Sunday, December 11, 2016

2016 - Year End & Thoughts For The New Year

So... it's been a terribly long time. How long??? Long enough for Blogger to have changed some of their admin features sets... still not long enough for me to have revamped this site... HAHA =P

That long.

Preeeeeetty crazy. So... Let's catch up!

The rest of October was a blur. So, there was Ascend Event by WebPT, PPS, and just a blur of getting back to the "norm" -- which included getting crazy sick, then... the rest of my family getting crazy sick. #SoThatHappened

Speaking at Ascend and the incredible networking at PPS was just simply glorious. You can find my thoughts on them here on the UpDoc Media Blog:
  1. Ascend Event
  2. Recap: Private Practice Section Conference 2016 (PPS2016)
Beyond this, I've finally decided to get an Instagram for my "Dr. Ben Fung" brand. With that checked off and this blog continuing... I'm still in the works to getting to two or three... or four posts I owe myself in my Daddy In The Raw #DadBlogger.

Seriously... I'm working on it. #SoCrazyBusy

OH! We saw MOANA. It was an incredible movie... wait.... probably better for Daddy In The Raw.

So, okay... back on track. I'm coming to grips with the fact that, I just have too many outlets. I think this will have to be a space for personal reflection, journaling, and generally, a quarterly'ish update.

Much of my most current writings are available via the UpDoc Media Blog...

Gee... other than that... this one SHORT update. I guess the real update is this:

Life has gotten cray cray! There are more platforms and more mediums than I can begin to fully appreciate... despite being some type of social media guru in the space of physical therapy. I expect there to be a consolidation of user behaviors.... after all, people want to feel connected.
Too many options will cause choice paralysis and feeling distant. So... my thoughts are these:
  • 2017 will have a convergence of technologies and user demands.
  • 2017 will also be an insane year for millennial entrepreneurs.
  • Next year, I expect people to crave the personal touch that is very much retro, right now.
  • I also expect the coming year to feel like an extension of 2016... simply because of some of the socio-economic dynamics which are holding on to their inertia.
  • Finally, I anticipate that the year 2017 will be considered one of the biggest years of finding unity, dispite disagreements... as well as finding growth in emerging opportunities previously considered a dead-end. Such benefits will come to those who are willing to look beyond their own likes, preferences, and penchants; to those who are willing to become more than they are, for causes greater than & more meaningful than themselves.


I guess that's it. See you around New Years!

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Wednesday, October 12, 2016

The VPTA Student Conclave 2016 Experience


I had the truly distinguished privilege and pleasure to be the #VPTASC2016's keynote speaker and additional breakout sessions speaker. The topics:
  1. The Inspired Professional
  2. Launching BEYOND Entry Level
First, here's the 15 minutes of my keynote:


AND... In no specific order, here are some take away points & highlights:



























Okay... my cut & paste function is officially tired. You get the idea ;)

It was an amazing production. The students, faculty, and everyone involved should be IMMENSELY proud. It was polished. It was professional. It FELT like a legit conference put on by event planners and media producers.

Again, my deepest thanks for being able to contribute to the event.

Annnnnnd.... That's all folks!
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Friday, August 5, 2016

Top Work At Home Dad Blogs

So, I had the surprising pleasure of being contacted regarding the inclusion of my blog to be listed as a "Top Work At Home Dad Blog!" It's kinda cool, since it seems they found out about all this via this direct blog I've been running for years.

Either way, it's nice to know people are on the lookout for this phenomenon & I'm glad to be included in such a collection; if anything, in hopes it can inspire and empower others to take that plunge into being at home with those who matter most in life.

Until next time!
-Ben


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Monday, June 20, 2016

So... I got stuck in an elevator

So, a week ago, I got stuck in an elevator during a family vacation / reunion.

It came completely unexpected. While the hotel was getting some work done downstairs, there was no evidence it would affect the elevators per se. In fact, the moment I got into the elevator, there was a lady who came out all cheery as could be with a plate of food.

I went in after she came out, hit the button from floor 3 to 1, for the lobby. I felt the elevator go down. Then, it stopped. And... the door didn't open. I hit the open door button... the closed door button. Nothing. I thought, "Huh... maybe it's a glitch?" So, I hit for floor 2 and figured if the door opens, I'll just take the stairs down and let the front desk know.

