Traveling through Thibodaux and Houma (in four parts)

Part One:  Workers Comp Meeting in Baton Rouge

The sun rose as I was driving between Natchitoches and Alexandria on the morning of  Tuesday, October 4th, 2011, a beautiful sunrise with colors of purple and blue easing into hues of orange and yellow under a cloudless sky.  Low fog laced roadside ponds, soon to be burned off with the heat of the sun.  Traffic was light, the driving easy in my little grey Prius.

I was heading first for a 10am meeting at the Office of Workers Comp (OWC) in Baton Rouge with fellow PT's (Greg LeBlanc, Seth Kaplan (from BR), Gini Davis from N.O.), OT's (Keri Walker from N.O. and Angel Brown from B.R.), Kim Bueche Hardman with PTPN and Sherie Phillips a consultant from BPCC in Practice Management around the state and her co-worker Julie Bowers by conference call.  Also in attendance was Sue Newman who is the Medical Services Manager with the OWC.  She had called this meeting.  

I have stated in an earlier blog that I am here to listen and learn, and I was excited that I could be present for this meeting to do just that.  I know in my new role as President of LPTA that this early phase is a learning curve for me, so to be able to hear the issues first hand around a table with some very knowledgeable people is a blessing.  I was thankful I had the time off to make this meeting. 

What did we discuss?  This meeting was about the PT and OT codes for Workers Comp (WC) cases that were implemented after a great deal of hard work on the part of PT's and OT's back in 1994.  Gini and Keri had been initially involved and we were thankful they could make this meeting to give us some historical background.  I learned that Louisiana is the only state that has special codes for workers comp cases since 1994, and that they were initially put into place because at that time the coding technology (CPT codes) did not discern PT or OT skills and services provided.  Now, technology has improved (with the advent of therapy modifiers), and providers are now aware of who is billing for the services provided.  

So, the question became: Do we need these specially-created Louisiana-specific codes, or can we now use the 97000 codes with the modifiers as the rest of the country does? Discussion ensued.  Sue Newman was going to check into this, but the consensus was that this was not a legally-mandated change in our state, but that it arose out of a therapy-protective ideology back in the early 90's.  And the consensus quickly emerged that now with newer technology, the providers can indeed know by coding and modifiers who is providing the service, and that we probably should go back to the CPT codes for workers comp cases to be consistent with the rest of the country.  Sue Newman was going to meet with legal counsel at the OWC and make sure this will be legal, but it appears that we are on our way toward this change in coding for workers comp cases in our state.  The CPT codes are updated yearly from the AMA, and our Louisiana-created codes had not been updated since their implementation in '94, so this is also an advantage to using the CPT codes as well.  

Of course, during that discussion, the workers comp fee schedule was discussed and all agreed that this needs to be updated as well (as the fees have not been updated since 2004!), but that was not the purpose of this meeting.  Perhaps that can be the focus of future meetings at OWC!

Part Two: Hanging in Houma

After a brief stop at LPTA offices in Baton Rouge and a delightful lunch meeting with Bland O'Connor and Melinda Wilk from that office, I headed to Houma.  Passing fields of sugar cane, getting stuck behind slow-moving sugar cane trucks, I enjoyed the drive through pastoral scenes of southern Louisiana.  Loved seeing the moss-covered live oaks and plantation homes.  I was not in northern Louisiana anymore!  On my way, I made a call to Terrebonne General Medical Center in Houma, La, and arranged a meeting with some therapists there.  

Perhaps I had pre-conceived notions of what a medical center in Houma might look like, but I was surprised at the first class, multi-story, modern hospital that greeted me, with its banks of windows and clearly-marked parking areas.   I easily found the therapy clinic and was greeted by three therapists:  Ali Turner, PT who is rehab director and works in inpatient rehab, Blair T. Duthu, PT, who works in outpatient, and Terry L. Babin, PT, who works acute.  First, let me say that I was surprised and amazed by Ali's work to arrange therapists from all 3 areas to meet briefly with me at 3pm when I know that pt care was in full swing!  This meant so much to me!  They all three expressed surprise as well that I would personally come visit them from Shreveport as their President.  All were quite pleased.  We discussed concerns about Medicare rules changes in rehab, about staffing issues.  This facility has 8 therapists, PT's and PTA's in these 3 settings.  Most are from the Houma area.  Blair is a recent DPT grad from the N.O. campus and was in school when Katrina hit.  She has maintained her membership in APTA/LPTA and I thanked her for that.  I had prepared a memo to give to all I visit and went over the points with those 3 therapists, asking Ali to share this with the other therapists there.  At the conclusion of our brief meeting, they all said, "No one has ever done this before."  I told them I was there to listen and learn and meet you where you work and live.  I left them my contact information, and asked them to please contact me with any questions or concerns.  

