From Washington, we get a physical therapist’s perspective on healthcare from Carol Ann Davidson. It is a reunion of sorts on the Perspectives on Healthcare Podcast with Rob Oliver. Carol Ann was Rob’s physical therapist over 25 years ago when he was rehabilitating from his spinal cord injury. She is a member of Generation X and in addition to being a physical therapist, Carol Ann is a wellness and yoga instructor.
Here are 3 things that stood out as Carol Ann Davidson gave us a physical therapist’s perspective on healthcare:
· The numbers have become increasingly important in documenting progress to justify a course of treatment to the insurance company.
· Quality healthcare is about engaging with people on an individual level, getting to know your patient and listening to them.
· People go into healthcare because they truly want to help people. Often, the biggest problems for medical professionals are a result of the system, not the patients.
You can learn more about Carol Ann Davidson through her website:
Website: https://www.cadavidsonyogapt.com
Here is the text of Carol Ann Davidson giving us a physical therapist’s perspective on healthcare:
Introduction to Carole Ann Davidson
Rob Oliver: Thank you and welcome to Perspectives on Healthcare. I have to tell you, I am super excited about my guest today, and here’s why. She’s someone who literally knew me way back when. My guest today is Carol Ann Davidson. She is a physical therapist as well as a wellness and yoga instructor. But here’s the backstory on this. Carol Ann was my physical therapist when I was in rehab immediately following my spinal cord injury. So she was very, very young at the time, and she has not aged at all. She is still just as young and amazing as I remember her way back. I won’t say how many years ago. Carol Ann, welcome to the show.
Carol Ann Davidson: Thank you. Thank you so much for having me. It was such a joy when you reached out. I hadn’t heard from you in so many years, and it’s great to see you and reconnect.
Rob Oliver: Yeah. So just by way of introduction, I will say that you are a member of Generation X like I am, and you are coming to us today from out in the state of Washington.
Tell me about yourself and your role in healthcare
Rob Oliver: So let’s kind of jump in here. Tell me a little bit about yourself and your role in health care, please.
Carol Ann Davidson: So as you mentioned, I’m a physical therapist and I’ve worked in a lot of different settings over the years. I’ve been a therapist for almost 30 years, and I guess it has been 30 years. And for a while I stayed home with my kids after working for about 20 or 25 years and was a stay at home mom. And then when I decided to reengage back in work, I’ve always loved yoga. And I went to get my yoga teacher training and decided to integrate physical therapy and yoga and kind of move towards the wellness aspect.
Rob Oliver: Okay. So how did those two kind of meld together for you? Is it an easy fit or is it something that listen, I’m going to show my bias here, okay? Sometimes physical therapy seems to me to be very numbers oriented, and it’s all measurements and calculations and everything needs to have a number associated with it. And yoga doesn’t quite seem to be that way. So can you comment about how those two work together?
Carol Ann Davidson: Sure. Well, I guess in my years of doing physical therapy, I was mostly worked in rehab hospitals or in hospitals and acute care and started back in the 90s when the numbers weren’t so important. I really think that numbers over time have gotten more important because of insurance companies really requiring showing progress in a numerical way. So that wasn’t as much of a focus years ago. Of course, we needed to progress people, but documenting it in that way wasn’t so important. And I guess I’ve just really moved towards wellness. I decided to go towards that route because I’ve always loved yoga just for my own practice. I really like that it addresses the physical body that I always feel good spiritually and emotionally afterwards. Just the whole book being mindfulness. And I saw over time when I worked in rehab that people didn’t really have a place to go once they were discharged from rehab to kind of maintain that wellness. So you don’t see people in wheelchairs or who have injuries that often more significant disabilities in gyms, for example, to go to a gym and work out. And I just felt like there wasn’t a place for people who might be nervous about injuring themselves just to continue that process of therapy. You get discharged after six or eight weeks, but you still need to maintain your body and stay physically fit. So I just saw yoga as an Avenue to do that. And so really my focus now with the yoga and wellness is working with people. It’s either adaptive yoga or senior seniors who might have some injuries and just feel like I need someone who knows my body and knows what’s going on with me to guide me through how to do this safely and benefit from it.
The definition of quality healthcare
Rob Oliver: Got it. What does quality health care mean to you?
Carol Ann Davidson: So I thought a lot about this. Quality healthcare for me has always really been engaging with people on an individual level. It’s one of the reasons why I decided to do physical therapy was because I could spend more time with people then. I know doctors have these limitations on how long they can spend with people. It’s a much quicker turnaround. So it’s really getting to know people and getting to know their goals, listening to them, understanding the context of their lives. I did home care for a long time, which I’ll kind of get into in a minute, but I really liked working with people in their environments where I could see what their needs were so deeply listening to people and understanding their goals and not imposing your own goals on people. I think that’s really important.
