|
|
Robin Smith, PT
Miami Physical Therapy Associates
Miami, FL
"I’m looking for an Australian patient so I can put a pin there on our world
map," says Robin Smith, PT, owner of Miami Physical Therapy Associates.
Spinal cord injury patients from as far away as Russia, China, and many
countries in South America and the Middle East have come to Smith’s clinic
for specialized physical therapy in the last 25 years.
"The spinal cord injury population can be pretty small in the sense that they
share information, so word-of-mouth plays a big part in our referrals," notes
Smith, who says 50 to 60 percent of his practice is comprised of that
population.
It is unusual for a small, independently owned outpatient PT office to
rehabilitate patients in wheelchairs because it is an expensive undertaking
that is typically done in special rehabilitation centers or hospitals. But Smith’s
reputation and expertise in treating spinal cord injury patients led
Independence Technology, a Johnson & Johnson company, to contact him
when seeking a clinic in the Southeast United States to assess and train
patients in the use of the INDEPENDENCE® iBOT™ 3000 Mobility System.
Miami PT Associates then became the first outpatient PT office in the United
States to qualify for assessment ant training for the iBOT device.
In addition to operating much like a traditional power chair, the iBOT can
elevate the user to eye level, climb stairs and curbs, and traverse grass,
gravel, sand and other forms of uneven terrain. Approved as a prescription product by the FDA in 2003,
the iBOT is the most thoroughly tested, studied and sophisticated device ever manufactured for the
disability community, according to Independence Technology.
Currently, Miami PT Associates is one of 12 facilities in the country approved for iBOT assessment and
training. When a patient in Smith’s region contacts Independence Technology about getting an iBOT, a
company representative refers the patient to the clinic for a preliminary evaluation, during which Smith
determines whether the patient has the cognitive and physical ability needed to operate the device. If so,
Smith does the necessary training with the help of an obstacle course set up outside the clinic. Patients must pass a "driver’s test" to ensure they can
operate the product safely and effectively.
After the preliminary assessment, Smith determines whether a patient
qualifies for training. He gives his recommendation to the company and a
final decision is made. "It’s a credit to the company that they recognize the
value and importance of having an independent PT work with them in this
process. There is no conflict of interest because I don’t sell the product, nor
do I get profits when the company sells it. I am reimbursed by the patient or
the patient’s insurer -- not by the company -- for the assessment and
training, and that removes any potential for conflict of interest."
Smith says the iBOT certification work is only one component of his practice, which he started in 1981.
He and his staff see a wide range of patients including high-profile athletes, ventilator-dependent
quadriplegics, and those with ALS and other debilitating diseases. The major portion of the practice
consists of clinical care for patients who have suffered catastrophic injuries.
"Twenty-five years ago I started out as a general PT practice, and then spinal cord patients seeking an alternative to the institutional setting began coming to our clinic for more
one-on-one treatment." After
receiving his PT degree from the University of Maryland, Smith moved to Florida, where his first job was at Jackson Memorial Hospital in charge of the spinal cord unit. His second job was with the University of
Miami, where he worked on a National Institutes of Health research project and wrote the PT protocol for
spinal cord injury patients.
"There is a real need for outpatient therapy for these patients," observes Smith. "Spinal cord institutions
have really cut back on inpatient stays for rehabilitation, largely dictated by third-party payers, many of
whom allow only 30 days of inpatient rehabilitation." Prior to managed care, Smith says, a typical
admission for inpatient rehabilitation was 3-4 months for paraplegics and 6-8 months for quadriplegics.
In addition to Smith, Miami PT Associates has 2 full-time PTs, 2 part-time PTs, a full-time PT Assistant, and 6 part-time
aides who are in the process of becoming PTs or PTAs. There is also a part-time OT with a spinal cord
specialty and a speech therapist who comes in when needed.
The clinic has treated PTPN patients from other parts of the country when they have been involved in accidents in
Florida. Smith, who became a PTPN member in 1991 when PTPN of Florida began, says he initially joined because he
had faith in the principals who were forming it. "I was frustrated with being a small fish unable to compete for contracts. As an independent PT, large payers
wouldn’t contract with a single provider. And since then, PTPN has kept me out of legal trouble by giving me a ‘heads up’ on important issues, deadlines and opting in
— or out — of contracts."
His advice to PTPN members interested in his practice niche? "This is not a specialty that PTs can just add in," he cautions. "One must have a real clinical expertise in spinal cord injury treatment. It is a
specialty area that requires specific equipment, experience in the progression of the program and the ability to recognize the many complications that may arise. It’s a very specialized and demanding
population, and it requires years of experience. There are many pitfalls, and a lot of liability as well."
But for Smith, it is clear that his work is also deeply rewarding.
Contact Robin Smith at 305-444-0074 or miamipt@bellsouth.net.
For additional information about the INDEPENDENCE® iBOT™ Mobility System, visit
www.ibotnow.com or call Independence Technology at
866-204-6126.
Photos used with permission from Independence Technology.
|
