Over the past year or so, the idea of MIPS participation has undergone an enormous transformation in the minds of rehab therapists. When the program was first introduced, we were optimistic about participation, and we heralded its arrival as an opportunity for therapists to prove their worth to CMS. But, as time passed and more details about the program came to light, our perception of MIPS morphed and twisted until it looked like a big, bad, kind-of-scary boogie monster—like the one that used to hide under your bed when you were a kid. MIPS was (and in some ways, still is) a big shadowy unknown:

• The program was—and is—difficult to understand;
• Many companies have used the widespread MIPS-related confusion as a vehicle for fear-mongering; and 
• In years past, the burden of participation often outweighed the benefits of opting in. 

Unfortunately, with the looming industry-wide cuts to Medicare payments, therapists may no longer have the luxury of pushing MIPS back to a dusty corner under the bed. It’s looking increasingly likely that 2020 may be the year that rehab therapists have to shine the light of our attention directly on the MIPS monster—and face the program head-on.  

What did MIPS participation look like in 2019?

Last year was rehab therapists’ inaugural MIPS inclusion year, and those who were required—or chose—to participate were tasked with navigating a myriad of complicated rules and requirements. For instance, you could perfectly satisfy all MIPS reporting requirements, but if you submitted your data late (keeping in mind that the definition of “late” varied depending on your submission method), then all your data would go down the drain. Didn’t correctly adjust your reporting to account for a topped-out measure? There went some of your MIPS points. Forgot to attest to your completed improvement activities? Tough. CMS is more than willing to dock points from your final score. 

2019 Performance Threshold

Needless to say, navigating the MIPS minefield could get a little treacherous—especially because failure came with a potentially steep price. A therapist who failed to meet the minimum performance threshold of 30 points would receive a negative payment adjustment of up to 7% on all Medicare payments two years in the future. Conversely, a therapist who exceeded that 30-point threshold would receive a positive payment adjustment up to 7%. Therapists who exceeded a secondary threshold of 75 points would receive an additional positive payment adjustment of up to 10%. However, all positive payment adjustments are (and will continue to be) limited by MIPS’s neutral budget plan—so, the actual incentive payments therapists see vary based on how many participants failed, met, and exceeded the two performance thresholds. In other words, nothing is guaranteed.

2019 Required Categories 

In 2019, rehab therapists were only required to participate in two of MIPS’s four categories: quality and improvement activities. Quality, the most complicated category, involved reporting measures based on a therapist’s billed CPT codes (i.e., did you complete a specific task when you billed a certain CPT code under a certain set of circumstances?). At the end of the day, PTs, OTs, and SLPs could choose to report from a selection of 15, 16, and three measures, respectively. 

The improvement activities category was a little bit easier to complete—but, for most outpatient therapists, it was a totally new concept. It required therapists to perform various tasks that would improve the quality of care in their practice across a 90-day time frame. The scope of these tasks varied from administering patient surveys or using a QCDR, to encouraging patient outcomes monitoring. 

What will MIPS participation look like in 2020?

As was expected, CMS implemented some updates to the MIPS program for the 2020 performance year. Namely, it raised the thresholds—thus tightening the margin for error—and bumped up the potential rewards and penalties of participation. CMS raised the performance threshold from 30 to 45 points and bumped the secondary performance threshold for exceptional performance from 75 to 85 points. Those who don’t surpass the base performance threshold of 45 points could see a downward adjustment as steep as 9%—but those who score more than 45 points could earn as much as a 9% bump to their Medicare payments in 2022. 

Rehab therapists will still only have to report for the quality and improvement activities categories, but successfully doing so will be a little bit harder. Quality measures must be reported more frequently, and, for those who opt into group reporting (as more than half of WebPT’s MIPS participants are expected to do), more clinicians will have to physically complete the group’s selected improvement activities. Furthermore, CMS added a handful of net new quality measures for PTs, OTs, and SLPs to report, and it removed, modified, or added a total of 24 different improvement activities.

How will this year’s MIPS changes affect rehab therapists?

Essentially, these changes all boil down to one concept: higher risk, higher reward. While CMS hasn’t made MIPS participation ridiculously difficult, it will still be harder to meet the reporting criteria this year compared to previous years. And remember, it’s not all about upside: participating therapists will need to submit more data and perform better than ever before in order to avoid a downward payment adjustment that can fall as low as 9%. 

However, it’s important to keep in mind that there are two sides of this coin. MIPS remains a budget-neutral program, which means the positive adjustments that successful providers earn come directly from the pockets of the providers who fail to perform. Because it will be more difficult to successfully participate in MIPS in 2020, there will likely be more abject failures—which means that payment bonuses might see a slight bump.

Is this your ticket to recouping some of the revenue lost to the impending 8% and 15% cuts? 

CMS hit the rehab therapy industry with a double whammy this year. Not only will PTAs and OTAs see a 15% payment reduction on the services they provide independent of a therapist in 2022, but the industry as a whole will also see a sweeping Medicare payment cut in 2021 that CMS is predicting will total around 8%. This could have some serious financial implications for many clinics—especially those with a large Medicare population. 

But, if you participate in MIPS and perform well, you have a chance to recoup some of your lost revenue. Remember, the 15% PTA and OTA reduction will take effect in 2022—the same year that 2020 MIPS participants will receive their performance adjustments. Unfortunately, the 8% payment cut will occur in 2021 (one year before the 2020 payment year) so this solution is not perfect—but it’s better than nothing.  

Balancing Act

Now, before you rush out and sign up for MIPS, please understand that I’m not casting MIPS as a revenue-balancing guarantee. As I mentioned previously, opting into MIPS is a risk-reward kind of deal—and in previous years, the reward hasn’t exactly been awe-inspiring. CMS has released one year of MIPS performance results (for 2017), and it revealed that the highest incentive payout was a modest 1.88% increase—and that included the boost from the exceptional performance bonus. This is a far cry from the 15% and 8% cuts that Medicare is hurling our way, but again, it’s something—and I do predict that there might be a slight increase to the average positive MIPS payment adjustment in the coming years. 

My thought is that this may be a way for therapists to make up for the steady stream of downward adjustments that we can’t seem to escape. However, I want to emphasize that MIPS isn’t an added revenue guarantee, and some practices might still be better off avoiding the program altogether. For example, 94% of the TINS that participated in MIPS through WebPT in 2019 were small practices—for which reporting can be more burdensome. That’s why it’s absolutely crucial that you do your due diligence and really weigh the pros and cons of MIPS participation in your specific organization.

WebPT and MIPS 

If you do decide to participate in MIPS, you don’t have to do it alone. We’re dedicated to ensuring our Members’ success in this program, which is exactly why we teamed up with a QCDR (Healthmonix) to submit five quality outcomes measures to CMS for inclusion in the 2020 measures set—all of which were approved and will be available next year. In other words, our Members will no longer have to submit FOTO measures to complete the quality category; instead they can report the outcome measures that are bundled in with WebPT’s MIPS solution. And while it’s difficult for us to predict our Members’ final 2019 MIPS scores (there is still another month left in the year, after all), the TINs that have already attested to their improvement activities are projected to exceed the neutral payment threshold. 

