Winter 2014

A publication of the Physiotherapy Association of British Columbia

Urban Poling, an Emerging Trend for Many Patient Conditions by Barb Gormley, Director of Education with Urban Polling Inc.

Physiotherapist Dolores Langford was to mental health clients to increase a keen early adopter when ACTIVATOR their aerobic activity and to reduce the walking poles were introduced to the metabolic side effects of medications. BC physiotherapy community several “The poles encourage an upright years ago. “I took one of the very first and symmetrical posture, rather ACTIVATOR workshops ever offered than the forward lean of a walker by Urban Poling in 2007,” recalls or an asymmetrical lean from one Langford, who is the regional clinical cane,” says Langford, noting that the resource physiotherapist for Vancouver ACTIVATOR poles were co-developed Coastal Health and teaches at Capilano by an occupational therapist. “There’s University and UBC. “At the workshop, also an immediate reduction in lower I immediately understood the benefits extremity pain when weight bearing, as that the poles could offer to some of my well as improved balance and walking Dolores Langford demonstrates Activator clients as an alternative to canes, crutches confidence. And the rhythmic placing of walking poles and sometimes even walkers,” she says. the poles helps to pace and cue gait.” 1. wide bell-shaped tips 2. large ergonomic handles Ideal for many populations Special design features 3. a strapless handle design that Today, Langford prescribes ACTIVATOR ACTIVATOR poles are similar to makes them simple to grasp and poles for clients with age-related changes traditional Nordic walking poles, but they helps prevent injuries in the spine, Parkinson’s disease and have several special features that make 4. a locking system that withstands osteoarthritis of the hips, knees and them safer and more effective for clients 200 pounds of pressure ankles. She has also introduced them with balance concerns: 5. anti-vibration features that prevent rattling

IN THIS ISSUE Urban Poling for higher-functioning clients As a runner with problem knees, Toronto physiotherapist Sharon Switzer-McIntyre switched over to Nordic walking about five years ago. C-Spine Rule Task Force Update ...... 4 Leveraging a New Initiative for Pharmacist Screening of Arthritis ...... 7 “I was pleasantly surprised at how much Remuneration of Physiotherapists for Court Testimony ...... 12 upper extremity and deep abdominal activation occurred,” says Switzer- How Do You Know Your Patient is Improving? ...... 15 McIntyre, an assistant professor in the Professional Development Calendar ...... 24 Department of Physical Therapy at the

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PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA Keeping British Columbians Moving For Life Directions bcphysio.org

PRESIDENT’S MESSAGE

Keeping PABC Moving for Life

On the national front, I attended the regulator. PABC wishes to continue to Branch Presidents Forum meeting in work with the College on this front and Toronto recently. These meetings are an support members where it can during opportunity for all provincial presidents the implementation phase. We have and CPA representatives to meet and had some very positive meetings with discuss issues affecting the profession the College and UBC at our consortium, Jason Coolen, BScPT, BSc(Bio) which has been a great venue to share President on a national scale. CPA continues in its efforts to provide strong leadership ideas and achieve common goals. for the profession. It continues its work Happy winter to all! on enhancing its member services and In closing, I would like to thank all All members should be happy to know ensuring the profession of physiotherapy previous members for renewing in that as always, your dynamic board of is an active player in the Canadian September and thank new members for directors of PABC has been hard at work healthcare system through promotion joining our incomparable PABC club. on your behalf. We had a board meeting and advocacy. We had some good Membership has its privileges, and it is in September in Vancouver and a recent discussions on current issues affecting my pleasure and privilege to continue to teleconference doing more good work the profession here in BC such as the serve the membership of PABC. My email for our members. Some of you checked high vacancy rate for physiotherapy box is always open: president@bcphysio. out the Board’s ultimate Frisbee game on within some of the health authorities, org so please drop me a line. the beach via the Facebook page back in competition in the private rehabilitation September - it was a little downtime after market, and new grads gravitation to Jason Coolen co-owns Oakridge Physio, a busy day. private practice. Vancouver Physio, and North Vancouver Physiotherapy clinics. He is the father of During that September meeting we These items are on our radar, as is the two young children, and is completing his worked on new Value of Physiotherapy Quality Assurance Program designed osteopathy credential. Jason has been statements to help us promote the good by CPTBC. The College continues to on the PABC Board of Directors for three work our members do every day. Watch work on the delivery of an effective years and has presided over PABC in his for these documents to be posted on tool that is fair to our membership, voluntary leadership capacity since April the web. Speaking of the web, PABC has while also meeting its mandate as a 2013. updated its website with a fresher, more functional look. We have received some At their September great feedback. Big thanks to Fiona for weekend of the development of the new site. Nice meetings, the work team! Board hit the beach for ultimate The Board also created a Code of Honour Frisbee. L-R: Jenny at the September meeting. Directors Hogan,T revor committed to adhering to the following Potts, Valerie values: Neifer, Kevin Integrity: being honest and Bos, Aart Van congruent with the values of the Gorkum, Jason Board Coolen, Rebecca Respectfulness: acknowledging Lee, Chiara that the individual’s observations, Singh, Remmert thoughts, feelings and wants have Hinlopen. (missing: value regardless of agreement Tanja Yardley, Engagement: actively participating Craig Sully) in and between board meetings PABC’s Board of Directors demonstrate the latest trend. According to the 2013 Trends Accountability: being committed Report from global ad agency JWT, the number one trend for organizations is to “use to following through with actions, play as a competitive advantage.” They note that unstructured playtime in multi-day decisions and their consequences meetings increases stimulation that increases attentiveness and leadership retention.

2 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions

CEO’S MESSAGE

Promoting the Value of Physiotherapy

muscle problem, behind family doctors T Continue emphasis on doctors as (21%), doctor’s recommendation a primary and critical audience for (including physio) at 19%, chiropractors communication and relationship (16%) and massage therapists (15%). building. Rebecca B. Tunnacliffe, MA T Only 46% of respondents knew Chief Executive Officer they didn’t need a referral to see a PABC’s Promotions Task Force met last A big change is in store this year for physio, and yet 71% of those who month to formulate the implementation how the public is informed about went to physio got a doctor’s plan. Thanks to Cassandra Basi, Corine physiotherapy. Gone is the TV ad referral. Doctors continue to be a Van Doorn, Dan Hewson, Erica Mahon, that was ground-breaking when we critically important audience/channel Phil Sheppard, Riley Louie, Sarah Stroh, first introduced Ray the x-ray man as for educating the public about and Scott Okrainetz for ideas you’ll see he swam, cycled and played soccer; physiotherapy. come into action over the coming months gone is the waiting room full of PABC as we continue to put your promotional members, dressed in colourful costumes, The surprise – Dr. Mom has been replaced war chest (14% of membership dues) to representing patients injured in work and by the Hip: work. play and needing their physiotherapist T Visits to physiotherapists are to keep them Moving for Life. As clever dominated by younger British Reading and Leading and memorable as these TV ads are, their Columbians (age 18 to 34), who are by Rebecca B. Tunnacliffe effect is diminishing. also the most likely (47%) to schedule a visit without having to go through their Flat Army, Dan Pontefract (2013) Our recent public opinion poll informed GP. When we last polled the public it I saw this author, who is a senior us that we can capture the public’s was the middle aged woman who was executive at Telus, present his attention in a few new ways. It was a seeing and referring family to a physio. leadership model at a summit last good news, bad news story. The good This is an encouraging trend to see a spring. The author was better on the news is that the majority of respondents younger generation choosing physio stage than on the page, and while I have visited a physio and the satisfaction more often, and that — unlike the older didn’t enjoy the tone of the book, I and confidence levels are very high: generation — they know they don’t have found his central thesis to be T 67% told us that either they or a need a referral. compelling: organizational culture is member of their household has defined by one single criterion, which visited a physiotherapist. Seven out Key Insights is the manner in which employees/ of ten of those who went to physio PABC’s strategic plan has made promoting members are treated by their direct were referred by a doctor. the value of physiotherapy a key focus. This leader. Pontefract listed these six T The level of confidence in survey’s findings are aligned with some tenets for leaders to create a culture of physiotherapists is equal to that in of our top strategic priorities, including engagement: doctors, and higher than massage defining the value of physiotherapy in key T Be trusting therapists and chiropractors; the messages, and increasing the focus of T Be transparent in your views and public has a high level of respect for communications on stories of how physio actions physiotherapy. adds unique value to a patient’s well-being. T If you say it, do it Key insights from this survey are: T Encourage risks and accept T The level of satisfaction with T Choose communications and marketing mistakes physiotherapist treatment channels where we’re most likely to T Talk straight, don’t be vague is particularly high (86%), and reach young people (age 18 to 34). T Talk less, listen more dissatisfaction is low (13%). T Increase the visibility of What I learned in addition to increasing The bad news is that respondents don’t physiotherapy in all channels, and my attention to these six tenets, is the think of us first, and they still think they tell the public stories about what importance of focussing on the heart need a referral: physiotherapists can do, and how it of a challenge: “great leaders are great T Only 12% of respondents said they helps them with their pain and mobility simplifiers who cut through complexity would think of physiotherapy first issues. to offer solutions.” when they have a back, neck, joint or

Keeping British Columbians Moving For Life 3 Directions bcphysio.org Urban Poling...continued from cover page

University of Toronto, and a longtime fan View of a New Grad in Rural Practice of the activity. by Phil Sheppard, MPT

Switzer-McIntyre has introduced Urban My journey west began with a job posting on the PABC website that perfectly captured Poling’s Nordic walking poles to fairly high the practice I was seeking when I decided to work in rural Canada. I was attracted functioning clients who require gait aids, to the lifestyle, the endless opportunities for outdoor activities, and the diverse clients with joint replacements, clients professional experiences of the north in particular. who need confidence while walking, and clients who simply need to improve their When I applied for the position, the owner of Alpine Physiotherapy, Graham Pollard, fitness. couldn’t say enough good things about the location and practice experience. My expectations were far exceeded when in my first days I was whitewater kayaking When Switzer-McIntyre dislocated her hip and mountain bike trail riding. In addition to the outdoor lifestyle, northern BC is while water skiing several years ago, she incredible because I am working in so many practice settings, including orthopaedics, was fortunate to already be proficient with paediatrics, and aboriginal health. The opportunities feel limitless! poles, and they became an important part of her rehab plan. Soon after arriving in BC in September, I got a phone call from PABC president Jason Coolen; he’d been told by the president of the Ontario Physiotherapy Association Easy to learn (OPA) that he should get me involved. As a student I had the opportunity to work with Walking pole technique is quite simple, OPA, which is how I came to appreciate that being involved in my association was an says Langford. For the ACTIVATOR poles, important component of my career. At CPA Congress last May I was fortunate to be the elbows are held bent at 90 degrees as awarded the Helen Saarinen Rahikka student leadership award for contributions to they swing, and the poles remain vertical the profession for work I did with OPA in advocating for the role of physiotherapists in throughout. Users press firmly on the base Ontario. of the handles which engages the core, encourages a tall posture and provides I am now on a PABC task force, and in PABC’s new public rural practice peer mentoring stability. group. Rebecca also asked me to write this article because she thought my passion for rural practice might be of interest to my new physiotherapist colleagues. For Nordic walking poles, exercisers stand with a tall posture, swing the poles with I am very excited to work at Alpine Physiotherapy and the College of New Caledonia. long straight arms and press on the wide I work with a new grad from UBC and we really feel that we have hit the jackpot! I base of the handles to create forward have great mentors and really feel like I am making a difference in underserviced propulsion and core muscle engagement. parts of Canada. I am also looking forward to working with PABC to advocate for The poles are angled behind the body at physiotherapy. all times. Phil Sheppard graduated from Queen’s University in November 2013. In his final year, For information on ACTIVATOR walking he had a paediatric placement in Nepal at the Special Education and Rehabilitation poles and courses, visit Center and at International Friendship Children’s Hospital in Kathmandu where he www.urbanpoling.com. helped open an outpatient rehabilitation department with funds and equipment collected in Canada. C-Spine Rule Relevance to Physios: Task Force Update

