Fast Tracks to Recovery: Advanced PT Strategies for Early RTW in Workers’ Comp Cases

Fast Tracks to Recovery: Advanced PT Strategies for Early RTW in Workers’ Comp Cases with Lucas Myers

In this episode of Fit for Duty, Dr. Larry Earl, president of the National Association of Occupational Health Professionals, is joined by Lucas Myers, Senior Director at ATI Physical Therapy.

They delve into the world of advanced physical therapy for occupational health. They discuss the use of work conditioning, an innovative method that combines standard physical rehabilitation with elements tailored to job-specific tasks, by simulating workplace scenarios as part of the therapy process. This approach provides a transformative bridge between recovering from injury and securing a safe and effective return to work.

Myers also highlights the importance of effective communication between the therapist, physician, and injured worker. The possibility of customizing therapy sessions to resemble actual work situations is explored as well. The conversation also touches on the need for continuous learning, preventing work injuries, and the importance of advocacy for patients.

Key Conversation Points:

00:06 Introduction to Fit for Duty Podcast

00:58 Exploring Advanced Physical Therapy Strategies

03:16 The Role of Physical Therapists in Occupational Health

06:44 Understanding Work Conditioning and Work Hardening

09:20 The Importance of Simulating Work Tasks in Therapy

10:26 Identifying Suitable Candidates for Advanced Therapy Techniques

20:40 Addressing Misconceptions and Challenges in Work Conditioning

29:44 The Future of Physical Therapy in Workers’ Compensation

32:16 Conclusion and Wrap-up

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[00:00:00] HOST: Welcome to Fit for Duty, the podcast elevating occupational health. I'm Dr. Larry Earl, president of the National Association of Occupational Health Professionals. As guardians of workplace health, we stand at the intersection of well [00:00:20] being and success. Fit for Duty delves into hot topics, OSHA regulated exams, workers comp, drug testing and so much more.

[00:00:29] HOST: Join us for practical tips, real stories, and conversations that spark change. Whether you're a seasoned professional or passionate about healthy workplaces, Fit for Duty is your [00:00:40] roadmap to a fitter, safer, and more productive workplace. Subscribe now on all major podcasts. platforms. Let's shape a future where well being fuels workplace excellence.

[00:00:51] HOST: This is Fit for Duty with Dr. Larry Earl.

[00:00:58] HOST: Welcome back to Fit for Duty [00:01:00] where we delve into the fascinating world of occupational health. Today we're tackling a topic that resonates. It's deep within the bones of every treating physician, physical therapist, case manager, and worker alike. Fast tracks to recovery, advanced PT strategies for early return to work in workers comp cases.

[00:01:19] HOST: But [00:01:20] hold on, this isn't your run of the mill stretch and ice approach. We're diving headfirst into the realm of advanced physical therapy practices. Where functional recovery meets work simulation and where the phrase getting back on your feet takes on a whole new meaning. Forget passive ice packs and repetitive exercises.

[00:01:39] HOST: We're talking [00:01:40] work conditioning, a transformative dance between physical rehab and job demands. Imagine a world where injured workers don't just regain strength, but practice using that strength in the very scenarios they'll encounter on the job floor. Lifting, carrying, climbing, we're replicating it all, tailor made for each unique [00:02:00] trade and task.

[00:02:01] HOST: Now, some might say, isn't that what physical therapy already does? But here's the rub. Traditional acute care often falls short when it comes to return to work. It excels at healing tissues, but to bridging the gap to real world demands, that's where work conditioning shines. [00:02:20] It's the missing link, the secret sauce.

[00:02:23] HOST: The bridge between feeling better and thriving at work. So buckle up fellow occupational health warriors, because this episode is going to be a game changer. We're meeting with Lucas Myers, senior director at ATI Physical Therapy, and dissecting the latest in work conditioning [00:02:40] techniques, sharing success stories that will make you believe in the power of rehab, and tackling the challenges.

