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Challenge Question Number 1 for Physical Therapist #1166

Clearly describe what you expect from the students:
There are two areas to look at:
1) Who is going to be responsible for paying for the woman’s physical therapy bills? Why? (Choices: the woman’s insurance company, workman’s compensation, or the woman herself).

2) Develop an outline of a physical therapy treatment plan for her shoulder condition utilizing the following information:
Diagnosis – Right shoulder rotator cuff strain

Goal – Return to full duty within 2-4 weeks without shoulder pain
Treatment Options: Ice, heat, electrical stimulation, massage, passive range of motion exercise, sling, resisted exercise using dumb bells, resisted exercise using rubber tubing, active range of motion exercise, ultrasound, resistive exercise using medicine balls, resisted exercise using weight machines.

In order to give the teacher some guidance in evaluating the student's project(s); list some tips that may help to assess the student's work:
1) Payment: This issue needs to be addressed prior to the patient being seen, so that there are no misunderstandings about who is responsible for payment. If she reported the injury and it was approved by her supervisor, then Workman’s Compensation will be the payer. This needs to be verified by contacting the Work Compensation contact person.

If it was not approved, the patient will likely turn it over to the insurance company and it will pay under the coverage of her plan (i.e.: 90/10 with $500 deductible; she is responsible for the first $500 of the medical bills, then the insurance company will pay the remaining 90% of the bill and she will pay 10%).

Ultimately the patient signs a form that states they are responsible for their bill and if they can't get coverage somewhere else, they will pay for their treatment. Cost of physical therapy averages $85.00 a session.

2) Treatment Plan: This should start anywhere, depending upon how the patient presents her problem during the evaluation. People with the same diagnosis could be worlds apart regarding the severity of the discomfort, the overall health of the patient, the length of time the problem has persisted, and the age of the patient. In addition, the patient’s ultimate goals need to be considered.

Suggestion: Look for starting with the easiest “feel good” things (we call “modalities”). To begin with, use ice, heat, electrical stimulation, massage, passive range of motion exercise, sling, active range of motion exercise, and ultrasound. Then proceed to implement the following activities: resisted exercise using weight machines. resisted exercise using dumb bells, rubber tubing, and medicine balls. The students should prioritize how they would use the twelve options to treat this patient.