Dec 03 2020
LaBella, Rachel
Professional Goal Statement:
As a physical therapist, it is my mission to provide compassionate, holistic, and personalized care to all my patients. The majority of my personal life experiences with physical therapy and previous careers lie in orthopedics with an emphasis on musculoskeletal conditions. I plan to use this foundation of orthopedic skills to further build my experience in this field by participating in UNC’s Integrated Clinical Experience (ICE) and becoming a teaching assistant for the program’s musculoskeletal courses before graduating. I plan to work either in an outpatient orthopedic setting or pediatric outpatient clinic, and want to continue expanding my skills as a practitioner by entering an orthopedic or pediatric residency program and obtaining my Orthopedic Clinical Specialist certification (OCS). I will continue to develop my professional curiosity and use up to date research while practicing and ultimately hope to provide my patients with the tools to better themselves and achieve their goals. |
Career Plan:
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Self Assessment:
Strengths
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Areas for Growth:
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Objectives:
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Specific Strategies:
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Clinical Rotations:
Clinical 1: Pivot Physical Therapy (June-August 2019)
- 8-week clinical rotation with a focus in outpatient orthopedics.
- Evaluated and treated children, adults and geriatric patients presenting with chronicconditions such as LBP, tendinitis, scoliosis, and acute injuries including, but not limited to,
ACL reconstructions, total knee replacements, and arthroscopic rotator cuff repairs.
- Gained experience with workers comp cases and cultivated knowledge on proper codingand billing procedures.
- By the end of the rotation managed a caseload of 40 patients a week.
Clinical 2: UNC Acute Hospital Oncology and Neuro (March 2020)
- 2-week clinical rotation with a focus on acute rehabilitation specializing in oncology and neurology patients.
- Evaluated and treated adult and geriatric patients in acute rehab hospital undergoing chemotherapy, radiation, surgical removal of tumors, and individuals who experienced stroke, TBI, SCI and other neurological conditions.
- Gained interprofessional experience working with physicians, nurses, OT, social work and other healthcare professionals.
- Managed 50% of a new grad caseload for simple cases and 20% for moderate/complex cases.
Clinical 3: Theraplay Junction Inc. (March-April 2021)
- 9-week clinical rotation in pediatric physical therapy in privately owned facility with occupational and speech therapy in addition to PT services.
- Evaluated and treated pediatric patients with autism, down syndrome, Angelman’s, cancer/tumors, stroke, toe walking, CP and an assortment of orthopedic conditions
- Experience with serial casting, bracing, assistive devices, sensory stimulation toys.
- Patients ranged from 4 mo to 13 yo with minimum to maximum assist levels.
Clinical 4: BioMechanic Physical Therapy (2021)
- Final 12-week Rotation in outpatient orthopedics.
- Patient caseload consists of treatment and evaluations for post-op patients, LBP, shoulder,hip, knee, and ankle pathologies acute and chronic.
- Experience with new modality technology including MLS Laser for therapeutic treatment.
Electives:
- Teacher Scholar for MSK II, Summer/Fall 2020
- Advanced Orthopedic Assessment, Fall 2020
- Integrated Clinical Experience Outpatient Ortho with UNC Health, Fall 2020
- Topics in Sports Physical Therapy, Spring 2021
Capstone: Instrument Assisted Soft Tissue Mobilization (IASTM) and Graston Techniques. (Advisor – Jon Hacke)
Instrument Assisted Soft Tissue Mobilization (IASTM) & Graston Techniques
- https://unc.voicethread.com/myvoice/thread/17438556
- Evidence Table_ IASTM & Graston Techniques
- Instrument_Assisted_STM_And_GrastonTechnique_Flyer
Additional Products:
- Critically Appraised Topic
- LaBella_POTS&EDS_Pathophysiology_ClinicalPresentation_OrthopedicClinicalConsiderations
- Heart-Wise Community Health Program
- Community Health Program Evidence Table
- RLaBella_Lung Adenocarcinoma
- Mr. Metastasis
- Dr. Differential
- Ethics Video Case Presentation – https://www.youtube.com/watch?v=nXXO-DoxzuE
Reflections of DEI Experiences:
A Webinar by Dr Damon Tweedy, author of the book Black Men in White Coats: “Reflections on Race and Medicine in the Year of COVID-19 and Nationwide protests.” https://www.youtube.com/watch?v=1xyadm9Mhqk&feature=youtu.be
Dr. Tweedy is an associate professor of psychiatry at Duke University School of Medicine and practicing physician at the Durham VA and was kind enough to lead a webinar that reviewed his experience as an black man practicing medicine and some of the injustices he has experience throughout his journey. One key point he presented was how medical education and the health care system perpetuate health disparities. He goes on to explain how in some instances black men or women are provided different medicine to treat the same conditions as white men or women. In this instance he has found these decision-making processes frustrating and to be occasionally ineffective. Dr. Tweedy then explains how provider bias and patient mistrust exacerbate health differences. For example, he found that those individuals described in a stereotypical way such as “shiftless, lazy, hanging out with the homeboys” were less likely to be prescribed appropriate treatments. There is no need for this language in the medical chart to describe the underlying condition of the patient. These words only serve the purpose of transmitting the bias of one practitioner to another. Dr. Tweedy then goes on to speak about the challenges he and other minorities have faced in the world of medicine. He brought to attention the concept of dual consciousness as he manages being a black man and setting a good example while also trying to navigate the medical world which is predominantly white.
P Goddu A, O’Conor KJ, Lanzkron S, et al. Do words matter? stigmatizing language and the transmission of bias in the medical record. J Gen Intern Med. 2018;33(5):685-691. doi:10.1007/s11606-017-4289-2
Because this study was noted in Dr. Tweedy’s webinar, I thought it prudent to further review how language and implicit bias contributes to healthcare disparities and patient mistrust. It is fairly well documented patients are in fact, not treated equally in our healthcare system be that because of age, race or ethnic identify, social class, health literary, substance and use disorders, or obesity to name a few things. Dr. Tweedy mentioned how the language used in medical records can inadvertently transfer implicit bias between healthcare professionals. This was put to the test as medical students and residents reviewed “two chart notes employing stigmatizing versus neutral language to describe the same hypothetical patient, a 28 year old man with sickle cell disease.” Following the review, it was found that the students and residents failed to choose a more aggressive pain management plan and maintained a negative attitude toward the patient who was described with the stigmatized language. To think that a patient’s quality of care can be decided based on a few choice words in a medical chart is frustrating and only furthers the mistrust between patient and provider. When an individual is receiving medical care, there should not be this cloud of worry hovering above their head, wondering if their physician truly has their best interests in mind. More emphasis should be placed on documentation and the use of patient first language to provide an accurate representation of the patient’s condition while eliminating stigmatizing language.
Self Reflection:
I remember when I was initially searching for physical therapy programs to attend and came across UNC’s, thinking this would be a “reach” school for me so to speak. However, I knew that when I applied and received an invitation to interview that I was going to do everything in my power to become a student of this program. Low and behold 3 years later here I am finishing up my final rotations, classes and assignments, nervous, but ready to continue my professional career as a physical therapist. For myself, this program fit me to a T and I felt I was truly able to thrive as a student and improve as an individual. All of my strengths that I brought into the program have only been enhanced and all my weaknesses are now seen only as opportunities for growth. Thank you to all the professors, student aids, my classmates and family for helping me learn and succeed! I am incredibly grateful to have experienced such an important part of my life with such amazing individuals.
Rachel: Thank you for sharing all of your hard work! It is nice to see some examples of what you have accomplished and how you have grown. Good luck to you! Lisa