In the ED Now

Guest: Dr. Sarah Steely Wright, PharmD, BCPSHost: Dr. Rebekah Griffith, PT, DPT, NCS, FAAOMPT In this episode, Rebekah sits down with emergency department pharmacist Dr. Sarah Steely Wright to explore how emergency department physical therapists and pharmacists can work together to improve patient care, reduce barriers to discharge, and practice at the top of their respective scopes. From medication reconciliation and resuscitations to fall prevention and medication-related mobility impairments, this conversation highlights just how much these professions have to gain from stronger collaboration. What You’ll Learn The education, residency, and board certification pathway to becoming an emergency medicine pharmacist. What an ED pharmacist actually does during a typical shift—including resuscitations, stroke alerts, intubations, medication reconciliation, culture follow-up, antibiotic stewardship, and discharge planning. How pharmacists help solve medication allergies, insurance barriers, prescription issues, and medication access problems before patients leave the ED. Why medication-related adverse effects are often overlooked contributors to falls, dizziness, impaired mobility, and functional decline. How PTs can better identify medication concerns and know when to involve their ED pharmacist. Practical communication strategies for discussing medication-related concerns with physicians and advocating for patients without creating conflict. Common medication combinations that increase fall risk and should raise concern during a PT evaluation. The value of interdisciplinary teamwork in reducing unnecessary ED utilization and improving patient outcomes. Key Discussion Topics The evolving role of the emergency medicine pharmacist Pharmacists as bedside clinicians—not just medication experts Polypharmacy and functional decline Medication effects on mobility, balance, and vestibular assessment Steroid allergies and selecting safe alternatives Insurance and discharge barriers beyond rehabilitation placement Substance use, supplements, and medication safety Building trust between PTs, pharmacists, physicians, nursing, case management, and social work Collaborative approaches to safer discharge planning Top Takeaways Pharmacists are essential members of the ED team whose expertise extends far beyond dispensing medications. Medication side effects frequently influence a patient’s mobility, balance, cognition, and rehabilitation potential. PTs often uncover important medication information during functional assessments that may not emerge elsewhere in the patient’s evaluation. Early communication between PTs and pharmacists can improve safety, optimize treatment plans, and prevent avoidable complications. The best patient outcomes occur when every discipline practices at the top of its scope—and collaborates across traditional silos. Memorable Quote “It takes a team.” Connect If you enjoyed this episode, subscribe to In The ED Now and leave a review. Share this episode with your emergency medicine colleagues and help spread the message of practicing together at top of scope.

Episode Summary What does it look like to practice truly at the top of scope in one of the most rural healthcare settings in the country? In this episode, Dr. Rebekah Griffith sits down with John VanEyk, PT, an embedded Emergency Department Physical Therapist at Tséhootsooí Medical Center on the Navajo Nation. John shares his journey from consult-based care to a fully embedded ED role, discusses the unique challenges and opportunities of serving a tribal community, and explains how innovative approaches—including musculoskeletal point-of-care ultrasound—are helping transform patient care. 🗣️ Featured Guest John VanEyk, PTEmergency Department Physical TherapistTséhootsooí Medical Center | Fort Defiance, Arizona With more than 30 years of clinical experience, John has helped build and expand ED physical therapy services on the Navajo Nation and is a leading advocate for top-of-scope emergency practice in rural healthcare settings. 🧭 Key Takeaways Building an ED PT Program Lessons learned from consult-based, hybrid, and fully embedded models Why finding clinicians who want to work in the ED matters Strategies for growing programs in rural and underserved communities Practicing on the Navajo Nation Unique cultural and logistical considerations in tribal healthcare Addressing barriers such as transportation, follow-up access, and limited community resources The importance of relationship-building and continuity of care The Generalist Advantage Why emergency department PTs need broad clinical skills Caring for patients across the lifespan and across diagnoses Preparing students and new graduates for emergency practice Ultrasound and the Future of PT How John uses musculoskeletal point-of-care ultrasound in the ED Identifying tendon injuries, fractures, effusions, and even unexpected DVTs Why ultrasound may be one of the next frontiers for physical therapy practice Creating System-Wide Value Reducing unnecessary transfers and imaging Improving patient flow and access to care Supporting clinical decision-making in resource-limited environments 💬 Noteworthy Quotes “Mindset plus skillset—that’s what practicing at the top of scope really means.” “You have to find people who love the emergency department. That’s how programs succeed.” “I think ultrasound is the future of our profession.” 🔗 Resources Mentioned Top of Scope: The Emergency Department Physical Therapist Practice Handbook Top of Scope Summit On-Demand Recordings Musculoskeletal Point-of-Care Ultrasound Education 👤 Why This Episode Matters This conversation highlights what’s possible when physical therapists are empowered to practice at the top of their scope, even in resource-limited environments. Whether you’re building an ED PT program, serving a rural community, or looking to expand your clinical skillset, John’s experience offers practical lessons and inspiration for the future of the profession. ✅ Great For Audience Benefit Physical Therapists Learn strategies for ED practice and program development Rural Healthcare Clinicians Explore innovative solutions to limited resources Students & New Graduates Understand opportunities in emergency care Healthcare Leaders See how ED PT improves outcomes and system efficiency 🎧 Listen now to learn how top-of-scope practice, innovation, and a commitment to service are transforming emergency care on the Navajo Nation. Learn more about POCUS and Dr. Stephen Ramsey here.

