The Voice of the Patient

This episode is a reading of a blog post from Joletta Belton. Read more amazing posts at Jo's blog: www.mycuppajo.com

You can find Joletta Belton on Twitter @mycuppajo

The post (Psychological: Let's Talk About the P in BioPsychoSocial) is very refreshing for me to read, because I often see other health care providers fear the "psychological" aspect of health care.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Geros Collective at http://GerosCollective.com

At the Voice of the Patient, we are dedicated to enhancing our ability as health care providers to truly listen to others and to establish a therapeutic alliance. In some cases, we can benefit from listening to the experience and mindset of other providers, such as Mandy Chamberlain.

Mandy Chamberlain is an occupational therapist and the founder of Seniors Flourish, where she blogs, podcasts, and hosts a learning lab for occupational therapy practitioners. She earned her Master of Occupational Therapy through the University of North Dakota's School of Medicine and Health Sciences, and decided to focus on Community-Based Medicine. She has a varied clinical background working with geriatrics through home health services, home modification consultation, long-term care, assisted living, inpatient critical access and outpatient therapy services. She now works and consults in the mountains of Colorado.

We talk about how much that occupational and physical therapy have in common, particularly in our mutual desire to serve humanity. We also discuss our shared path to rehabilitation careers through our initial desire to treat mental health. We spend time discussing the importance of the interdisciplinary team and of communication between health care providers. We agree that it's hard, but we talk about ways to improve the quality of our teams in pursuit of serving our patients.

Check out Mandy's website: Seniors Flourish. She also hosts her own terrific podcast, also named Seniors Flourish, which is also a member of the Geros Collective. You can follow Mandy on Twitter.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Geros Collective at http://geroscollective.com

At the Voice of the Patient, we are dedicated to enhancing our ability as health care providers to truly listen to others and to establish a therapeutic alliance. In some cases, we can benefit from listening to the experience and mindset of other providers, such as Dr. Faye Reiff-Pasarew.

Dr. Reiff-Pasarew is an assistant professor of hospital medicine, director of the humanism in medicine program and unit medical director at the Icahn School of Medicine at Mount Sinai. She received her MD from the University of California, San Francisco Medical School and completed her residency in Internal Medicine at Mount Sinai Hospital. She also produced the podcast series "The Art of Medicine." Her interests include: the medical humanities, end of life care, and the doctor-patient relationship.

Dr. Reiff-Pasarew and I discuss her recent article in the Washington Post: "I'm a young, female doctor. Calling me 'sweetie' won't help me save your life." Dr. Reiff-Pasarew shares her experiences with challenging relationships with patients because of attitudes toward her age and gender. She offers many ideas for how providers can overcome these challenging relationships and how to benefit our healthcare system by eradicating these stereotypes.

We discuss narrative medicine, how she uses poetry to teach medical students about delivering cancer diagnoses, and how she has included patients in grand rounds at her hospital.

Check out Dr. Reiff-Pasarew's podcast: The Art of Medicine. You can follow Dr. Reiff-Pasarew on Twitter or send her an email at faye[at]theartofmedicinepodcast[dot]com.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

This episode is a reading of an amazing blog post by Kat Wilson, called "The Side Effects of Chronic Pain Nobody Talks About."

You can find this post and other awesome posts from Kat at her blog: Chronically Composed, A Scottish Journey With Chronic Pain.

Please connect with Kat Wilson through the following media:

• Twitter: @katwilson04
• Instagram: @katwilson04
• Facebook: @ChronicallyComposed
• The Mighty

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

At the Voice of the Patient, we are dedicated to enhancing our ability as health care providers to truly listen to others and to establish a therapeutic alliance. In some cases, we can benefit from listening to the experience and mindset of other providers, such as Dr. Kenneth Miller.

Dr. Miller is a physical therapist and educator with more than 20 years of experience working in home care and inpatient rehab settings, as well as more than 8 years in adjunct faculty roles. He is currently a clinical educator at Catholic Home Care, in Farmingdale, N.Y. He has taught for New York Institute of Technology, University of Michigan–Flint, and Touro College. He is the co-author of the book Providing Physical Therapy in the Home, published by the American Physical Therapy Association (APTA), as well as the author of peer-reviewed publications in Neurorehabilitation and the Journal of Geriatric Physical Therapy. He has presented at the APTA Combined Sections Meeting and NEXT Conference. Dr. Miller chairs the APTA's Home Health Section Practice Committee and is a member of the editorial boards of Topics in Geriatric Rehabilitation, GeriNotes, and the Journal of Novel Physiotherapy and Physical Rehabilitation. He is the recipient of numerous honors, including three APTA Home Health Section awards. He is a Board Certified Geriatric Specialist, a TeamSTEPPS Master Trainer, an APTA Credentialed Clinical Instructor, and an APTA Certified Exercise Expert for Aging Adults.