Rob Oliver: Yeah. It’s interesting to hear you say that because so often people look at medical professionals and they come to the medical professionals to say, okay, what should I do? Or you tell me kind of thing, and you’re kind of switching that around to say, you tell me what you want to do, you set the goals, and then we work together to accomplish those. That’s a really cool thing.
An example of quality healthcare
Rob Oliver: Can you give me an example of quality health care?
Carol Ann Davidson: Yeah. So for many years I worked with an organization called Rehab Without Walls, and it’s not located in the Northeast right now, sadly, but it’s in the west. I worked for them in California and also here in Washington, and it’s a home, and community reintegration model. So we worked with people mostly with neurologic disabilities, but we work in the home, and then also we took them out in the community. So there were teams of therapists that work together, usually PT, OT, sometimes speech. They were individually case managed, and we took people wherever they needed to go to work on their goals. So, for example, if somebody had a brain injury and had trouble with concentration or visual issues, like scanning the environment, the OT and I would do a co treatment to the grocery store, and I would work on walking up the curb, getting the cart, walking through the grocery store. And the OT would work for scanning for certain items, making sure the person cognitively could check their list and manage check out and money and the math. And it was just this really integrated work right where it needed to be for somebody’s life. And I worked for them for a very long time in different places. And I just thought it was a wonderful model.
Rob Oliver: Talk to me a little bit about this, because what you’re doing is you’re moving people out of the hospital environment, out of the medical environment, and moving them into their world and into the real world. And that’s got to be a very fulfilling thing because it’s not academic, it’s not theoretical, it’s very practical in the nature of what you’re doing. Is that resonating with you?
Carol Ann Davidson: Oh, yeah, absolutely. I thought back to yours when I worked in rehab, like when I worked with you, and we had these mats that we worked on in the gym, and then you go to somebody’s home and their bed is in the corner, and they have their night stand there and they have a dog to maneuver over and close on the floor or like a really tiny doorway and then their car. I remember spending a lot of time working with you, trying to get you in and out of the car because you’re so tall. Right. Just how to manage people in their own environment is just so different than working in a hospital. It totally opened my eyes to the barriers that people have to deal with in the real world.
Rob Oliver: Sure. But it’s funny that you say that because I remember actually being in rehab, and I don’t remember if the OT and PT work together on this or not, but I remember the first time that I got to take a power wheelchair out into the community, and I went to Wawa and I bought a pint of ice cream. And it was just the understanding that I’m able to get out there and I’m able to do all of the things that I needed to is really empowering, especially for someone who was recently injured or recently acquired a disability. And they begin to see the possibilities because initially most of what is in front of you is the deficit. So that’s phenomenal work.
What do you wish people understood about your role in healthcare?
Rob Oliver: What do you wish that people understood about your role in healthcare, and you can take that from physical therapy, from yoga, wellness or any combination of those that you so choose.
Carol Ann Davidson: That could be a rather long answer. My immediate reaction when I heard this question or read this question was kind of like, well, most people here, I’m a PT, and they immediately talked to me about back pain or something that they have like that. And that wasn’t the kind of physical therapy I did. So I guess the first thing is really understanding how broad physical therapy is. Most people think of it as orthopedic injuries, shoulder injury or like I said, back pain and our expertise in movement science and body mechanics and preventing injury. So that I would like people to understand as far as yoga, a lot of people view yoga as something just for the 20 year old, super flexible, bendy kind of person or also view it as a religion. And it’s really neither. So the yoga that I do is really about anybody can do yoga. I mean, yoga can just be even breath practices really to just work on breath work and meditation, or you can do yoga in bed, you know, with certain stretches and strengthening and for posture. So I just feel like it’s much broader than thinking about it coming into a pretzel shape.
Rob Oliver: Right. It’s interesting to hear you say that because I have a friend of mine who is recovering from covet and breathing exercises and even just mindfulness in breathing for him are something that he’s got to work on. And I didn’t realize that that is something that’s covered in the yoga practices that would be beneficial, a recommendation I will have to make. Yeah.
What excites you about the future of healthcare?
Rob Oliver: So tell me, what excites you about the future of health care?
