On this episode of the Healthy Wealthy and Smart Podcast, Dr. Kyle Ridgeway and Dr. Kenny Venere join me for Part 2 where we discuss the necessity for evidence in physical therapy! Kyle Ridgeway is a senior physical therapist at University of Colorado Hospital and coordinator of physical therapy quality improvement project in the medical intensive care unit. Dr. Kenny Venere is a home health physical therapist at Intermountain Healthcare in Salt Lake City, Utah. Make sure to check out Part 1 if you missed it!
In this episode, we discuss:
-Is physical therapy science based?
-Why we should breed a culture of skepticism in physical therapy
-Fad treatments and why practitioners are attracted to them
-Kyle and Kenny’s passion for the science behind physical therapy
-And so much more!
The current marketing of continuing education in physical therapy acts as a barrier to evidence based innovations. Kyle believes, “Because of perverse incentives and the way the continuing education model is structured, it lends itself to guruism… This is foundationally an educational problem,” as many physical therapists are not well trained to analyze claims and assess validity.
For the physical therapy profession to continue to advance in quality of care, Kenny stresses, “We need a culture in physical therapy that is skeptical. A culture that is comfortable with engaging in argument and debate.” He stresses that there must be plausibility to our treatments and that, “We have to be less certain in our convictions and I think that is a hallmark of a scientific profession.”
Scientific debate requires an open mind and the ability to incorporate new information however Kyle has found that humans struggle with this. He believes that, “If you were truly open minded and you’re coming in with no previous data, no previous preconceptions, and you are not taking a bayesian approach to this problem, you are equally open to both outcomes.”
Kyle restricts his treatments to those backed by sound evidence and carefully reviews newly vaunted treatments before exposing patients to them because, “These aren’t actually delineating things, these are actually diluting factors that make the profession we are at large less elevated.”
Kyle has found that physical therapy adds a great deal of value to the healthcare world and states, “My experience is other people in healthcare are just yearning for physical therapist’s input and once they get it they want more of it.”
Navigating the complexities of patient care can be difficult for new physical therapy graduates. Kyle advises, “We are seeing people at their absolute most distressing moments, in a convoluted system, with perverse incentives, and ridiculous rules. And it’s really complicated. I think the first thing was just letting in that uncertainty and being okay with the fact that you’re never there, you’re always improving, there is always something different to consider, and welcoming that journey.”
For more information on Dr. Kyle Ridgeway:
Kyle Ridgeway received a BA in neuroscience from Pomona College and a doctor of physical therapy degree from University of Colorado Denver: Anschutz Medical Campus. Currently, he is a senior physical therapist and team lead for medical ICU physical therapy at University of Colorado Hospital. He also serves as a clinical instructor for the University of Colorado Denver Physical Therapy Program. A quality improvement project in the medical ICU, that he designed and implemented, eventually became standard practice. He speaks nationally regarding acute care physical therapy specifically in critical care, acute care quality improvement, hospital readmissions, and outcomes following critical illness. He blogs at PT Think Tank https://ptthinktank.com/author/kridgeway/ where he aims to provide thoughtful analysis and critical thinking on various clinical, scientific, and humanistic topics relating to physical therapy. But, of course, that is just his opinion.
For more information on Dr. Kenny Venere:
Kenny Venere currently works as a home health physical therapist for Intermountain Homecare and Hospice in Salt Lake City. He graduated from Northeastern University in Boston, MA with his DPT in 2014. His primary interests within physical therapy are scientific literacy, meta-research and the philosophy of evidence based practice. He writes (infrequently) on these topics over at his website, www.physiologicalpt.com.
Resources discussed on this show:
Talking Points: An Oxford-Style Debate on Dry Needling
Why do humans reason? Arguments for an argumentative theory.
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