Rehab therapists are at a critical juncture. Medicare payments are steadily trending downward, and each of us has to make a decision: is it better to travel down the path of least resistance and try to shoulder CMS’s cuts—or face the MIPS monster head-on and try to take back some of the revenue lost? It’s a tough call to make, and only you know the right decision for your practice. I wish you luck—and please remember that WebPT will be in your corner to lend a helping hand and provide any education you need to succeed.

The post Founder Letter: Reconsidering MIPS: Should PTs Participate in 2020? appeared first on WebPT.

Recently, we’ve received a whole lot of questions about what physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) can and cannot do in practice—likely because many practice owners are re-evaluating staff roles and clinic operations in preparation of the Medicare reimbursement reduction for assistant-provided services, which takes effect in 2022. (Keep in mind, though, that providers need to begin affixing specific modifiers to assistant-provided services on January 1, 2020). For an example of how to streamline your operations to soften the blow of this cut, check out this EIM post by WebPT Co-Founder and Chief Clinical Officer Heidi Jannenga. For answers to your most pressing questions about what PTAs and OTAs can and cannot do in practice, read on.

But first, a quick disclaimer: The information in this blog post is for educational and informational purposes only. The delivery of physical therapy and occupational therapy is governed by state law and payer requirements. Thus, we strongly recommend that you review your state practice act and payer contracts as well as seek the help of a qualified attorney before establishing practice policies. This should in no way be construed as legal advice.

Can PTAs and OTAs complete progress notes?

Not for Medicare beneficiaries. According to Rick Gawenda here, CMS does not allow assistants to complete full progress notes. Instead, licensed clinicians (i.e., PTs or OTs) must write progress notes themselves. That said, as long as it is within their scope of practice in accordance with their state practice act, assistants are permitted to collect and provide documentation that supports the progress note, including, as WebPT’s Kylie McKee writes here, “the patient’s response to education and progress with certain skills,” as well as “the services provided as part of the intervention plan—including any home programs or adaptive equipment recommendations and the patient’s subjective comments about the services.” To be clear, all assessment as to whether or not a patient has met his or her goals—including “any clinical observation or objective tests and measures”—is the sole responsibility of the licensed therapist.

While many payers adhere to Medicare’s guidelines, some have their own rules, so it’s best to review your individual contracts as well as your state practice act. You’ll always want to adhere to whichever requirement is most stringent.

To learn whether or not an assistant can discharge a patient, check out McKee’s post in full.

Can PTAs and OTAs assist with initial evaluations?

For Medicare beneficiaries, the answer is no. As McKee explains, “Medicare does not reimburse occupational therapy assistants [or physical therapist assistants] for evaluative or assessment services.” Thus, “the OT [or PT] risks denial of payment and possible allegations of fraud if the OTA [or PTA] contributes to the evaluation.” For non-Medicare beneficiaries, you’ll want to review your payer rules and state practice act. For example, “New York law authorizes OTAs to contribute to patient evaluations by assisting with assessments and gathering data under the  supervision of the OT”; however, New York PTAs are not allowed to perform or assist with evaluations. If there’s ever a discrepancy between your state practice act and the payer rules, adhere to the strictest one.

Can PTAs and OTAs create, update, or modify a plan of care?

Not under any circumstances. The licensed therapist must be the one to create, update, or modify a patient’s plan of care.

Can PTAs and OTAs provide ongoing treatment to patients when the supervising PT is home sick?

That depends. All PTA-and OTA-provided services must be supervised by a licensed PT or OT, respectively, but to what degree depends on the “competency and experience of the [assistant]—as well as the complexity of the patient’s condition.” Beyond that, you’ll also need to factor in the guidelines outlined in your state practice act, if any, as well as your payer’s rules for your office setting. 

In private practice settings, Medicare requires, at a minimum, direct supervision of an assistant by a licensed therapist. That means the supervising PT or OT must be physically present in the office (albeit not necessarily in the same room) and available to intervene if necessary while the assistant is performing the services. In other words, assistants may not treat Medicare beneficiaries without a licensed therapist on site and available. That said, Medicare does not specify that the supervising therapist needs to be the same therapist who created the plan of care—only that he or she is familiar enough with the plan of care and the patient to properly support or provide guidance if needed.

In skilled nursing or assisted living settings, Medicare only requires general supervision of an assistant by a licensed therapist, which means “that the supervisor must provide initial direction and periodic inspection of the activity, but he or she does not necessarily need to be on the premises during every treatment.” That said, if there’s any reason to think that a patient or an assistant requires more supervision than the minimum, it is the licensed therapist’s obligation to provide it. 

If you’re an APTA member, you can access a PTA direction and supervision algorithm here.

Can PTAs or OTAs be supervised by another type of provider—say, a chiropractor or physician?

Nope. In all situations that we’re aware of, licensed physical therapists and occupational therapists are the only providers who are able to supervise physical therapist assistants and occupational therapy assistants, respectively. Neither chiropractors nor physicians may supervise therapy assistants.

Can a PTA or OTA diagnose a patient?

No. According to the APTA, “physical therapists’ practice responsibility includes all elements of patient and client management.” As such, “The entirety of evaluation, diagnosis, and prognosis, as well as components of examination, intervention, and outcomes, must be performed by the physical therapist  exclusively due to the requirement for immediate and continuous examination, evaluation, or synthesis of information.” The same goes for OTs.

Can a PTA or OTA tweak treatments during a session?

Yes; as the APTA explains here, “although PTAs cannot make changes to the overall plan of care, they are trained to make treatment adjustments to accommodate a patient during a session.” The same holds true for OTAs. 

Can a PTA provide joint mobilizations? 

According to the above-mentioned APTA article, “PTAs provide many of the treatments that a PT provides—passive range of motion, electrotherapeutic modalities, mechanical modalities, gait training, functional training, transfer training, wound dressing, airway clearance techniques, and therapeutic exercise for strength, flexibility, and balance.” That said, “PTAs cannot perform selective sharp debridement in wound care management.” Furthermore, “depending on state practice acts, PTAs may or may not be able to perform joint mobilizations. Some states do allow PTAs to provide grade V high velocity low-amplitude thrust techniques.” However, even if a PTA or OTA can perform a service under state laws, it doesn’t necessarily mean that an insurance company will pay for the service. That’s why it’s always best to cross-reference your state practice act with your payer contracts. For the APTA’s list of PT-only services, check out this document.

Can a PTA or OTA be held accountable for HIPAA violations?

Yes; all HIPAA-covered healthcare providers, including therapy assistants, are responsible for properly handling patients’ protected health information—and could face legal repercussions for failing to do so.

Have a lingering PTA or OTA question? Leave it for us in the comment section below, and we’ll do our best to find you an answer. 

The post Can PTAs Do Progress Notes? (And Other PTA and OTA Questions) appeared first on WebPT.

Waiting for all 50 states to have total, unrestricted direct access to physical therapy services reminds me of the one and only time I cooked a Thanksgiving turkey: it was a massive bird, and I was a novice enough chef to not realize how long it would need to bake. And because I’m impatient, I’d take a peek in the oven every 15 minutes or so to see how it was progressing. Slowly but surely, the fine fowl cooked into a beautiful golden brown, and I pulled it out of the oven—just in time for the dessert course.

From where I’m sitting, it seems like PTs have had a similar experience when it comes to standardizing direct access laws across the US. Of course, it’s taken years for things to get to where they are now, which is significantly longer than my paltry poultry parable. (Try saying that five times fast.) But direct access standardization—that is, unrestricted patient access to physical therapy as a first-line treatment option—is a critical must-do for the healthcare community. Here’s why:

1. It’s better for patients.

Physical therapists have the proper training to treat direct access patients—and to refer patients to other providers when necessary.