We discuss the role of the 3 D's -- dementia, delirium, and depression. Dr. Miller shares his experience with seeing the 3 D's in clinical practice as a physical therapist. For any questions or comments, you can find Dr. Miller on Twitter @kenmpt. Dr. Miller also teaches a pharmacology course for GREAT Seminars.

Resources:

• Dr. Miller's course for GREAT Seminars: Clinical Implications of Pharmacology for Therapists Working with Older Adults
• Patient Health Questionnaire-2 (PHQ-2): http://www.aafp.org/afp/2012/0115/p139.html
• Geriatric Depression Scale (GDS): http://www.psychcongress.com/saundras-corner/scales-screeners/depression/geriatric-depression-scale-short-form-gds-sf
• Mini-Cog: http://mini-cog.com/mini-cog-instrument/standardized-mini-cog-instrument/
• Montreal Cognitive Assessment (MoCA): https://www.mocatest.org/
• Saint Louis University Mental Status (SLUMS) Exam: http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1151
• Mini-Mental Status Exam (MMSE): https://patient.info/doctor/mini-mental-state-examination-mmse
• Confusion Assessment Method (CAM) Test: http://www.medscape.com/viewarticle/481726
• Cornell Scale for Depression in Dementia (CSDD): http://www.psychcongress.com/saundras-corner/scales-screeners/depression/cornell-scale-depression-dementia-csdd

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

This is the fourth episode of our Mental Health Matters series with Sean Hagey. In this episode, Sean talks about the public perception of mental illness, within health care professions and outside of health care. If you haven't listened to the first three episodes, then check them out. In the first episode, Sean begins his story, sharing powerful experiences throughout his life. In the second episode, Sean talks about treatment, coping mechanisms, and progress despite challenging times. In the third episode, we talk about the interplay between mental health and his relationships with friends and family.

Sean approached the Voice of the Patient with the idea for this series and has asked that we help to eradicate mental health stigma. We believe that the stigma cannot be erased without gaining a level of comfort with our own personal discomfort. Sean wants to tell his story, and he wants us to ask all of the necessary questions to bring understanding of patients with mental illness or symptoms of mental illness.

Sean Hagey is a home health physical therapist assistant in Kansas City, MO, and is the creator of GetPT1st. He recently started a new advocacy program for mental health, Mental Health Matters, which you can follow on Twitter @HopeForMH. You can follow Sean on Twitter @SeanHagey. Sean has also written several powerful articles on The Mighty.

Check out Project Semicolon and To Write Love on Her Arms.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

This is the third episode of our Mental Health Matters series with Sean Hagey. If you haven't listened to the first two episodes, then check them out. In the first episode, Sean begins his story, sharing powerful experiences throughout his life. In the second episode, Sean talks about treatment, coping mechanisms, and progress despite challenging times.

Sean approached the Voice of the Patient with the idea for this series and has asked that we help to eradicate mental health stigma. We believe that the stigma cannot be erased without gaining a level of comfort with our own personal discomfort. Sean wants to tell his story, and he wants us to ask all of the necessary questions to bring understanding of patients with mental illness or symptoms of mental illness.

Sean Hagey is a home health physical therapist assistant in Kansas City, MO, and is the creator of GetPT1st. He recently started a new advocacy program for mental health, Mental Health Matters, which you can follow on Twitter @HopeForMH. You can follow Sean on Twitter @SeanHagey. Sean has also written several powerful articles on The Mighty.

In this episode, Sean talks about the interplay between mental health and his relationships with friends and family.

Check back next week for the fourth episode in the Mental Health Matters series. In the fourth episode, Sean talks about the public perception of mental illness, within health care professions and outside of health care.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

This is the second episode of our Mental Health Matters series with Sean Hagey. If you haven't listened to the first episode, then check it out.

Sean approached the Voice of the Patient with the idea for this series and has asked that we help to eradicate mental health stigma. We believe that the stigma cannot be erased without gaining a level of comfort with our own personal discomfort. Sean wants to tell his story, and he wants us to ask all of the necessary questions to bring understanding of patients with mental illness or symptoms of mental illness.