[00:02:46] HOST: Let's be honest, there are always challenges. Head on, ready to unlock the hidden potential of return to work. Prepare to be amazed by the power of advanced physical therapy, and let's show the world that fit for duty isn't just [00:03:00] a slogan, it's a reality. Stay tuned, because the revolution in workers' comp return to work starts right now.

[00:03:07] HOST: I'm your host, Dr. Larry Earl, and this is Fit for Duty.

[00:03:16] HOST: Today we have a special guest who's a beacon of knowledge and [00:03:20] expertise in the world of physical therapy. Let me introduce you to Lucas Myers. Senior Director at ATI Physical Therapy. His trailblazing work at ATI spans 16 years and has brought about remarkable advancements in patient care, setting a high benchmark for others in the industry.

[00:03:38] HOST: A respected leader, [00:03:40] a devoted therapist, a dynamic speaker, Lucas is just the expert we need to enlighten us today. Hey, Lucas.

[00:03:48] GUEST: Hey Larry, how are you today?

[00:03:50] HOST: Can you give us a brief overview of your journey in the physical therapy field, especially your role as senior director at ATI Physical Therapy? [00:04:00]

[00:04:00] GUEST: Sure.

[00:04:01] GUEST: Sure. Happy to. my, my journey started Larry at Marquette University, where I actually initially was an athletic trainer, while I was in physical therapy school there. And I think graduating with a background in athletics, my affinity, like many, outpatient orthopedic physical therapists was.

[00:04:19] GUEST: to [00:04:20] treat athletes. what I, what I quickly came to realize when I got into the real world is that uh, everyone who is seen in physical therapy is not a professional athlete. but what I also learned was, that there was a, uh, a large portion of injured workers that really had a close representation to [00:04:40] an injured athlete, right?

[00:04:41] GUEST: They're, they're basically an industrial athlete. And I think in starting to treat these patients early on in my career, really kind of started to, started to realize that there's, there's a gap. in kind of the universal quality, and the predictability of care that came with this very complex patient [00:05:00] population.

[00:05:01] GUEST: and so that really started my passion for, you know, this injured worker patient population. Yeah.

[00:05:05] HOST: Excellent. So, so what is it with all that, what is the role in your opinion of physical therapists in the care of injured workers?

[00:05:14] GUEST: Yeah, I think that, you know, the injured worker space is really complex. And I think, when we think about it, I [00:05:20] compare it oftentimes to, you know, a traditional commercial physical therapy patient, you know, a weekend warrior, Larry, or, or someone who just has an injury that's been recommended by maybe their physician to go see therapy, a therapist.

[00:05:33] GUEST: you know, when we think about that patient. It's pretty straightforward, pretty simple, right? You have a, you have an individual who [00:05:40] presents to the clinic with an injury or an ailment or a pain or an ache, and the physical therapist gets to work directly with them to, uh, you know, attempt to resolve their issues.

[00:05:50] GUEST: I think that when we think about the injured worker though, in comparison, there are, there are, uh, A litany of additional stakeholders that are [00:06:00] involved in the care of that, that patient, right? anything from, you know, the occupational medicine physician to the adjuster, to the nurse case manager, to the employer, to the physical therapist, to the patient or the injured worker themselves.

[00:06:11] GUEST: there's a lot of additional stakeholders. And so really the physical therapist is at the center of this. and they really represent a key [00:06:20] individual to maintain the progress of the case, as well as the communication amongst the stakeholders. you know, and I think it's, it's, it's interesting because there is one universal goal, regardless of which stakeholder you're referring to, you know, the number one goal for all of the stakeholders is to return that injured worker.

[00:06:39] GUEST: to [00:06:40] work as safely and efficiently as possible.