One of the main beefs surgeons and physicians have with patients skipping a doctor’s referral and heading straight to a physical therapist is the risk of injury or an overlooked diagnosis. However, physical therapists are trained to diagnose injuries and diseases related to the musculoskeletal system. As mentioned in this APTA resource, an article published in JOSPT (Moore et al, October, 2005, pages 674-78) described “over 50,000 patients seen by PTs via direct access, and not one incidence was reported of patient injury or adverse event, or of a PT having their license revoked or suspended.”

Furthermore, physical therapists know when a diagnosis is beyond their scope of practice, and they have the proper judgement to refer patients to a physician whenever necessary. The same resource cited above also referenced “30 published patient case reports where individuals came to physical therapy with a variety of musculoskeletal complaints. According to the reports, “the PTs examined the patient, recognized unusual examination findings and referred the patient. This patient referral to a physician led to a more timely diagnosis of a multitude of conditions.”

PT is safer than physician-prescribed medications.

Physical therapy is also a much safer alternative to many of the meds doctors prescribe to mask pain. According to a survey from the American Pain Society, “Chronic pain is highly prevalent in the United States, affecting nearly one-third of the American population.” As a result of the chronic pain epidemic, pharmacological interventions—specifically, opioid prescriptions—have increased exponentially. In fact, as WebPT Co-Founder and Chief Clinical Officer Heidi Jannenga explains in this Evidence in Motion article, “low back pain patients who accessed conservative therapies first were ‘75% to 90% less likely to have short or long-term exposure to opioids.’” 

On the flipside—and coming as a shock to no PT whatsoever—patients who opt for meds or surgery over movement therapy are vulnerable to a barrage of risks, including addiction or death. For that reason, the CDC recommends that patients seek non-pharmacological treatments for chronic pain. And as musculoskeletal experts, physical therapists are perfectly suited to provide such treatment. However, patients may be less willing to jump through hoops to access a PT in states with provisional direct access.

Patients achieve the same (or better) outcomes with physical therapy.

Doomy and gloomy health risks aside, prescription meds should never be the first choice for treating pain, as they don’t actually treat the source—merely the symptom. According to this resource from the CDC, physical therapy and exercise therapy are far more effective at treating and reversing the cause of many types of chronic pain—from osteoarthritis to fibromyalgia. In some cases, PT modalities reduce pain and improve function “immediately after treatment” and “improvements are sustained for at least 2–6 months.”

2. It’s better for healthcare spending.

Referral requirements create an additional financial burden for patients—and a barrier to care. 

So, with all of these health benefits, it makes sense that patients and payers alike would want physical therapy to be more readily available. Unfortunately, the cost of PT care—due in large part to lack of insurance coverage—has put a massive barrier between PTs and their potential patients. And one way we can start alleviating some of that financial burden is to remove the unnecessary visit to a physician’s office. In fact, according to this APTA-backed study, “Individuals who saw a physical therapist first in states with provisional access had significantly higher measures of health care utilization within 30 days, including plain imaging and frequency of physician visits, than individuals who saw a physical therapist first in states with unrestricted access.” Conversely, “those who saw a physical therapist first in provisional-access states had 25% higher relative costs at 30 days and 32% higher relative costs at 90 days, whereas those who saw a physical therapist first in unrestricted-access states had 13% lower costs at 30 days and 32% lower costs at 90 days.”

PTs are experts: they know when a patient is a good candidate for physical therapy—and when he or she is not—which means a trip to the doctor’s office to obtain a referral for PT is completely unnecessary and a total waste of time and money. Cutting out that step lowers the barrier (if only a little) between physical therapy patients and their providers of choice.

Physical therapy is more cost-effective for payers.

But patients aren’t the only ones who benefit financially from increased accessibility to PT services. In the aforementioned article, Jannenga also cites data saying that “claims for musculoskeletal episodes accounted for more than 16% of total spending—a percentage greater than that associated with any other condition. Furthermore, 75% of that spending went toward prescription medications.” (For context, more than 11% of UHC’s total spend was associated with claims for cancer treatment.) In other words, directing musculoskeletal patients toward physical therapy could end up saving the healthcare system a whole lot of dough. And lifting restrictions on direct access encourages patients to seek conservative care paths that result in fewer dollars spent.

3. It’s better for the physical therapy profession.

Direct access helps establish PTs as first-line providers.

Okay, we know physical therapists have the education and clinical decision-making ability to oversee patient care from start to finish. However, because they rely so heavily on physician referrals, PTs have struggled to position themselves as the first-line providers we know they are. Lifting restrictions on access to care could actually help shift this perception.

Furthermore, when PTs have the opportunity to treat patients one-on-one throughout the entire episode of care, they are able to collect more holistic and meaningful outcomes data, because they’re running the care plan from beginning to end. And they can leverage that data to effect positive change—from negotiating for better third-party reimbursement rates to advocating for themselves (and their patients) by proving the efficacy of physical therapy to the government powers that be.

It’s a step toward industry standardization.

Standardization is a big ol’ problem in the PT profession, and that’s especially true with respect to current direct access law. While it’s true that every single state (plus Washington, DC and the Virgin Islands) is a direct access state, as of 2019, only 20 states allow total, unrestricted access to physical therapy services. (Although that’s up by two since last year!) That lack of standardization creates confusion for not only providers, but also patients.

Here’s the thing: PTs receive—more or less—the same education in every state. Each state requires the same degree level and skills in order for an individual to become a licensed physical therapist. So, considering the fact that PTs across the country are held to the same baseline educational standards, it doesn’t make a whole lot of sense for states to not hold them to the same practice standards, too. And once that’s standardized, it could make it easier for lawmakers and insurance payers to create pathways for things like telehealth services—thus, bringing the profession into the 21st century. 

So, there you have it: the top reasons for giving patients unrestricted direct access to care. Did this article whet your appetite for more direct access info? Click here to check out our guide to direct access by state. And, as always, feel free to drop your questions in the comment section below!

The post 3 Indisputable Reasons Why All Patients Need Unrestricted Direct Access to PT appeared first on WebPT.

With the upcoming payment changes for PTAs and OTAs, we’ve received a lot of questions regarding supervision requirements for therapy assistants in the outpatient setting. So, we thought our readers would benefit from some examples of common, real-world scenarios the type of supervision each one requires.

Disclaimer: We are not your attorneys, and we do not know all the details of every state practice act, requirements for every commercial payer, or rules that apply to your specific clinic setting. The information in this blog post is for educational and informational purposes only. The delivery of physical therapy and occupational therapy is governed by state law and federal payer requirements. Thus, we strongly recommend that you review your state supervision requirements and payer contracts as well as seek the help of a qualified attorney if you have lingering questions.

With that, let’s get to it:

Scenario #1: An occupational therapy assistant is licensed in the state of New York and works in an outpatient private practice, and an occupational therapist asks him or her to assist with an evaluation of a Medicare Part B patient.