The Canadian C-Spine Rule was created help PABC members to use the Canadian Where does clinical judgment factor in? to determine which clients with acute C-Spine Rule more confidently and Research to support its use (valid, traumatic neck pain need imaging. effectively. In addition, we are currently reliable, 100% sensitive in thousands of We in PABC’s C-Spine Rule Advisory preparing a manuscript for submission ER patients, superior to ER doc’s clinical Group (CRAG) has been working for to a journal; stay tuned for future judgment alone) over a year to study the relevance to developments. physiotherapists. Register here: Learn much of what you need to know http://sticking-neck-out.eventbrite.ca Thanks so much to the 516 Orthopaedic in our upcoming free webinar on March and watch for your laminated and Sport Physiotherapy Division 11th at 7:30 Sticking your neck out: Do C-Spine Rule & FAQ sheet in the Spring members who participated in our all patients with neck trauma need an Directions. survey last spring about physiotherapy x-ray? CRAG Members: Marj Belot (chair), Alison management of trauma to the cervical In it you will learn what we’ve discovered: Hoens, Carol Kennedy, John Howick,, spine. Your responses are shaping the What is the C-Spine Rule? Antonio Zenone Dr. Linda Li, Bill Lyons, next phase of our project, especially How is it meant to work? Guido Wizotski, Peter Francis, Sarah the development of key resources to How to apply (video) Hrabi, and Melina Kurtakis.

4 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions

BC’s New Physician Education Will Impact Physiotherapy Referrals Physio Forum by Neil Pearson, MSc, BScPT, BA-BPHE, CYT, RYT500 Saturday, April 26, 2014

Book your day to catch up with physio The BCMA has developed a new pain education course that I’ve been involved with. friends and hear leading colleagues All BC’s doctors are learning evidence-based pain management strategies, and these share their wisdom. On Saturday April th strategies support physio practice. This could potentially increase collaboration and 26 , PABC, CPTBC and UBC present referrals. the biggest day of the year for the profession. Background The BCMA creates Practice Support Program (PSP) modules to improve patient care Come to the Forum for coffee and and improve job satisfaction. Previous topics included mental health, patient self- registration at 7:30, and then settle in at management and musculoskeletal injuries. 8am for the professional development sessions. The education day starts with Pain BC successfully advocated for a PSP module specific to pain. The faculties of Benefits of Incorporating by Craig Dale, medicine, physiotherapy, psychology, and pharmacy were invited to help develop this followed by Healthy Body for a Healthy module, and roll it out in early December 2013. Brain by Dr. Teresa Lui-Ambrose, and proceeds to Ask the Expert in which Educational Content Alison Hoens asks Clyde Smith, Dr. Darlene Reid, Dr. Linda Li and Chiara The module’s primary goals are to change the paradigm from which pain is Singh What’s Hot, What’s Not in understood, to enhance how MDs educate patients about pain, and to increase Exercise Prescription. After lunch, we’ll the number of strategies used by MDs in primary care well beyond prescribing hear about Advancing Physiotherapy, medications and referral to a pain clinic. Many educational scripts are offered in this One Athlete at a Time from Alex module, such as: McKecknie. Rounding out the afternoon “This medication is to help you move better. If it does not, we need to change is Jason Coolen moderating Emerging our plan. Finding ways to move with more ease is vital to helping you with this Trends in Practice with Michael Yates pain problem.” on shockwave therapy, Neil Pearson on therapeutic yoga, Steve Kotzo on PTs Physiotherapy has played a huge role in the content of this pain module. MDs are in ER, and Jacek Kobza on diagnostic enthusiastic to provide brief education, a breathing technique, and guidance about imaging. movement in their primary care practices. They know the importance of movement and decreased sensitization in recovery from pain, and will be looking to work with In addition to the CPTBC and PABC like-minded physios as colleagues in this difficult work. awards and AGMs, there will be Practice Matters presentations by the College Spinoffs and by CPA. Similar education strategies are being considered within nursing and pharmacy professional associations. I am working with PABC on bringing a module to you. We Finish the day at 4 pm with a wine and want all BC’s MDs to think of PTs first when they consider referring their patient to like- cheese reception in the UBC Lounge minded colleagues. where posters and case studies are posted, and the day’s talking books and Next Steps tech corner conclude their chats with BC MDs will look to you to provide consistent messages, and to collaborate more colleagues. closely in patient care. Together with Pain BC, we are interested in your thoughts on the messaging for a primary care PT pain course. Specifically, we are seeking physio Registration opens on March 4th pain champions who are interested in working with us to deepen their knowledge and and closes April 5th. enhance their skills to partner with GP pain champions across the province. If you’re interested, please contact Pain BC. Go to www.bcphysio.org or www.cptbc.org to access our joint Pain BC contact: [email protected]. registration site, or go straight to https://physioforum2014.eventbrite.ca. Neil Pearson is a physiotherapist, Clinical Assistant Professor, and yoga therapist focusing on people with persisting pain problems. He practices in Penticton at the To help offset the cost of administration, Sports Clinic and at Purple Lotus Yoga. He loves to run and cycle, and is learning to a nominal fee will be charged (the direct surf. He is now writing a parable about pain. per-person cost for the day is $80).

Keeping British Columbians Moving For Life 5 Directions bcphysio.org

Public Practice Directions Research Supports the Power of Word of Public Practice and PABC: Why Mouth for Membership According to the Metropolitan Insurance 2012 Association Study, my Career Commitment? 32% of association members joined because of recommendations by Jill Longhurst, BScPT, Public Practice Advisory Committee Chair from advisors, colleagues, experts, family and friends. Word of mouth In my last article I talked about why I a bit guilty taking advantage of these recommendation for membership has work in public practice. This time, I’d advances without contributing through the most influence on one’s decision like to tell you why, as a physio in public committed membership. to join an association. practice, I’m a long-term member of PABC. For many of us in public practice, we The study notes five factors that might be the only member at our site; motivate a member to make a My reasons for being a PABC member only 20% of PABC members are in public recommendation to peers: are varied. Some are altruistic, others practice -- public practice has a large 1. perception that it is a good a little more selfish. I’ll even admit that share of non-members. How do we organization I’m a member out of habit; I joined as encourage others to join in support of 2. faith that it is the leading a student (over ten years ago!) and I’ve our professional association? I’ve never source of best practices become used to it since then! been a good salesperson, and I don’t like 3. feeling a strong connection to be too pushy, and yet maybe, when to the association There are many reasons being a the topic comes up, we public practice 4. belief that the membership PABC member is good for any physio, members can mention something that enhances their credibility regardless of workplace. Access to PABC has done for us, or we can talk 5. opinion that the association education, professional support, library about what PABC has done for the is proactive services, malpractice insurance: these are profession. Or maybe we can continue my selfish reasons for being a member. to lead by example, and keep our own Whether or not I use these services on a membership current as the years fly by. regular basis, I know they’re there for me Jill Longhurst works for Vancouver Coastal at any time. They’ve also been extremely Reaching Physicians and Health at George Pearson Center in well publicized, even targeted at public Vancouver, and is the chair of PPAC. Pharmacists through practice members through initiatives like Arthritis the ambassador program, so everyone Physio-4, a Year of should know about them. Hearing of arthritis initiatives afoot, Conditions We Treat PABC’s Knowledge Broker Alison I also have to acknowledge that, even Thanks to North Shore Sports Medicine Hoens worked together with an if I don’t use any of these services Clinic that’s been the backdrop for our expert panel of members in arthritis directly, I know my membership dollars 2013 Physio-4 year-long promotion. research and care to create resources are being used to support and promote Each of the 4 Tips of the month, plus for physicians to facilitate referral to the profession at all levels. During the monthly website and Facebook physiotherapy. A similar package is my almost six years on PABC’s Public banner photos were taken of PABC being created for pharmacists. Thanks Practice Advisory Committee (PPAC), members in Paige Larson’s big new to Lynne Feehan, Marie Westby, I’ve seen first hand the energy and effort clinic. The 12 conditions and their 4 Gregory Noonan, and Linda Li for the put towards advocating for those of us tips for prevention and/or treatment following tools on the PABC website in the public sector, with many tangible highlighted how PABC members which will be provided to family results (creation of the knowledge keep British Columbians Moving for physicians in BC. broker position, communication with Life. Thanks to each of these PABC 1. Arthritis decision tree (when to the provincial government, and an extra members for being our physios and see a physiotherapist) discount on insurance are just a few patient models: Sid Raddalgoda, Helen 2. Patient resources to guide things I can list). Ries, Cameron Bennett, Lis McLatchie, physical activity Lindsay McLeod, Dorothy Berwick, 3. Arthritis physiotherapy resources I think we can all admit that a strong Darlene Reid, Alex Scott, Kate Norrish, at Mary Pack Arthritis, Hospitals/ profession and a strong professional Kate Young, Chelsea Sheppard, Linda publicly funded physiotherapy, image benefit each of us. And that is Maedel, Cassandra Basi, Derrick Young, and private practice members a good enough reason for me to keep Karly Sutherland, Natalie Grant, Tanja with additional arthritis training my membership current. I would feel Yardley, Chris Napier, Sandra Lamb, Hayley Carter, Augustin Navarro.

