As I look at the state of the profession, it baffles me that more PTs do not pursue specialization in areas that are both challenging professionally and financially rewarding.
PTs try many ways to improve the skills and tools used in clinical practice. Many choices exist for therapeutic and diagnostic skills if we want to continue and control. Time spent on entry-level doctoral training covers many, but not all the possibilities for possible decisions to improve opportunities for practice. But it seems PTs slip when it comes to the opportunity of innovation practice in the field of electrophysiological testing (EMG, NCV ....)
Since the provinces and territories of 50 were trained and guidelines for using the electrical properties daily practice. PTs traditionally apply electrical principles in the treatment of neuromuscular disorders. All areas of modality practices led PT but mostly have clearly seen an assessment downward. Clearly payers consider the application of electrical treatment modalities related to the passive service or unattended and as such justify cuts in reimbursement. Although we always treat patients using these modalities interest in electric treatment procedures decreased from the PT community.
In the general medical community, however, the electrical tests of neuromuscular systems has grown dramatically during this period. But in PT, we saw no significant interest in this area of practice. Why in the world would it be? Have we forgotten that our training also includes tests with electrical principles? Well, it is true most of the provinces and territories to focus on treatment modalities, but fail to see the opportunity to use their knowledge and training in power tools like a "test" mode. Fortunately, these test opportunities are always in high demand and pay back very well compared to treatment modalities, even after a recent sharp reductions in reimbursement.
test Elctrodiagnostic or EDX is used to evaluate nerve and muscle disorders, and has been a part of the practice of PT since the 50s Hailing from classical forms as chronaxie duration of the tests and traditional strength EDX today ' hui consist of two separate tests nct and eMG. NCT basically evaluates nerve conduction velocity in response to electrical stimulation and EMG records the electrical activity of a muscle. NCT are performed with surface electrodes and EMG uses a small needle electrode. These tests help clinicians to diagnose entities from the compression of the central nerve such as the carpal tunnel syndrome to radiculopathy and disorders such as myopathy and diabetic neuropathy.
Today, although physiotherapists are trained in the principles that underlie the electrical testing of EDX field is dominated by PMR and neurology disciplines. PT emphasis on treatment and diagnostic tests was the responsibility of the "doctors" .but why? For me the answer is clear - "money" - as reimbursements for EDX climbing in the 70s; s and lines almost over arbitrary 80 day were drawn in the sand by the medical community to define EDX that the practice of medicine. Historically dependent on the medical community PT tended to acquiesce to these limits arbitrary practice.
But over time, the industry has gradually "pushed" against the medical establishment defending the right of therapists to practice EDX. Today's climate for PT transforms practices. Economic pressures on private PT practices lead near extinction. Despite the obvious challenges therapists in private practice need to explore opportunities for growth and sustainability.
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John Palazzo PT, DSC, ECS- EMG Specialist
Dr. Palazzo received his bachelor of PT, MS in human anatomy at Ohio State University, then D.Sc. Clinical Electrophysiology Rocky Mountain University of Health Professions in Utah. Born and raised in Ohio, he moved to Michigan and stayed put to continue his career in PT and the current specialty track in EMG / NCV testing.
In the early 80s, he founded "NEUROLAB" EMG private practice with a focus on service orthopedic medicine centers and labor, professional. When entering in practice EMG Dr. Palazzo encountered many practical difficulties. In the late 80s an important legal precedent for PTs in EMG practice culminated when he defended a major antitrust action against several competitors organized physician groups that harmed his life.
Dr. Palazzo represents the interests PT / EMG legislative, regulatory, legal and refund on state and national levels and is characterized by the following:
-1980 dedicated private practice to provide permanent free EMG testing services
-1985 PT first board certified as a clinical specialist electrophysiology (ECS)
-Cofounder Blue Ribbon APTA section on EMG EMG practice panel
efforts - Prompted and financing in late 0s for a national health insurance policy for the recognition of the PTs performance and reimbursement of EMG tests.
- APTA expert and advisor to the AMA CPT code Working Group panel on EMG CPT coding issues
key -APTA rep to defend the practice of PT licensure and insurance advice in more than 20 states
-Member of the Advisory Committee supporting Medicare Michigan (CAC)
-Adjunct PT faculty of five universities of Michigan
-clinical publications and research on compression disorders of peripheral nerve and sports injuries.
-02 co-founder of the US Congress Electroneuromyography (ACE)
On a personal level, Dr. Palazzo made it a priority to enjoy family time, repair broken things and play a competitive game but friendly handball.
Latest posts by John Palazzo PT, DSC, ECS specialist - EMG (see all)
- PTs and practice opportunities - July 9, 2014
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