According to the New York Occupational Therapy Practice Act, licensed occupational therapy assistants “provide occupational therapy and client-related services under the direction and supervision of an occupational therapist.” More specifically, New York law authorizes OTAs to contribute to patient evaluations by assisting with assessments and gathering data under the  supervision of the OT. However, because Medicare is the payer, Medicare rules will also apply here. And because Medicare does not reimburse occupational therapy assistants for evaluative or assessment services, this trumps New York state law. So, in this scenario, the OT risks denial of payment and possible allegations of fraud if the OTA contributes to the evaluation. 

Scenario #2: A physical therapist assistant is licensed in the state of New York and works in an outpatient private practice, and a physical therapist asks him or her to assist with an evaluation of a Medicare Part B patient.

Now, let’s take a look at the same scenario, only this time it’s a patient being seen under a physical therapy plan of care. According to the New York state practice act, “Duties of physical therapist assistants shall not include evaluation, testing, interpretation, planning or modification of patient programs.” As such, the PT cannot instruct the PTA to perform an evaluation on the patient. Furthermore, just as with evaluations performed by an occupational therapy assistant, Medicare will not reimburse an evaluation that a PTA completes. 

For more details about Medicare’s rules for PTAs and OTAs, check out Chapter 15 of the Medicare Benefits Policy Manual, Section 230.2

Scenario #3: An occupational therapist evaluates a Medicare Part B patient and develops a plan of care, and the occupational therapist assistant conducts subsequent treatment. 

Now, consider the second scenario, except in this case, the therapist has evaluated the patient and determined the plan of care, and the therapist assistant carries out treatment during subsequent appointments. New York’s law does not specify the level of supervision an occupational therapist assistant must be under while carrying out these services, but the OT must implement the appropriate level of supervision based on the competency and experience of the OTA—as well as the complexity of the patient’s condition. That said, in private practice settings, Medicare requires direct supervision of an assistant by a licensed therapist “unless state practice requirements are more stringent.” As WebPT’s Erica McDermott explains in this blog post, “direct supervision means that the supervising therapist is physically present in the office—but not necessarily in the same room—and available to intervene if necessary at the time the assistant performs the services.” So, in this scenario, the physical therapist or occupational therapist would have to directly supervise the OTA during the Medicare patient’s care.

Scenario #4: A physical therapist evaluates a Medicare Part B patient and develops a plan of care, and the physical therapist assistant conducts subsequent treatment. 

Unlike their occupational therapy counterparts, PTAs are required to be under a specific degree of supervision while carrying out treatment modalities per the New York state practice act: “Supervision of a physical therapist assistant by a licensed physical therapist shall be on-site supervision, but not necessarily direct personal supervision.” In other words, a licensed physical therapist must be in the same building while the PTA treats the patient. However, he or she does not need to be in the same room as the assistant.

This actually aligns with Medicare’s physical therapist assistant supervision rules as well. Just as with OTAs, Medicare requires PTAs to be under the direct supervision of a physical therapist during treatment. This simply means a PT must by on-site—but not necessarily in the same room—while a PTA conducts treatment.

What if the assistant is treating a Medicare beneficiary in a different setting?

Now, if the patient is receiving therapy treatment in a different practice setting, the rules may change. Medicare’s direct supervision requirement only applies to the outpatient private practice setting—so if, for example, the above scenarios occurred in an assisted living or skilled nursing setting, the PTA or OTA would only need to be under the general supervision of a PT or OT. As we state in the aforementioned blog post, “General supervision means that the supervisor must provide initial direction and periodic inspection of the activity, but he or she does not necessarily need to be on the premises during every treatment.”

For OTAs, just as with the outpatient setting, New York law does not specify the level of supervision required for an occupational therapy assistant in an assisted living or home health setting. However, the law requires the assistant to provide services under the direction of a licensed therapist, which includes consultation with the OT. Furthermore, the OT must implement the appropriate level of supervision based on the competency and experience of the OTA—as well as the complexity of the patient’s condition. The therapist can supervise the assistant by being available by phone, meeting with the assistant regularly to discuss patient goals and progress, and reviewing the assistant’s documentation.

Scenario #5: An OTA completes a progress report on a Medicare Part B patient on the 10th visit.

Now, let’s look at the second scenario again, but in this case, the therapist asks the assistant to assess the patient’s progress and administer treatment on the patient’s 10th visit. New York law authorizes an OTA to participate in progress updates as these are considered regular treatment notes. So, if the patient was a non-Medicare patient, an OTA could complete the progress report. Remember, though: CMS rules always trump state rules. CMS defines a progress report as something that is written on or by every 10th visit regardless of the reason for the visit, and while the CMS benefit policy manual allows assistants to contribute information to these reports, they cannot execute progress reports on their own.

So, in the outpatient private practice setting or assisted living setting, the assistant can participate in the progress note by observing the patient as he or she performs the tasks associated with his or her therapy goals, but the therapist must be the one who assesses whether or not the patient met those goals. (This includes any clinical observation or objective tests and measurements.)

Scenario #6: A PTA completes a progress report on a Medicare Part B patient on the 10th visit.

Similar to the OTA scenario, the New York state practice act allows PTAs to complete progress reports, and therefore, a PTA could complete a progress report on a non-Medicare patient. However, if the patient is a Medicare Part B patient, the PTA may not complete a progress report. That said, a PTA can document certain elements of a progress report.

What parts of the documentation can an assistant complete?

Medicare progress notes typically summarize treatment sessions up to the date of the progress note, and the PTA or OTA can help document the patient’s response to education and progress with certain skills. The assistant can also document the services provided as part of the intervention plan—including any home programs or adaptive equipment recommendations and the patient’s subjective comments about the services.

Can an assistant discharge the patient?

The same supervision requirements that apply to progress reports also apply to the discharge phase of treatment. This is because a discharge note essentially functions the same as a progress report: it summarizes the patient’s care up to that point and includes assessment and documentation of the patient’s progress toward—or completion of—his or her goals. Under the direct supervision of the therapist, the assistant can review any home programs and provide the patient with adaptive equipment and/or durable medical equipment (DME) recommendations. The assistant can also suggest home modifications and the level of family assistance needed for certain activities of daily living as well as provide recommendations for continued therapy. But because this is essentially a progress report, the PT or OT should step in to assess progress toward goals and record objective measurements. Both the therapist and the assistant can document the summary of the intervention in the discharge note.

Final Considerations

If you’re ever unsure about whether a PTA or OTA can perform duties during treatment, here are a few things to consider:

• The jurisdiction comes first. You must always follow the rules of your state practice act—even if the insurance payer has less stringent rules. While we used New York state as the example in these scenarios, there is a ton of variation among state practice acts, so it’s important you know what your state says about the responsibilities of PTAs and OTAs. 
• CMS’s supervision rules vary between settings. In our scenarios above, the assistant works in an outpatient private practice. However, the rules for supervision change from setting to setting.
• PTAs and OTAs can never create, update, or modify a plan of care. Establishing a plan of care is entirely up to the therapist. However, assistants can participate in an evaluation, re-evaluation, or progress update by collecting data (e.g., taking vital signs) and/or supervising patient treatment—as long as it is initially determined by the PT (e.g., the assistant can review a home exercise program). But again, the level of data collection allowed is contingent upon the state practice act.
• Assistants can advance treatment within the established plan of care. Assuming the PT or OT outlined the advancement of treatment within the established plan of care, the assistant may progress treatment as necessary. For example, let’s say a patient who underwent knee replacement surgery has a goal to walk with a cane, but he or she starts with a walker. Assuming the therapist performs regular status checks over the course of the episode, an assistant could work from walker to crutches to cane.