[00:06:44] HOST: And, uh, and you know, obviously there's lots of physical therapy techniques that are available for these patients, but today we're talking about some of the advanced conditioning techniques. So can you get into a little bit about what is work conditioning?[00:07:00]

[00:07:00] HOST: Uh, what's work hardening? Sometimes we still hear that term. What's the difference between those two things? Uh, are they the same? And how does that differ from traditional physical therapy

[00:07:09] GUEST: techniques? Sure. Sure. Yeah. When you think about traditional physical therapy or acute physical therapy, you know, it's very specific to an impairment.[00:07:20]

[00:07:20] GUEST: Right? So again, a patient presents with pain or a range of motion issue or a strength issue that that is correlated with their inability to perform basic functions. obviously, you know, that's where traditional or acute physical therapy addresses those specific problems. presentations. when we start thinking [00:07:40] about more advanced techniques or we think about work conditioning and work hardening, you know, really we're shifting from specifically an impairment specific intervention to a combination of impairment.

[00:07:52] GUEST: and vocational specific interventions. And, you know, I think that, work conditioning specifically, uh, is going to focus a [00:08:00] little more on strength, maybe power, endurance, motor control, functional abilities, and the like. but really represents a, a, a bridge between kind of acute physical therapy or addressing a specific impairment.

[00:08:15] GUEST: And the requirements that returning to work would entail. So [00:08:20] when we think about going back to work, we try to kind of put the requirements into two different general buckets, material handling, or the, you know, the actual. Work that has to be done, the amount of force required to do a particular job, and then that's one bucket.

[00:08:36] GUEST: And then the other bucket, which is essential job functions. [00:08:40] So what else does that patient have to do or that injured worker have to do? Do they have to climb? Do they have to spend their whole day on their knees? whether it's climbing ladders or stairs or driving a forklift, those are essential job functions.

[00:08:52] GUEST: Work hardening, and it depends on where you are in the country, work hardening sometimes has, pulls in then, you know, kind of an [00:09:00] additional layer of multidisciplinary approach. sometimes work hardening will include psychology or vocational retraining. that is not my expertise. you know, I stick to really what we call work conditioning, work hardening.

[00:09:13] GUEST: I think the other thing that we bring into work conditioning. Is, uh, you know, work simulation [00:09:20] activities. So again, uh, in contrast to acute physical therapy where you may be, you know, thinking about a traditional gym setting and, and machine weights or dumbbells, in work conditioning and work hardening, we're simulating more work activities.

[00:09:34] GUEST: So being on a ladder or, you know, being in your full work gear during a session in [00:09:40] order to, again, replicate most accurately the job that you will have to do when you return.

[00:09:46] HOST: I remember, I remember the old, uh, work hardening center, uh, centers. Years ago, a couple of decades ago that looked like an industrial, uh, you know, factory floor, right?

[00:09:58] HOST: They would have, [00:10:00] uh, assembly lines, uh, set up and a half a car or a truck over here that people would work on. I don't know if it goes to that extent today. You can certainly simulate those tasks in other ways, right?

[00:10:13] GUEST: Correct. Correct. Yeah, we don't have any half a cars, but I remember those times as well.

[00:10:18] GUEST: But, but you are right, [00:10:20] right? That the, the simulation of tasks is what's really key to the success of a program like that. Yeah. So how do you,

[00:10:26] HOST: how do you work with, uh, you know, typical treating provider? It could be an Ahmed doc. It could be a nurse practitioner in an urgent care center. How do they know that they have a suitable candidate for something?

[00:10:38] HOST: like this for the advanced, [00:10:40] uh, therapy techniques. Is that, is it up to the therapist to, sort of make this aware and available to treating providers or should everyone just know about this?

[00:10:51] GUEST: Yeah, it's a, it's a great question, Larry. And I think that, uh, the answer is yes to all, right? Again, we talked about kind of the multitude of stakeholders involved.

[00:10:59] GUEST: but the [00:11:00] therapist really is the one who has the opportunity to spend the most time with the patient and understand kind of where they're at on their journey to returning to work. you know, we, at ATI, we really try to focus on keeping it simple for the therapist, right? So, not that everything is an algorithm, but we leverage, you know, some of the, the ratings [00:11:20] that are provided by the departmental labor.

[00:11:22] GUEST: and the Department of Labor rates every vocation with a, what's called a PDL or a physical demand level, and that basically rates the intensity of a particular occupation or job title. and when we think about patients that present to physical therapy that are at a medium physical demand level [00:11:40] or heavier, So in other words, they're not doing sedentary desk work.

