EPISODE 7: Moving (Functionally) Toward Improved Communication- Lindsay Bilson, DPT

Today’s guest is Lindsay Bilson, DPT- outpatient physical therapist and true patient advocate. I am good friends with Lindsay personally and have learned much from her in regards to functional movement patterns. She also happens to be a great person! Lindsay has many interesting points in this episode as pertaining to communication within the greater healthcare team!

Today’s Guest

Lindsay Bilson DPT

Lindsay Bilson is a doctor of physical therapy who works at Buffalo Rehab Group Physical Therapy in East Amherst. She grew up in Lockport, NY and graduated high school in El Paso, TX.  Lindsay moved back to Buffalo where she graduated from the University at Buffalo with her DPT. She currently resides in Pendleton, NY with her husband Jeremy and three children, Andrew, Cameron, and Kendall.  

Lindsay started working for Buffalo Rehab Group in 2005 while attending grad school.  She fell in love with physical therapy after spending some time as a volunteer with her older sister who was studying to become a physical therapist. Lindsay confirmed her passion for PT when she had surgery on her knee and had to go through the process as a patient herself. 

She is the office leader as well as mentor for new staff, and clinical instructor for students, for the Amherst clinic.  Lindsay is involved in women’s health including post partum care and core strength as well as osteoporosis but enjoys treating every injury, surgery, and balance impairment.  She reports, “seeing a patient reach their goals and regain their function and quality of life is the absolute best feeling!”

When Lindsay is not in the clinic, she loves finding new adventures around Buffalo with her family and friends, walking down by the river with an ice cream in hand, skiing, dancing, traveling, and organizing.  She has also been a volunteer ice skater with SABAH since 2006.

Email: lindsay@buffalorehab.com
Website: https://buffalorehab.com/
Office Phone: 716-568-1251

Key Takeaways

• Front office staff is key to a good patient experience as the first line of communication with her practice.
• Oftentimes, patients have no idea what is going on with their care even after many visits to their physician.
• Lindsay and her practice pride themselves on patient education, filling the gaps in knowledge about the patients’ disease and treatment plan.
• She comments on the need to be an advocate for your own care.
• Lindsay strongly believes that as a healthcare team we need to focus on the patient as a whole and not just the specific area we are asked to treat.
• Lindsay wants to remind healthcare providers to focus on the “final goal, which is great patient experience, great patient care, great quality with great outcomes.”

“We are all our own specialist and we all need to be working together.”

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Transcript

Andrew Tisser 0:00
Dr. Lindsay Bilson, welcome to the Talk2MeDoc Podcast!

Lindsay Bilson 0:02
Thank you, Dr. Tisser.

Andrew Tisser 0:02
All right, well get rid of the formalities now. So, Lindsay and I are good friends. Her husband, Jeremy, and my wife, Alysia, we all hang out together in balmy Western New York. So really grateful to have you on the show! I already gave a little bio about you to the listeners, but in your own words, could you tell us who you are and what you do and what you’re all about?

Lindsay Bilson 0:42
Sure. My name is Lindsey Bilson. I am a physical therapist and I work at Buffalo rehab group physical therapy. The location that I specifically work at is in East Amherst. We have 11 locations and we’re growing. It’s specifically an outpatient orthopedic, physical therapy clinic. And I love it.

Andrew Tisser 1:10
Awesome. So this show is about team communication. So as an outpatient physical therapist, who would you define as your team?

Unknown Speaker 1:21
So I am the office leader at our Amherst location and we have several clinicians. Our team clinician-wise is made up of PT (physical therapist) and PTA (physical therapy assistant) teams at each of our Buffalo rehab group locations. One of the things that we do a little bit differently is that each PT is paired up with their own PTA, their physical therapist assistant, and when patients come in, they see that team each and every time they’re not bounced back and forth between other therapists, other assistants or other locations, but of course, to have a great clinician side of things Need an awesome, we call them patient care representatives, our front office staff, and they’re the patients first, you know, first impression first line of communication with making appointments and things like that. So that’s really the whole the whole team in the sense of, you know, our front office staff, of course filling and the PT and PTA teams.

Andrew Tisser 2:25
I see. So the first line of communication with the patient in your entire office is your representatives. So any issues there would certainly detract the patient experience and then your communication with the representatitves would certainly be instrumental would you say?