Well, I felt the elevator go up to level 2. And, it stopped. Then, it completely stopped. NOTHING responded. Good thing I had my phone. I called the front desk which was apparently a call center. THEY called the front desk and came scampering to make sure I was okay. Well... I wasn't going to waste any time... I jumped on Facebook Live, Twitter (#PTstuck), and Periscope. You can see the videos here:
The firefighters came and rescued me. They thanked me for being cool and not yelling them. Apparently, there are some pretty thankless folks out there who rake anyone they can find over the coals... even their own rescuers... for mishaps, regardless of fault or blame. Weird.

Well... all that was fun and done. NOW, I need to deal with this water damage leak thing coming from the unit above me.... *sighs*... Such is life. #HappyFathersDay.
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Wednesday, June 1, 2016

Are You ADD? Documentary - on Indiegogo.

So, by now, most of you know that I have ADD or ADHD (as it is now termed). I've held an international pen name in Asian communities & support groups, with articles read by millions; I've blogged on it, I've vlogged on it... and, I've had the pleasure of interacting with a gentleman by the name of Wes Gray who is producing an indy-documentary on ADD.

I'm very interested in how this is going to be played out & love the line from the intro that ADHD is "an asset in your life." I completely agree & feel that is should be seen that way. Much like any type of energy asset; fuel can be used to burn, to explode, to lay in waste, or... to be harnessed!

Check it out. Consider supporting on indiegogo.com. I'm eager to see it upon release!


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Thursday, May 12, 2016

Ben Fung's Digital Footprint Map

So, I just came across this idea to mentally map out where my digital footprint is. Then, I decided... why not actually map it out?! Then, I was wondering where my Twitter based impressions have been leading toward...

 

Result: Good company. Good people. Gotta love Twitter!

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Friday, April 29, 2016

A Year Out Of School... Again...


So, for those of you that don't know... I've been through too much school. Not as much as some others... but, too much... haha, for my family.

I met my wife in grad school round #1 for my DPT. Then, not two years into marriage, I started an MBA program. Well... it's been a year since I was conferred an MBA in Marketing with Distinction from the University of Michigan.

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Friday, April 15, 2016

Product Review: The Pelvic Clock™

Today's product review is sponsored by The Pelvic Clock™.


While I don't do many product reviews on this blog; and more so, do product reviews on my dad blog #DaddyInTheRaw... there is a remarkable story behind the Pelvic Clock -- the person, behind the product.

As with many inventions, the Pelvic Clock came out of personal necessity. Founder & CEO Yana Blinova created the Pelvic Clock during a time when she was told her spine was so of whack, that her only hope was spine surgery. Being an olympic coach, she knew the power of Physical Therapy... both professionally and personally. Both her parents were olympic coaches; and, one of her twin brothers -- being born with clubfeet -- experienced transformative improvements through Physical Therapy.

Refusing to give up, she looked around her house for ANYTHING she could use to augment therapeutic exercises and alleviate her low back pain. Fashioning a broken pot lid & a towel for padding, she performed the popular Pelvic Clock exercises and felt immediate relief across her sacroiliac joint & low back.

Not thinking much about it until far later when her many clients urged her to produce the Pelvic Clock as formal product, she went to work on design and production. After numerous revision and manufacturing intensities two years in the making...

The Pelvic Clock™ is proudly made in the USA!

It's a rather intuitive device with a truly comfortable material texture. It isn't too hard, nor is the height of it impossible to appreciate in terms of spinal extension. It is also more intuitive (to me at least!) with the explanation of the Pelvic Clock exercises as well as the proper muscle engagement in performing the pelvic clock exercises as a whole.

Yana and I had a wonderful conversation together and remarked on both the portability (for home health), the ease of use and simple patient education, and of course, the fact that it can be utilize in the clinic as ther-ex. The Pelvic Clock can be used on a hard surface, a soft surface such as a mattress, and even against a wall... which was, as Yana recalled, how a pregnant Physical Therapist used it the first time she was introduced to the product.

Through personal use of the Pelvic Clock, I was truly impressed by how HARD it was to cheat. Typically, with supine core exercises, it's easy to engage with the lower extremities to feign substitute and compensatory movements. However, I tried... I mean, I REALLY TRIED to perform a posterior pelvic tilt with the lower extremities... No Go. However, *BOOM* with core engagement... PPT #Done.

The Pelvic Clock is highly rated on Amazon -- and -- I agree! It's a solid product. Feels really nice. Is quality material. And, is made in the USA! I can see this useful in the clinic as a foundational exercise for low back concerns. And, since the exercise is rather self regulating, it can also be used much like most warm up exercises are in the clinic in terms of maximizing time management & productivity. Of course, that's after a patient has demonstrated proper exercise technique ;)

I'm very pleased to present the Pelvic Clock with my recommendations. While the price may be seemingly high; the quality it presents with, the ease of use, and the fact that is made in America earns it my thumbs up!
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Thursday, April 7, 2016

Trainers, Chiropractors, and Scope of Practice. OH MY!