[00:11:44] GUEST: They're actually doing something physical throughout the day. You know, those, those patients should be considered. Furthermore, if you have a patient that presents that's medium or heavier, and they're currently not working full time with unrestricted duty, [00:12:00] Again, that that lends itself to a probable candidate for consideration.

[00:12:05] GUEST: I think the third thing that we think about at ATI is, you know, how long has that particular patient been out of doing the job that they're doing on a regular basis? It, you know, I think about it like, uh, like someone who exercises on a regular basis, right? They go to the gym every [00:12:20] single day. They've spent years getting into the condition they're currently in, similar to a worker who does the same job all the time that has some physicality to it.

[00:12:29] GUEST: if you get away from the gym for a day or two or it's around the holidays, is it the end of the world? No. but the longer or the more prolonged that time is that you're away from that [00:12:40] routine, that physical routine, the quicker that those culminating effects start to leave your body, right? And I think that that's pretty critical.

[00:12:48] GUEST: When we're thinking about returning an injured worker to work, you know, again, what's the physicality of the job that they're returning to? How long have they been out of work and when was the last time that they performed those duties [00:13:00] with relative success?

[00:13:01] HOST: So deconditioning back to reconditioning.

[00:13:04] HOST: Yeah, exactly. Right. Yeah. Yeah. And, uh, you know, so I was going to ask about how often should work conditioning be considered? You kind of talked about that in, in which, uh, patients, those that typically have moderate to heavy. type jobs, [00:13:20] right? So what effect does this have on successful return to work? Does it make a

[00:13:25] GUEST: difference?

[00:13:26] GUEST: It does. It does, Larry. And I think, you know, when, when you think about acute physical therapy or your traditional physical therapy intervention, you know, you're thinking about seeing a patient, maybe you see them two times a week, three times a week, maybe, I don't know, an average physical [00:13:40] therapy session, 45 minutes, 60 minutes ish.

[00:13:43] GUEST: you know, when you think about total work. Right. Which is just simply reps times, sets times weight in an average acute physical therapy session. You know, you're thinking about probably accumulating maybe four or 500 pounds of work over that [00:14:00] 45 or 60 minutes session. Right. So if you think, okay, I'm doing that and I'm doing it twice a week, or maybe I'm doing it three times a week in, in preparation for returning to work or addressing whatever impairment that I have, you know, in comparison, we think about, an average medium job and what that patient [00:14:20] or that injured worker is going back to in an eight hour day, they will need to lift upwards of 15, 000 pounds.

[00:14:27] GUEST: If we get into the heavy and very heavy category, we're talking about 30 to 35, 000 pounds in an eight hour day. So. You know, when we think about trying to create a bridge or we think about the gap that's [00:14:40] involved, again, we think about the things that we just talked about, right? How long have they been out of work?

[00:14:44] GUEST: If you've been out of work for a length of time and you're currently performing four or 500 pounds of work two times a week, but the expectation is for you to get back to 20, 000 pounds a day, there's a gap there. Right. There's a gap there. You can't, you can't go from running five K's on the weekend to [00:15:00] running the Boston marathon overnight.

[00:15:01] GUEST: Right. so there is a bridge that's required in order to provide for the most optimal return, which is a safe and effective return to your job duties. So that

[00:15:11] HOST: would really be one of the key benefits, really, of these advanced physical therapy techniques is creating that bridge, getting from A to B without just all of a sudden [00:15:20] showing up and, uh, you know, after traditional techniques, and, uh, perhaps being prone to reinjury.

[00:15:27] GUEST: Absolutely. And I think it does, it provides the space in which to also, you know, again, try to simulate those duties. So instead of going back and saying, I think I'm ready, or I hope I'm ready. you can go back with a [00:15:40] relative confidence that, Hey, I have already actually performed a lot of these duties, or I have performed or replicated, simulated a lot of these duties.