So, there you have it: six PTA and OTA supervision scenarios. If you have any questions regarding supervision—or you’d like to provide a scenario of your own—let us know in the comment section below! 

The post OTA and PTA Supervision: 6 Real-Life Scenarios appeared first on WebPT.

This time of year can be, well, complicated. Whether you’re scrambling to finish up your end-of-year goals, planning your work around vacations and holidays, or orchestrating a family get-together, ’tis the season for stress. But, amidst the chaos, there’s so much to be thankful for—and that’s something that’s certainly not lost on physical therapy patients. So, this Thanksgiving, we’re serving up a big helping of gratitude (hold the gravy) for physical therapists and the impact they’ve had on our lives. Check out our collection real PT patient stories below:

Spooner Physical Therapy

“Two years ago I had a beautiful baby boy. I knew that having a baby would really change my body, but my doctor didn’t talk much about the recovery process afterward. For the last two years, I’ve been dealing with diastasis recti, which is the separation of your abdominis muscles that allows for your body to accommodate a growing baby. This separation is totally natural and affects nearly 50% of mamas. 

As a result, I stopped working out; I was overly cautious with my day-to-day movements, because I was scared about injuring myself further—but I expected that my body would just fix itself. This severely limited my regular activities (no more rock climbing, I didn’t sign up for soccer, and there was no way in hell I felt like I could ever take another bootcamp class at the gym again). In addition to not being able to do the things I loved, I was also scared that as my son got heavier I would increasingly strain that gap in my abdomen more and more as he grew. I got pretty depressed about it, to be honest, and I didn’t feel like I would ever make any progress.

Luckily, I work for a company that promotes rehabilitation through physical therapy, and I found a physical therapist to help me restrengthen my core. In only three visits, she told me that I had made incredible progress, and that if I’d come in that day for the first time, she wouldn’t be concerned with my diastasis at all because I was functionally normal.

I’m still going to PT today because I have a little way to go, but I now see the light at the end of the tunnel and know that I’ll be able to regain the strength that I once had. And I have my physical therapist to thank for that.”

“When you first have a baby, you assume all the aches and pains are normal, but then the months pass and you get fed up with feeling broken. Such was my plight when I sought out pelvic therapy. At first, I downplayed everything ailing me, but my therapist was so empathetic, intelligent, and communicative that I quickly established a strong level of trust with her. She not only fixed the hip pain and postural issues plaguing me, but also helped me feel like myself again.”

“I was diagnosed with carpal tunnel last year and started going to physical therapy. The people there were very cool and helped me learn exercises that really helped reduce the pain and discomfort in my hands. It’s awesome to consider how I started out thinking I might end up having to stop using keyboards—[and now I] hardly notice any discomfort.”

“My experience during my current PT has been amazing. My therapist, Brad, was able to identify that, even though I have low back pain, the root cause maybe my hips/pelvis. After years of living with an uneven pelvis, Brad was able to make a quick adjustment that I have been able to maintain and has alleviated a ton of pressure. In addition to in-clinic services, Brad provided a simple starter HEP that is paired with a printout, emailed videos, and an app to update and message the clinic if needed. Outside of the therapy itself, the front office staff, technicians, and other therapists are so kind and courteous.”

Endurance Rehab

“I have seen physical therapists on and off for years, but I just recently had one of my best PT experiences. My therapist specialized in treating long-distance runners, so he was immediately familiar with the majority of injuries I had experienced over the previous decade, and he used my history in conjunction with the recent symptoms I was experiencing to formulate a diagnosis no other healthcare provider had even considered. Due to his depth of knowledge and expertise, though, I totally trusted what he was telling me, and I followed his treatment plan to the letter.

By the time I was finished with my care plan, I had never felt stronger (even compared to my college athletics days). Running is such a huge part of my life; I honestly don’t feel like myself when I can’t get in my daily run. This is why injuries are so incredibly frustrating—and why I’m so incredibly thankful for a therapist who was able to help me finally solve my chronic injury issues.”

Desert Hand Therapy

“Overall my experience was great! Front office staff, PTAs, and the PT were very helpful and friendly. The staff were open and honest with treatment. They set goals and timelines for my therapy and made sure I stayed on track. I looked forward to my appointments, and at the end of my treatment, I was functioning at 100%!”

Orthopedic Sports Therapy

“I originally went to PT because I had excruciating forearm pain. Gripping anything was horribly painful, and I couldn’t work on my laptop without extreme pain. When I went to get help from a PT, my PT almost immediately discovered that I actually had a neck injury. I had messed up my neck during a fall and pinched my nerves, which caused a sharp pain to cascade down my arm. My PT worked on my neck for a few months and, despite a doctor telling me I’d have nerve pain for the rest of my life, I’m now completely pain-free!”

Jarrett Orthopaedic Rehab

“I started at Jarrett in October of 2018 with significant back and hip pain. I was unable to ride my bike for more than 30 minutes without extreme pain. Working with my therapist, I was able to build a plan that got me riding long distances within two months almost completely pain-free. The skill and caring that my therapist—and everyone in the office—demonstrated makes them, in my opinion, the best physical therapist I’ve ever been to.” 

Empower PT

“About two years ago, out of the blue, I started having a hard time walking. By the time I got home from work, I could not put any weight on my legs—nor could I walk. I literally crawled (barely) from my car to my house. The pain was unbearable. I went to my doctor and to a pain management doctor who discovered that my spine had several herniated disks. He wanted to do everything from injections to narcotics to surgery. I asked about PT and was told I could try it but that it was unlikely to be effective.

During the first three weeks, I could not stand without crutches and spent the majority of the time in a wheelchair; when I returned to work I was on crutches, and, after what seemed like forever, I started PT. They helped me get stronger and learn to walk. It was like my legs had forgotten what they were supposed to do. I could not walk for very long, and it was painful, so I would compensate for the pain. I was also impatient, so I would walk any way I could. I started to get comfortable walking like this, so then my therapist had to help me retrain the way I walked. After several months, I was completely away from the crutches and wheelchair. It has been almost two years, and now I can finally walk through the grocery store without help. (And most recently, I walked a full two miles!) I am thankful to my PT for helping me through this—and without narcotics.”

Apex Physical Therapy

“I literally hadn’t been able to bend my back, use my core, or lift anything over the weight of my chihuahua for three months after my spinal fusion. My PTs helped me get back to feeling comfortable and moving again. When I would get frustrated with how much strength I had lost, they encouraged me to keep trying and assured me that it would come back. Also, they’d always tell me how great I was doing, which kept me feeling positive. I had previously received therapy for my two microdiscectomies, but getting back after my fusion was super hard. I was so thankful to have a team walk me through getting back to my new normal.”

So, just in time for Turkey Day, hats off to physical therapists! We’re so grateful for everything you do.

The post Why We’re Thankful for Physical Therapy: 9 Real Patient Stories appeared first on WebPT.

As 2019 comes to an end, it’s giving season for nonprofit organizations across the globe! SEED SPOT is celebrating the opportunity to #InvestInImpact with the community this year by telling the stories of our incredible entrepreneurs, and sharing the life-changing impact these alumni are creating in communities nationwide.