I made no further appointments, but walked in to two other outpatient PT clinics in Houma unannounced but with the informational sheet in hand, a smile on my face, and a spring in my step.  At the first clinic, I was greeted warmly by Mark Kinnard, PT of Terrebonne Physical Therapy Clinic on Verret Street.  It just so happens he is a '96 graduate of the program in Shreveport, so we talked about Mary Denny and Sharon Dunn fondly.  He is in practice with his father Donald "Bo" Kinnard, PT who trained at Emory, and his brother Luke Kinnard, PT who has been out of PT school only 3-4 years!  What amazing history in this clinic!  Bo and Mark were quite willing to discuss issues that concern them, and these include the inability to find PT's to hire in that area of our state.  I asked if they are CI's and they do take students, so that does help in hiring issues.  They were worried about computerized documentation requirements.  More comprehensive direct access is also a desire for this practice, as you will see with most all the private practice owners I have come across in my travels.  Bo does FCE's, and we discussed workers comp issues a bit.  I got a nice tour of their facility, and I encouraged attendance at that evening's District Meeting in Thibodaux, leaving with a smile on my face.  

Thank goodness for GPS and smart phones, because my next stop I found easily.  It is my goal during this year-long tour of Louisiana to stop by each of the clinics and facilities that have met APTA's Facility Challenge in 2011, and this next stop was one of those, Donohue and Trahan.  John Donohue, PT graduated from New Orleans campus in '73 and dropped names of PT's he considers contemporaries such as Ken Barrilow, Max McCloud, Barney Stewart. (Rich history!) He is in practice with Monique Trahan who was unfortunately not present that day.  There was another therapist working on gait with a young child with CP.  John, a most delightful man, is very pro LPTA.  He had no concerns to discuss with me about our organization and offered support if I ever needed it.  His clinic, which he proudly showed me, is very open and airy with good spaces.  This was a delightful visit, as all had been that day. 

Part Three: Thibodaux District Meeting

Craig Pate, PT  Houma District Chair

On to Thibodaux for the district meeting at Craig Hebert's clinic, Thibodaux Physical Thearpy, with Craig Pate, PT, who is the District Chair for the Houma District.  Craig Pate had set up a dual-purpose meeting for that evening.  At 5:30pm, to a gathering of about 12 therapists, Craig Hebert, PT spoke about a new initiative in their city to perform comprehensive scoliosis screening in the private schools, which lack school nurses to perform these screens.  It seems that this is a personal issue for Craig H., because his son at age 15 was diagnosed with scoliosis, and he did not want this to slip by on any other child.  Craig H. got a copy of the Easter Seals guidelines for scoliosis screening and went over this handout with all present who signed up to screen 4th, 6th, 8th and 9th graders in the private schools.  Safety and privacy issues were discussed, as well as methods to flag those student who appeared to need follow-up with their physicians.  It is wonderful that this many therapists in that area are willing to give their time to screen children for scoliosis!  It is also a wonderful promotion of physical therapy in that community.  

At 6:30, the District Meeting began, with refreshments provided by Craig Hebert.  About 15 were in attendance at this meeting, and it is the first the Houma District has had in a couple of years.  Bo Kinnard, whom I had met earlier that day, was in attendance.  Craig P. spoke about issues he learned at the recent LPTA BOD meeting, and he had me speak briefly as well.  Craig H. also educated all present about the scoliosis screening initiative.  I suggested someone write this up for the Bayou Bulletin, as this is such positive news for this area in the world of physical therapy.  Of course, I encouraged membership, as I do everywhere I go.  I will not take off my Membership Chair hat ever.  Good members in good numbers are what make an association successful, even in the more rural areas of the state!  There was some discussion at the District Meeting as well about issues that LPTA may need to address.  These included Direct Access (see a trend here?), rules for PT signage (one therapist had seen "physical therapy" on a chiropractor's sign), and the community colleges (Fletcher and Unitech) in that area creating a "PT tech" college associates degree.  These issues I will bring up before the LPTA Board at our next meeting.  The meeting adjourned at 7:30.  Was terrific to see such good attendance at this meeting, and the therapists there appear to have a wonderful camaraderie.  

