Let me preface this post with a little info about Medicare.  Medicare?  Turkey vultures?  Huh?  Bear with me.  For those of you unaware, Medicare is both an insurance carrier (they hate paying for things) and a government program (they also hate paying for things).  As such, Medicare finds doubly ways to not pay for things.  One creative way they do so deals with therapy students of all disciplines.  Physical therapy, occupational therapy, speech, you name it.  I, as a student, am allowed to treat patients as long as there is a physical therapist in the building I can run to for help.  That’s the law.  Medicare recognizes this and has no provision disallowing students from treating their patients.  However, they do have a major problem with paying for any such care.  That’s right, folks.  The government believes I am skilled enough to treat people, but not skilled enough for them to have to pay for said treatment.  Sweet.  That means that for any Medicare patient I provide care for, a licensed therapist has to sit there and watch me, not doing anything else, in order for my facility to get reimbursed.  This typically isn’t a problem since Harborview has plenty of non-Medicare patients I can see solo.

Uh-oh, hold the phone.  That all changed two days ago.  Harborview’s internal compliance office recently decided that, in an institutionally-sized case of CYA, we would adopt the strictest compliance laws (Medicare) for all patients.  I can no longer see a patient without my instructor staring at my every move.  There are two other students on the rehab unit as well.  That means when we’re all working with patients in the gym, there are three licensed therapists who could be spending their time doing actual therapy who, instead, have to sit perched on stools, staring off into the distance.  A la what?  That’s right, turkey vultures.

Speaking of vultures, I almost died today.  I was helping a patient walk when I was hit with a violent case of coughing.  Seeing as I couldn’t simply drop what I was doing and get a drink of water, I had to just bear it.  And since I couldn’t just cough all over my patient, I held it in as much as I could until my eyes started watering and I felt like vomiting.  It’s pretty much the visceral reaction I’d expect from snorting a line of gnu shit.  It was quite strange and less than pleasant.  Moral of the story?  Don’t hold in your coughs.  Unless you’re into snorting gnu shit and the consequences thereof.