Episode 25 - Ezekiel Gherscovici, part 2: Linking the Assessment to the Treatment and “Keeping it Simple”

Ezequiel Gherscovici PT, Dip. MDT

Physical Therapist
Buenos Aires, Argentina

Show Notes

Challenges:

Through his training and influence in the Mechanical Diagnosis & Therapy Eze learned that the pay for service reimbursement model doesn’t lend itself well for efficient clinicians to be properly reimbursement for their expertise simply because so many modalities and techniques that are reimbursed are not necessary especially when patients are empowered through proper education.

The movement toward pay for performance anticipated in the future would be a component of the answer to improve this problem.  Studies have been published stating significant numbers of major complications and even deaths occurring from medical error.  As penalties begin to occur by payers to manage inefficiencies from providers, efforts to demonstrate excellence in musculoskeletal care through collected outcomes should be our immediate action.  

Comparing the performance of clinicians would be a way for the public to be informed of the quality of the available care.  One such resource to do so, related to hospital performance, is through the link below.

www.medicare.gov/hospitalcompare/search.html

Other immediate actions should include our educating elected officials and decision makers within our government to reveal our true value.

Strengths:

Patient and provider safety is a key strength and should be better able to position us in our healthcare system. Progression of force beginning with patient force and only when indicated, the clinician generated forces, provides safety to the patient and the providing therapist.  

A Memorable Story:

Eze shares a patient story of a professional mixed martial art fighter and trainer. He presented as a typical patient and resolved well.  An unexpected call from him surprised Eze and what followed was a twist to the story.

A Clinical Analogy:

Ezequiel uses the analogy of a broken leg. He likens it to a simple derangement including tests that reveal the broken leg similar to our sub-classification, “setting” the fracture to reducing the derangement, cast the leg to our maintaining the reduction of the condition, gradual weaning from the supportive devices to recovery of function and ultimately to prevention of future episodes.

Best Advice:

“Always Give Your Best.” No matter who you’re working with or what you’re working on, do your best.

A Resource I Wouldn’t Do Without:

www.votervoice.net – Website to assist you in reaching out to your representatives and government decision makers in the USA.  This can help us get our concerns related to improved mechanical care and reimbursement models to the appropriate people.

Recommended Studies:

van Helvoirt, H. Transforaminal epidural steroid injections followed by mechanical diagnosis and therapy to prevent surgery for lumbar disc herniation. 

To access the study click here.

Personal Habit Contributing to Success:

Being well organized and prioritizing.  His sophisticated software that helps him to do so is called… pen and paper!

If you have experience with public health efforts Eze and Colin Davies(Episodes 13 and 14) would welcome you to contact either of them.

To reach Eze his email is e_gherscovici@mckenziemdt.com.ar