This year, our campaign theme is #InvestInImpact, and it’s all about celebrating the life-changing impact our alumni are creating in communities nationwide. But before you take out your wallet, it’s important to know the facts. When you make a gift to SEED SPOT, where does your dollar go? Who is your gift supporting? What impact are they creating in the world? We’ve got answers for you! Here are three reasons why you should #InvestInImpact with SEED SPOT this holiday season:

Just $1 Goes a Long Way 

SEED SPOT has served 884 entrepreneurs since 2012. These alumni have raised $53.3 million in capital, generated $82.6 million in revenue, created 2,385 new jobs, and positively impacted the lives of 8.2 million people with new products, services, and technologies. That’s a lot of impact! For every $1 donated to SEED SPOT programs, our entrepreneurs have generated six times that in revenue, raised five times that in capital, and impacted one life. Now imagine the impact you could create by giving $50, $100, or even $500! This empowers entrepreneurs like Carlos Castellanos of BioForce Medical to develop life-saving cancer diagnostic devices that help oncologists with early cancer screening and treatment monitoring.

SEED SPOT Supports Traditionally Underrepresented Entrepreneurs

Of the 884 entrepreneurs SEED SPOT has served since its founding, 81 percent of founders identify as traditionally underrepresented entrepreneurs that have been historically denied equitable funding access by financial institutions. SEED SPOT empowers early-stage entrepreneurs to leverage business as a catalyst for social change and levels the playing field for entrepreneurs of diverse identities and backgrounds. Underrepresented entrepreneurs – especially women, entrepreneurs of color, and low-income founders – face significant barriers in accessing entrepreneurial opportunities. Through its portfolio of accessible and founder-friendly programs, SEED SPOT strategically connects women, entrepreneurs of color and low-income founders with industry professionals, investors, and successful entrepreneurs to help them launch and grow ventures with social impact.

SEED SPOT Supports Local Communities

At its core, SEED SPOT keeps local communities – and the humans that live, work, and play within them – at the heart of every program and service we offer. SEED SPOT trains and supports local Community Organizers in deploying our signature programs and building local ecosystems of support. In turn, these Organizers apply their intimate understanding of the local community to empower entrepreneurs that develop innovative products and services, create jobs, and spur both local and national economic growth!

This year, we brought programming to Seattle, WA with the support of Seattle ecosystem expert John Johnson. John says it best: “As a SEED SPOT alum, I saw the need for a collaborative, inclusive, and impact-driven community in Seattle. As I became further embedded in the community, I kept hearing for individuals that they wanted a safe place to start and grow their ideas that have a social benefit. It just made sense to work with SEED SPOT and bring the Launch Camp here!” Read more about John’s experience here.

Do any of these reasons resonate with you? Here are four ways you can support impact-driven entrepreneurs during this year’s #InvestInImpact campaign:

1. Join the SEED SPOT 500: The SEED SPOT 500 is a committed group of SEED SPOT champions, and our premier group of donors. They are entrepreneurs, SEED SPOT mentors and alumni, and community advocates and champions that are changing lives with $42/month or $500/year gifts. You can join HERE.
2. Make a one-time gift: No matter the size, your donation is put to work in launching an impact-driven entrepreneur on a life-changing journey. Give a gift HERE.
3. Buy an entrepreneur coffee or tea: Caffeine is a critical part of changing the world — enough said.

Our work is only possible because of supporters like you – thank you for investing in the dreams and hard work of impact-driven entrepreneurs nationwide.

The post 3 Reasons to #InvestInImpact This Holiday Season appeared first on SEED SPOT.

If you ever look at negative company reviews on Glassdoor, you’ll see a recurring theme: “Management was awful, but my coworkers were great.” Coworkers can make or break your experience at a company, but even if you don’t immediately click with your team, there are plenty of ways to build camaraderie intentionally. Feeling connected with your coworkers has many benefits. They’re a support network during tough times, and they form the foundation of your professional network as you forge your physical therapy career path (whether you choose to stay in patient care or pursue a non-clinical role). With a constant stream of reimbursement cuts and payment changes, things have gotten a bit negative in the rehab therapy world lately—which means it’s more important than ever to build trust, support, and positivity among your colleagues. Here are some ways to connect with coworkers and create lasting relationships that you can nurture throughout your PT career.

1. Journal Clubs

Journal clubs were quite popular for a while, but as companies tightened lunch hours and increased their focus on productivity, many journal clubs fell by the wayside. That’s a shame, because one of the best ways to remain invested in your profession is to team up with others who share your passion, and talk through the latest evidence with them. Luckily, you can get pretty creative with how you set up a journal club.

Here are a few ideas:

• Point person: One person reads articles in advance, distills the results for the group over lunch, and leads a follow-up discussion. You can switch up the leader for each meeting or elect a point person or two who seem up to the challenge.
• Online clubs: You and your coworkers can join an existing online journal club and talk through cases. For example, the OT Potential Club is managed by an OT who pores over OT-related research each week, distills it for ease of consumption, and moderates a subsequent online discussion on the article. 

2. Lunch-and-Learns

These are technically different from journal clubs, but they’re equally open to your own interpretation. Some people do use lunch-and-learns to discuss journal articles, but others will grab an empty space and take turns doing quick 5-15 minute presentations on various topics, followed by discussions. The nice thing about this setup is that you can build the transferable skill of presentation, which can be really helpful for if you ever pursue sales roles, clinical trainer roles, or other non-clinical positions that require speaking in front of groups.

Here are a few ideas:

• Round-robin presentations: Participants can do 5-10 minute PowerPoint presentations on all sorts of topics, both clinical and non-clinical.
• Single presenters: A single therapist or assistant can prepare a longer presentation on a topic of choice.
• Language skills: Depending on your patient population, lunch breaks can also be used to practice healthcare terminology in another language. 

3. Patient Power Hours

Some settings can be particularly taxing from a diagnostic, physical, or emotional standpoint. If you’re working with a challenging patient population, it can be helpful to talk through certain cases (anonymously and without violating HIPAA, of course) with coworkers. Consider patient power hours, where you get together with coworkers and chat through your most challenging cases. 

Here are a few ideas:

• Lunchtime power hours: These have some crossover with lunch-and-learns, but you can round-robin or take turns each session presenting challenging cases and seeking feedback. 
• Post-work walks: Similar to a “learn-and-burn”—a term that many entrepreneurs use to describe walking or exercising while listening to educational materials—an off-hours walk-and-talk session affords you the opportunity to talk through challenging cases with your coworkers. 

4. Group Workouts

It’s so frustrating when a month passes and you realize you simply haven’t been active. But work and life commitments often take precedence over your fitness—and, unless you commit to exercising during normal work hours, it can be a challenge to get yourself to the gym. Luckily, many of us work in gym settings where it’s easy to become active, especially when you team up with one or more partners who can hold you accountable. Rather than documenting during lunch, shoot for point-of-care documentation (whenever it’s safe and feasible), and use part of your lunch break to get moving!

Here are a few ideas:

• Plank competitions: Whoever holds a plank the longest gets to wear a crown for the rest of the day.
• Gym time at work: Challenge yourself to use some of the older, more, uh, dated equipment in the gym—or simply stick to the treadmills and bikes. 
• Weightlifting days: Grab the therapist with the most strength training experience and ask him or her to teach weight lifting techniques to the whole staff during lunch.