Sean Hagey is a home health physical therapist assistant in Kansas City, MO, and is the creator of GetPT1st. He recently started a new advocacy program for mental health, Mental Health Matters, which you can follow on Twitter @HopeForMH. You can follow Sean on Twitter @SeanHagey. Sean has also written several powerful articles on The Mighty.

In this episode, Sean talks about his treatment, coping mechanisms, and successes during his life.

Check back next week for the third episode in the Mental Health Matters series. In the third episode, Sean talks about the interplay between mental health and his relationships with friends and family.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

This is the first episode of a mini-series on mental health with Sean Hagey. Sean approached the Voice of the Patient with the idea for this series and has asked that we help to eradicate mental health stigma. We believe that the stigma cannot be erased without gaining a level of comfort with our own personal discomfort. Sean wants to tell his story, and he wants us to ask all of the necessary questions to bring understanding of patients with mental illness or symptoms of mental illness.

Sean Hagey is a home health physical therapist assistant in Kansas City, MO, and is the creator of GetPT1st. He recently started a new advocacy program for mental health, Mental Health Matters, which you can follow on Twitter @HopeForMH. You can follow Sean on Twitter @SeanHagey. Sean has also written several powerful articles on The Mighty.

In this episode, Sean begins his story by sharing his experience with depression, including how it has affected him since childhood.

Check back next week for the second episode in this mini-series on mental health. In the second episode, Sean talks about what his treatment, coping mechanisms, and successes during his life.

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

At the Voice of the Patient, we are dedicated to enhancing our ability as health care providers to truly listen to others and to establish a therapeutic alliance. In some cases, we can benefit from listening to the experience and mindset of other providers, such as Dr. Mark Bishop, PT, PhD.

Dr. Bishop is an Associate Professor in the Department of Physical Therapy. Dr. Bishop received his entry-level training in Australia and has extensive experience working as a physical therapist. His research interests are in the management of musculoskeletal conditions, particularly pain, by orthopedic physical therapy. He also researches nonspecific effects in physical therapy, including the role of the expectations of providers and patients in therapeutic outcomes.

We discuss many aspects of the therapeutic alliance, including therapist expectations, patient expectations, and placebo. We talk about research from Dr. Bishop and other scientists that have tested the role of expectancy in treatment, and Dr. Bishop shares advice for providers to maximize outcomes in an evidence-based manner.

Further reading:

• Journal articles on expectations:
  • Individual Expectation: An Overlooked, but Pertinent, Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain. Bialosky, Bishop, and Cleland, 2010.
  • The influence of expectation on spinal manipulation induced hypoalgesia: An experimental study in normal subjects. By Bialosky, Bishop, et al. 2008.
  • Patient expectations of benefit from common interventions for low back pain and effects on outcome: secondary analysis of a clinical trial of manual therapy interventions. By Bishop et al., 2011.
• Journal articles on placebo:
  • Placebo response to manual therapy: something out of nothing? By Bialosky, Bishop, et al. 2011
  • Placebo, Nocebo, and Expectations: Leveraging Positive Outcomes. By Benz and Flynn, 2013.
  • Placebo and the new physiology of the doctor-patient relationship. Benedetti, 2013.
  • Understanding placebo and nocebo responses for pain management. Colloca and Grillon, 2014.
• Journal articles on equipoise:
  • Review of clinical equipoise and personal equipoise. By Chad Cook and Charles Sheets.
  • Early use of thrust manipulation versus non-thrust: RCT. Cook et al., Man Ther, 2013.
• Objective measures of expectations
  • Development of the Stanford Expectations of Treatment Scale.
  • Patient-defined desired outcome, success criteria, and expectation in outpatient physical therapy: a longitudinal assessment. Zeppieri & George, 2017.
• #NeedleorNot
  • Oxford Style Debate on Dry Needling at CSM 2017.
    • Thanks to Kenny Venere, Kyle Ridgeway, Kali Aucoin, Mark Milligan, moderator Scot Morrison, and coordinator Sandy Hilton.
• Blog posts and podcasts:
  • Expectations versus reality, by Kenny Venere
  • Customer Service, by Jerry Durham.
  • Don't Beat Patients with the Science Stick, by Dave Reed.
  • Psychology in Physical Therapy, by the Evidence in Motion Practice Leadership Podcast
  • PT Inquest: The Costs of Low Value Healthcare

You can find Dr. Bishop on Twitter @physiobish. You can email him at [email protected].

If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT.

Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice.

---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org

*Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com