6 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions Leveraging a New Initiative for Pharmacist Screening of Arthritis by Greg Noonan, BScPT, BScBiology; Marie Westby, PT, PhD; Lynne Feehan, PT, PhD; and Alison Hoens, MSc, BScPT

Did you know that in September a Are you ready? What can you do to ensure that you are ready to assist national initiative was announced for these patients who need the unique expertise of a physiotherapist? pharmacists in over 1,200 Shoppers Now is the time to approach your local Shoppers Drug Mart pharmacist with your Drug Marts across Canada to provide clinic’s referral information. You may wish to develop something specifically targeted to arthritis screening and information? address the needs of arthritis clients. You could also reach out to collaborate with the This three-year partnership between pharmacists and local family doctors in your community to set up an arthritis education Shoppers Drug Mart, Arthritis Consumer event. Of equal or perhaps greater importance is that you have access to the latest Experts and the Arthritis Research evidence regarding the effectiveness of exercise prescription and physical activity Center of Canada involves the provision participation in arthritis care; information that can help you provide evidence-informed of a self-administered joint exam and care for people living with arthritis. The following resources are available to help you: questionnaire. The intent is to assist PABC website – check out the information that provides (1) a general overview with early detection and treatment e.g. Arthritis Society resources and Cochrane Reviews, and (2) practice guidelines of arthritis, particularly inflammatory and recommendations for OA and for RA (including nonpharmacological arthritis. Early identification and effective interventions) http://www.bcphysio.org/resource/arthritis-resources-physiotherapists treatments can reduce the progressive 1. Patient Fact Sheet on Exercise for Arthritis from the American College of joint damage and marked functional Rheumatology website – http://www.rheumatology.org/Practice/Clinical/Patients/ limitations associated with untreated Diseases_And_Conditions/Exercise_and_Arthritis/ arthritic conditions. This initiative also 2. Exercise is Medicine Canada - this is a national initiative with which CPA is encourages pharmacists to assist the collaborating. http://www.exerciseismedicine.ca/ individual, in conjunction with their family 3. Physical Activity Line of BC – this free counselling service provided by exercise physician, to monitor their symptoms and physiologists provides guidance that includes arthritis content, counselling on medication use over time. physical activity and transition from therapy into the community. You may wish to share this information with the pharmacist in your local Shoppers Drug Mart. What are the implications for http://www.physicalactivityline.com/ physiotherapy of this initiative? 4. Screening Tools This initiative provides an avenue for a. BC Medical Association - Rheumatoid Arthritis: Diagnosis, Management and referrals to physiotherapy that are Monitoring, Sept. 30, 2012. Available at: http://www.bcguidelines.ca/pdf/ self-directed, pharmacist-directed and rheumatoid_arthritis.pdf family physician-directed. Given that (1) b. Apps - Arthritis ID Pro (for the health care provider) and Arthritis ID (for patients) there are already 4.6 million Canadians to screen for inflammatory arthritis living with arthritis, (2) that this number http://www.arthritisresearch.ca/arc-links/arthritis-apps/arthritis-id-pro-app is anticipated to increase substantially 5. Courses for physiotherapists – the Arthritis Continuing Education program (ACE) is a within the next decade, and (3) that early course provided by the Mary Pack Arthritis Program for allied health professionals detection and aggressive treatment of http://www.arthritis.ca/Provinces/BC/Resource-Guide/Healthcare-Professionals/ inflammatory arthritis can prevent the ACE-Program previously common crippling deformity, 6. Community resources for patients the potential benefits to Canadians a. Self Management BC is a joint initiative between the University of Victoria and the living with arthritis are evident and Provincial Ministry of Health. There are several programs that may benefit patients welcome (http://www.arthritisalliance. affected by arthritis: ca/docs/20111022_2200_impact_of_ 1. Active Choices program - coaches and supports persons with chronic disease arthritis.pdf ). The implication for the (including arthritis) regarding exercise and physical activity physiotherapy profession is that there is 2. Arthritis/Fibromyalgia Self-Management program – provides information and clearly an opportunity to leverage this practical skills for managing various forms of arthritis initiative to ensure these individuals 3. Chronic Pain Self-Management program – provides patients strategies to better who are screened and identified as manage their symptoms and daily lives having arthritis can be appropriately All three programs may be found at referred to physiotherapists for http://www.selfmanagementbc.ca/CommunityPrograms assessment, education and support b. Dr. Mike Evans YouTube video promotes the importance of physical activity, with integrating appropriate exercise especially with chronic disease - http://www.youtube.com/watch?v=aUalnS6HIGo and physical activity into their daily lives. If you have any questions, contact the Mary Pack Arthritis Program: http://www.vch.ca/403/7676/?program_id=2367 Locations available: Cranbrook, Penticton, Vancouver and Victoria.

Keeping British Columbians Moving For Life 7 Directions bcphysio.org

Library and Information Technology Directions Members Storm the Gates for Librarian Services by Deb Monkman, MLS, BSc, PABC Librarian

Did you know that for every dollar that and answer specific information needs, health care associations like PABC invest demonstrate how to use library resources, in library services, they can expect a and promote life-long learning and Most Popular Topics $9 return on investment? A new study information literacy through access to Researched by Members from Australia joins the host of other PABC’s extensive resources. Overall, 1. EPAs (including ESWT) studies demonstrating the value of health I provide research and assistance for libraries, saving your time and delivering around 500 requests in a year, and supply 2. Paediatrics high quality information that can directly over 1,000 journal articles, over and above 3. Occupational injury impact patient care.1 PABC’s library members’ self-serve use of the library. 4. Concussion services for members began in 2006 as 5. Knees a virtual-only library and they continue How does this compare with other 6. Backs today on the member site with (1) high associations? As you know, PABC is the quality databases and full-text journals, only physiotherapy association in Canada 7. IMS/Acupuncture (2) curated collections of physiotherapy to provide library services. In a survey 8. Outcome measures resources (outcome measures, mobile of health association libraries in Canada 9. Sports injuries apps, guidelines, etc.), and (3) the and the US, only 30% provided services 10.Pain services of a clinical librarian to provide to members, most serving association lit searching, article retrieval, and training staff only. Of those who serve members, 2. Members Search Up a Self- on how to use databases and find articles some report success serving only 10%.3 Serve Storm (See page nine for a list of key library The College of Physicians and Surgeons Members search up a storm for resources). of British Columbia Library has a long- themselves on PABC’s databases standing tradition of delivering services to and full-text journals provided by the 1. Members Continue to Storm their membership and they report serving Electronic Health Library of BC (eHLbc). the Gates for Library Services the same percentage of the membership For example, in the first ten months of as we do.4 This is exciting for us, and Over the years, you have made strong 2013, there were 7570 searches, which is demonstrates that physiotherapists are use of library resources and services, and within the range of previous years (7000 indeed evidence-informed professionals. this trend continues today. In particular, to 10,000 searches). we are very happy to report that in four What do members ask about? The hot years, there has been steady, high use Further, in the past two months alone topics are fairly consistent over the years, of personalized librarian services, and there have been 3817 page views of but concussion was new to the top ten for I have provided services to 45% of the resources on the new PABC member site, 2013. membership. In addition, it is notable that which now has a search interface instead 25% of members have taken a Knowledge of browsable static pages. “I have to say, your help is one big point in Team webinar on how to find, appraise, favor of ongoing PABC membership.” and apply research to practice. “I just checked out the new website, and it seems really well laid out. I think these “Thanks so much...once again. I really I provide direct member service to save changes will make a HUGE difference appreciate it and don’t know what I would you time by doing literature searches and in how people access library services.” do without your help. This is one of the retrieving articles so you can focus on Farron Fedechko, Member and Library most amazing benefits to being a PABC clinical practice.2 This is PABC’s keystone Advisory Board (LAB) Partner. member!!!” library service: making personal contact with members by email to understand 3 Personal communication on Health 3. Learning Away from the Storm Association Libraries discussion list, a in the Comfort of Home 1 Australian Health Libraries Return on Medical Library Association group, suggests Investment, November 2013. http://www. In 2013, PABC’s Knowledge Team (which health association libraries estimate they alia.org.au/news/2124/australian-health- reach around 10% of membership. See comprises our Knowledge Broker Alison libraries-return-investment J Med Lib Assoc 101(4) October 2013 Hoens, our Member & Information 2 According to the Australian study ref- http://www.ncbi.nlm.nih.gov/pmc/articles/ Services Manager Fiona Chiu, and me) erenced above, 75% of those who used PMC3794689/ gave a total of 11 free webinars. Webinars a librarian’s lit searching services said it 4 Personal communication with Karen are a popular way to learn in the evenings improved the quality of the information MacDonnel, Director, CP&S Library Services received, and 71% said it saved them time. from the comfort of home; 425 members

8 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA

Ϯ  bcphysio.org Directions attended, 80% of who attended two or the full Cochrane Library (systematic more webinars. Recordings are available reviews and all other databases) with our Key Library Resources Use ‘Search the Library’ or go to the on the member site for those unable to other EBSCO databases and journals, Clinical Library on the Member site. attend. so you can now do your own searches. 1. Databases Although we are unable to replace all of T Medline Pre- and post-webinar surveys over the the losses incurred this year by eHLbc and T CINAHL years consistently demonstrate that OVID, we still have all the essentials from T Cochrane Library members increase their knowledge and EBSCO, and as a bonus, you can search T PsycINFO improve their skills as a direct result of the them all together now. T Rehab Reference Center via CPA one-hour time investments. For example, 2. Full-text Journals before taking the Intro to the Library Going forward, in addition to maintaining T A-Z Journals List of 3000 full-text for the Absolute Beginner webinar, 51% these popular library resources and journals T How to find full-text journals surveyed said they believed the library services, I will be providing one-on-one 3. Practice Resources contributed to their evidence-informed training via webinar for those who would T 3-D Anatomy practice, compared to 94% after the like to update or improve their information T Guidelines webinar. competencies. Please feel free to contact T Outcome Measures me at [email protected] to discuss T Patient Education “The Intro for the Absolute Beginner your information needs. T Mobile Apps helped me to discover how to get answers faster with less frustration, therefore Librarian’s Retrospection getting some up-to-date support and info I was responding to a reference question this week when I realized that I answer I can apply back in practice — all at your clinical questions very differently now than I did when I joined PABC over 4 years fingertips rather than just in books!” ago. THEN, I would have done only a lit search because that all that was available to me. NOW, I provide a lit review as well as other PABC resources such as: 1. referral 4. Smooth Sailing Ahead to PABC’s peer advisor list; 2. hot topic alert; 3. Knowledge Broker toolkits; 4. CPA’s Did you miss the Cochrane Library for a Rehab Reference Centre; 5. Our Library page resources: OMs, patient education, while there? It’s back! PABC has integrated mobile apps, home exercise programs. What will the coming years add to this list? PABC’s WorkSafeBC Liaison Update by Jamie MacGregor, BScPT, BSc Kin, CHT