Unknown Speaker 2:45
Oh, absolutely. I mean they’re giving us the first information on the patients, whether it’s diagnosis, insurance, all the paperwork and everything. So that kind of sets the pace and sets the experience for the patient. If the front office is not nice to them or not giving a good response to them is quick and hurried on the phone or with the email responses, that’s going to negatively affect how they think physical therapy is and how they think buffalo rehab group is as a company, before they even get to me, even if I’m, the greatest therapists they’ve ever worked with, if they didn’t have a great experience with that front office staff, that patient care representative, they’re going to already kind of have a pre judgment on their care.

Andrew Tisser 3:36
Absolutely. Have you ever run into any issues with the within the greater team, not just the representatives, but everyone at the office?

Lindsay Bilson 3:46
Explain that. What do you mean?

Andrew Tisser 3:49
So I guess what I’m trying to say is, has there ever in your career at that particular office, have you run into any either positive or negative experiences that you can explain to the listeners in regards to communication itself now, it doesn’t have to relate to patients, but it can be within the greater teams.

Lindsay Bilson 4:12
Yeah, I mean, just in general. A lot of times when a patient comes in a physical therapist is not typically not the first healthcare professional that they see for, you know, fix their injury or their surgery. New York State is great in the sense that they have what’s called direct access. So technically, a patient can come in and see us directly without seeing a primary care physician or an urgent care or anything like that for 10 visits or 30 days. Some insurances negate that if your Medicare you obviously need a script to come to physical therapy, but for the most part, we are not, the first health care person that a patient’s going to see.

In fact, we’re probably the third, fourth or fifth person In that line. So that can make it definitely hard and different if a patient’s kind of get bounced back and forth, as far as hey, I have this injury, I have no clue what’s going on, you know, my primary care just kind of shuffled me off after a few minutes to this person. Now I’ve gotten imaging and who knows what the X ray said, the MRI, no one said anything. And then I went back to a specialist, they said to come here, and now I’m seeing you and I still don’t know what’s going on.

That’s honestly a good chunk of what we hear and what we see from patients. They’re coming to us, unfortunately, pretty clueless, as far as what their injuries are, sometimes even what surgeries were even performed or what post op guidelines they should be following. And they just had this major surgery and they’re like, fill in the gaps for me what’s going on. So that would that mean? That’s obviously a very negative thing that happens but on a positive and you know, as a physical therapist, we are fortunate that we can spend a good amount of time with our patients, especially on that initial evaluation.

And we can kind of fill in the gaps for the patients. We pride ourself at Buffalo rehab group on patient education, making sure that we’re establishing that value and that expectation for those patients so that they really understand you know, not only what their diagnosis is or what surgeries they had, you know, what are you know, the things right off the bat that’s going to make them better? What are the things that they’re doing at home without even realizing it? That’s going to make them worse. If I’m not helpful to them, what you know, what are the plan B options, going back for imaging, getting injections, medication changes, what other healthcare team members can I help connect them with so that they’re getting the best quality of care restoring their function, restoring quality of life.

And I think having patients leave that initial visit, understanding that expectation of what’s going on, and helping them fill in the gaps is huge. That’s really the the positive and two things that that’s a great thing to help do for patients on our end. And it’s something like I said, we really pride ourselves on is that patient education. You do it on that first visit, and we do it for every visit after right, because no one really retains that information all too well. And things change. So it’s important you continue to educate them on that.

Andrew Tisser 7:41
Yeah, that’s, you know, it’s really remarkable. It’s a bit of a social commentary on our current healthcare system, but that the patients can see three or four different providers before they get to see you and still not know what surgeries they had or what the plan is or what’s going on. I think that kind of speaks to the mission of this podcast. Well, and it’s it’s really is remarkable honestly, to hear from you. And I’m a bit embarrassed to say but I didn’t even know, all that goes into to physical therapy, as you just explained, I mean, that really is treating the patient, you know, not just their function, but the lapses in education and wellness as a whole. So that’s, that’s a really interesting perspective that I was unaware of.

Unknown Speaker 8:28
Yeah, I think I actually was talking to a patient of mine this morning, who happens to be an occupational therapist, and we were just discussing some things and we’re not pharmacists so we can’t prescribe or anything but we can suggest and say, why don’t you talk to your physician to see if this is something that could help you when, the physician may see them for all of a few seconds where again, I’m spending a couple hours. A couple of times a week with them and I get to see the good, the bad and the ugly with them. And I said, why don’t you see if they can, see if this anti inflammatory will be helpful for you. And at first she kind of got brushed off and we were talking about it this morning and I said, it’s pretty sad, not everybody, but, for the most part, you really have to be an advocate for your own care.

