Wagner
Posts: 1239
Joined: January 24, 2003
From: Indianapolis
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In no way is this case meant to be viewed as controversial or in any shape or form the typical case seen in a therapy clinic.
The appropriate disposition for this patient is to see a physician, likely in an Emergency Department.
In no way was this case meant to confuse what is the appropriate course of action for therapists.
What is the purpose of case presentations ?
My purpose is to teach differential diagnosis and medical pathology. My cases are meant to be challenging, asking people to think on their feet and "pretend". When all you see all day long are horses, and you see a hoofprint, you think "oh look at the horse"...I am presenting zebras.
And yet these cases are ultimately NOT tricky, they just prompt critical thinking. They are cases I see daily and each decision I make is supported by objective data. The answers CAN be found and do not lay in the "gray areas" of "what is causing this radiculitis".
I hope we can continue to enjoy these cases and understand that referring these patients to a physician is the ultimate correct answer...
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: CASE 1 - January 13, 2006 11:25:00 AM
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Randy Dixon
Posts: 744
Joined: August 6, 2004
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I think it is fun, and more importantly, useful. If you are a PT for a football team it's a good idea to at least watch a game or two, and even better to understand the game. Most therapists don't work for football teams, they see patients referred from situations like this. It is a good idea to understand this game.
Maybe it needed to be expressed that something presented here isn't necessarily within the scope of PT practice but I think it was understood.
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Re: CASE 1 - January 14, 2006 12:18:00 AM
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Sean_Collins
Posts: 74
Joined: October 20, 2005
From: Massachusetts
Status: offline
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It is always good to have what is understood become explicitly stated so that everyone knows what is understood. On that note, I appreciate the cases and Dr. Wagner's insights and skill in presenting such cases and in no way do I want to stop such dialogue. Merely wanted to state some observations and obtain feedback. Please realize that I am new to the RehabEdge posting - only been a couple of months now that I have been reading/posting on a somewhat regular basis. So, for what a lot of you find understood, I am still learning.
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Sean M. Collins, PT, ScD, CCS
Associate Professor
Research Coordinator
Department of Physical Therapy
Coordinator, Graduate Program in Disability Outcomes
Adjunct Professor, Department of Work Environment
School of Health &
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Re: CASE 1 - January 14, 2006 12:19:00 AM
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Sean_Collins
Posts: 74
Joined: October 20, 2005
From: Massachusetts
Status: offline
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With Dr. Wagner's permission - I would like to post the next case. Is this OK?
I am off to teach a course - "Rehabilitation for the Medically Complex Patient: Advanced Decisions in Cardiac Conditions" - long day, but lots of fun!
_____________________________
Sean M. Collins, PT, ScD, CCS
Associate Professor
Research Coordinator
Department of Physical Therapy
Coordinator, Graduate Program in Disability Outcomes
Adjunct Professor, Department of Work Environment
School of Health &
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Re: CASE 1 - January 14, 2006 5:26:00 AM
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Dr.Wagner
Posts: 1239
Joined: January 24, 2003
From: Indianapolis
Status: offline
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Sure, I probably have posted 10 cases in the past...mine are typically fit the title of the forum and are mildly "medically complex". They always have a "medical" aspect, but always with a musculoskeletal component.
You may feel free to post the next case, I simply post the ones I see everyday that those PTs here may find interesting.
Usually I post things that people know "that just isn't right" but I don't allow the "send them to the doctor answers...and have people 'shut off'" They must continue to problem solve past their "comfort zone".
_____________________________
Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: CASE 1 - January 15, 2006 5:14:00 AM
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Dr.Wagner
Posts: 1239
Joined: January 24, 2003
From: Indianapolis
Status: offline
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I always post cases that I see in the ED, adds a bit of realism.
To those that read the posts, is there anything you would additionally like to see? I assume a combination of Geriatrics, neuro, medical, ortho is all ok...yep some peds here and there.
_____________________________
Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: CASE 1 - January 16, 2006 1:32:00 AM
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SJBird55
Posts: 2362
Joined: May 10, 2004
From: Michigan
Status: offline
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There is an interesting editorial in January's JOSPT. The JOSPT site doesn't have January's journal online yet, but when it does, I'll see if I can get a link to the editorial.
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