5. Lunches Together

This one might seem really obvious, but hear me out. Sometimes, it’s helpful to simply use your lunch break to eat and talk with your coworkers about non-work-related things. While most clinics keep therapists on schedules that preclude taking leisurely offsite lunches, you can still arrange to sit together in a new spot in the facility—or even spend lunch hours talking about favorite shows! (I know, I know—now that Game of Thrones is over, is it even worth it?)

Here are a few ideas:

• Soup exchange: On cold days, everyone brings enough of their favorite soup for the whole clinic to enjoy. You can take turns doing this so everyone gets to (has to) bring enough for everyone.
• Polar bear lunch club: On a cold-but-sunny day, everyone brings layers galore and sits outside to eat lunch and get a dose of mood-boosting vitamin D.

6. Birthday Celebrations

Feeling appreciated and noticed is vital to preventing burnout. Management may or may not take the initiative to celebrate birthdays, but bringing attention to each individual’s special day is an excellent way to make him or her feel valued. If you become the birthday party planner, you’ll build trust and good cheer in the clinic—and you can add event planning to your resume!

Here are a few ideas: 

• Themed birthday potlucks each month: While smaller teams can usually get away with individual celebrations, it often makes sense to do group birthday potlucks on a monthly basis for larger teams. Add a unique feel to these events by giving them themes, such as “lucky” foods for March or healthy treats in January. Pre-work breakfasts can also work, but people might be a bit grumpier than they’d be at lunchtime!
• Happy hours: If you’re on a team with younger, less encumbered-with-responsibility folks, you might want to have informal happy hours outside of the clinic. These typically build lots of camaraderie, as long as you avoid letting them turn into vent sessions—or worse, inadvertently exclude coworkers who don’t drink or can’t attend due to post-work family obligations.

7. Award Ceremonies

In a healthy, fun-loving clinic environment, you’ll usually have a variety of personality types: the person who is always early and organized, the person who goes above and beyond at community events, or the one who always puts together slick flyers—just to name a few. So, why not recognize each MVP for his or her unique talent or contribution? Not only can you create ribbons for the winners to wear at work—which can help spark conversation with patients—but you can also work with management to further reward and recognize the honorees. These ceremonies can take place at the end of the last Friday of each month or quarter, with the last patient(s) of the day sticking around to help vote!

Here are a few ideas:

• Best mood: There is no substitute for the positive vibe created by a coworker who is always cheerful and smiling. Reward him or her with recognition, gift cards, PTO, and other treats to keep those smiles coming!
• Most artistic: Is someone from the office always coming in early to decorate for the holidays? Does he or she design fancy flyers for community events? Consider gifting that person an art class at a local college.
• Most improved: Did one of the therapists recently earn a new certification? Has someone’s documentation skills skyrocketed? Acknowledge this at your awards ceremony!

8. Meditation Breaks

Meditation has been shown to help decrease stress, and it can be a great team-building activity for stressed-out staff. Most folks who are new to meditation can only do it for a few minutes at a time, making it the perfect pre-work bonding activity. You could also do it at lunch or after work, but because many settings have flexible hours and people coming and going, a morning meditation session often works best. 

Here are a few ideas: 

• Meditation master: Elect a team member to lead meditation sessions every week, or pass the duty around to new folks each time. (Those who are less inclined to lead sessions could find free guided meditation sessions online and play them for the group.)
• Themed sessions: Consider encouraging therapists to open up about stressors at work, and then design meditation sessions around topics addressing those stressors.

9. Social Time

Sometimes, we don’t really need anything fancy or work-based to bond with our coworkers. The simple act of getting together outside of work can be incredibly helpful with cultivating camaraderie, and it only takes one person to get the ball rolling for these events. 

Here are some ideas: 

• Local outings: Once per quarter, find a local event (hiking, camping, kayaking, book clubs, etc.) and go with your coworkers. It’s a great way to connect outside of work and build the types of bonds that go beyond being work buddies. 
• Clothing or houseware swaps: Get 10-15 colleagues together and have them bring gently used clothes, housewares, and babies’ and kids’ items. You can look online for swap rules (some folks like to draw numbers for “pick order,” while others go for the free-for-all approach). 
• Escape rooms: Escape rooms are incredible for team-building and identifying each others’ strengths and communication styles. While management might not foot the bill for this kind of event, groups can land some pretty good deals at these places. 

The best thing you can do for your career is to build a strong professional network. You never know where you—or your coworkers—will wind up in five, ten, or 20 years, so it’s a good idea to create strong, genuine bonds with them whenever possible. What are some of the ways you forge these relationships with your coworkers? Please share in the comments!

The post 10 Ways to Build Camaraderie With Your PT Coworkers appeared first on WebPT.

Speech-language pathologists, speech therapists, and audiologists help people better connect with their friends, family, and peers every single day. Verbal communication is one of the main building blocks of human relationships, and it’s something most of us take for granted. So, if an SLP has touched your life in some way this year, now’s the time to show him or her just how much you appreciate it. But, finding a thoughtful, personal gift can be a time-consuming endeavor, and who wants to spend hours scrolling through endless pages of SLP shirt results when they could be snacking on cookies and eggnog?

Luckily, we’ve already done all of that scrolling for you. Below, you’ll find a list of our favorite SLP gift ideas, organized by category. Consider these gift ideas for speech therapists our gift to you. Cheers!

Baubles and Bling

Is the SLP on your list an accessory aficionado? If so, then this is definitely the section for you. Any of these shiny doodads would be the perfect complement to any ensemble—formal or casual.

1. Bangle bracelets are fun and funky, so if those words describe the SLP in your life, then she’ll love this charming option.
2. Not that SLPs need any help in the inspiration department, but this message-focused necklace would make a fantastic wearable keepsake.
3. Okay, so you can’t actually give the gift of time, but this decked-out watch will help any busy SLP stay on schedule in style.
4. Lots of SLPs have to wear the same boring ID card to work every day, but this bejeweled badge holder will add some sparkle to their daily ensembles. (Hurry, there are only two left!)
5. While your favorite SLP won’t actually be able to wear this gift, he or she can certainly use it to accessorize a holiday tree: check out this handmade bread dough speech therapist ornament. (You can customize her hair color and add a name and/or a year.)

Flair You Can Wear

While SLPs specialize in the spoken word, the written messages scrawled on these items of clothing have special meaning to this special group of people. Plus, some of them are downright hilarious—and who doesn’t love a jolly good laugh this time of year?

1. Know an SLP with a funny bone? This comical cartoon shirt is sure to elicit a chuckle or two. (You can also find it in a women’s long sleeve here and as a onesie here.) This one’s amusing, too.
2. Ahoy, matey! Whether your humor-loving SLP prefers land or sea, this pirate-themed shirt is a great gift option.
3. If your favorite SLP just had a baby, consider sending this speech-therapy themed baby bodysuit or this bib.
4. Most SLPs could write pronunciation keys in their sleep, and this T-shirt takes that unique skill and turns it into a clever way for speech therapists to show everyone just how much they love their profession. To browse a whole page of smile-worthy speech-themed tees, click here (seriously, there are so many good SLP gifts here).
5. This SLP-themed shirt from 3E Love is one of our all-time faves, and with good reason. Click here to check out the inspirational story behind the brand.
6. As this custom applique tee suggests, that annoyingly catchy Bonnie Raitt tune could totally be the theme song for speech-language pathology.
7. Have an SLP in your life who loves the TV show, Friends? Then this Speech Squad shirt with the tagline, “I’ll be there for you,” might just be perfect. How you doin’?