[00:15:48] GUEST: Yeah,

[00:15:48] HOST: well, I, you know, I think that's commonplace that people have a fear even, even the providers sometimes have a fear of, gee, can this person really go back to work and not get re injured? Now, you know, because [00:16:00] they've done it. I think everyone can be more confident. Not only the patient is confident, the provider is confident.

[00:16:07] HOST: Yeah, there,

[00:16:07] GUEST: there, there also is. Not only that, that physical preparedness to your point that you alluded to right there, there begins to be a mental confidence that's also instilled in the patient as they're able to actually perform the [00:16:20] particular duties. And, and again, the better we are at simulating some of those job tasks, the more transference there is for that confidence to be related right to the job site.

[00:16:30] HOST: Makes sense. Yeah. Can you give us some examples, some sort of success stories of folks that you've seen go through this process and what it's meant to them? [00:16:40]

[00:16:40] GUEST: Yeah, I mean, I think about it. I'm asked oftentimes about examples, and I have one patient that always comes to mind, who happened to be a firefighter that I was working with on an on and off basis.

[00:16:51] GUEST: But, when it came for him to return to work, it was the exact scenario we've been talking about. he had suffered an ankle injury and his ankle was healed.[00:17:00] there was literally nothing, nothing, from a biomechanics standpoint that was, that was holding him back. nothing from a strength range of motion function perspective, however.

[00:17:10] GUEST: again, we're talking about an occupation where, you know, he's required to be in, in a lot of different scenarios that, that are mission critical to saving [00:17:20] individuals lives. So as an example, you know, we had, we had in coming to, to the clinic. He had brought his full firefighter gear. he was lugging hoses up and down ladders.

[00:17:31] GUEST: He was dragging dummies through the clinic, around other patients, right? Again, to simulate the tasks that he was going to need to do. You think about something like, [00:17:40] like a firefighter. and, with an ankle injury and having to carry 50, 7, 500 pounds worth of hose up a ladder, you know, with one hand and three points of contact, it can be a challenge, right?

[00:17:51] GUEST: And he was successful, but being able to simulate that, not only from a physical preparedness. But from a mental preparedness and a [00:18:00] confidence perspective, that's really what the differentiator was, was for him to be successful. And for him to ultimately return to unrestricted full duty was him to be able to simulate some of these tasks on a repetitious basis.

[00:18:13] HOST: Yeah, very cool. You know, sometimes, uh, we have some obstacles [00:18:20] in getting stuff like this approved. Are there any special authorizations or permissions required to implement advanced techniques? And if so, how do you go about getting those? Is there a specific, uh, order that the physician has to

[00:18:37] GUEST: go through?

[00:18:38] GUEST: Yeah. good question. You know, again, going [00:18:40] back, when we think about the multitude of stakeholders involved in an injured worker, uh, case, communication is of the utmost importance, right? and again, at the center of that communication oftentimes is, is the physical therapist. so the physical therapist ability.

[00:18:56] GUEST: to tell a story, through their documentation [00:19:00] is, is critical, right? Because many of the stakeholders are relying on that documentation to track and follow this injured workers pathway toward restoration of ability to do their job. now, you know, in different states there are different requirements, but generally speaking, the referral source or the overseeing physician [00:19:20] prescribing the service.

[00:19:21] GUEST: And then the payer or the authorizing agent endorsing that need are really the two critical pieces. but again, those individuals are very reliant on understanding the picture of where this particular injured worker is in the pathway back to work. and again, I think in general, [00:19:40] when it's a.

[00:19:40] GUEST: Applied appropriately, it represents a really good objective representation of progress toward returning to work. Again, we go back to what the limitations of acute physical therapy can be, and this can represent that bridge, but only if and when that story is told in a very [00:20:00] sequential and methodical fashion.

[00:20:02] HOST: Right. And that's what I was just going to ask about. So it would typically always follow the traditional healing tissue type of therapy, right? And then, uh, there would be a recommendation to go on depending on job demands and, uh, the things that you've mentioned, how long has someone been deconditioned, [00:20:20] deconditioned.