Carol Ann Davidson: The focus on wellness, really, there is more focus than there used to be on wellness and prevention and avenues where people really have a lot more choices as far as that goes. And it’s more mainstream. So complimentary practices like acupuncture, massage, meditation classes, mindfulness breathing practices, all of that, I think, really can help someone’s recovery. And so that does excite me, even Medicare. Now there are classes that are covered under Medicare under the Silver Sneakers program. And so I see that as exciting in healthcare.
Rob Oliver: Can you talk a little bit about that? Because that’s really an expansion of where medicine has been. It was that medicine is looking at diagnosis codes and treatment plans, and in some ways, you’re looking to address symptoms, to move to that preventative medicine model is really unique and different. Can you just talk about that a little bit, if you don’t mind?
Carol Ann Davidson: First of all, I think sadly, it’s largely maybe not largely, but it is driven by insurance companies, and that is something else. I wanted to say that when you ask me something I wish people understood, I think that so many of us who went into healthcare really want to help our patients. And some of the challenges with healthcare, when I hear other people complain about it, I feel are more related to the system than people who really want to help. I view that most people that choose to go into healthcare really, truly in their hearts do want to help people. And it’s just the sad state of the system. But I do think just to get back to your wellness thing, I think that people recognize that spending money and helping people to go to exercise classes or have these other avenues to stay well before they get injured actually helps save money from the insurance company. So I think that’s largely where it’s been driven, but it’s also consumer driven people asking for it and much more with social media people recognizing and knowing what their options are.
Rob Oliver: Yeah. I mean, when I was a kid, you always learned that an ounce of prevention is worth a pound of cure. And so in that way, you’re looking at what can be money that is invested in people’s health. And wellness today is something that it’s not going to eliminate all future medical expenses, obviously, but it’s going to be something that makes a huge difference in the future. The other thing that I was thinking about, when you’re talking about why people go into medicine, I had the chance to talk to a group of nurse practitioners a little while ago, and I gave them an exercise to do. And it was while you were in school, write down why it is that you want to do this job and take that. And there’s two options. One is paste it on your mirror so that every day when you go to work, you’re reminded that this is why I started this, and that you’re going to fight with the system, you’re going to have difficult clients, you’re going to have all of these issues. But as long as you remember every day, the other is take it and tuck it away somewhere safe. And one day when you are feeling frustrated with the number of shifts that you have had or you’re feeling worn down just to take that piece out and remind yourself, okay, yes, it’s not as easy, but here’s why I started this. And the work that I’m doing does make a difference.
Healthcare quality improvement strategy
Rob Oliver: What is one thing that medical professionals can start doing today to improve the quality of health care?
Carol Ann Davidson: I think listening to their patients, as I said, listening to your and really trying to understand their goals and their needs and the context of their lives, recognizing what’s reasonable, what’s possible for somebody to do is really important, and then educating themselves on what else is out there. This piece about wellness that I’m talking about so that it would be impossible to be an expert on everything for your doctor to also know all the literature about example, again, acupuncture or yoga or these other things that are available but to at least know about them and then refer your patients to other practitioners and then talk to them that’s the other thing is to coordinate the care so that you have an opportunity to really work together. That gets back to what I was saying with reamboot walls. It’s really a coordinated team of folks so that someone sees the whole big picture. I see that really lacking when I used to work years ago in acute care, you’d get somebody who’s in the hospital for a long time and they’d have neurology would look at them and Cardiology would look at them and gastroenterology. Someone was really complex and there are all these services looking at somebody, but no one was looking at them all together.
Rob Oliver: That’s such an important thing. And I know when I was in rehab, there used to be I don’t know what the official title was, but there was like a team meeting about each individual patient at least once a week Where PT, OT, physical medicine, rehab, any other of the others, psychology, everybody together would come and have a meeting about this particular patient in which everyone was contributing and I think that’s really a key. And when you leave the rehab setting, there’s no one necessarily out there that’s doing the coordination on that. In your ideal world, would that be like a PCP or who would you imagine as kind of the hub in the communication wheel?
Carol Ann Davidson: That’s a good question. I do think it’d probably be the PCP or maybe even like some sort of case manager kind of person, but I have people now that come to me for yoga And I have to admit I don’t always reach out to the PCP or to the other people. I wish sometimes I wish I could ask more questions, but they’re hard to reach or it’s just there is no forum to do that.
Rob Oliver: So. Yeah, okay. Wonderful. Listen, Carol Ann, it has been wonderful to chat with you. It does feel like old home week. And first of all, thank you for being here. Second of all, thank you for the amazing impact that you have had on my life from being a part of my rehab from the very beginning. And lastly, I appreciate you coming on and sharing your perspective on healthcare.
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