Alan Fredendall, PT, CF-L3

CF-L3// Iraq & Afghanistan Combat Veteran @usarmy // COO @icephysio

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@Jerry_DurhamPT @DaveKittleNow Yes sir. Patient cancels/reschedules their own appointment, is charged the late cancel/reschedule fee, and AI begins texting 3 patients every 30 min who have availability for that time slot. First one to text back gets the appointment.

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@DaveKittleNow @drjoshfunk @BoBabenko Also the folks billing insurance might want to check in with their patients on what their bill looks like. Most large clinics are billing 7 units per visit and balance billing the difference to the patient. There are thousands of people paying $500+ for an insurance visit

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@DaveKittleNow @drjoshfunk @BoBabenko Love it Dave! Thanks for taking care of yourself.

90% of the human race is now classified as sedentary yet we can't quite seem to put our finger on why healthcare costs are so high or why our reimbursements are so low...

[Jeff Moore @jeffmooredpt]

No, you don’t “need reps” in a high volume clinic before starting your own practice.
Making a bunch of Kraft macaroni and cheese does nothing to help you become a gourmet chef

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@jhausmann @jeffmooredpt Preach

[Jeff Moore @jeffmooredpt]

Twitter sphere: we’ve got an animated discussion rolling in another thread and I’m looking for some crowd sourced assist.
Question: what are we considering a “high volume PT clinic” or “PT mill” these days. Assuming no billable, qualified, LICENSED help

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

Beautiful. As @dr_mitch_dpt would say:

"Opinions are cool, but data is cooler"

[ChadCookPT @chadcookpt]

@jeffmooredpt @jeffmooredpt. Ending 2020 with a bang! I think it needs to be both don't you? And that's ok. Certainly, it depends on the patient and their journey, but in my experience most expect both. I think studies' support that too. Here's an older one.

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@MikeMakher @EddieErnstPTA For GPP programing, burpees are used as a way to continually vary exercise and maintain high intensity, no different than a rower, bike, ski erg, etc. Wondering what sort of metabolic conditioning you program for your patients and athletes by comparison? - /6

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@MikeMakher @EddieErnstPTA Finally, the burpee and its modifications (step out/step up, no drop, etc.) tells me a lot about an individuals ability to floor transfer.The burpee and its regressions are an excellent way to work on floor transfers with older adults to teach functional independence - /5

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@MikeMakher @EddieErnstPTA Seeing someone score above 100 reps, into the 110s, 120s, 130s, etc. tells me that they a much more efficient ability to process lactate and shuttle it back to the liver for conversion back to pyruvate for use as energy, even more so because no body region is getting rest - /4

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@MikeMakher @EddieErnstPTA Furthermore, because it is such a low skill, high work movement, it can tell a lot about a person's aerobic capacity. For example, a classic benchmark workout is a 7 min. AMRAP of burpees. Someone scoring under 100 repetitions is someone that is very deconditioned. - /3

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@MikeMakher @EddieErnstPTA By requiring minimal range of motion and skill, it is a movement that can be performed by most individuals. In a workout, it is added as a way to add fatigue into the system and make other movements feel heavier, high skill movements harder, etc. - /2

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@MikeMakher @EddieErnstPTA Hi Mike, as someone that programs metabolic conditioning and aerobic capacity work for athletes on a regular basis, the burpee is very useful. Your argument that it is a low skill, high work movement is exactly why it is useful - /1

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@dougducey Looking for clarification on Executive Order 2020-07 - currently rehab professionals (PT/OT/SLP) are not allowed to see patients via telehealth but are often seeing 15-20 patients each, face-to-face, each day, without PPE.

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@HighmarkHelp Every provider everywhere would like more information. Every single provider in PA, DE, and WV would like to know your policy. Please address it here.

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@StateHealthIN @GovChrisSununu @NVGovernment @GovParsonMO @ehawaiigov @delaware_gov @georgiagov @GovAndyBeshear @GovJanetMills @MoGov @NYGov @NYGovCuomo @GovMikeDeWine any plans for the governor to open up access to telehealth for citizens?

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@HighmarkHelp Asking on behalf of rehab pros nationwide. 32/50 state BCBS associations have allowed PT/OT/SLP to offer telehealth to patients either voluntarily or by state executive order. @Highmark is not one of them, why?

See https://t.co/BnkLAsobhk for reference

[Alan Fredendall, PT, CF-L3 @AlanFredendall]

@NJGov any information about allowing telehealth visits/e-visits for rehab patients at this time to reduce the number of face-to-face visits in PT/OT/SLP clinics? Some insurers (@horizonbcbsnj) will not pay despite PTs being allowed to see patients this way