274: Drs. Kyle Ridgeway & Kenny Venere: It’s OK to Argue: Skepticism & Nuance in PT

Healthy Wealthy & Smart

On this episode of the Healthy Wealthy and Smart Podcast, Dr. Kyle Ridgeway and Dr. Kenny Venere join me for Part 1 where we answer viewer questions on a variety of topics ranging from dry needling to physical therapy as a solution to the opioid crisis! Kyle Ridgeway is a senior physical therapist at University of Colorado Hospital and coordinator of physical therapy quality improvement project in the medical intensive care unit. Kenny Venere is a home health physical therapist at Intermountain Healthcare in Salt Lake City, Utah.

In this episode, we discuss:

- Should dry needling be implemented as a physical therapy intervention?

-What is physical therapy’s role in the opioid crisis?

-How can acute care PT’s better collaborate with home health PT’s following discharge from the hospital?

-And so much more!

Kenny and Kyle did not set out to change any minds at their dry needling debate at Combined Sections Meeting. Instead they sought to encourage skepticism to those who are still appraising the evidence and Kenny hopes, “they left more informed and just the greater goal of having people think more critically about how they choose to implement interventions in a physical therapy practice. How they think about the literature on interventions in physical therapy practice was really what we hoped to accomplish.”

Kenny advocates physical therapists should be very selective and vet new methodologies before they are adopted into their toolkit by supporting a high bar for evidence of effectiveness. He stresses, “Research is everything. Without it, we have nothing.”

Although physical therapists are well equipped to play a key role in treating chronic pain, opioid use is a multifaceted problem with many players both in the medical field and pharmaceutical industry. Kenny believes, “Physical therapists I think have a role but it’s important that we be humble in the claims we make about our role. We are by no means a panacea or a cure for the opioid crisis but I think we can play an essential role in what is a bigger puzzle.” Kyle warns about the realities of treating chronic pain and states, “I get justifiably nervous when we start talking about physical therapy as the answer to the opioid crisis…it’s nuanced and it’s layered.”

Kyle suggests hospitals should rethink how they evaluate patient satisfaction and disentangle pain from quality of service and care. Kyle points out that, “We made pain a vital sign. Patient satisfaction in the hospital is one of the most talked about things in administration and if you mix this context together there’s real incentive to say we have to do something to take this pain away.”

More collaboration across physical therapy settings may lead to a more holistic approach to tackling unique patient healthcare needs. Kyle finds that one of the problems is, “These communications really don’t happen between settings and especially between acute care and home health.”

For more information on Kyle Ridgeway:

Kyle Ridgeway received a BA in neuroscience from Pomona College and a doctor of physical therapy degree from University of Colorado Denver: Anschutz Medical Campus. Currently, he is a senior physical therapist and team lead for medical ICU physical therapy at University of Colorado Hospital. He also serves as a clinical instructor for the University of Colorado Denver Physical Therapy Program. A quality improvement project in the medical ICU, that he designed and implemented, eventually became standard practice. He speaks nationally regarding acute care physical therapy specifically in critical care, acute care quality improvement, hospital readmissions, and outcomes following critical illness. He blogs at PT Think Tank https://ptthinktank.com/author/kridgeway/ where he aims to provide thoughtful analysis and critical thinking on various clinical, scientific, and humanistic topics relating to physical therapy. But, of course, that is just his opinion.

For more information on Kenny Venere:

Kenny Venere currently works as a home health physical therapist for Intermountain Homecare and Hospice in Salt Lake City. He graduated from Northeastern University in Boston, MA with his DPT in 2014. His primary interests within physical therapy are scientific literacy, meta-research and the philosophy of evidence based practice. He writes (infrequently) on these topics over at his website, www.physiologicalpt.com.

Resources discussed on this show:

Kyle Ridgeway Twitter

Kenny Venere Twitter

Talking Points: An Oxford-Style Debate on Dry Needling

Physiological PT

PT Think Tank

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Xo Karen

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