Have you ever seen the animated film Ratatouille… it’s a clever film about a humans, the restaurant industry and a little Rat. Debbie Basile in our AP department and I occasionally speak about the movie as being one of our favorites. In building up to the finale, there is a scene where the local ‘Critic’ comes to eat a meal and Demands to be impressed. He ASKs for “A little Perspective!” What follows is a great scene where the critic is impressed and ultimately reflects back on his own limitations in asking much of others yet not risking anything of himself in serving others…

I thought about this a bit this week. For some of us, the pressures of getting it “ALL” done right the first time seems so easy to consultants, facility leaders and others who are afforded the time to criticize our work yet doing the work and doing it well and with passion is not always easy. Recently I was speaking to a consultant who was sharing with me some issues she found when visiting another Skilled Nursing Facility in the area… As a consultant she and her team discovered some areas that could be improved.  The message was here is a problem and it needs to be fixed.  As a result there was heightened pressure of the SNF owners, consultants down to direct pressures on the healthcare team… to correct X, Y and Z issues and do it yesterday!

What really caught my attention was during this process, speaking to the consultant it was revealed that other organizations are “much worse than the organization in question, in fact “X” facility has some of the best we’ve seen” yet the message to the facilities, and filtered down to the team was here is a problem and fix it yesterday!

I believe too often we focus our energy on the 2% of issues and forget to appreciate the 98% of the efforts that we do daily to make a positive difference.


What you should know about IASTM

Shawn Burger… 

A growing trend in Physical Therapy is the use of IASTM.  Frankly most people do not understand the value of it.  Let me do my best to explain through a little Q and A.

Q.  What is IASTM?

                A.  IASTM is a form of massage where “instruments” or a “Tool” is used in place of one’s hands.

Q.  Why would I want IASTM?

                A.  Early Research and growing anecdotal evidence leads us to believe patients get better results.

Q.  How does IASTM work?

                A.  Mechanically, early evidence suggests that IASTM works as a stimulant of the inflammatory cascade.  Meaning patients with muscular-skeletal problems involving muscles and soft tissue (i.e. Ligaments, Tendons and fascia) who suffer from chronic pain may have their tissue “stuck” in the healing cascade and unable to heal themselves.  Research shows that Fibroblasts are significantly stimulated with the technique.

Q.  When did IASTM begin?

                A.  Various models of the technique have been around in cultures for thousands of years.  In the Western Healthcare Model, IASTM began in earnest during the early to mid 90’s in Indiana.

Q.  Who and what are the IASTM techniques?

                A.  There are 3 major competitors in the IASTM market all originated from the same research and same principle “partners.”  The original Technique was called Grastech, changing its name to Graston after the founder David Graston.  Later on, Dr. Sevier, one of the principles left to start his own company ASTYM and later still, David Graston having sold Graston Technique started his own company SASTM.

Q.  What difference is there between the 3 major IASTM companies?

                A.  Materials, Education and Business Model.  The technique minus semantic vernacular is the same.

Graston Technique:  Steel Instruments, 25.5 hours of training, clinician purchases for aprox $3700

ASTYM:  Plastic Instruments, 12 hours of training, clinician pays $700/yr for 10 years ($7000 total)

SASTM:  Plastic Instruments, 4-6 hours of training, aprox $1000 investment.


                A.  We offer Graston Technique at all twelve (12) of our sites.  We particularly like that the instruments are made of steel and therefore we feel more comfortably that they can be truly CLEANED between uses from one patient to the other.   Along with their quality clinical education are driving forces in our ability in maintaining a quality work environment.

Want or Need?

Shawn Burger…

I pondered our services this week as I tried to determine between a want and a need.  I was given a gift card recently to “Peets Coffee and Tea.”  Without much thought, I discovered myself frequenting Peets not once, but twice a day.  Why not?  Its free right…

Well, it’s not actually free as my gift card quickly dropped to a $.49 balance before I finished the month.

Isn’t this like Health Care???  When we have a low – no co pay why not see the Doctor for every ache, sniffle and cramp…  but when we have to pay for the services, we better be dying before we call for an appointment.    I wonder if everyone paid full Value for their services, how much of those services would be used?  Would we really have a MD, Nurse and Physical Therapy shortage?  

Probably not…

What’s the Price?

Shawn Burger…

It’s easy to complain about healthcare pricing.  When I was a kid, I was told repeatedly that there are simply two types of people in this world… those that do things (you may not like what they are doing, but at least they are doing) and those that complain about those that do.  Doers and complainer’s we say in our house.

Needless to say, the constant complaining regarding our healthcare system is confusing.  What really is the point?  I for one don’t have the answer, but I was recently surprised to find out that behind the noise, there are people doing.  Simple solutions to one issue at a time, making life easier for everyday people like yours-truly. 

So what is so interesting that caught my attention?  $4 prescriptions at Walgreens.  You see, last year I had a ‘traditional’ HMO insurance plan with a $10 co pay.  This year, I decided to be a doer and enroll in a HSA were my responsibility is the first $2500 of all health care costs for the year.  My first trip in the New Year to Walgreens, I was shocked to pay only $4 for the same medicine that I paid $10 for the prior month.  What’s the difference I asked?  Simple, the insurance costs more, more people to pay for, more paper to push, more work that costs more money!  When you’re paying “cash,” there is only Walgreens and the patient so the costs are a lot less.

What the… I wanted to say!  But I said thank you with a ‘doing’ smile and went home.  If only our Hospitals were so simple.

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