Re: Expanding the service landscape

[Guest guest]

Hi,

Appreciate the topic and your concerns. My thoughts as I read this this

though go to the " normal " process of education to providers on new or

innovative techniques or new ways of looking at old treatments. it

involves research as the starting point. Publish case studies like the

one you report and get noticed. Work with others on studies involving

more participants and present at conferences. Then take it on the road,

doing seminars to educate clinicians on whta you have found to work. This

is the process that would help bring the techniques to the forefront.

M. Howell, PT, MPT

Meridian, ID

thowell@...

Greetings,

>

> I have been listening in on the valuable conversations about the PT

> business and I am hoping you will humor me with some feedback regarding

> the questions I am posing below.

>

> I am a neurotherapist with a specialized practice in Autism Spectrum

> Disorders, TBI (including CVA) and chronic neurologically affecting

> illnesses (like MS, Parkinsons, CFS, Chronic Lyme, Mold Illness).

>

> For the past 5 years I have been evaluating different neurofeedback

> (NFB) technologies (both active and passive) for efficacy with these

> different populations as the field has dramatically changed from old

> school approaches used for many years. My starting goal for the client

> is recovery, which for me means restoring sufficient function and

> capability that the individual is a productive contributor to society.

>

> While the NFB is only one part of the puzzle that I address, I have a

> functional medicine practitioner involved with every case to address

> nutrition, metabolic issues and toxicity, the NFB is almost always a

> game changer for these difficult cases. The client must be willing to

> engage in lifestyle changes as well.

>

> I have observed a dearth of PT/OT/SLP credentialed practitioners in this

> growing field. I am wondering why that is and have been speaking to some

> local PT/OT/SLP colleagues about this.

>

> The insights I have so far include:

> -NFB is completely absent in the scope of education for PT/OT/SLP

> -the Neuro & Peds advanced training does not include this body of work

> -no CEUs are presently offered for PT/OT/SLP practitioners in NFB

> classes

>

> The other things I am wondering about include:

> -is there reimbursement for these services (particularly CPT codes 90901

> and 97152)? Can it be folded in as therapy under traditional 97112

> because it is focused on physiological capabilities (for example in a

> CVA with spastic limb we do a specific passive therapy on the homunculus

> to normalize control and movement)? -is there capital to make equipment

> investments which are required to offer these modalities? -if insurance

> coverage was readily available, would it be more attractive? A parity

> bill that went into effect in June 2011 is likely to improve this

> situation with insurance. -is there an issue with the skillset required

> to offer such servcies?

>

> Maybe what I am really saying is if you follow the money, does it make

> sense for these practices financially, not just based on outcome?

>

> Does it make better sense for niche practitioners rather than larger

> scaled practices? Is this because of " out-of-network " status or other

> reasons?

>

> I am trying to make sense out of why such potent approaches are not

> being embraced by the rehabilitation community, when they are really the

> front line to these populations.

>

> To give an example of what can be accomplished in ASD:

> In 18 months, 11YO male echolalic ASD client with aggression and no

> ability to learn (self contained babysitting classroom) has no

> aggression, is now speaking, reading, writing and is entering LD school

> to " catch up " .

>

> To give an example of an emerging CVA outcome:

> In 6 sessions, a 41YO female with CVA at age 29, very limited verbal

> expression, visual field disturbance (only right lower quadrant of

> vision functioning, far vision blurry), spastic R arm and ltd use of R

> leg). Following 6 sessions can now speak whole sentences, can multitask,

> can see 50% of visual field and far vision mostly clear) with spasticity

> in arm releasing more each session.

>

> I am indebted to you for sharing your thoughts and opinions on these

> questions. Thank you and Happy Holidays!

>

> Jackie de Vries, MS