[00:20:21] HOST: So there's going to be usually a recommendation from the therapist. Who has these techniques available to the provider and then, uh, and then ultimately to the claims adjuster or the employer, whoever's making that decision on authorization,

[00:20:37] GUEST: right? That's exactly right. Exactly. Yeah.

[00:20:39] HOST: [00:20:40] Yeah. Very good. What are some sort of misconceptions about?

[00:20:44] HOST: Work conditioning. Why would an adjuster or an employer think it's not a good idea? Are they concerned that people are going to be out of work longer? Or what are the, what are the

[00:20:54] GUEST: issues there? Yeah, it's a great question. And I think, uh, you know, predominantly there is, [00:21:00] there is one, there is one concern that continues to come up and I think it is a misconception.

[00:21:05] GUEST: And that is that, you know, work conditioning presents a risk of injury. to the patient, right? The, the patient may be seen acutely for their shoulder, but now you're going to put them through this full body conditioning program. That's going to last four to five hours a day, five days a [00:21:20] week. and they're liable to hurt their back or their hip or their foot or their ankle.

[00:21:24] GUEST: And, and again, I think that, you know, there's reasonable concern, for the health and wellness of the patient as a whole. specifically those who haven't performed this level of intensity of activity in the past. Right. but again, I'll come back to [00:21:40] what are the requirements of the job?

[00:21:42] GUEST: If the requirements of the job are laid out in such a way. That again, there's this gap we as, as a clinician, right, as an interventional specialist, we need to figure out that step wise path to get from point A to point B and point B being a successful return to full unrestricted job [00:22:00] duties. so I think when applied appropriately, there can be this nice and steady gradual increase, right?

[00:22:06] GUEST: Everybody doesn't show up on their first day of work conditioning and handed to 80 pound dumbbells to lug around for the next four to five hours. That's not how it works, right? it's about picking the right interventions that challenge the patient appropriately, that's [00:22:20] consistent with the material handling requirements and the essential job functions of their specific job.

[00:22:26] GUEST: Yeah.

[00:22:26] HOST: And I, you know, that concept of having functional job descriptions, I think is often missing as well. So that's a whole nother session we're going to get into, uh, hopefully in another, another show. That's great. Definitely want to talk about that. [00:22:40] Uh, so let's, yeah, let's talk about some of those challenges that you maybe has faced in implementing advanced, uh, techniques and how, how have you overcome those?

[00:22:49] HOST: Yeah. Yeah.

[00:22:50] GUEST: It's a, it is a good question. I, I think probably the, most frequent challenge is probably the, really the lack of understanding and, and preparation from a clinician perspective, right? [00:23:00] I think that when we, when we think about, a physical therapist or an occupational therapist, they go to school, there's a lot to learn.

[00:23:06] GUEST: There's anatomy and physiology and biomechanics and kinesiology. I, there's, there's very limited exposure, if you will, to understanding payer specific requirements or a particular specific subset of the patient population. [00:23:20] so that relies a lot more on, on the job type training in these scenarios, specifically as it pertains to the injured worker patient population.

[00:23:27] GUEST: I think what, what we at ATI have done, really is, is tried to, we've customized our proprietary EMR software. specifically for injured workers, to intentionally, very intentionally [00:23:40] guide their clinical documentation process. Again, there's very specific things that are required and it sounds silly, including things like, what does Larry do for a living?

[00:23:53] GUEST: What are exactly the requirements of whatever that particular occupation is? That gives us our goals, right?[00:24:00] where is Larry right now in his ability to accomplish those particular goals? Where's your current level of function, right? It's the same terminology that we use clinically speaking, but when you frame it in an injured worker patient population it requires extra attention and extra level of detail to ensure that again, we go back to [00:24:20] what's the single most important thing.

[00:24:21] GUEST: for all stakeholders involved, how do we get the patient back to work as safely and efficiently as possible? If our documentation isn't tailored to that, then we're missing the mark altogether. so I think that that's number one. Number two, I think, uh, nothing will ever substitute, you know, on the [00:24:40] ground training for clinicians who have a passion for this patient population.