When we start to feel the need to muscle up for term protection, defending scope of practice, etc... it all comes from a good place -- that the public consumer needs to be FULLY AWARE of what they are buying and who they are actually buying it from.

Still... we don't want to come across like this guy:
"This guy hates charity." - Monster's University

Positive media will always beat out negative media as it pertains to change. Sure, negative media gets more "press"... (contradiction in terms)... or, rather, is likely to get more attention. However, it may not actually get any action.

So, how do we do this? How do we go about protecting ourselves, our customers, and the consumer at large without looking like we're trying to nitpick, or even worse, come across like we're bullying other professions. Here are my suggestions:


1. Forge Strategic Alliances.
For every profession, there exists a continuum of excellence from totally amazing to "shouldn't even be in this profession." We see it all over healthcare, we see it in other professions, and certainly in personal trainers, chiropractors, etc.

Instead of saying the proverbial, "Get off my turf!" I suggest we approach the best of the trainers, chiros, acupuncturists, massage therapists... anyone who would otherwise seem to be a "threat" and make THEM our champions. After all, kind words mean a LOT more coming from someone who may be perceived as a rival. Some of the most successful cash and out of network physical therapists I know create alliances with those that would otherwise be stereotypically considered "the enemy."

It should speak volumes that such personalities are THAT successful because their mindset is not on the scarcity of resources; but, on a growth mindset that there isn't a piece of the pie to be had... rather, to make the pie bigger!


2. Get Public!
How many chiropractors, massage therapists, and TENs representatives do you see at your county fair, farmer's market, or local health fair? And... how many PTs? #PointMade

Truly, if we even wish to hope to have some semblance of professional brand awareness amongst our consumer base, we need to at the very least GET PUBLIC. GET VISIBLE. GET OUT THERE. We can't blame consumers for going to the most visible brands for substitutable expertise and solutions. We only have ourselves to blame on that one.

Therefore, what must be done is for physical therapists to capture every opportunity out there to get publicly visible. This means social media, health fairs, conferences, county fairs, conventions, community events, schools, sponsorships, ads, local news, the local paper... you name it! Anywhere there are people, ears, or eyeballs... PHYSICAL THERAPISTS SHOULD BE THERE. That... is the only way we can point the arrow to the practitioner of choice regarding physical health, the movement system, pain, rehabilitation, etc.


3. Approach Everything via Consumer Concern.
It's all about protecting the consumer. Just like we want accurate food labels, we want accurate labels on exercise, fitness, wellness, and healthcare.

This is where we can approach from a legal standpoint of false advertisement, misrepresentation, etc. We don't need to publicly blast people for doing (knowing or unknowingly) what is against the law, or at the very least, is inaccurate or unethical in terms of advertisement. What we can do, is come at this from the angle of concern for the consumers. After all, no one wants someone post-op to get hurt because they went to the wrong person, right? After all, no one wants someone who has a healthcare concern to be cared for by someone who is unlicensed, right? After all... it's all about making sure the public is protected, knows their options, and are free to make their best choice as consumers.

Coming at it from the lens of social responsibility is a powerful focus and gets a lot of positive attention, even regarding uncomfortable topics at hand which require hard changes.


Some Closing Thoughts 
As PTs, we definitely need to advocate for our consumers, protect our profession, and defend our scope of practice. We can do so with strong allies on all sides, rather than by pointing fingers at misdeed. We can do so by being a beacon of hope and constructive thought in the eye of the public. We can do so by demonstrating genuine concern for the consumer, over our own "turf," "scope," or "gain."

It is through such angles of approach that we gain favor in the public eye -- that we constantly aim for the betterment of all through transparent mindsets of mutual growth and societal benefit at large.
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Tuesday, March 15, 2016

#PrimaryCarePT

About a year ago, I stated my thoughts "A Case For The Primary Care Physiotherapist."

Just recently, I had two dental care experiences which were vastly different from each other. While there's much to say -- and -- I *will* say, regarding the customer experience factor... there is far more significant discussion available regarding integrating a primary care PT element into healthcare. And, even some cursory discussion regarding a PT insurance much as medical, dental, vision, etc... so, why not "physical?"

After all... who is REALLY doing the "physical" examinations?