The Art of Therapy

Creating a speech therapy program is a lot like creating art: it requires great passion, vision, and patience. These pieces embody the fusion of the visual and auditory senses, making them well-suited additions to any SLP clinic, office, or waiting room.

1. Architectural letter photography is a growing artistic trend, and this sleek photo collage—and this one—show why this style is so popular.
2. Give your favorite SLP a poster as bright as his or her personality with this colorful piece of pop art.
3. This poster is perfect for any speech-language pathologist who loves his or her job—and I think it’s safe to assume that includes pretty much all of them.
4. Don’t know your SLP’s favorite color? No worries. This unique, sound-wave generated piece incorporates the whole rainbow. And this one is in black and white.
5. Throw a gallery frame around this anatomy art, and you’ll have a conversation (pun intended) piece that any SLP will appreciate.

Fun and Functional

Many people write off practical gifts as a holiday no-no, but we know we’re not the only ones who would rather receive any of the items below in place of the ubiquitous holiday fruitcake.

1. It might not be feasible to give your SLP a beach vacation, but you can definitely give him or her this groovy beach towel.
2. Decorative pillows get a bad rap, but this cute cube o’ cush would add a nice touch to any SLP’s home or office.
3. If you know an SLP who appreciates a little snark in the morning, this clever coffee mug might be just the gift you’re looking for. If your SLP is more of a hot cocoa person, check out this chocolate-themed cup.
4. This adorable tote bag would make a great gift on its own, but if you really want to spread some holiday cheer to your favorite SLP, you could fill it with festive cookies.
5. Know an SLP who appreciates a nice, cold after-work beverage? Then, he or she might like this vintage-logoed pint glass.
6. This speech therapy-themed wall clock would look fabulous in any clinic—or classroom. After all, isn’t it always time for speech somewhere?
7. Gift this sweet tote bag for the SLP in your life who is no longer practicing but hasn’t lost one bit of love for the profession.
8. If your favorite speech therapist has a sweet tooth, then consider sending some adorable SLP-themed cookies on a stick. Who doesn’t love chocolate and sprinkles?
9. We wouldn’t want to leave out the partner of an SLP—we know he or she is important, too. So, here’s a “My ♡ Belongs to a Speech Therapist” decal that’s perfect for that other half.
10. Have a speech therapy teacher in your life? Consider gifting this picture book—loosely based on the classic story, “There Was an Old Lady Who Swallowed a Fly”—titled, “There Was a Speech Teacher Who Swallowed Some Dice.” 

Words of Appreciation

Sometimes, the best gifts are the ones written from the heart.

1. Looking to express your appreciation in writing this year? Check out these pronunciation key greeting cards, sure to give your SLP all the feels.

There you go: our top SLP gift picks for 2019. Now that you can check one more person off of your shopping list, you’ll have more time to start addressing all those family holiday cards. Have a gift suggestion that isn’t included here? Leave a comment below to share it with the world.

The post 28 Perfect Gifts for Speech-Language Pathologists appeared first on WebPT.

By: C’pher Gresham, CEO of SEED SPOT

To create a more prosperous world with activated entrepreneurs, Global Entrepreneurship Week 2019 (GEW) kicked off on Monday, November 18th. There are events launching globally to highlight the role of entrepreneurs creating more vibrant communities and provide the founders with support and resources to further grow.

At SEED SPOT, GEW is about celebrating the big dreamers, impact-driven entrepreneurs around the world sparking positive social and environmental change. Throughout the year we celebrate entrepreneurs, yet this week we hosted our Impact Entrepreneur Meet-Up in Phoenix and DC providing free resources to early-stage entrepreneurs to learn how to start and grow their ventures.

IMPROVING THE HUMAN CONDITION IS A WORLDWIDE CHALLENGE

The world continues to be plagued by large-scale problems affecting billions of people in communities around the world.

• By the year 2020, the world will need nearly 500 million new jobs to meet the demands of new generations joining the workforce (World Economic Forum).
• By 2050, there will be over nine billion people to feed on earth – a demand 60 percent greater than it is today (World Resources Institute).
• By 2050, there will be two billion people over 60 straining our global health system to provide equitable, consistent, and reliable care to vulnerable populations (World Economic Forum).
• According to the Global Gender Gap Report, it will take the world until 2133 to fully close the gender economic parity gap at the current rate of change (World Economic Forum).
• The gap between rich and poor is at its highest level in decades. There remain pervasive inequities in access to education, health care, and finance (International Monetary Fund).
• Due to human activity, greenhouse gases are at their highest level in 800,000 years and the earth has warmed nearly 1°C over the past 50 years (National Oceanic and Atmospheric Administration).
• Two billion people worldwide, including 200 million small and medium-sized enterprises, do not have access to high-quality, affordable financial services (World Economic Forum).

The challenges we face together are real, but human ingenuity through entrepreneurship will overcome them. 

ENTREPRENEURS ARE THE WORLD’S PROBLEM SOLVERS

We need innovators ready to roll up their sleeves and get to work actively solving challenges in spite of naysayers, uncertainty, and obstacles that may stand in their way.

We need entrepreneurs like Connie Tommerdahl and Carol Hirschmugl from SafeLi Materials, LLC who are creating a more efficient lithium-ion battery that will power a cleaner future. We need entrepreneurs like Mike Olsen, the co-founder of Proctorio, who is making education more accessible through an online learning integrity platform. We need entrepreneurs like Dr. Lisa FitzPatrick, founder of Grapevine Health, who is empowering community-based support and digital communication to improve health literacy and health care engagement in at-risk communities.

Solving climate change, pay inequities, or equitable access to healthcare will not come from a single company, nonprofit, new technology, or government program. We need thousands of entrepreneurs solving the world’s most pressing challenges.

BUT WE NEED THOSE ENTREPRENEURS EVERYWHERE

Despite the need for an uprising of diverse, impact-driven entrepreneurs, barriers to access still exist, especially for those outside of Silicon Valley, New York City, or Boston.

• At least 81percent of entrepreneurs cannot access a bank loan or venture capital (Kauffman).
• Between 2007 and 2012, less than one percent of venture capital in the US went to African-American or Latino founders (CNN).
• In 2018, less than three percent of venture capital in the US went to women founders (Fortune).
• Only 30 percent of the $99 billion in venture capital invested in 2018 landed outside of the metro areas of San Francisco, San Jose, New York, and Boston (Bloomberg).
• About 25 percent of Americans have thought about but decided against starting a business because of a lack of support (Gallup).
• The average accelerator has an acceptance rate of 3.8 percent, being more exclusive than all Ivy League schools (GAN).

These barriers exist when there is overwhelming proof that diverse entrepreneurial teams provide faster exits and create more profitable companies. In the recent report “All In: Women in the VC Ecosystem” released by Pitchbook, companies with at least one female founder are currently exiting a whole year sooner than the typical startup founded entirely by men: a median of 6.4 years vs. 7.4 years. In addition, a study conducted by the Boston Consulting Group found that “increasing the diversity of leadership teams leads to more and better innovation and improved financial performance.” The study found that companies with diverse management teams reported 19 percent higher revenue than teams with below-average leadership diversity.

It’s time to level the playing field.

Come join us. 

Register for a program near you today.

Donate to empower more entrepreneurs.

The post A Call To Action: Invest in Entrepreneurs Changing the World appeared first on SEED SPOT.