Lindsay Bilson 9:27
And she’s fortunate that she has a little bit of background, being an occupational therapist, not everybody has some of that knowledge, but we really do have to fight for our own care sometimes. And, and try to improve your own quality of life to really say hey, this is what’s going on. I know better. You know, my therapist told me and you need to help me out here. We really do have to be to be advocates at that end because not everybody does. Get to spend the time with that patient and treating them as a whole person, that they might look at just the shoulder because that’s what that doctor is there to see him to do. But again, in the end, we’re there to treat the entire person and restore their full function, their full quality of life. And every aspect of that. So it was it was sad to kind of hear her say that, but she had to push so hard just to feel better.

Andrew Tisser 10:34
Yeah, well, I mean, at least she was able to do that. Do you ever get patients that are really hesitant to bring things up to their docs that you may have suggested?

Unknown Speaker 10:44
Yeah. I mean, so again, we’re talking about communication. I think, understanding that hopefully we’re moving towards an area and health care where it is more of a level playing field. You know, we’re all specialists in. We’re all experts in what we are trained to do our careers. And I think, within our own selves, as healthcare professionals, we need to understand that a little bit better. That, you know, you don’t know what I do completely, you just said that yourself and there’s some things that I don’t know that other physicians and specialists are capable of doing or can do with their patients that I’m not going to step on your toes with something I’m not going to step on a pharmacist toes for prescribing a medication I’m not going to step on a neurologist toes for giving a nerve block to somebody just because I don’t think that’s right.

Lindsay Bilson 11:49
That’s not my specialty. And and I hope that we’re moving towards understanding, communicating working together for the patients. Because that’s that’s what it is. It’s a human being that we need to treat as a whole and work together take our talents and our specialties to get them better and back to the top. And it’s not this tiered or hierarchy system anymore, or at least you hope not. We’re very fortunate at some of our locations that we can work pretty closely with orthopedic doctors and surgeons, and we can have that direct relationship with them. You know, we are a privately owned company, we’re not physician owned, but you feel very comfortable talking to those doctors directly.

If there’s a problem with those patients. If there’s an issue with the surgery, something is unclear I can get right on the phone and advocate for the patient myself if they’re hesitant on it or unsure and that’s a great relationship to have and they’re very understanding of what we do as rehab specialists and what other people/health care providers do, but it is more of a level playing field and more of a collaborative effort versus some other clinics or, or other health care providers that are may be unfamiliar with, with us or with with rehab, that it seems very distant, very non connected.

And that obviously makes it harder for myself or for the patient if we do need to make changes or we do need the physician support on something and we’re not connected with them or they’re hard to get ahold of, I write a note asking for a suggestion on something and I may not hear back for several days or several weeks and in the meantime, the patients kind of hanging in the balance wondering what the next step is. So the That’s the hard end of things. But like I said, we are fortunate that we can be close to some of those orthopedic surgeons and, and and they’re very, they trust us, you know, we’ve had that relationship with them. And that’s great. And that really helps a patient’s overall quality and care.

Andrew Tisser 14:21
Yeah, I mean, it sounds like you have a great relationship with with the providers you work with. So and then that you’re fortunate in that regard. How about your inpatient colleagues? Do you think they they’re quite as lucky or do you think they’re more challenges there?

Lindsay Bilson 14:36
in patient you’re saying like, rehab facilities and things like that?

Andrew Tisser 14:41
Yeah. As an inpatient physical therapy.

Unknown Speaker 14:42
Yeah. I mean, I’ve never personally worked other than some residencies in in hospitals. That’s my only experience with hospital based PT. But when I was there as a student, definitely you’re, I mean, the doctors are right there. A lot of that is communication and the the medical notes and the books and things like that it might not be face to face unless you’re doing rounds with the physician in the early morning. But they might not have the same connection in the sense that they’re really only seeing most patients for a couple of visits.

Lindsay Bilson 15:21
And then, you know, off they go, were a couple of days, you know, not many people are spending lengthy times in the hospitals. But I would say you know that the physicians are right there, it just might not be more face to face care. I mean, maybe if you talk more specifically with an inpatient physical therapist, they might have a different take on it. But I know when I was there other than rounds and reading their notes, if I could read their handwriting and the binders that was that was pretty much it. That was my interaction with them. You know, you were working more with the nurses or the other rehab specialists on team to say hey, how this person do today. You know, I’m going to go in and see him at two o’clock and give me a heads up that was more just an in passing conversation.