The Siegel Three:  Sydney, Abigail, Mason

I was invited by Mark and Cherry Siegel to stay at their house.  I truly appreciated this, because I am doing this tour on my own time, with my own nickel.  This was an idea I had on my own, and I want to do it early in my first year, so of course there is no budget for this.  And I am doing it gladly, for I love to give back.  Mark and Cherry both trained in Shreveport.  Cherry was in the class just ahead of me, and she worked at LSUHSC with me just as she was getting pregnant with their triplets.  So, we have a connection, and I was delighted to stay with them and catch up.  Sweet Mason gave me his bed, and Sydney and Abigail were delightful as well.  Triplets at eight years old are more manageable than triplets at one or two, I imagine.  What I loved about this visit was watching the interaction and separate, distinct personalities of these three precocious children!  High energy, but great respect for each other!  I think Mark and Cherry are doing a wonderful job of balancing parenting and therapy work.  Cheers to them!  

Was I tired after my long day?  Sure was!  But I was filled up with the warm reception I had received at all the facilities and clinics I had visited.  In talking with the therapists in the Houma/Thibodaux area, I was thrilled to be welcomed with open arms.  I made plans to visit some Thibodaux clinics the next morning before departing.  

Part Four: Thibodaux Therapists

At the District Meeting the evening before, I met many of the therapists I was to visit this Wednesday, Oct. 5, 2011.  They all invited me to see their hospitals and clinics, and I was happy to oblige.  My first stop was Thibodaux Regional Medical Center, a 185 bed multi-story hospital which had recently undergone renovation and was state-of-the-art, thanks to a very forward-looking CEO.  I walked into the entrance corridor and it was wide with marble floors and great art on the walls, very welcoming and upbeat with good lighting.  I went to the 4th floor rehab unit at 8am and there was Jason Ledet, PTA, who greeted me there.  Jason is over the entire 18 bed rehab unit and acute therapists.  All the therapists there spoke highly of the physiatrist who oversees the operation of the therapy at Thibodaux Regional, Dr. Cowan.  He is apparently a good friend of physical therapy and works well with all.  Jason has not been in this leadership role long, but is committed to providing the best quality care within the guidelines. Some of his concerns were a shortage of therapists and coverage for the therapy needs in this hospital.  He stated they do take students.  He also has concerns regarding the ever-changing rules for rehab admission and how some patients fall through the cracks.  Their rehab unit had also recently been updated and he showed me around.  It felt very clean, bright and upbeat.  Great OT areas with bathrooms and kitchens, as well as PT areas.  I met therapists showing up to work, including Cherry Siegel, PT and Cherry Aquino-de Lara, PT.

In that same Medical Center, but in a different building, I visited the outpatient clinic, and was greeted by Billy Naquin, PT who is our Federal Affairs Liaison and agreed to continue in that role (Thanks, Billy!).  Billy had been in New Orleans but the after-effects of Katrina pushed him back home to Thibodaux and today he heads the outpatient Spine Center and that outpatient unit, working closely with Dr. Cowan.  This is quite a diverse outpatient clinic, offering ortho and neuro rehab, PT/OT/ST.  They do some peds Medicaid, and some sports medicine. Also very interesting is that this clinic does drug screening for folks in the community.  There is a special team dedicated to the neuro rehab and I met Lauren Vedros-Jones, PT and the OT and ST that work with these neuro patients.  Good state-of-the art equipment and a nice OT kitchen with washer/dryer, stove, sink were there.  I went in to the ortho side and spoke with Lee Cortez, PT and J.D. Adams, PT whom I had met at the meeting the night before.  They were busy with patient care in a hopping clinic.  Check out the Medical Center's video at: http://pinkglove.co/37.  Features the therapists strongly!  Great video!

My next stop took me to the Daigle, Himel, Daigle Physical Therapy Clinic, another father/son clinic.  I went at 9am when patient care was in full swing, and that clinic was hopping!  There were senior citizens on the Total Gym, young athletes on the treadmills, folks riding bikes, lifting weights!  It was organized chaos with everyone working!  I got to meet briefly with Leslie John Daigle, PT, the father with 45 years of membership with APTA/LPTA and his son John Leslie Daigle, PT, with 20 years membership!  Wow!  Eddie Himel, PT was out that day.  I just thanked the team for their continuing support of our organization and gave hugs all around!  They thanked me for visiting.

All in all, my visit to Houma/Thibodaux was a huge success and I met many therapists in many settings where they work and live.  Great history, great support of LPTA!  I am listening and learning, definitely.  I welcome comments on these blog posts. Are they way too long?  Do you like the detail?  Any ideas, input for me as LPTA President are welcome.    If you want to message me privately, my email is bethwardpt@gmail.com.

Next stop, next blog:  New Iberia!