Hello colleagues. Happy New Year to you to Work Services team at WSBC continues contract to retain those inappropriate all. May this note find you healthy, happy, to monitor the referral process, they referrals to OR1 that are not ready for and prosperous. Below is a brief summary have discovered fewer but persistent program-based care and require ongoing of recent issues and developments with cases where the RTWS-NA has not made acute physiotherapy for up to three WSBC in the last quarter. contact with the treating therapist prior weeks prior to participation in the OR1 to making the referral to OR1. They program. This has been met with mixed Contract Negotiations continue to monitor and address these reaction from providers. Some feel the Unfortunately, I am a broken record instances in a continuing effort to reduce rate of compensation for that period is with little to report other than ongoing their frequency. As in the past, I ask inadequate, while others are happy to negotiations that seem promising, but you to communicate to me if you have incorporate this additional service. Some have yet to deliver something concrete. I encountered a scenario where your patient providers are simply not equipped (either remain optimistic, despite measuring the was transferred to OR1 without discourse from a staffing, facilities, or treatment time for development of this model and with the RTWS-NA. An email containing expertise perspective) to provide this negotiation of this contract in YEARS at the circumstances and details, including service, while others can readily do so. As this point; it feels as if we are ‘close.’ INCOMPLETE IDENTIFIERS OF THE this initiative is relatively new, the RTWS CLIENT (e.g. an alias such as ‘Ms. J’ or a team is currently monitoring the data on Return to Work Specialist- Nurse first name only, but NOT THE FULL CLAIM usage of this treatment phase of OR1, Advisor (RTW-NA) Update NUMBER OR PERSON’S NAME), as well as the referral patterns to this service, etc. As you are aware, the roll-out of the the board officer’s name is necessary. If/ The goal is to continue to monitor this program using RTWS-NAs in referrals to when the full details are required in order usage, as well as the cost of care, and ORP1 providers was not without issue to address the issue, they will be solicited the possible impact on the OR1 duration for many PT providers. In previous issues via telephone or secure email. and durable return to work outcomes. In of Directions you’ve heard me describe short, some providers are frequently steps being taken by WSBC to address OR1-Acute PT Treatment retaining premature referrals for acute these concerns. While there have been As many of you know, OR1 providers treatment, while others are not at all. very positive steps taken, as the Return now have the ability under their new continued on next page Keeping British Columbians Moving For Life 9 Directions bcphysio.org continued from previous page Members Site The new-look site is up and running, One, Two, Three, Achieve! complete with a WSBC Liaison blog! Now, if I actually write something, there Three Easy Goals Using will be tidbits there to read. Keep an eye out for negotiations updates, FAQs, etc. Three Simple Features You can find this on the Members Only by Fiona Chiu, BA, MLIS, Member & Information Services Manager site; login at bcpysio.org, then BUSINESS MATTERS/Insurers/WSBC and you’ll see my (currently vacant) blog. A brand new year calls for brand new what keeps you striving to learn the best As always, find me via email with resolutions. Have you made any for 2014? practices to work effectively with patients. questions or concerns at Overseeing our member and information [email protected] or services, I want us to work together to There are currently 61 inspirations on our [email protected] achieve three easy goals this year by using website, yet we have over 2100 members. three features of our revamped website: Have you written yours yet? Provide us with Protecting the your Physio Inspiration, and help promote 1. Virtual Forum: Participate and the value of physiotherapy. Interests of Our support your practice How can I stay current with what’s How do I submit a Physio Inspiration? Members happening in physio? Are my peers 1. Log in to the member site by Alison Hoens, PT, PABC Knowledge experiencing the same challenges? How 2. Click “My Account” on the top right Broker, and Lynne Feehan, PT, PhD can I get a second opinion? How can I hand corner share pertinent news with my peers? 3. Write in the box that says “Share a PABC members may be interested to If you ask yourself these questions, you physio inspiration” know that there are many occasions on will be happy to know that you can find 4. Click “Submit” which your interests are being quietly the answers on the Virtual Forum. It is your supported by PABC. One recent example brand new go-to online discussion board Your inspiration may appear on the front was a policy review by WorkSafeBC where you can share and discuss: page of the website, and will appear in regarding recognition of osteoarthritis T General interests/news the Inspirations section: bcphysio.org/ (OA) of the first carpo-metacarpal joint T Practice support, insights and inspirations. In addition, one inspiration is (CMC) as an occupational disease in challenges related to physiotherapy featured every week at the top of the Find physiotherapists. WorkSafeBC undertook a Physio search pages. an updated literature review to determine If you have a practice question or physio whether there was evidence to continue information you’d like to share, it only 3. Find a Physio: Update your Profile to support compensation for OA of takes 60 seconds to make a post or Find a Physio has been used up to 576 bilateral CMCs in physiotherapists. The comment. So get started! times per day since our website has been comprehensive and rigorous review was renovated! This translates to over 4,000 independently reviewed by an external How do I make a post or comment? views per week, or over 16,000 views per expert and subsequently shared with 1. Log in to the member site month of individuals seeking your expertise. PABC for comment. In my role as the 2. Click “Virtual Forum” tab Can you find yourself on our website? Please PT Knowledge Broker I was asked to 3. Click “Create new post”, or “Add new check your own listing and ensure you have evaluate the documents and provide comment” a biography, workplace(s) indicated, and a direction for PABC’s response. I enlisted The Virtual Forum is a member-operated photo - you’ll see that the members without the expertise of Lynne Feehan (PT, section of the website. So, the more photos lack that feeling of community that PhD, previous senior hand therapist members who contribute, the more putting a face to a name provides. for WorkSafeBC and a Certified Hand compelling and invaluable the dialogue Therapist). Together we reviewed the will be. It is accessible 24/7, and we How do I update my Find a Physio public documentation and recommended that, encourage you all to be a leader this year profile? given the current gaps in the evidence, by visiting the Virtual Forum as a part of 1. Log in to the member site the decision to retire the previous policy your daily routine. 2. Click “My Account” on the top right of compensation for OA of the CMC bcphysio.org/virtual-forum hand corner be deemed ‘interim’ pending further 3. Click “Edit” research, and that claims for CMC OA 2. Physio Inspiration: Share yours! 4. Click “User settings” on the left hand from physiotherapists continue to be You are Canada’s most physically active column, then “User picture” to submit reviewed on an individual basis. In health professionals and are also the a photo addition, we requested that funding rehabilitation specialists recommended 5. Click “Public Profile” on the left hand be allocated for research to determine most by physicians. The public is curious, column to update the rest occupational risk factors that may and we are keen to let them know what Please feel free to email me at fiona@ be contributing to OA of the CMC in motivates you to maintain a healthy bcphysio.org so that we can work together physiotherapists and other workers in BC. lifestyle, how physiotherapy works, and in achieving our three goals this year.

10 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions

Private Practice Directions Three Pillars of a Successful Physiotherapy Business by Perry Strauss, BHScPT, MHA, Business Affairs Committee Chair

Your 2014 Business Affairs Committee is experience that results in a positive 2014 because we believe this area has focused on identifying opportunities to customer experience, leading to a great opportunity for enhancing the improve the efficiency and effectiveness a sustainable business practice physiotherapy experience. Our approach of private physiotherapy operations and a growing recognition of will be to review literature in this area, across BC. We recognize that many of physiotherapy as the customer’s first survey and identify best practices and then these opportunities reside within the choice. report back to you so you can enhance your following categories which BAC thinks 3) Operations: the activities (logistics, service. of as the three pillars of successful workflow, tools, etc.) that are used by physiotherapy business: 1) Power clinics to support the physiotherapy Operations: We have many tools and Relationships, 2) Customer Management, offering. documents to support you (eg. Private and 3) Operations. We are defining these Practice Toolkit, review of scheduling areas in following way. Where is the BAC’s focus? and billing software), some of which we will be revisiting, and some that we are 1) Power Relationships: the strategic Power Relationships: We are maintaining currently working on (eg. pros and cons of relationships that PABC develops to and working on efforts to improve our incorporation). ensure that the best interests of the relationships with major insurers and profession and of our membership considering our plans for renewed Please keep an eye out for a spring are considered by decision-makers in government relationships in 2014. survey. We welcome any of your ideas and government, insurers, etc. comments in any of these areas. You can contact the BAC by emailing Perry Strauss 2) Customer Management: the Customer Management is an area that directly at [email protected]. management of the customer the BAC is particularly interested in for

ICBC Update by Marj Belot BScPT, MSc, FCAMPT, CAFCI, PABC’s ICBC Liaison

PABC-ICBC Liaison Recap of 2013 2. Physiotherapists may now bill up to training period. Some changes that affect By Marj Belot, BScPT, MSc, CAFCI, ICBC 20 physiotherapy visits through Teleplan physiotherapy clinics are: Liaison for patients with an ICBC claim number a. Non-Teleplan billings will no without a doctor’s referral, without getting longer have claim numbers 1. Two new e-forms were rolled out and pre-approval from the adjuster. ICBC has attached, but will have the should now be in use in all the ICBC claim an obligation to pay all physiotherapy visits invoice number that the clinic centers. The links to the forms will be sent up to the point where the adjuster advises submitted by ICBC and they cannot currently be that treatments are not authorized. It is b. Claim numbers will look slightly initiated by physiotherapists: still advisable to phone for confirmation different (two alphabetic T CL452A: equivalent to CL20 (also still of coverage and to communicate with characters at the beginning in use) and billable manually at $46 the adjuster when providing specialized instead of one). T CL452B: “Therapy update” which is a services or on accidents that are “older” brief unpaid written communication i.e. prior to the implementation of this 4. ICBC has selected a dozen physios (confirmation that physiotherapy is policy in July 2013. Adjusters have been across the province to interview, seeking reasonable and necessary) includes: asked to routinely set the end-date four feedback regarding things ICBC could a. Estimated number of visits and months from the initiation of physiotherapy improve, things physios are happy with, timeframe on non-complex cases. thoughts regarding a preferred provider b. Brief diagnosis of the problem, network and various payment options and whether it relates to the 3. As of November 18, 2013, ICBC including block funding. Do you have MVA is gradually introducing new claims feedback you’d like to have included? c. Areas being treated management software over the next Please email me at d. Expected discharge date year. Each adjuster will have a two-week [email protected] or PABC at [email protected].

Keeping British Columbians Moving For Life 11 Directions bcphysio.org The Remuneration of Physiotherapists for Court Testimony: Avoiding Disappointment

by David J. Wallin, Barrister & Solicitor, Director of Whitelaw Twining Law Corporation