Andrew Tisser 16:08
And I was reading in your bio, that you’re an instructor to students and you kind of orient new staff. Could you elaborate on maybe how communication plays a role either positively or negatively in your teaching capabilities?

Unknown Speaker 16:24
Yeah, I think the first thing I asked so we get several students for all the local schools in the area. And then any new staff, even if they’re already an established physical therapist, any new staff gets mentored at our locations and there’s a designated person at each office that does that. It’s usually anywhere from an eight to 12 week mentorship, and then there’s continuous not necessarily we don’t call it mentorship, we call it coach ups but continuous interaction and help that’s offered throughout their time as much as they need it. But I think the biggest thing that we tell them is the patient education aspect of it. Again, I kind of said in the beginning, if you don’t establish that, that value, that connection with that patient on that first visit, they’re not gonna want to communicate with you, if you don’t tell them that you understand them and understand their conditions and understand their background, their lifestyle, then they’re not going to trust you.

Lindsay Bilson 17:31
And I think that’s really key. You know, just examples what do you give a patient who’s 92 and still lives alone, versus somebody that’s, you know, 92 and has the help of caregivers and things like that, it’s totally different. So if you don’t dig a little bit deeper and try to communicate with that patient, on that level, your plan is going to be completely off and that’s that’s hard for students. or staff that may not be familiar with, you know how we’d like to do things that before a rehab group, if they don’t have that patient connection, that rapport, that’s a hard thing to train, you know, you can train anybody and clinically, you know how to be a good therapist. But if you don’t have that bedside manner and that communication aspect of the people person aspect of things, that’s tough. But we do try to instill that in our staff, and it’s something we look for with each of our hires.

Andrew Tisser 18:33
Yeah, there’s there’s definitely things that are not teachable. But I think, reinforcing what you do, that’s, that’s super important, but it sounds like you guys got a great group there. So you’re, you’re very fortunate in that regard. We’re going to shift gears here a little bit. This part of the show, I like to try and get to have the audience get to know the guests a little bit more. So Lindsay, what What drove you to become a physical therapist?

Unknown Speaker 19:04
I am the youngest of five siblings. And I actually have a sister who is also a physical therapist, where she’s several years older than me. So growing up, she was already in college and studying to be a PT. And she had the largest textbooks, the most amount of notes, and she was constantly studying on her bed and I was like, I don’t know what you’re doing. I was probably three, four years old. I said, I don’t know what you’re doing. But there is no way that I want to grow up and do what you want to do. At the time, it was just a bachelor’s program for physical therapy. And you I believe, at that time had the option to go for your masters if you wanted to go for that fifth year. And I ended up spending some time with her as I got older into middle school in high school, and I volunteered she actually worked at a hospital that had outpatient and inpatient and I I think my mom just kind of dumped me off one day and said, I want you to go hang out with your sister for a little bit.

Lindsay Bilson 20:05
And I left there thinking, Wow, you have literally the coolest job you get to be with these patients and spend actual time with them, getting to know them. You see them from start to finish, at their worst coming in with their slings and their crutches and their boots and whatever. And you know, for the most part, they’re walking out and they’re running again, and they’re skiing and they’re lifting their grandkids. And it was just so so cool. Fast forward another 6-7-8 years and now it’s a doctorate program.

When I was looking into it, it was very new and not all the schools had the doctorate program. They were still transitioning from masters to doctorate and I came back up I was actually living in Texas at the time, and I came back to Buffalo to be with my older siblings. They were starting to happen. Some kids, and I knew that you we had the doctorate program, the DPT program and I said that’s what I need to do. So not only was it not even four or five years like she did but you be has a six year program so and, and idea we did it. So now she laughed at me because she’s like, you hated this. And I said, Nope, your job is so cool.

Andrew Tisser 21:23
Oh, that’s cool. That’s an awesome story. And then now you do it. All right. So you’re, you’re a full time therapist, you train a new people, your head of your office, and I think you got a couple kids hanging around!

Unknown Speaker 21:36
I do. I have a three year old son he just turned three the other day. And I actually have a boy girl one year old twins. So we are very busy at home. I have wonderful parents and in laws that help watch the kids so that I can be you know, working full time and it’s great. They’re good kids.

Andrew Tisser 22:03
Well, Lindsay’s oldest son Drew is already better than me at basketball.

Lindsay Bilson 22:09
I guess because you guys share the same name.