🔹 Episode Summary Emergency Department Physical Therapy is more than just mobility support — it’s a gateway to better outcomes, reduced admissions, enhanced patient experience, and system-wide cost savings. In this episode, Dr. Cassie Mountz explains why embedding PT at the “front porch” of care transforms the entire healthcare house. 🗣️ Featured Guest Dr. Cassie Mountz, DPT, ED-PT leader and innovator. Dr. Mountz shares practical insights from her experience pioneering ED-based PT programs and advocates for expanding practice scope nationwide. 🧭 Key Takeaways The ED as Healthcare’s Front Porch Early PT involvement influences admission decisions and care pathways immediately upon patient arrival. Example scenarios where prompt PT action shifted the patient journey. Implementing ED‑PT in Real World Settings Effective strategies for training, staffing, and securing administrative support. Practical tips for building interprofessional collaboration in fast‑paced environments. Clinical Impacts of Embedded PT Improved pain management, reduced opioid use, fewer unnecessary admissions, and enhanced patient satisfaction. Highlighted metrics and case outcomes. Teamwork That Works Best practices for coordination between PTs, physicians, nurses, and case managers. Embedding PT workflows within existing ED processes. Advocacy & Vision for the Future Dr. Mountz’s goals for national recognition and standardized ED-PT protocols. Steps practitioners can take to champion change in their institutions. 💬 Noteworthy Quotes “We’re caring at the threshold — right where everything begins.” (~00:05:40) “Early mobilization isn’t just convenient — it prevents decline in complex patients.” (~00:13:25) “When PT is embedded in the ED team, positive ripple effects spread throughout the system.” (~00:22:10) 🔗 Links & Resources Dr. Mountz’s key publications on ED-based PT and service integration Case series and pilot studies showing admission rates and length-of-stay reductions Additional reading on interprofessional collaboration in acute care settings 👤 Why This Episode Matters Ideal listening for ED clinicians, physical therapists, hospital leaders, and health policy stakeholders Combines story-driven examples with system-level evidence and action steps A motivational roadmap for expanding PT scope and creating value at the point of entry ✅ Great For … Audience Benefit Physical Therapists (PTs) Understand how to start or scale ED-PT services Clinic & Hospital Administrators See cost and care benefits of early PT in ED Interprofessional Clinicians Learn strategies for seamless team integration Policy & Advocacy Leaders Get vision-aligned frameworks for role expansion 🎧 Listen or watch now and discover how the ED “front porch” can become a powerful gateway to patient-centered, cost-effective care.