Treating professionals are often uncertain to the Supreme Court Civil Rules is payment for the anticipated time that as to their legal rights and obligations unfortunately beyond the scope of this was to be spent in court if the witness when it comes to providing testimony in article. Instead, this article will focus on is provided with less than a stipulated court proceedings. This most frequently the more common scenario for which a working notice for such cancellation. arises in the context of the legal physiotherapist is introduced to the legal A notice requirement of two to three proceedings commenced by a patient for system. working days is not unreasonable and the injuries that brought the patient to it would rarely be the case that such a the clinic in the first place. What Can I Expect? request for remuneration for lost clinical Most counsel will agree to reimburse time would be challenged by the lawyer One of the practice issues that can the physiotherapist for any time spent or law firm that wishes to introduce the arise for a treating physiotherapist in relation to general discussions with evidence of the treating physiotherapist. relates to the issue of payment for the counsel; preparation of the witness for physiotherapist’s time expended in the court; as well as the time taken to provide Conclusion context of such bodily injury litigation. such evidence in court. Most lawyers practising in the area of bodily injury litigation recognize the However, it is important to note that valuable insights that can be provided Time is Money such matters need to be determined in by calling evidence from treating As with many professions the value of advance between the engaging law firm professionals such as physiotherapists. the services we provide to our clients is and the physiotherapist and not taken for Accordingly, it would be the rarest of measured in the form of the time spent granted. Accordingly, it is important that cases that such a lawyer, recognizing assisting the client with their problem. both parties have a clear understanding the value in calling such evidence to This being the case, the concept that and agreement in relation to issues of assist the trier of fact in understanding “time is money” is an axiom well witness scheduling and remuneration for the nature and extent of the plaintiff’s understood by all busy professionals, professional services in advance. injuries, course of treatment and regardless of the nature of their particular the anticipated future treatment expertise. Despite efforts to try to settle cases requirements of the plaintiff, would well in advance of the trial, the fact of then refuse to fairly compensate the The issue of the physiotherapist’s the matter is that cases frequently settle physiotherapist for the fair value of his or entitlement to remuneration for very close to the time that the trial is her time expended in seeking to assist services provided to legal counsel scheduled to proceed or the time that the court process. However, as with in the context of legal proceedings the physiotherapist is expected to testify. any working relationship, it is never a (including courtroom testimony) is When this happens, it is often the case bad idea to ensure from the outset that often misunderstood. This lack of that the physiotherapist has already all parties have a clear understanding understanding can lead to a general made scheduling arrangements to be of their respective expectations and reluctance for physiotherapists out of the clinic and available to testify obligations. www.WTinjury.com to become involved in such legal in court. In the event that settlement proceedings. This is unfortunate, as most occurs close to the date that the physiotherapists and other “front line” physiotherapist is scheduled to testify, Website Kudos treating professionals have a wealth the physiotherapist may not be able What are members saying about of practical knowledge and clinical to reschedule client appointments to the new website? experience to offer in the context of such make productive use of this time. If this legal proceedings. We’ve launched our revamped website, happens, it is not unreasonable to expect which includes: new Find a Physio/Clinic that the physiotherapist may request fair In order to avoid such disinclination when search features, a community section for compensation for such lost opportunity encountering the court process, it is first members to exchange ideas, the virtual for productive work. forum for discussion, updated ICBC/WSBC important to understand the general help content, quicker access to library parameters which a treating professional In order to avoid such practice issues, resources, a section just for students/new providing litigation or courtroom many treating professionals and medical- grads, a job seekers board, and much, assistance is generally entitled to. legal consultants have developed their much more! Have you visited yet? Visit own policies with respect to charges for bcphysio.org and feel free to send me A discussion of the formal “Subpoena late cancellation in such circumstances. your feedback to [email protected] to Witness” from a lawyer pursuant Many of these policies will require full anytime.

12 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions Computer Practice Management Systems for Your Clinic: A Short Review by Linda Walker, PT

PABC’s clinic owner peer group has been T Price is negotiable if you like to T Good service/training meeting over the year to discuss topics barter T Instant schedule access from all of mutual interest. At the most recent T Text reminders to patients is an add- devices remotely meeting, the group gathered and shared on with an extra fee T If the system goes down at one clinic information about the computer practice T Booking to billing is smooth you can still book appointments by management systems available for use in T Good reliability in terms of computer simply phoning your second location our clinics. We hope this short summary “down-time”, at most half a day of our findings will help guide your (happened once in seven years) Cons: choices in the future. T Can access schedule remotely by T Some still question the reliability of logging in cloud-based systems, although the The systems in use by our peer group clinic owner using this system has not were Clinicmaster, ClinicServer (and Cons: had any problems with it an Excel schedule program). The main T Extra fees seem to abound for things T Cost seems to be a bit higher difference between these systems lies like converting old files, EMR, text T Based out of the UK in their software, which is either on a message patient reminders hard drive in-house or cloud-based. T Training had to be done during office Besides these two options, one other Clinicmaster requires each clinic to hours, and there is a three-hour time owner is happy using PracticePerfect purchase the software that is then difference issue with the company (formerly InTouch), a PC-based in-house stored and backed up in your own being in Quebec system that works well for multiple clinics. clinic. ClinicServer is cloud–based, T One complaint about difficulty This system took about three weeks which requires less in-house computer converting all old files, i.e. WCB to convert and set up and about 25 equipment and therefore smaller initial T Not able to use multiple devices receptionist hours to do the conversion, set-up fees. Clinicmaster was the most T Not able to service more than one and the owner has been happy with the commonly used system by far. clinic location; you have to buy two service. Price seems to be higher than programs and computer systems for ClinicServer though. Clinicmaster each location T PC based; will not run on an Apple With all systems there have been no Pros: computer unexpected costs, and all have the T Monthly flat fee, as opposed to T Not easy to navigate through all flexibility to add features as you see paying for each physio in your clinic of the options which can be time- fit. I have been in touch with all of the T Canadian company based out of consuming for receptionist reps and all have been helpful and have Quebec answered questions in a timely manner. T Good tech support ClinicServer T Useful marketing tools, i.e. good We hope this has helped simplify the choice of running 'stats' on referral Pros: options for you and your clinics. sources T Cloud-based T Electronic Medical Record available T Can service multiple clinics easily Linda Walker owns Brentwood T Good online training T Mac/iPad accessible Physiotherapy & Massage and Peninsula T First year discount if you pay up front T Can be Mac based plus have a PC at front desk Physiotherapy on Vancouver Island.

Website Kudos...continued Here’s what some of our “I really like the current students sections “I recently had a new patient request members had to say: on mobile apps as student are now in a my services after searching for a physio “I found the fee schedule part helpful technological era where almost everything online. I was surprised and confused at having just received a subpoena to testify is done with electronic devices. The apps first because I have yet to be put on the in an ICBC trial vs one of my previous that are listed are very helpful and useful.” clinic website (still under construction). I clients. Having never been through this JL soon realized she must have found me via process before I had no idea what I was “Just checked out the new website. Looks PABC’s Find a Physio service! Thanks!” expected to charge. I found the page great. I love the Peer Practice Advisor DW easy to find and easy to understand.” CA Resource - I just contacted one of the The Find a Physio resource has been our “This is great, the graphics are great and advisors. Working in a small private second highest source of referrals for my much easier to use, especially the Find practice, having that resource is so physiotherapy services (after google). a Physio section. Great changes, I am valuable.” MC Thanks for all your hard work! KW impressed.” PL

Keeping British Columbians Moving For Life 13 Directions bcphysio.org

We’ve Come a Long Way, Baby! Little Physios Karen Bhartu is a mom, bringing into by Diarmid Scotty McVicar the world Emmanuelle Kathleen (7 lbs 5 oz) on November 7th. Jen Keefer, Canopy Physio, had her 3rd When I recently reviewed the 2013 PABC Fee Guidelines for private physiotherapy, I child on November 6th. James Davie was was slightly startled by the numbers. As someone who is very much in the twilight of 6 lbs 15 oz. his career, I have some historical perspective about the increasing fees over the years Kari Loftsgard, Creekside Physio, had that I thought might be appropriate to share. Eddie Tate (6 lbs 10 oz) on September 3rd, welcomed to the world by 3 year old When the Canada Health Act came into being in 1966, the province was to pay for brother Ben. services outlined in the Act and in return the federal government would match the Stacey Miller, BC Children’s Hospital, province dollar for dollar on what was spent. This changed to a lump sum transfer had her first baby Mackenzie Sarah payment in 1970 based on population. Physiotherapy was not covered by the Act, Schmidt on September 13th (7 lbs 13 oz). but some provinces (BC, Ontario, Saskatchewan, Alberta) paid for services in private clinics. Ontario and Saskatchewan later put a freeze on the number of clinics being Helen Ries, Sitka Physio is a first-time paid and in many respects froze the fees being paid. BC and Alberta continued to Mom. Samuel McGregor was born pay for private physiotherapy with small increases being given on occasion, usually September 10 (6 lbs, 6 oz). following fierce discussions between the physiotherapy association and the Ministry of Steve Nairn, Sitka Physio, is a new dad Health. to Alexander Sebastian (7 lbs 14 oz).

In 1988, the BC government introduced a $5 user fee for those over a certain income, Kirsty Exner gave birth to Amelia Rose rd and over time both the remuneration and the user fee slowly increased. With the on September 3 (7.5 lbs). government remuneration being lower than the cost of providing physiotherapy, most Gillian Clayton had her first child, clinics opted out of the BC health plan and started to increase the user fee required to Matthias Hercules on August 12th (7 lbs 3 offset the increasing cost of doing business. oz) just a few weeks after competing in the Vancouver Triathlon (sprint). Finally in 2002 the BC government delisted physiotherapy for those earning above the Natalie Grant is a first time Mom to threshold level of around $23,000 per year. BC was the last province in Canada where Charlie (9 lbs), born July 17th. every individual had some form of coverage for physiotherapy provided by a private clinic. Clinics responded by increasing their fees and their visit length; the average John Beesley, Fraser Valley Physio, is a clinic range was $30-40. The shift to market rates and the elimination of the BC health new Dad to Anderson, born March 24th plan funding resulted in a drop in caseload for most clinics, both in the number of (7 lbs 8 oz). people attending physio but also in the number of times a patient would attend. Dan Mueller, Burnaby Hospital, is a new When the BC health plan was paying a portion of the 12 visits per year, patients were Dad; Jacqueline Kimberly was born more than willing to attend three days a week if this would help them recover their (8 lbs 4oz) on November 30th. functional ability. When the government support was gone it was hard to get patients Shawn Turnau, Fernie Physio, welcomed in once per week even if they had an insurance plan; it took time for them to become daughter Eveline Jude (8 lbs 14 oz) into used to paying up front and then claiming from their insurance later. In my case this the world on November 25th. She shares resulted in a 29.5% drop in patient visits from 2001 compared to 2002. the birth date with brother Ollie! If you have read this far I am sure you are asking how far fees have come. In 1984 when Board of Directors I moved from Manitoba to BC we received $11.20 per 15-minute visit; now most clinics are charging over $50 for a similar time period. Positions Each year a few of the eight elected All I can say is “We’ve come a long way, baby”! Director positions come to their term-end. In April, three regional positions are up for What does the future hold? Can we continue to raise our fees on an annual basis? If I election: can relate my personal experience when in Las Vegas for a course I was quizzing the Fraser Valley: Remmert Hinlopen retires physiotherapists as to what they were getting paid? One physiotherapist indicated after three terms (6 years) that the company he works for billed $100.00 per visit and the insurance companies Northwest: Valerie Niefer, ending second would send back a cheque for $27.00. That means that 27 cents on every dollar being term paid by the insurance company. Kootenays: Craig Sully, ending first term. While Directors from NW and Kootenays A word of caution: we have as a profession, done well but we must respect that the may run for another term, members from money for our fees comes from either an individual or an insurance company. We have all three regions are welcome to run for to be cautious not to raise our fees too often or too much as the well may go dry! election. Email [email protected] for an application form.

