Christopher Wilson, PT, DPT, DScPT, Residency Director, Oncologic Rehabilitation, Beaumont Cancer Institute, Farmington Hills, Michigan, discusses the benefits of the integration of physical therapy and rehabilitation professionals into the cancer care continuum.
Dr Wilson and his team received a 2020 Association of Community Cancer Centers (ACCC) Innovator Award for their work, which they accepted at the ACCC 37th [Virtual] National Oncology Conference.
Transcript
Hi there, everyone. I'm Chris Wilson. I am the residency program director for the Beaumont Health Oncology Residency in Metro Detroit, Michigan.
We were honored to get an innovator award for the ACCC for our presentation related to integrating physical therapy and rehabilitation professionals into the cancer care continuum specifically related to integrating into prehabilitation and survivorship.
The big thing when it comes to rehabilitation is, we're almost always thought of as interventionists. The person has a problem, be it back pain, or they sprained their ankle, or they had a stroke or a heart attack. We go in, and we intervene.
That still is a really, really important point about cancer-related physical therapy and occupational therapy. However, there are the other ends of the spectrum which also includes the prehabilitation and then also the sustainable wellness.
At Beaumont, we educated our team members on a concept called PRISM. PRISM is really just an educational tool designed to let people know, including our own therapists, that we also have a role in prehabilitation, that's the P-R, I, for intervention, the S is for sustainable wellness, and the M is for model.
That's really where PRISM comes into is, it focuses on, "Yes, we're interventionists, but we also do prehabilitation and sustainable wellness."
There's a lot of research as it relates to improving a person's health-related quality of life and more successful outcomes and overall quality of life when it comes to cancer care. That is a big role for the rehabilitation professionals.
There are some barriers to getting into rehabilitation, and some of them are administrative, some of them are educational, and some of them are, honestly, financial. We'll be talking a little bit about each one in turn.
The first one is related to the education component. Not a lot of folks realize, but physical therapists and occupational therapists don't get a ton of cancer rehabilitation training in our entry-level program, which is actually why at Beaumont, we started our clinical residency.
Clinical residency is a one-year post-graduate immersion clinical experience, and then those folks hopefully go on to become board-certified specialists.
There are also other specializations such as Lymphedema Certification. The American College of Sports Medicine has a cancer exercise specialization, and even pelvic floor physical therapy is a subspecialty, and that's something that we don't necessarily think about.
A really big component of our cancer population is those with colorectal, genitourinary, and gynecological cancers.
Those folks, in additional to normal cancer-related fatigue, and pain, and neuropathy, and all the other side effects that some cancer survivors might experience, these folks might also experience difficulty with bowel and bladder functions, through things like constipation or incontinence, or sexual dysfunction.
There is that subspecialty of pelvic floor physical therapy who can really help to mitigate some of those issues. That's really our big thing, is to have a physical therapist available across the entire spectrum.
Some examples of what we do at Beaumont for that include going into the tumor board, having a therapist at the tumor boards and at multidisciplinary clinics, where they might do some screenings, and this gets into the administrative component of things.
How do we take a physical therapist or occupational therapist out of the clinic to do that is, we use those as making sure that the patients get the services that they need.
One of the things that we really focused on making sure that we did was understanding what our screening to referral ratio was.
We really did not have a formal benchmark for that because we didn't want therapists referring to other physical therapists for reasons other than they actually need the clinical care, but we do track that to make sure that our program is budget-neutral or making a profit.
Even things in the survivorship clinic or tumor boards are in multidisciplinary clinics in the survivorship end of things.
We also do a lot of sustainable wellness. We'll screen them after their cancer journey is done, again, and then if they have needs, again we can initiate rehabilitation services like PT and OT, or we can also provide an exercise prescription and being able to let the person know that our services are available should they need anything.
In and of itself, understanding the cancer disease process is probably the most challenging part for a cancer physical therapist or occupational therapist because the interventions that we do, yes, they might be a little bit different, but they're things that really are our bread and butter.
Things like reducing pain, improving range of motion, improving strength, reducing fatigue, including energy conservation and pacing techniques.
Occupational therapy has specializations in restoring activities of daily living, returning to work, or improving cognitive issues. Those are all things that we can really do.
The nice thing is that for those specific traditional interventions, they are all reimbursable services by the physical therapist or occupational therapist, so there really isn't anything that's different.
As long as there's clear documentation that the person has an impairment that might be related to cancer, and then that can translate into a quality physical or occupational therapy plan of care.
We really focus on getting that entire spectrum, from initial diagnosis all the way through survivorship, and making sure that we're supporting the individual through that entire continuum of care.
That is the gist of what I wanted to explain to you guys today. Thank you so much for listening.