[00:24:43] GUEST: in March of, of 24, we'll have completed a year long, uh, roadshow that, that addressed 900 clinics worth of clinicians, in our enterprise. And again, you know, that in combination with ongoing development of, of assets and [00:25:00] continued education for our clinicians, you know, supporting. The continued development of treating the injured worker is, is imperative.

[00:25:09] GUEST: it's not a once and done. It's not something that you can just train once and hope it sticks. It's like any other technique. It requires repetition after repetition to ensure that your skillset continues [00:25:20] to increase.

[00:25:21] HOST: So, so you talked about, uh, you know, advancements in terms of skill sets, uh, advancements in the EHR system that you're using, perhaps the algorithms that you use for the specific conditions that you've developed.

[00:25:34] HOST: Uh, those are all sort of, uh, innovations. Are there any other advancements or innovations that you can share with [00:25:40] us in the physical therapy world that you're kind of excited

[00:25:42] GUEST: about? Yeah, you know, I, I think about when, when you think about physical therapy, right? It's been a long, it's been around for a long time.

[00:25:49] GUEST: you know, and, and I think. When, when you think about the fact that, you know, 70 percent ish of PT cases in general are considered very successful, [00:26:00] it continues to beg the question of why we can't get patients access to physical therapy sooner in the life cycle of whatever impairment or issue that they're dealing with.

[00:26:09] GUEST: You know, I think that, uh, you know, healthcare spend continues to be a hot button topic. it's certainly a crisis that we've continued to talk about in this country. And I think definitely physical therapy is part. [00:26:20] Of the solution or at least directionally toward a solution to getting that, that, that, uh, spend under control and all the while not necessarily limiting the quality of the care or the outcome to the patient themselves.

[00:26:32] GUEST: so I don't know that necessarily there's any, any, uh, any silver bullet innovations that we're going to see in the next decade that are going to [00:26:40] revolutionize the PT space. but I do think, uh, you know, continued work and continued efforts at getting patients, more patients, access to. P. T. care sooner.

[00:26:50] GUEST: I think is, is mission critical to, uh, to this initiative as well. Yeah.

[00:26:54] HOST: Yeah. Very good. You know, you mentioned, uh, how you, uh, went on this road show. How do you, [00:27:00] how do you keep these, the skill set, uh, skill set up in your therapists? And then what, what would you tell other types of therapists? Uh, other.

[00:27:08] HOST: Well, therapists that are not in ATI that are interested in maybe developing that skill set. Maybe they're not doing it. How would you advise them to go around, go about getting this kind of expertise?

[00:27:19] GUEST: [00:27:20] Yeah, I think it starts where you're right with identifying the clinicians that want to make this part of their practice.

[00:27:25] GUEST: like anything, you know, we're drawn to the things we enjoy and I think instilling a passion or, or identifying a passion to treating this injured worker, this industrial athlete, really is, is kind of the first step. I think then, you know, what we've done internally at ATI is [00:27:40] supported our clinicians who have identified themselves with, you know, live trainings.

[00:27:44] GUEST: we have started, you know, uh, a bank of, of virtual recording trainings that they can continue to learn at their own pace. and then we're really excited in 2024, we're going to be starting our, our certificate program, internally for treating the injured worker, which again, just allows our clinicians to [00:28:00] separate themselves from the field with just a little bit different type of distinction.

[00:28:04] GUEST: I think, outside of ATI, any clinician, You know, I think who's interested in specializing in the injured worker, you know, number one, I think starts with, hey, come out and ensure that you're, that you're rock solid confident in addressing the impairments of, of all of your patients. [00:28:20] again, being confident and understanding, all of the aspects of traditional physical therapy is the bedrock to excelling in this particular space.

[00:28:28] GUEST: so that's step one. I think once you're there, then really ensuring. Finding a mentor, finding somebody who's been, you know, working with the injured worker patient population for a long time, and then asking a lot of [00:28:40] questions, right? Being willing to be a lifelong learner. I learned things every day from our field clinicians.