14 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions How Do You Know Your Patient is Improving? How Do You Prove It? Members Say How They Use Outcome Measures in Clinical Practice by Deb Monkman (Clinical Librarian) and Alison Hoens (Knowledge Broker)

Measuring patient outcomes can be the ‘golden key’ to enhancing our clinical WĞƌĐĞŶƚĂŐĞŽĨƌĞƐƉŽŶĚĞŶƚƐǁŚŽƵƐĞƚŚĞƐĞ decision making, improving the patient’s understanding of and satisfaction with ϱƚLJƉĞƐŽĨKƵƚĐŽŵĞDĞĂƐƵƌĞƐ care, and augmenting the credibility of 100 our profession with other care providers and funders. But how do we find, select, 90 apply, score and interpret outcome 80 measures (OMs)? Which ones should we 70 use? Where do we start? These questions 60 kindled a new series of free evening webinars by the Knowledge Team, with 50 Alison and special guests, which began 40 in November (recording available), and 30 continue through the new year (register 20 under Courses). PABC’s free webinar series is meant to complement CPA’s 10 OM series which focuses on an in-depth 0 review of specific outcome measures. Impairment Performance Activity Patient Patient specific To prepare for our webinars, we asked reported members about their experience with OMs and received 47 responses to our survey. These results are consistent with those T Berg Balance Scale reported in the literature. However, T Patient Specific Functional Scale 1. What benefits do you think there is an increasingly recognized T 6 Minute Walk Test T Elderly Mobility Scale OMs provide? need, consistent with the International T Goal Attainment Scale Most respondents to the survey feel Classification of Function (http://www. T Rotator Cuff Quality of Life that OMs benefit their patients (85%), who.int/classifications/icf/en/), to move T Timed Up and Go themselves (83%), and their profession beyond impairment measures — we (68%). Only five respondents said they do not need to stop measuring and Some of these OMs will be included in the don’t use OMs, suggesting that patients reporting ROM and strength but we webinar series. know if they get better without the use need to enrich our measurement by of OMs. also including standardized measures of function, i.e. the effect on activity and 4. Which webinars are you most 2. What kind of OMs do you use? participation. Indeed, the value of adding interested in attending? patient-reported outcome measures is A full 87% of respondents were interested Members most often use impairment- being recognized by incorporating these in an overview of how you find, select, based OMs, such as ROM, strength measures as indicators of quality of care apply, score and interpret OMs. This and pain, and least often use patient- in countries such as Canada, Australia and webinar, with Alison and her guest PABC specific OMs, such as the Patient Specific the UK. member Dr. Vanessa Noonan, was held Functional Scale or the Goal Attainment in November, and the recording and Scale. Performance-based OMs (e.g. recommended resources can be found BERG, TUG), activity or participation- 3. Which OMs are of interest? on the members’ site. Members who based OMs (e.g. lower extremity From a list of 40 OMs, respondents attended commented: functional scale), and patient-reported identified the following measures of “To be brutally honest outcome OMs (e.g. DASH) were not used often. greatest interest: T Lower Extremity Functional Scale measurement was not something I T Activities Specific Balance Confidence had ever given a lot of thought to... Scale but you have changed that.” T Foot and Ankle Disability Index continued on next page

Keeping British Columbians Moving For Life 15 Directions bcphysio.org continued from previous page “I have been trying to choose one or more outcome measures to use in What Members are Doing the Extended Care Facility here, and now you have given me the info and PABC’s longest-standing tips to clear the befuddlement.” member, nonagenarian Miriam “The session stimulated critical Jayne, for the first time in thinking about outcome measures 62 years has not renewed and how to use them in practice.” her membership. A member “I liked having clinically relevant since 1951, Miriam retired in examples, and outcome measures 1988 yet remained part of the that apply to conditions I treat.” PABC community for another “I liked the 10-step approach to 25 years. PABC thanked her selecting and applying an outcome for her commitment to the measure.” profession, and for Christmas “You’ve made a good case for urging sent a certificate of appreciation us all to seek more OMs and to use and a poinsettia to her home in them.” Miriam Jayne mailed PABC this beautifully Vernon. hand-written letter that we shall treasure for its We are in the process of developing the elegance and 62-year career retrospective. next two webinars focusing on OMs in two populations: (1) shoulder pathology with Cameron Bennett, and (2) total joint This month, a team of BC physios and students is headed to southern India for arthroplasty with Dr. Marie Westby. The a clinical placement with the non-profit organization Samuha-Samarthya. The webinars will build on the content of the team is led by Hilary Crowley (Enid Graham Memorial Award winner 2013) who first very successful webinar. If you did founded the Samuha Overseas Development Association. Joining Hilary are clinical not have an opportunity to participate supervisor Andrea Mendoza and physio students Danielle Boyd, Kailen Houle, in the first webinar, please view the Maegan Mak and Marcia Denhoed. They will be working with children who have recording on the member site (search the neurological injuries and disabilities as well as treating adults with spinal cord library, or go to the Clinical Library). The injuries. Leading up to their departure, they raised funds for equipment and supplies content is appropriate regardless of the through “Dollars for Development” organized by Andrea Mendoza. Donations are still setting in which you work (public, private, welcome at www.samuha.ca. community) or the patient population that you treat (paediatric, orthopaedics, Hillary Acosta, who is on the board of directors of the non-profit organization MOVE neurology, geriatrics, etc). Adapted Fitness and Rehabilitation Society of BC, has opened the MOVE Adapted Fitness and Rehabilitation Centre, handily next door to NeuroMotion in Victoria where We look forward to having you join us she practices. The aim of MOVE is to provide both youth and adults with physical for the next webinars in this series on disabilities the access to assisted exercise and therapy. The facility is wheelchair February 12th and April 9th 2014. accessible and has specialized equipment, trainers, and volunteers. At the opening of the facility, Captain Trevor Greene and paralympian/MLA Michelle Stilwell said a Yes, PABC Does make a few words and cut the official ribbon, with a host of other celebrities looking on. Says NeuroMotion owner Pauline Martin, “This kind of fitness facility has been a dream of Difference Hillary’s, and when the space came open next door it was her chance to make that In our December member poll, we dream come true.” http://moveadaptedfitness.ca/ asked “do you use PABC practice resources (webinar, vodcast, lecture, librarian, website) and does it influences your practice?” 90% of you said YES L-R: Adam de Levie (President We know we are on the right track of the board of MOVE), Hillary with what we present to you, and we Acosta (Vice President of the continually work to keep resources Board), Bob MacDonald (from relevant and in the right dose. This CBC radio’s Quirks and Quarks), makes a wonderful bookend to the Captain Trevor Greene, MLA member satisfaction survey in January Michelle Stilwell 2012 when 55% of you said that you get Excellent Value from your PABC membership, and the other half of you believe you get good and fair value, for an overall value-for-money measure of 99%.

16 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions

Recent new grads Sean Overin and Fraser Perry had Congratulations to the new grads their final clinical placement in September in Tangalle, who enjoyed their convocation and first Sri Lanka. Says Sean, “It has been such a special steps as full-fledged physiotherapists on experience out here and I’m just so happy to be part November 29th. of a profession that is given the opportunity to keep people around the world moving for life.” Shown Winning the PABC awards were: here, Fraser and Sean are building a slide board in the Ayli Berson (highest cumulative standing jungle from a coconut tree and a piece of corrugated in case-based course), Susan Moriarty poster board for a spinal cord injury patient who (promotion of the profession), Levana was having trouble transferring to and from his bed. Luu (leadership), Geoff Wilson (second Fraser says, “We used what was around and built highest academic standing), and Sharaya him one on site since these people do not have the Friesen (paediatrics). After presenting resources or financial means of getting one.” The these awards, RBT presented each placement was a reminder to Fraser and Sean of how student with a pen for charting inscribed lucky Canadians are, and how creative physios can be. with the PABC logo and the graduate’s name. Jayne Garland presented Heather Sean is now practicing at Broadway Wellness while Keep with the UBC award for the highest also working with the UBC track and field team and academic standing in the program. Two the Meraloma rugby team. Fraser is now practicing at community awards were also presented: CBI Oasis Sports Injury in Abbotsford. See their blog Alim Dhanji gave Jeff Brown the at www.physiosrilanka.blogspot.ca. Healthcare Financial Group award for business acumen and entrepreneurial Ironman champion Gillian Clayton was featured in Triathlon Canada and the Georgia spirit, and Christine Heckman gave Straight recently for racing this season while pregnant. She was running and swimming Fraser Perry the new LifeMark Health up to the day before delivery, and wrote a blog about high-level activity during Leadership, Clinical Excellence & pregnancy and about labour and delivery. Gillian “loved labour”, and is open to Innovation Physical Therapy Award. providing encouragement to fellow members. See her blog http://goo.gl/wNVdOf Reach her at [email protected].

UBC associate professor Linda Li was awarded the prestigious Canada Research Chair in Patient-Oriented Knowledge Translation in November. The position acknowledges her incredible hard work and her success at altering the world for people with arthritis by state-of-the-art translation of research results into useful information. The Chair comes with $500,000 funding to support Linda’s research program that aims to evaluate new approaches to knowledge translation that will enhance timely care for people with chronic musculoskeletal diseases. To improve the dissemination and use of research findings, her team will study the use of digital media tools for assisting patients to seek timely treatment and to support their self-management.

Karol Elliott (L) and Karen van der Hoop (R) are well-known BC physio twins who have now become UBC donors. Together with their dad, Fred Wiley (C), Amy Taylor, Knead Therapy Clinic, a graduate of the Pharmacy triumphed at this finish line recently. In class of ’53, the family have made bequests to the university. Fred’s bequest will help Reykjavik, Iceland, Amy ran a personal expand pharmacists’ health care expertise and outreach, while Karen and Karol’s gifts best in her 6th half marathon, but are earmarked for the Jane Hudson Scholarship and the Margaret Hood Scholarship, this time she was also running with as well as for the Rehabilitation Sciences Alumni Bursary. “Jane Hudson and Margaret Team Diabetes. Diagnosed with Type Hood were founding members of the School of Rehabilitation Sciences and heads of the 1 Diabeties 13 months previous, she departments of Physical Therapy and Occupational Therapy respectively when Karen and raised $6,525 for the Canadian Diabetic I were in university. They were our instructors and we admired them,” explains Karol. Association, Insulin pump and all across the line in 2:02:07. UBC new grads Susan Moriarty and Eric Marriott, and MPT student David Ridgewell have just announced a Mentorship Pilot to launch in February. The program is designed Judy Russell was added to hometown to provide students with an avenue to connect with physiotherapists one-on-one. This Niagara Falls’ Wall of Fame for her career program will be entirely student-led and will follow strict expectations so that all involved in sport physio that included roles on partners will find value throughout the experience. To be a mentor, email dg.ridgewell@ several Olympic and world champion gmail.com for details. teams.

Keeping British Columbians Moving For Life 17 Directions bcphysio.org

University Corner

Join Us at the Forum It varies enormously; sometimes we Student View: Turning get 40 offers for our 80 students, and by S. Jayne Garland, PhD PT, Head, UBC sometimes 120, so occasionally we are the Page Department of Physical Therapy oversubscribed, whilst at other times by Marcia Denhoed, MPT2 we are desperate!

