A Day’s Work: Physical therapist

Donna DeMilio (photo by Lauren Thomas)

The attention focused lately on the nationwide opioid crisis has shed much-needed light on the complex problems associated with the use of addictive drugs for pain management. What hasn’t come up as often in the discussions are alternative solutions to manage acute or chronic pain without resorting to opioids in the first place. And that’s where physical therapy comes in. 

October is National Physical Therapy month, designated as such in 1981 by the American Physical Therapy Association. A different theme every year heightens awareness of the benefits physical therapy can bring in helping people improve mobility and find relief from pain. This year’s effort is concentrated on raising awareness of physical therapy as a safe and effective alternative to opioids for pain management. 

Here in New Paltz, Donna DeMilio is the clinical director at Access Physical Therapy & Wellness. “We have all kinds of different modalities that can help with pain without getting you addicted to medications,” she says. “Try physical therapy for pain relief first. Our hands can help, we do fissure work, we have the heat, ice, ultrasound, laser… we’re the ones that will help make it better, and we coordinate with your doctor. We see what works and what doesn’t and go from there; every patient is different.”

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DeMilio was first made aware of the value of physical therapy when she was just six years old. “My grandfather had a stroke, and was unable to speak, or move half his body. He went from being a strong guy to disabled. But when he went to rehab, he came out walking and talking. He used a cane and had some disabilities, but he was able to move again and enjoy life still.”

By high school, DeMilio was already working toward a career in physical therapy. She loved math and science, so a career in healthcare seemed a natural fit, and having witnessed the benefits of rehab for her grandfather, “I got what that was all about,” she says. “And I loved playing sports — I played softball and volleyball — so I decided to do something with athletes, and with people getting better.”

She graduated from Quinnipiac University in Connecticut with a bachelor’s degree in health science and a doctorate in physical therapy. DeMilio has also been certified in LSVT BIG, a treatment for people with Parkinson’s disease, and RockTape Fascial Movement Taping (a technique that promotes pain relief through changing how your body interprets pain).

Her first experiences as a physical therapist were at Vassar Brothers, where she worked for three and a half years full-time, simultaneously working two nights a week at the Access Physical Therapy clinic in Wallkill. “Then that flip-flopped,” she says, “and I worked for Access full-time and per diem at the hospital when needed.” She transferred to the New Paltz Access clinic when it opened in March of 2016 — in a much smaller space they’ve since outgrown — and was appointed its clinical director in January of 2017.

The position involves scheduling and jumping in where needed, basically overseeing everything and making sure things run smoothly. “I like that role,” DeMilio says. “I get to see how everyone interacts, and patients talk to me about how they like their therapist. I love treating patients, but I get to see the back end of everything that happens in the office, too.” It’s almost like having her own physical therapy practice, she adds, but with a supportive boss she can consult. The company invited her to attend a leadership development program last year, which taught the participants about every aspect of the business from leading the staff to billing and marketing.

Originally from Westchester County (near Valhalla), DeMilio now lives upstate in Durham. She and husband, Dave, who works for the U.S. Postal Service, will celebrate their fifth wedding anniversary this month, and the couple have one daughter, 18-month-old Riley.

In chatting with DeMilio recently, we asked her a few questions about her path to becoming a physical therapist and what a day’s work is like in that profession. 

What is the most challenging thing about being a physical therapist?

Dealing with insurances. That’s definitely the hardest thing! They only give patients a certain number of visits, so you have to figure out how to use the visits appropriately so the patient gets better in the time frame they give you. And getting the best for the patient; sometimes people need more time, and insurances will give you more visits, but you have to fight for each and every one, going back and forth with the insurance representative, and they always have the final say. It’s frustrating.

What part of the work do you like most?

Helping patients and seeing them get better. From the time they walk in to the time they’re completely done, it’s amazing to see their recovery, and see patients feel better. It’s very rewarding interacting with them and seeing how they’re doing.

Have you seen the field change much in the time you’ve been doing this work?

I’ve seen the changes from the advancement of surgeries. My first clinical was in the hospital, in acute care, and a knee replacement then was a three-hour-plus surgery, and the patient was in the hospital for many days before being sent to rehab and then home. Now you go into the hospital and you’re home the next day. You get physical therapy that day; quicker and more aggressively. Even ACL surgeries are more advanced now with the protocol allowing patients to do more and get better faster. And the faster you’re in your own environment at home, the faster you’ll get better.

What personal attributes do you think a person needs to be a physical therapist?

People skills, friendliness and wanting to help people get better. When you’re in pain, you don’t want to do anything, and there’s a fear factor for patients, too; ‘What do I do, how do I do it?’ We try to make everyone comfortable and at ease here. And you have to always want to learn more, to expand your knowledge. You’re never done learning.

How do you learn the ropes when you begin as a physical therapist?

You have four clinicals throughout school in different settings; I first came to Access as a student in 2011 doing my last clinical. You have a mentor, and you can go back and forth with them, asking questions. There’s always someone with you, and you’re never overscheduled. You learn how to use the system, how to manage patients, and once you’re ready to be a therapist, you take your boards and then you’re ready for the field.

How many years of school are involved to become a physical therapist?

It’s six and a half years of school for your doctorate. Then once you’re licensed you have to take 36 hours of courses every three years to keep your license. There is also a physical therapy assistant (PTA) career with a four-year program. A physical therapy assistant can treat patients just like a therapist, but can’t do evaluations, discharge a patient or change the plan of care.

Do you think there are any misconceptions out there about what physical therapy is?

Yes! Sometimes people think if they come in, they’re going to be in pain. I’ve heard them refer to us as ‘physical torturers!’ They’ll say, ‘I went to some place and I was in pain for days.’ But we’re not going to give you pain for days; that’s not what we do. We’re here to make you better! You might be sore, or have aching muscles, but if you’re sore for more than a day, let’s take a step back. 

Since pain and injuries can happen to anyone, you must work with all types of people.

That’s true, and no patient is ever the same. Everyone handles therapy differently; you learn who to be more gentle with, who to be more aggressive with. And we work with every age group; I even have some babies that I treat. The age range is probably four months up to 96-year-olds, now.

Every exercise is different, too — people like certain things, they don’t like certain things. But we have a nice atmosphere here where we work together and we communicate, and we know who is better with a certain therapist, and we see whose hands they like better. 

You also learn who tolerates pain better. It can be good to have a high pain threshold, but it can be bad, too, because that person will push through everything and that makes for more inflammation and pain, and is not going to help you in the end. People think ‘no pain, no gain,’ but that’s not how it actually works.

Access Physical Therapy & Wellness is a family-owned business. Chris and Steve Albanese — brothers as well as physical therapists — began with one small clinic in Montgomery, NY and have since opened more than 30 “Access” locations. The New Paltz clinic is located at 246 Main Street, Suite 8 in the Cherry Hill Plaza. In celebration of National Physical Therapy Month, all patients who come in during the month are eligible to win a raffle for a gift basket of health-related items. For more information, call (845) 419-5033 or visit https://www.accessphysicaltherapywellness.com/. 

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