[00:28:44] GUEST: And I think, you know, I'm continued to be amazed by the amount of information that I continue to learn on a daily basis, despite working with this patient population for over two decades. You know, I think that, and then of course, there's lots of opportunities out there. you know, from, uh, from the [00:29:00] point of the, you know, the U.

[00:29:01] GUEST: S. Department of Labor and Statistics has lots of great information. There's groups like the WCRI or the WorkComp Research Institute that's constantly pushing out. great information about what's relevant right now. And I think continuing to stay relevant is, is really, is really key, right? It's, it's, this is not a type of, patient population that, you [00:29:20] know, that, that's stagnant that you can learn today and it'll apply 10 or 20 years from now.

[00:29:24] GUEST: The, you know, the ecosystem is continuing to evolve and I think our ability to continue to evolve with it again, with an insurance that we're still of the mindset, we're working on the same goal. How do we safely and efficiently get that patient, that injured worker, back to work? [00:29:40] you know, that remains kind of the cornerstone.

[00:29:42] HOST: Of course. Yeah, of course. So lastly then, uh, Lucas, what is the future of physical therapy for work comp, and specifically, uh, with regards to advanced techniques and work comp? Where are we going?

[00:29:55] GUEST: Yeah, you know, I think as a field, you know, I think we all need to continue [00:30:00] to improve our approach to this patient population.

[00:30:03] GUEST: you know, I think that when we go back and at the beginning of the conversation, we talked about how, how do they differ from a traditional commercial patient that we see walk into a clinic? you know, one of the single most impactful differentiators is the fact that when we're dealing with an injured worker, they're not working right.[00:30:20]

[00:30:20] GUEST: We're talking about it. an individual's livelihood. We're talking about an individual's ability to provide for their family, to get up with a purpose every day. And, uh, I think we need to continue to take that immensely seriously, and continue to advocate for these patients. you know, they, they want to get back to work.

[00:30:36] GUEST: They want to continue or resume their livelihood. So [00:30:40] continuing to advocate for the patients, continuing to advocate for, you know, more employers to put in, more injury prevention programs. you know, we think about, we deal with the, the, the patient and the injury after it's happened. you know, we need to continue to invest time, effort, and energy on the front side.

[00:30:55] GUEST: How do we prevent these from happening at all? There are, there will always be injuries [00:31:00] at work. But how do we minimize them or how do we, how do we decrease the intensity of those, uh, those, those episodes so that, so that we can have them back to work in two or three or four weeks instead of six, eight or 12 or 16.

[00:31:11] GUEST: Right. so I think that that partnership, right, that partner, that partnership between injury prevention, and then continuing to strive for that [00:31:20] consistent and predictable care for injured workers after injury really gives us our greatest hope at having the greatest impact.

[00:31:28] HOST: Yeah, very good. You know, I, uh, and I love the concept of, you know, the preventive, we're going to be talking about poet, right?

[00:31:35] HOST: Doing, uh, assessments on folks, maybe before they get into [00:31:40] these positions to identify if there is a higher risk of injury and maybe some conditioning. And as you indicated, some athletic trainer work before, right? They go into some of these positions. So lots more to talk about there. So, uh, advanced physical therapy techniques for workers comp recovery, Lucas Myers, our [00:32:00] guest.

[00:32:00] HOST: Thank you very much for great conversation today. It's great having you here.

[00:32:04] GUEST: Yeah, no, thank you. I appreciate it. A lot of fun today.

[00:32:07] HOST: Yeah. Yeah. Good discussion. Uh, lots more to come from ATI physical therapy and, uh, This is Fit for Duty. Thanks for joining us. And that wraps up this episode of Fit for Duty.

[00:32:19] HOST: Thanks for joining me [00:32:20] today, everyone. I hope you found this conversation as engaging and informative as I did. As always, building healthier, happier workplaces starts with knowledge and collaboration. So if you enjoyed this episode, please consider subscribing to Fit for Duty. Wherever you listen to podcasts, that way you'll never miss a beat when it comes to the latest [00:32:40] trends, best practices, and inspiring stories in occupational health until next time, stay safe, stay well, and keep elevating workplace excellence.


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