Any way... without further ado... here is my vlog on...!




As always, thank you for being with me! I'm eager to hear your thoughts. Be sure to tweet me @DrBenFung or feel free to leave a comment below or in the YouTube video itself!

Best,
-Ben


PS. If you want to read more on such related thoughts, you can find them here:
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Monday, February 29, 2016

Now That CSM Is Over

So, CSM was in-sane.

The biggest conference in physical therapy in the United States happened two weeks ago. And, I'm *finally* starting to feel like I'm recuperating.

Perhaps the best part of it was finally being able to meet the many people I first "met" via social media. Yeeeees... there were a LOT of #APTACSMSelfie's!


Now That CSM Is Over

Now that CSM is over, it's time to reboot, refocus, and grind away!

First off, I'm looking forward to getting my dad blog, Daddy In The Raw, started up in good stride again. There are a lot of past posts that I did have scheduled out; but, just didn't feel the timing was right since things change as blogs & life-in-general develop. I'll be pushing them out shortly so that we can all catch up with how the heck this happened...


Secondly, I'm really pleased to share that UpDoc Media Version 2.0 is up! This includes a brand new look, a refocus on our boutique digital marketing service, and the grand opening of the UpDoc Media Store!

Finally, I *KEEP* flirting with the idea of doing some kind of regular broadcast. I'm not sure what that regularity will entail... I've had several requests for a podcast, some for a traditional YouTube vlog, plenty of people love #Periscope. I'm just trying to figure out best medium, best time day, best frequency, etc.

What I want to make unique about this broadcast: I want it to be kind of a rolling Q&A that encompasses mind set, attitude, success, business, professional development, and how to relate personally, professionally, collegially, etc... kind of blend the content of what I have here, at UpDoc, and even at Daddy In The Raw in a more universal & comprehensive outlook on how to approach that magical blend of balance, go-getting, and achievement.

ALSO, I want to make this regular broadcast manageable... something less than 10 minutes per broadcast. There are already enough 30+ podcasts and what nots out there. This one is going to be fast flowing, no nonsense, only the good stuff....

Alright, enough of me dreaming out loud about it :)

Let me know if you're interested.

OKAY. That's it for now! CSM is over. It's time to get back to work!
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Wednesday, February 10, 2016

#DisneyPT & CSM Tips


#DisneyPT

ARE YOU GOING?!

1 month ago, I wondered how many folks going to CSM were also going to crash Disneyland. The answer: At least 30! So, then I got to wondering, which day would people plan on going? And, it appears that Wednesday the 17th is going to be the majority day. However, there will be some going on Thursday, Friday, and even Saturday.

So, if you are indeed going, I am pleased to have 10 Tips on how to make the trip absolutely perfect!

10 WAYS TO MAKE YOUR DISNEYLAND TRIP, PERFECT.

Otherwise, that's just about it. In case you need some tips in attending CSM for the 1st time, here are two posts, one from a general perspective & another from a student's perspective. Enjoy!
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Friday, January 29, 2016

My Thoughts on ADD / ADHD

So, some of you know that I was diagnosed with ADD (when it was still called that) as a youngster. Over the years, I've figured out a way to channel all that energy. I don't think it's anything except a super power at this point. Once you can properly engage & channel minds on this far side of the attention-continuum-curve, it's basically like channeling the power of the sun.

I did a video blog on this via my Dad Blog called "Daddy In The Raw: The Real Life of a Work At Home Dad." It's linked below. I hope you enjoy it and that it helps!

Best,
-Ben
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Wednesday, January 27, 2016

Vertical Balance: A New Look At Work-Life-Balance

Following a Periscope by Dr. Jeff Moore on balance and entrepreneurialism, I went to thinking about how I'm achieving balance. I realized for years, I had it wrong. I was balancing life as one balances things on a plate. Hence, the sayings like, "My plate is full." However, I think that a new way of looking at balance is vertically. Originally, I sad like the leaning tower of Pisa. A better way of seeing it, is like the game Jenga.

Here's my video blab on achieving work-life-balance by doing it vertically.


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Monday, January 11, 2016

CSM and Disneyland

So, I put out a poll on Facebook and Twitter. Here are the results:

There will be at least 30 of your colleagues & their families, romping around at the Happiest Place On Earth!

 Can both be done?! Well... I'll let you decide ;) This post isn't about finding or making the time. This post is all about what you can do while you're at Disneyland and some tips from a seasoned Disneyland Annual Passholder in how you can maximize your Disney experience at the parks. After all, if you've decided to go... you already know that it is worth it. And, if you are wavering, maybe this post will show you what 30+ people already know... it is worth it ;)

LOL. Who are we kidding? Of course I'm trying to get you to go!