Andrew Tisser 22:13
That’s it. That’s it. Well, if you have if you have any time to read, do you have a current book recommendation? Lindsay, I’m a bit of a book nerd.

Unknown Speaker 22:24
I’ll tell you Andrew, my my top books these days are Curious George pup patrol and probably quarter I so I you know, you should probably look into those books. Now.

Andrew Tisser 22:36
Those are above my reading level.

Lindsay Bilson 22:38
Oh, sorry. Yeah. No, but I’m just kind of going back to again, the foundation of what I do as a rehab specialist, our focus or what we kind of try to teach our new staff and everything is is that functional based rehab program. So I go back a lot to Gary Ray, that if you if you look him up, he talks a lot about functional movement patterns and understanding that, you know, our our body moves in multiple directions and multiple planes using multiple pieces at one time. And that’s really how we design our programs for our patients.

They might be coming in for an ankle injury, but you better believe that we’re addressing, you know, the back the hips, the knees and the ankle. So his stuff is actually really cool. It’s, I want to call it incredibly old because some of the stuff we watch is on VHS tape and it had to get converted over but his, his, it was very forward thinking at that time and it continues to evolve and a lot of clinics now kind of use those principles and incorporate some of that but the original owners of our company, you know, they’re Gary Gray nerds, they love him and he It’s a it’s a interesting you know, he does a lot of videos these days can you but it’s an interesting watch for sure.

Andrew Tisser 24:08
Absolutely. I have to check that out. You do you have time to do anything for fun Lindsay?

Lindsay Bilson 24:14
yeah three kids. It’s always fun right? Yeah, I love exploring buffalo I like I said I moved back to the area several years ago and you know, it’s it’s definitely new and evolved recently. I love getting outside. I used to live out in tonawanda so walking the river and just having an ice cream in hand going down to the playground with the kids. That’s what we like to do. I used to dance in my in my past time so I still love dancing, put some music on and dance and things like that and just checking stuff out around around town for sure.

Andrew Tisser 24:52
Absolutely. It’s especially is a beautiful time of year when it’s about 80 degrees and sunny outside, right.

Lindsay Bilson 24:59
Oh yeah, you got Take up skiing and all the snow sports that we embrace the snow. Yes, you do.

Andrew Tisser 25:04
Yes, you do. So this question is a little selfish because as a physician, I’m always curious if you could give physicians or or mid level providers, one piece of advice in the area of communication what what would that be?

Lindsay Bilson 25:20
Yeah, I think, again, going back to a little bit, maybe what I alluded to before is just understanding that we’re all our own specialists and we all need to be working together. You know, the, the obvious things, Oh, sure. I get better handwriting so we can communicate better actually write stuff down. So we don’t have to assume what you’re saying. No, just kidding. But, but just understanding that we need to understand that as healthcare providers together, that we’re we’re all in this together for the patient and we need to relay that to the patients as well.

A lot of them still kind of go back to some of the old school like my physician has the final say and, you’re not going to trump that you know, person six people down the line kind of thing. But I would hate for for a physician to comment on somebody, movement patterns and things like that, again, that’s not what their specialty is. So I think just communicating in the sense of have to get to the patient better, making sure that we’re all listening to each other and, and working towards that final goal, which is great patient experience, great patient care, great quality with great outcomes.

That’s an important and especially moving forward in this very fast paced healthcare society. Where we all want this instant satisfaction, if we don’t get the answer that we want, we’re moving on. But if we can understand that process from the very first point of contact, whether it’s me or whether it’s you, that that we understand that process for that recovery and how that’s going to work as a patient that I’m already sold, and I’m already getting there, you know, I’m going to get better.

Andrew Tisser 27:25
Yeah, I mean, it’s, it’s wonderful to hear that, honestly, because we all are striving for that goal. But sometimes things get lost in the shuffle. But yeah, we were a team and we should act as such. So this has been really fun. I really enjoyed our talk, Lindsay, I learned a lot of things and I think our audience will love hearing what you have to say. If they wanted to get in touch with you or reach out or learn more, how can they find you?

Lindsay Bilson 27:54
Sure. My direct email is my first name Lindsay at Buffalo rehab. dot com. So l i n ds AY at Buffalo rehab.com. You can find out more about our specific company, the locations that we offer just that buffalo rehab group. com. There’s a ton of information out there. Usually the email and things like that is best. if you need to reach me directly to the office on our phone 716-568-1251 and I’d be happy to answer any questions.

Andrew Tisser 28:32
Great. All right.This has been fun. We’ll talk soon.