Undergrad: University of Notre Dame (Go Irish!) Major: Anthropology and Pre-professional Studies – thought I would be an archaeologist.
Graduate: DPT at University of Iowa (Go Hawks!)
First job: Beth Israel Deaconess Medical Center in Boston, MA. A spectacular teaching institution with a skilled group of PTs who I am indebted to for teaching me so much in acute care and always offering mentoring and growth.
Hobbies: Running and biking, sports (besides Iowa and Notre Dame, love the Houston Astros and Portsmouth Football Club in England), Spending time with my family (wife Ann-Marie, 18 month old daughter Margaret, and 7 year old Golden Retriever Norm), reading anything and everything, travelling the world, birding, collecting soccer jerseys.
Most exotic place travelled to: Mongolia.
Favorite travel experience: Deplar Farm in northern Iceland.
Favorite food: Pizza (Piece Pizza and Milly’s in the Pan in Chicago, Zoey’s Pizza in my hometown).
Favorite restaurant: Buvette’s or Girl and the Goat.
Describe how you became involved in Emergency Department Physical Therapist Practice.
Initially I was interested in the assistance of our Geriatric Emergency Department Innovations (GEDI) Program at Northwestern Memorial Hospital to reduce unnecessary admissions and observation stays for geriatric patients seeking care in the ED. An anecdotal statement I initially heard in the ED from an attending physician was, “the patient’s age usually matches the percentage of likelihood for admission via ED presentation.” Being part of a team of MDs, RNs, SWs, and other volunteer staff I found the benefit of my skill set in optimizing patient and hospital outcomes while implementing my GCS background. As my time continued to expand in the ED I slowly realized the great need for our PT skills via vestibular care, MSK evaluation and treatment as well as care initiation of other patient groups (neurology, medicine, etc.) that need quicker access to care with significant time awaiting inpatient beds.
What makes your ED practice or setting unique?
The size and location of our ED creates many amazing opportunities as well as challenges to providing quality care. With five attending led teams during the daytime hours our volume is high and patient acuity and psychosocial dynamics can be complex. I thrive in having a unique set of patients every day and continuing to learn from all the skill practitioners around me.
Why do you think this is a valuable practice area?
There is no other area, in my opinion, where we can use our hands-on skills and physical examination to assist with differential diagnosis and treatment. As medicine shifts to less and less time laying hands on the patient and becomes more reliant on clinical tests and imaging, we have a great spot to add value to patient examination and assisting with care.
What barriers did you have to overcome personally and within your facility to practice successfully in this environment?
Entering into large team of providers as a single entity (PT consult= “call Kyle”), I had to demonstrate my ability to help the team through constant communication and education of our role as a therapist. I frequently engaged providers to shadow my evaluations and always tried to provide education in areas where clinicians did not have confidence. This allowed me to not only teach incoming residents HINTs examinations, special tests of the lower extremity, etc., but also allowed a great opportunity to ensure my orders for evaluation would never be an issue.
What are the most common patient presentations you see in your practice?
Geriatric falls, low back pain, dizziness, failure to thrive, complex trauma, & stroke.
If someone reading this wants to practice in the ED, what guidance would you give them?
Have a solid basis in acute care PT to best understand common pathologies of the ED and how they are treated, also learning to communicate uniquely to physicians. PTs have a different language for many things that we treat, if we do not learn how to discuss our findings with the team in an approachable and meaningful way we lose that connection.
What is your philosophy about what makes an ideal ED PT?
Open-minded, never satisfied with knowledge and someone who can approach any patient and build connections/rapport to make a difference.
What was your biggest win in the ED?
Progressing from a service with 1 to 2 pages a week to now having 2 full time providers. The more coverage and care we make available the more lives we improve.
What future directions do you see for physical therapists in the Emergency Department?
Hopefully a care model for some pathologies where we provide direct care and assist in triaging complaints that are better suited to PT evaluation and treatment vs. current practice. Also hoping for enhanced ability to order imaging. I’m currently lucky to have MDs that have supreme confidence in what we do, so I can always request imaging as needed, but to have that autonomy would be great for the profession.
For More From Dr. Strickland
Watch or listen to our full interview. For more on Dr. Strickland’s research about physical therapist practice in the Emergency Department, click here.
To start your own thriving PT in the ED practice, click here.