CSM and Disneyland

I probably don't even need to say it, you probably already know: I'm a Disney FIEND. I love all things Disney & Star Wars; therefore, Disneyland (and Disney California Adventure) is just plain awesome. The fact that CSM is but and only next door to the Disneyland Resort, I can only hope that more and more of you will be helping me do a #DisneyPT TAKEOVER!

Considering that most of the CSM activities will be ceasing around 5 or 6pm -- AND -- that Disneyland is open until midnight for both the Friday & Saturday... there should be plenty of opportunities to get into the parks.

Here's what's up!
The Disneyland Resort is undergoing all sorts of changes in preparation for Star Wars land. What this means is that the train will be down and much of that same area surrounding the transition between Frontierland and Fantasyland. The good news is that because there is a bit less to do there, you don't have to feel paralyzed by too many options and trying to fit everything in. You'll have your option of park hoppers and various ticket prices to reflect how many days you wish to get in.

If anything, I'm hoping to organize an unofficial PT takeover... but, more news on that later.

If you haven't been to Disneyland in the last couple years... or decade. This is what you stand to gain!
  1. Tommorrowland is entirely Star Wars'd out. The whole place is now undergoing something called the Season of the Force. The whole area has Star Wars music, decor, and Star Tours is now a 4-D experience along with a special scene which ties in the new Star Wars movie, The Force Awakens!
  2. The Paint The Night Parade is perhaps Disneyland's best parade ever! Not only did it debut for Disneyland's 60th anniversary; it gave the proper nods to the old Electrical Parade which is now available in Disney World, Orlando.
  3. Oh, right! It's Disneyland's Diamond Anniversary!
  4. Many of the "fun" rollercoasters have been upgraded. This includes the Matterhorn Bobsled as well as Frontierland's Big Thunder Mountain. I went on Big Thunder just last week and the upgrades are incredible!
  5. Disneyland allows for FastPasses for you to spend in the park while your pass, waits in line and allows for a return time for you to cut the majority of most lines. If you have children, you can also use what is called a Rider Switch Pass where one of you waits through the line and the other gets to do something else. Then, you switch the passes and take 3 guests with you to cut the majority of the line. A similar effect goes for wheelchair access.
  6. There are a LOT more new shows including Mickey and the Magical Map, a brand new World of Color show in Disney California Adventure.
  7. Oh! And, if you aren't familiar with Disney California Adventure... it's the "adult" park. There, you will find great food, great rides (actual rollercoasters and what not), and great booze. That's right ALCOHOL.
  8. Space Mountain is now Hyperspace Mountain, re-themed with projections of Star Wars effects to really accelerate the ride experience.
  9. Many of the dark rides in Fantasyland have been upgraded in one fashion or another. An example is Alice in Wonderland and the new dynamic projections they have as you go through the ride itself.
  10. Downtown Disney has become its own thing. Great shops. Excellent food. Speaking of which, maybe #10.5 is Trader Sam's Tavern at the Disneyland Hotel... the volcano explodes regularly... as does the rush in drink orders ;)
So, finally, I must ask... if you're not planning on going yet... are you now?!

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Wednesday, January 6, 2016

Three-In-One BLAB Fest

Hi everyone,

Here is a much delayed release of my 3-in-1 blab session covering acute physical therapy, vitals, and professional ownership. I meant to release this quite a bit earlier, but! Well... life :)

So here they are!

  1. Vitals are VITAL (A Follow Up)
  2. 5 Ways Acute Care Was My Ultimate Game Changer
  3. Physical Therapy Attitude Check: Do you own or do you work?
Thanks for all the inspiration and engagement regarding those Facebook posts. Hope you enjoy these. And, get ready to laugh because it is beyond apparent how exhausted I was recording these. LOL! =P
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Physical Therapy Attitude Check: Do you own or do you work?

Physical Therapists tend to go to their daily jobs as workers. And, yet, there is all this complaint about being undervalued, under appreciated, being at the bottom of the totem pole, etc.  Ironically, this attitude is actually the root of the problem.

If you "work for," you will always care less.

If you "take ownership," then you will always care more. And, we need people to care more.


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5 Ways Acute Care Was My Ultimate Game Changer

You either love it or hate. If you're like me, you probably went into PT school thinking about outpatient ortho and/or sports, waiting that magical 5 years until you're good enough, and then opening up your own business.

