In episode 204 we conclude our conversation with Dr. Bob Robinson. A fellow of the American Academy of Orthopedic Manual Physical Therapists and a Diplomat of Mechanical Diagnosis and Therapy. He shares his observations about becoming a valuable asset to referral sources by offering triage of their patients, the keys to being a good manual therapist, how they've built a strong private practice and more. This week on MCF!
Patient stories with the Neurosurgeons
Bob recalls an incident when he successfully treated an acute lateral shift of Dr. Held’s work partner. Another case was a plastic surgeon who Dr. Held referred and after his MDT assessment, Bob classified him as a MUR and made a recommendation that he is a possible surgical candidate. Dr. Held was amazed that Bob was able to accurately categorize the patient, who he had scheduled for a surgery next morning. These two cases were the highlights for Bob to establish the credibility of the system with the doctors. He feels that PCPs and internists are more open to you when they realize that specialists believe in your practice; and also if you have specific answers to provide to the doctors from your assessments to help direct management of the patient.
Bob’s clinic provides in-services at YMCA, chamber of commerce, and have expos for marketing but he believes that word of mouth marketing is the best way. It is not always rosy picture without having first access to the patients but he sees an opportunity in giving successful outcomes to patients who have not had success at other clinics which helps referrals.
The clinic also has a certified therapist for EMG/NCV and also perform functional capacity evaluations, which has added value to the practice. They also provide work assessments and ask patients to bring job descriptions which are incorporated into the assessment and used as baselines. Hence, at discharge they are able to provide an objective report to the doctor; that helps the doctor to return these patients to work.
Thoughts on manual therapy
Progression of forces is valuable, putting hands on too early on patients does not help patient independence and hands on forces (OP and mobilization) are needed only in a few patients. It is good to have those manual skills, along with the knowledge of when to use them. Mobilization and manipulation are adjuncts to directional preference.
Bob has been practicing for 22 years and has achieved a lot. Bob’s excitement is now to build people under him, help other therapists in his staff to be the best clinicians. He wants his staff to at least become MDT certified.