We are thrilled to once again participate 2) Students input their top five selections th The turning of the year is a good time in the Physio Forum April 26 . Please into the HSPNet computer matching for reflection. Looking back on the blur join us in the UBC Lounge where you can system. We try and give students one that was 2013 brings back a few post- chat with our Clinical Ed team, check out of their top five choices if at all possible traumatic flashbacks of exam stress, but a “human book”, visit our tech corner (bearing in mind their learning needs on the whole, remembering 2013 brings for information on powerful clinical tools and their placement requirements). If back fond memories. This winter, the available in the digital world, participate students do not select your site then MPT1s have settled into the groove of UBC in the Physio’s Choice poster awards and you are not so likely to get a student. while the MPT2s have flown the coop for of course join us for the reception from 3) A mismatch of what is offered and back-to-back placements straddling the 3:45-4:45. what students require. Students need Christmas holidays. to complete placements in five distinct WE NEED YOU! clinical settings. As with the excess This August, the second ever class of the Have you ever collected outcome capacity, we sometimes get a mix of Northern and Rural Cohort began their measures on a unique or interesting case, offers which does not match the mix journey. Feedback from the MPT2s who participated in a practice-based research of requirements for students at that have been on three placements in these project, developed an intervention or particular time. communities has been very positive. education program to improve practice or 4) In level 2 and 3, many of our students Experiences in less serviced communities wanted to do so? If so, then please share complete an out-of-province or have provided plenty of exposure to many your experience with peers by creating a international placement so we have less areas of practice and a great variety of poster to display your case history, clinical students looking for BC placements. patients and conditions. program or research project. Darlene Reid Although the outflow is usually more and Susan Harris will present a webinar than balanced by the inflow of out-of- The MPTs are passionate about their hosted by PABC on “How to Put It province students wanting placements chosen profession and passionate about Together: Create a Clinical Poster of Your in BC, incoming students may have giving back to their community. Charity Expertise” at 7:30-8:30 pm on Wednesday, different requirements than the UBC events such as blood donor clinics, the January 22, 2014. Register here: students and again may not be able Relay for Life, Food Bank bake sales, and http://create-clinical-poster.eventbrite.ca to be matched with what we have Christmas food drives are some of our available. See the Call for Abstracts in this issue for philanthropic endeavours. Additionally, details on poster submissions, page 20. We do appreciate that if sites offer and some students took time away from don’t get assigned a student then they are weekends to volunteer with groups such as less likely to offer again, and we are always Adaptive Snow Sports, Special Olympics Clinical Education disappointed when we cannot fill a specific and Sea to Sky Aphasia Camp. by Sue Murphy, BHScPT, Med, Associate placement offer. If anyone has ideas as to Head how to manage this better given the large The UBC gang has been living up to its number of offers and students we are trying reputation for having the most active health to deal with, we would love to talk to you! professionals by dominating intramural “I sent you a placement offer but I didn’t sports. In the past year we have taken receive a student! Why are you begging for divisional titles in Day of the Longboat, more offers when you don’t need them”? Storm the Wall, dodge ball, volleyball and ball hockey. However, all the sports can We sometimes hear comments such really work up a thirst and we still manage as these from practitioners who offer to take a break from the books for a placements but who then don’t get night on the town. Highlights of the 2013 assigned a student. Understandably, this social calendar included beach parties, leads to a level of frustration for both the orientation week, Fall Ball, Christmas clinical site and for us at UBC. There are parties and a good old-fashioned hoedown several reasons why an offer may not be Sue Murphy (centre) was presented with the at a farm in Langley. No one can be exactly used: Faculty of Medicine Distinguished Achievement sure what 2014 holds but we do know that 1) Extra capacity. Although rare, the way Award (Excellence in education) by the Dean, the UBC students will be actively involved the system works is that we never Gavin Stuart. Rebecca Tunnacliffe (L) was there in their school and community and doing to applaud on behalf of PABC. know what offers we are going to get. things full force.

18 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions A Physio Student Interviews a New Grad by Katie Pauhl, MPT

We physio students are interested in the How does CPA influence you/your work mentor, this could be a far smoother and career paths of graduates who go before environment? less scary transition. us. I interviewed new grad Jennifer Chen The CPA is such a great resource, (2012), to gain insight into the transition which allows you to stay connected Clinical Pearls from student to physiotherapist. with others in this profession not only The one thing you wish you knew while in Canada, but globally as well. CPA’s you were in school? I had the pleasure of meeting new Rehab Reference Centre tool has How easy it is to use the many practice Jennifer well before she became a definitely influenced my assessments resources we have including the PABC physiotherapist. We first met about and treatments allowing me to keep up librarian—I wish I had made use of all of three years ago when she volunteered to date with the latest research. On top these tools! for a research project I was overseeing of that, I have peace of mind as a new at ICORD. She had completed her clinician knowing I have malpractice What is one clinical pearl you would undergraduate degree at UBC in HKIN insurance! want to provide to the upcoming while working at the Allan McGavin graduating class as well as new grads? Sports Medicine Centre as a receptionist. Although you may feel a lack of Upon completion, she went into the MPT The BIG Transition: Student to confidence when you start working as program. She is now a new graduate, and Clinician a new grad, know that the education I am in my second year, so she was kind The hardest part of the transition? you’ve received over the last two years enough to share what her most recent The hardest part for me has been is somewhere back there and the right transition has been like, and some pearls deciding which techniques would be best material will come to the surface when of wisdom. to use for each treatment plan because of you need it. Trust in the knowledge the plethora of knowledge accumulated you’ve gained, and make use of the First job from our program and additional courses. bountiful resources that we have! I landed a full-time position with In- Oh, and of course, to act confident when Motion physio, split between clinics I lay out the treatment plan despite How should the upcoming new grads in White Rock and in South Surrey. sometimes feeling uncertain! prepare? Although the two clinics are in the same To lessen the stress of the national company, their clientele and environment Has building rapport with new clients exams, prepare well by finding a good are quite different; one has a large gym been difficult as a new grad? study group and make use of practice and a multidisciplinary team, while the The biggest challenge I’ve faced is when questions and scenarios. Connect with other is smaller but with an abundance patients come in with the pre-conception those who have recently transitioned of resources and a very experienced that they don’t want to be seen by a from student to clinician and find out therapist/reception team. The two offer new grad or someone with minimal what their struggles and successes a breadth of experience and mentoring experience and are vocal about it, which were. Ensure you set aside down time from clinicians with different training. thankfully is rare! to do things that you enjoy be it sports, reading, television etc. And, when you What influenced you to start your Clinical Experience to Date look for a job, don’t be afraid to be career there? What was one thing that you didn’t picky – look for a place whose mission It started with a placement and led to expect to have happen in practice? statement matches yours. a job. I moved around the network of To have a doctor phone our clinic and clinics in the corporation until I found a ask my opinion regarding a patient on his Jennifer’s professional mission place where I could receive adequate caseload and whether or not the patient statement: mentorship, wouldn’t have to worry about is appropriate for physiotherapy—this To have excellence in providing immediately building a caseload, and blew my mind! individualized care, promoting good would have some support for continuing health and life-long wellness. education. They offered all of the above, What practice tools do you feel are and when I was introduced to the White missing? So, readers what’s your professional Rock/South Surrey clinics I immediately One thing that has made my transition statement? Can you relate to some of felt welcomed as part of their health care from student to clinician easier than I Jen’s experiences? team. had anticipated is having direct access to mentors who are interested in guiding I would like to thank Jennifer for taking me. I think that if all new grads had some the time to share her experiences with sort of new grad-to-clinician bridging us and I know her words of wisdom and toolkit complete with an experienced experience will help guide the next class.

Keeping British Columbians Moving For Life 19 Directions bcphysio.org

T Program evaluation: Describe Call for Abstracts the number of participants that go through your program Physio’s Choice Poster Fair at the PABC Practice on a monthly or annual basis, outcomes that indicate successful Forum, April 26, 2014 progression, adverse events. Cost per patient may also be included. Deadline for Abstract Submission: April 7, 2014 T Successes of program: Describe in one or two sentences how your program has made an impact and Engage your peers by presenting a poster at this year’s expanded poster session, why its continuation is essential. scheduled from 3:45-4:30 pm, April 26, 2014, at the Marriott Hotel, Vancouver. This year we welcome PT-related clinical contributions from all individuals and organizations affiliated with PABC in addition to research submissions. Please designate 3) Research Proposal or Study which of the following submission types you would like to make: T Contact author, email and 1) Case Study: Case studies may highlight a novel technique or area of practice, an preferred contact phone number unusual or interesting clinical finding or scenario, a unique or particularly successful L Authors, title, institutions approach, or a practice “pearl of wisdom”. T Introduction: Provide one or 2) Clinical Program: Therapists, educators or administrators who work in, or have two sentences that describe the developed, a rehabilitation or education program may present its features and/or rationale for the study. outcomes of interest to PABC members. T Relevance to PT: Describe in 3) Academic Research Paper or Work in Progress: This submission format is one or two sentences why this is intended to provide PABC members who are graduate students (or grad students important to the field of physical supervised by PABC members) an opportunity to present their original research. therapy. T Purpose/hypothesis: State one Potential presenters should submit a one-page summary or abstract of their poster (1 or both of these. page maximum, 12 point font, 1.5 spacing). The summary should be structured using T Methods: Summarize your study one of the three formats shown below and using their related headings. It should sample, study protocol and key provide enough background for the reader to assess the relevance to PT. measures performed or proposed. T Results or anticipated outcome: 1) Case Study Summarize your key results or anticipated results if your poster T Contact author, email and preferred contact phone number describes a proposal. T Authors, title, institutions T Discussion: Summarize the T Introduction: Provide one or two sentences to describe the rationale, unique impact that your study contextual issues, and unique features of your case. outcomes demonstrated or will T Case presentation: This section should include several sentences and/or a table demonstrate. of data that describes the history and results of relevant examinations or text results. The working diagnosis and clinical problems that need to be addressed IMPORTANT – PLEASE NOTE should be stated. How this case differs from the usual presentation and care Due to limited space in our assigned room should be described. at the Marriott, traditional large poster T PT management and outcomes: Describe the salient features related formats will not be possible. The poster to difficulties and successful progression of your patient’s response to must be a maximum of 45” x 45”. If your management. Be sure to describe objective outcomes and communications poster exceeds these dimensions, we with team members if relevant. cannot guarantee that there will be space T Discussion: Synthesize your interpretation of the key learning points from the to display it. Please come and put your case. What did you learn from the unique features of this case and how would poster up at the start of the day so that it you change your practice in order to address future cases that might be similar. can be viewed during breaks, and plan to be there in person at 3:45 to present and 2) Clinical Program answer questions. Prizes will be offered for T Contact author, email and preferred contact phone number the top two posters in each category! L Authors, title, institutions T Introduction: Provide one or two sentences to describe the rationale, Abstracts should be sent by e-mail to contextual issues, and need for the program. poster session organizers Alex Scott or T Format of program: Include details of the characteristics of the participants Darlene Reid. Please don’t hesitate to and the intervention. For the participants, you might provide the diagnoses, contact Alex or Darlene if you have any age range, and other features of patients that meet the inclusion or exclusion inquiries about the event or the submission criteria of your program. Describe the content and delivery of the assessment process. and intervention(s). Description of the health care personnel involved in the Alex Scott, [email protected], or program and the environment might also be informative. Darlene Reid, [email protected].

