204: The Most Effective Way To Incorporate The Evidence With EVERY Patient With Oscar Gallardo, PT, DPT, NCS

03/11/24 • 67 min

Do you feel like you’re as great a clinician as you could be? Do you know how to apply the evidence in an individualized way? Are you missing anything in your therapy toolbox, if so, do you know what it is? In today’s show we were so excited to interview Dr. Oscar Gallardo, PT, DPT, NCS after he won the PT Clinical Excellence in Neurology Award from the Academy of Neurologic Physical Therapy component of the American Physical Therapy Association. Oscar is dedicated to the advancement of physical therapy through many advocacy efforts. He spends countless hours treating patients, mentoring students, residents and other clinicians, and focuses on community wellness. He has transformed many lives in his 20+ years in the field and is definitely someone who will take the profession (and healthcare) further as he continues to devote time, effort and energy to these passions. Any clinician or student will benefit from this in depth discussion of what makes a person a really great clinician so they can overcome barriers, empower patients to overcome their real and perceived barriers, and ultimately find perhaps a lost sense of agency. The insights shared will enlighten clinicians at any stage in their career. Some of the discussion points touched upon in this interview include how to determine what to use in your practice from the evidence when you’re stuck between following best practice guidelines and the restrictions faced like resources, patient functional level, other patient/family priorities, and clinical appropriateness for the interventions being suggested. Additionally, we discuss an essential communication tool that can shift power dynamics ultimately leading to better outcomes, understanding of expectations, and satisfaction for patient and clinician alike. Helpful adages like “our discharge plan starts at the evaluation” and “think out loud” will strengthen patient/clinician relationships. Becoming an expert in neurologic therapy goes beyond your clinical skills and the bullet points in the research. Listen to hear how you can elevate your practice right now.

If you’re inspired by anything you heard, you can reach out to Oscar in the following ways:

[email protected]

@dr_o.g._theneuropt

If you’re inspired by anything you heard, you can reach out to Oscar in the following ways:

[email protected]

@dr_o.g._theneuropt

Previous Episode

203: Vestibular Private Practice, Mentorship And The Real Balancing Act With Christina Garrity, PT, DPT, NCS

In today’s show we interviewed Dr. Christina Garrity, PT, DPT, NCS about her vestibular therapy world! She left her clinic job to start a private practice because she found that people were not getting quick or easy enough access to this time-sensitive care. She made it happen while also juggling a busy family life plus teaching in PT programs. Soon she was given an opportunity to become a PhD candidate that she could not turn down. In the conversation we discuss the details of how she started small scale with her clinic, her decision to be a non-participating provider with Medicare and why it was necessary, her vision and mission, and more. Vestibular therapy is a special and important area as the chances of dysfunction increase as the population ages and Christina wants to make sure therapists have the tools to help every single person whether they seem like they have a vestibular problem or not (because some are not so obvious!). We make a special announcement about our future collaboration and how you can grow your confidence when working with anyone with a vestibular condition - especially the cases that confound you! This conversation will be inspiring to any therapist who loves neuro, has a practice, has ever thought about having a practice, loves vestibular, or imagines themselves doing something a little less traditional in their career path.

Learn more about Christina:

Labyrinth Physical Therapy & Wellness www.LabyrinthPT.com

Instagram: @vestibular_neuro_pt

Website: www.LabyrinthPT.com and courses: https://labyrinthpt.com/courses

Sign up for our email list to learn when we’re releasing Christina's vestibular course for the aging adult and for our beta launch of the BalanceBesties Vestibular Mentorship Group coming soon! https://www.neurocollaborative.com

Next Episode

205: What You Must Know About Medicare Maintenance Therapy And What Can Happen If You Don’t With Robbie Leonard, PT, DPT, CHC

Who wants to talk about a fun topic?! What if learning about Medicare Maintenance Therapy actually was fun and didn’t make you fall asleep? Well, that’s what you’re going to get on today’s episode! We sat down with our favorite Medicare Utilization Reviewer, Dr. Robbie Leonard, PT, DPT, CHC to discuss the hot and sticky points about Medicare skilled therapy. We know a LOT of US-based therapists have questions and we’re here to help! In today’s show we discuss some common misconceptions about using Medicare for therapy so we can help you pass an audit and stay out of trouble!

Some of the topics covered today include:

Medicare’s definition of medical necessity and when it does and does not cover services
The only 2 standards under which you can treat - restorative and maintenance and what they each mean
When do to restorative and when to do maintenance and why you should NOT mix the two
The questions you should ask yourself every time you see a patient: Could what I’m doing be provided by a caregiver or technical person that I train? If yes, it should not be billed at all. Unfortunately it doesn’t matter whether there is a qualified caregiver available or not.
How you get audited: You can be flagged to be audited because your data profile looks different. If you always use or never use KX you can be audited for being an outlier. You should never stop seeing people just because they’ve reached the threshold. This can be a red flag!
What you should NEVER say to a patient about their Medicare dollar usage
When it is and is not appropriate to stop providing skilled therapy (hint: it doesn’t have to do with where the patient is in their threshold spend!)
How to know if you can provide more therapy to a person who’s reached their threshold for the year: evaluations will always be covered!
Why you should not be concerned (or turn away) a patient who has used up to their Medicare threshold or beyond Initial threshold
What about Medicare and cash? If you’re providing a covered service you cannot opt out of Medicare as a therapist. You are legally obligated to file a claim.
What does wellness look like then?
What does a reasonable time frame actually look like?