Welcome to a special solo episode of In the ED Now. Today, I’m speaking directly to the new graduates—the DPT and PTA Class of 2025. Whether you’re celebrating with cap and gown or stepping into your first job full of nerves and hope, this episode is for you. This isn’t just a congratulations. It’s a call to action—a love letter to your potential. In this episode, I explore: • 🔬 The shifting landscape of healthcare and what it means for your role• 💡 Why innovation isn’t optional—it’s the future of patient care• ❤️ How compassion remains our most powerful clinical skill• 📣 What it looks like to advocate for patients, our profession, and each other• 🏔 Why top of scope isn’t just where we should practice—it’s where we belong You’re not just joining a profession—you’re inheriting a legacy. And more importantly, you’re being invited to reimagine it. Let this be your reminder: You are the ones we’ve been waiting for. Go forward boldly. 🔗 Links & Resources: • Follow @theeddpt on Instagram• Interested in continuing education? Check out our upcoming courses here 💬 Stay Connected Have a question, idea, or want to share your grad story? Tag @theeddpt and use #TopOfScope so we can celebrate you!

Did you miss journal club? No worries. Listen to the recording in podcast format. Article citation below. Good D. M. (2021). Emergency department physical therapy: An important tool for emergency physicians. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 28(8), 936–937. https://doi.org/10.1111/acem.14300

Who Dr. Meredith Grossman is a physical therapist in an outpatient hospital clinic. She shares her experience and knowledge around burnout in physical therapist practice. Why “Burnout is not your fault.” Episode Takeaways How to recognize and address burnout. Organization and systemic factors contributing to burnout. Actionable strategies for managing individual burnout. Connect with Dr. Grossman healthcareunravelled.com Instagram

Who Dr. Steven Kinney is a Physical Therapist who works at Hackensack Meridian Health. He also is an educator for PT students and PT professionals as well as an early career researcher. His clinical areas of interest include subjects that link together the many silos in the world of Physical Therapy. Why “PTs need to be aware of signs of opioid overdose and what to do to save a life.” Episode Takeaways: How to recognize an opioid overdose How to respond to an opioid overdose How to change the culture and stigma around opioid use Connect with Dr. Kinney on Instagram or Twitter.

Who Dr. Bush has been a PT in the ED since graduating 2.5 years ago. I interviewed Taylor 2 years ago after she had just begun in the ED as a new grad. I caught up with her again to find out how she and her practice have grown over the past two years. You don’t want to miss her lessons learned as they may help you in your practice. Why “I love what I do and I love telling people what I do! Come find out more about what PTs do and can do in this setting from someone who is entirely too enthusiastic!” Episode Takeaways ED PT is more than just placement. How and what you do for education is key. Spend the time. Catching big misses and when you miss… Learn from Dr. Bush at our upcoming Top of Scope Summit in October!

Who Dr. Barnes is a teen sports whisperer that loves the thrill of being a sports medicine provider on the bench with our team! I love being the first line of defense with other providers managing acute and emergent injuries, then getting to follow our athletes through the season to help reach their highest potential. Dr. Barnes is an emergency PT of a different type. She’s a first responder on the sidelines. You won’t want to miss what her day to day entails. There are so many practice lessons for us to be at the top of our scope. Why “Being a sports PT has many avenues outside of the traditional setting where you’re able to work as a team with several providers to elevate the athlete experience.” Episode Takeaways Importance of triage Clear communication to improve outcomes How to brief/debrief Stabilizing injuries Connect with Dr. Barnes theperformanceshift.com Twitter Instagram

Who Dr. Steven Goostree is a PTA to DPT with 15 years in the trenches in a variety of settings including the ED. As a fellow with experience in MDT, dry needling, and persistent pain management he now works in cash pay telehealth. Steven is a retired Triathlete, “foodie,” Corgi lover, sad Chicago sports fan. Why “Be bold! Don’t be timid in the ED. Other HCPs are intrigued with how much DPTs know!” Episode Takeaways Clinical reasoning in the ED “Green leafy” techniques How to assess not guess in the ED Beef up your manual therapy skills as a PT in the ED Connect with Dr. Goostree Drstevengoostree.com