20 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions

UBC LOUNGE at Many Happy Returns: Financial Planning the Forum and Considerations on your 2013 Filing

Human Library – This year we will by Alim Dhanji, BBA, CFP and Bradley Roulston, CFP highlight our PT clinical faculty members, making them available as We see financial planning like going on a hike – a financial hike. An important “books” that you can sit down with step in your financial hike is tax planning and positive cash-flow management. for a one-on-one conversation. The Maintaining a positive cash flow is the life-blood of anyone’s personal finance or list of titles will be circulated ahead business. of time, so that you can reserve your conversation spot during one of the Below are some tax-saving ideas. forum breaks or lunch. Titles will Year-end tax tips that haven’t gone out of fashion: include clinical areas or techniques, 1) Maximize your RSPs and start as young as possible. If you don’t need your RSP programs and stories about clinical deduction, you can still shelter your money and claim the deduction in future practice and life experiences in when your tax rate is higher. Get a bigger bang for your RSP buck. foreign locations. 2) There is no deadline for making TFSA contributions. If you have been over age 18 and resident in Canada since at least 2009, you can contribute up to Tech Corner – Do you own a Wii, $25,500 to a TFSA in 2013 if you haven’t previously contributed to a TFSA. The notepad or smartphone? Then annual TFSA contribution room for 2013 is $5,500. Investment income inside a you have a powerful clinical tool TFSA is tax-free and withdrawals are tax-free. at your fingertips. Come and see 3) If you are over 71 but your spouse isn’t, you can still make a contribution to demonstrations from UBC faculty his/her plan if you have RSP room. members and MPT students/alumni 4) All donations should be claimed by one spouse to maximize donation credits. on how video games and apps can Consider donating securities for better tax treatment. augment your practice. 5) All medical expenses should be claimed by the lower income-earning spouse to maximize medical tax credits. You can use any 12-month rolling period, not Physios’ Choice Poster Fair – Engage necessarily Jan-Dec timelines. with your peers who are presenting a 6) Deductions for home office, meals & entertainment and vehicle are possible poster at this year’s expanded poster for employees if a ‘Conditions of Employment’ form is applicable. session. Whether case study, clinical 7) Income split wherever possible. Equalize current and future incomes. program or academic research, the 8) A big fat tax refund is a bad thing! Complete a T1213 form, reduce your tax posters will stimulate your practice withholdings and increase your monthly cash flow. reflections. All those attending the 9) Best to borrow only for investment or business purposes (and to buy your meeting will have the opportunity home). Otherwise, pay in cash only – don’t debt finance for personal spending to cast their vote on the best-case 10) Meet an accountant or CFP now to arrange your affairs in the most tax- study/clinical program and the best efficient manner. Don’t wait to ask ‘how did I do last year’! research project to determine the As a friend of mine once said, “It is fine to pay your taxes, but you don’t have to Physios Choice Awards. Prizes will leave a tip!” be offered for the top two posters in each category! Contact [email protected] or call (604) 818-4112 for more information or to take your own financial hike. Consultant fees waived for PABC members.

Excellence Awards: Give the ultimate gift of the Profession In addition to having a transformational impact on a patient, being recognized by your peers for your excellence is the ultimate professional satisfaction. Give your colleague the gift of recognition: nominate a peer you admire for one of the PABC Awards of Excellence. New this year are the Lifetime Accomplishment and the Promising Young Professional awards, Professional Development Advisory Committee: in addition to awards for Leadership, Clinical Contribution, and L-R: Patrick Jadan, Jonathan Coelho, Jennifer Keefer, Professional Contribution. The nomination is easy; the form is on Dan Mueller, Tracy Barber, Andrea Reid (Chair), Louise the Members Site at www.bcphysio.org/content/awards-bursaries. Didyk, RBT, Cam Bennett

Keeping British Columbians Moving For Life 21 Directions bcphysio.org

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22 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA bcphysio.org Directions

Privately Hosted Courses Ž ;OL4J2LUaPL4L[OVK Details at www.bcphysio.org - Courses 6M January 4LJOHUPJHS+PHNUVZPZHUK;OLYHW`Ž x 2014 Series with Diane Lee - A Clinical Mentorship in The Integrated Systems Model, White Rock x Dynamic Neuromuscular Stabilization according to Kolar, Basic Course "A", Richmond February x Fit 4 Two® Pre and Postnatal Fitness Conference 2014, Vancouver March x Training=Rehab-Rehab=Training, Richmond x New Trends in the Prevention of Running Injuries, Richmond x Management of Lumbopelvic Disorders, Victoria April x Introduction to the Assessment and Management of Rheumatic Diseases: A Skills Workshop for Physical Therapists, Vancouver x Dynamic Neuromuscular Stabilization according to Kolar Basic Course "B", Richmond x McKenzie MDT Forum - Evidence & Clinical Application, Vancouver Evidence-Based. May x The Eclectic Approach to Soft Tissue Manipulation - Erson Religioso (The Successful Outcomes. Manual Therapist), Vancouver Empowered Patients. September x Dr. Stuart McGill - Building the Ultimate Back: From Prevention and Visit www.mckenziemdt.org (select Canada) Rehabilitation to Performance, Calgary, AB for info on: )


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   e e and other physios for the past 15 years that CPA malpractice insurance  is superior to all others! Not only are CPA’s rates competitive, you want the Association backing you in the event {,&"t€lfo kt of any type of claim. Going with {$&./', {${!{ alternative insurers to save money "''a-(${2a",' can in fact cost you big time when /',l af af{$!' .(%'$-a.#(',a0(##`{-"',($ there is a claim; only then does the {$&./',f '$a.,($`-"{--"(a&(-20(##-,.#2 '{--"' Discover How MDT Benefi ts fine print get highlighted that you are '(&'$-',+,{!!,'aa($`&.,,'$-{$!ê-.,'!'/'#%'$-a($ inadequately covered.” MWS Both the Patient and the Clinician -"'{,'{a+a'{-($`fa(-($($`{$!% (#(-2!.,($`-"'n -" e$-',${-(${#'{-($`2%a(.%ÐeÑg $-($.($`-"'"(`"#2 a.&&'aaê#a',('af-"'n -"e0(## '-"','%(',a'--($`+, “BTW, you at the PABC are by far !(a&.,a'{$!#'{,$($`($-(&{,'{aa.&"{aa',/(&'!'#(/',2f the most proactive, innovative Bursaries ,!.&-!'/'#%'$-f,'a'{,&"{$!.-&%'ag association I have had the pleasure of working with while I was in Nanaimo, Nominate yourself for an education '($/(-'2.-{--'$!-"'a2%a(.%f0"(&"($&#.!'a 'é'$!'!'1"( (-!{2a{$!{&'#' ,{-($+.,n -"{$$(/',a{,2 and now even in Australia. Love the bursary or funding to attend Congress. !.,($`{$'-0,*($`'/'$-f/'$($`{--"' .{,(.%g‚ ads, the physician letters were great The Ruth Byman and the Peter too. Thanks for making physio more Huijbregts Memorial bursaries award ,&".,'{$!,'`(a-,{-(${/{(#{ #'$#($'h aware to the public. Cheers.” RH $1000 toward your professional ($-',,+'aa(${#g. &g&{yeo kt development activities. PABC also $a,'! 2h “Must say – these recent newsletters helps fund your CPA Congress are the best for any association I registration fee. have seen. Practical learnings, a little bit of fun, aesthetically pleasing, and All applications at www.bcphysio.org/ highlights our members!” PS content/awards-bursaries s t€rol€osnrx##,''hk€rmm€rol€nkkox)g(&'Ò. &g&{

Keeping British Columbians Moving For Life 23 Directions bcphysio.org

Directions in Physiotherapy PABC Professional Development 2014 Directions is published three times a year: Winter, Spring and Autumn. Articles on members’ clinical practice Evening Lecture/Vodcast Series are welcome. The editor retains the right to determine content. Unless speci!cally indicated, statements do not Spring 2014 – “Our BC experts share their secrets – part II” re"ect the views or policies of PABC. Services or goods advertised are not “Case studies in chronic pelvic pain – What all physios can do to help” endorsed by PABC. January 22: with Susannah Britnell, BSc(Hons) Physiotherapy, FCAMPT, Published by: CGIMS PABC, 402-1755 West Broadway Vancouver, BC V6J 4S5 P: (604) 736-5130, E: [email protected] “Ultrasound Imaging of the Abdominal Muscles and Bladder: Website: www.bcphysio.org Applications for the Clinical Assessment of Individuals with Lumbopelvic Production: Heather MacNeil Pain” For Advertising rates, please contact March 7: with Jackie Whittaker, PhD, FCAMPT, CGIMS, CAFCI Stephanie at: [email protected].

Free PABC Webinar Schedule Fall 2014 – “Our BC experts share their secrets – part III” 7:30-8:30 pm T How to Put It Together: Create a Case studies with our local experts. Join us to “ask the expert”. Come Clinical Poster of Your Expertise, with ask them how they would manage clinical scenarios. Darlene Reid and Susan Harris Dates and topics TBD Mon, Jan 20 Location/time: T Move Beyond Impairment with Paetzold Lecture Theatre, Vancouver General Hospital, th Outcome Measures 2: Shoulder 899 West 12 Avenue, Vancouver BC Pathology, with Alison Hoens and Registration and refreshments 7:00 pm, Lecture 7:30 – 9:00 pm guests - Wed, Feb 12 Vodcasts: distributed to registrants one week following the live lecture T Sticking your neck out: Do all patients with neck trauma need an x-ray, with Marj Belot Tues, Mar 11 **PLEASE NOTE THE NEW FEE STRUCTURE ** Fees: PABC members “in T Move Beyond Impairment with person”: $30 (students $10), “in person” with the vodcast $35 (you must be Outcome Measures 3: Total Hip/Knee in attendance to get the vodcast); Vodcast $40; Vodcast “group rate” per Replacement, with Alison Hoens and site: PABC members $60; future members $120 guests - Wed, Apr 9 Register at www.bcphysio.org under “Courses” Weekend Courses Board of Directors 2013-2014 Introduction to the clinical application of rehabilitative ultrasound Jason Coolen: President imaging: lumbopelvic dysfunction Aart van Gorkum: Greater Vancouver/ March 8 – 9, 2014 with Jackie Whittaker, PhD, FCAMPT, CGIMS, CAFCI Sunshine Coast Director, Private UBC Friedman Building, Vancouver Practice Liaison Chiara Singh: Greater Vancouver/ Vestibular Rehab: A practical approach Sunshine Coast Director, Public September 20 – 21, 2014 with Bernard Tonks, Practice Liaison UBC Friedman Building, Vancouver Remmert Hinlopen: Fraser Valley Director, Finance Chair To register for courses or lecture/vodcast series, follow these three easy Kevin Bos: Okanagan Director steps: Tanja Yardley: Vancouver Island 1. Go to www.bcphysio.org and click Courses Director 2. In Presenter box, choose PABC Craig Sully: Kootenay Director 3. Under the Event column, click the course title you want Jenny Hogan: Central Interior/NE 4. Click “Register for in-person lecture HERE” or “Purchase Vodcast Director Here” Valerie Neifer: Northwest Director For more information, call PABC at 604-736-5130, ext. 2 or email Andrea Trevor Potts: MPT2 Student Director Reid at [email protected]. Rebecca Lee: MPT1 Student Director Bill Mackie, MD: External Director Thank you to our sponsors. Rebecca B. Tunnacliffe: PABC CEO

24 PHYSIOTHERAPY ASSOCIATION OF BRITISH COLUMBIA