Well, as life would have it, I would rotate through various settings and some how found the acute care hospital to be my love and passion as it pertains to the raw potential to which PTs can learn -- and -- to which PTs can contribute.

Here Are 5 Ways Acute Care Was My Ultimate Game Changer


  1. Best application of knowledge base.
  2. Highest level of clinical diversity. Yep, I did plenty of manual, ortho, and even ED.
  3. Highest level of clinical complexity. Where else are you going to get someone who has 20 different medical conditions, blood that should be melting out of their body, vital signs that make no sense, but are agreed by all in the medical team to appropriate for home discharge?
  4. INTENSITY. With the most intense medical situations & most intense patient care scenarios.
  5. Largest political canvas in healthcare. Acute care requires savvy to navigate and typically 10-15 years to move into a significant space of leadership (system level, VP, c-level, etc.), 2-5 years for first promotion. 5-10 years for leadership opportunities.

Some quick commentary. People get scared of the ICU. Well, the ICU is the safest place. You have the quickest response team right there, more monitoring that you could ever ask for. Rarely, does anything "go wrong" in terms of PT in the ICU. In fact and in my experience, all the accidents, strokes, and crazy events occurred on ortho (DVTs), trauma (complexity, despite medical stability), and medical units (because, the guard is down).

Additionally in acute care, you get exposure and opportunities to serve in wound care; be it laser, wound VAC, or MIST... or traditional stuff, sharps, even maggot. You get imaging, coordination with the entire healthcare spectrum of professionals. 

The opportunity in acute care for PT is immense. The ability to leverage nearly the entire spectrum of our clinical training is wonderful. Sure, you're not going to do mobs on everyone. But, really, is doing mobs all that PT is about? Surely not.

Think about acute care. It was the ultimate game changer for me. It remains, to this day, one of the most influential and significant leveraged experiences which affects my clinical practice.

If you're a student, get IN a hospital rotation. If you're a new grad, get some per diem hours... you will never regret it.
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Vitals Are VITAL!

So, I shared on the Doctor of Physical Therapy student's Facebook group this insane vitals situation, with a patient I saw this past week. You can find it linked HERE:

Essentially, I had a patient present with absolutely no signs, no distress, no discomfort, no nothing... with a normal'ish blood pressure. But! With a heart rate of 37bpm and O2 saturation of 77%.

Yeah... NOT. NORMAL.

My intent in posting that to the Facebook group was to convey how important it is to take vitals. I know it is still a point of disagreement and contention. Still, I've been told more than once that in any discipline or setting in healthcare, failure to take vitals (when someone goes wrong) is the first place lawyers check in terms of negligence.

Just something to think about. You've been warned.

In any case, I'll get on with this post only to say that it is a PASSIONATE topic for me. If you resonate with me, be on fire with me! If it offends you, I'm sorry it does... it doesn't change the facts. But, I think you'll find that the majority of clinical leaders out there agrees with the position I take.

Here's a quick recap:



Follow Up: Vitals Are VITAL!

To my knowledge, it's a happy ending. Our patient recovered and we can't entirely explain what happened. Personally, I still think referring to ED would've been more prudent -- but, per the policy given & the process followed, she was deemed medically stable enough to stay inpatient. However, the cardiologist involved did suggest "other" avenues of approach given a repeat situation.

My interpretation? I think there was a massively hidden cardiac issue given the "regular" irregular heart rate, history of complaint of chest pain, fatigue, etc. Doesn't that sound like a heart attack to you? Sure, the question: What could we have done? Comes up. Maybe nothing, maybe everything.

The fact is, without taking those vitals, most clinicians would've gone ahead with a full course of treatment for the day. That would've included a lot of exercise, both strength & cardio; exercise that very well may have cause the situation to go from odd into critical.

My follow up, simply stated, is this: Vitals are vital, not just because they are standard of care. Not just because it may implicate negligence when omitted. Not just because it's the right thing to do.

Vitals are vital because they serve as the prerequisite for just about EVERY physical therapy intervention we know. Exercise? It starts with vitals because we are causing a physiological stress response. And... I could go on. But, I just stopped typing this long list because it's exhaustive to even do so. Really, if you can't think of why and how important the cardiorespiratory system -- one QUARTER, mind you -- of physical therapy practice is, in how it interacts and is interdependent with the other three systems we treat... someone, needs to rethink how they practice.

Harsh? Sure. But, vitals are vital. Don't you dare put your patient at risk, ever.
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