Featured Fellow: Dr. Valerie Phelps PT, ScD, OCS, FAAOMPT

Dr. Valerie Phelps, PT, ScD, OCS, FAAOMPT graduated with a BS degree in physical therapy from the University of Minnesota in 1981. She was certified by the International Academy of Orthopedic Medicine, IAOM, in orthopedic manual therapy in 1989, and became an international instructor for the IAOM in 1994.

She became a Board Certified Orthopedic Specialist, OCS, through the American Board of Physical Therapy Specialties in 2003. She is a Fellow with the American Academy of Orthopedic Manual Physical Therapists, FAAOMPT. She graduated with a Doctorate of Science, ScD, in Physical Therapy from Texas Tech University, Lubbock TX, in December 2011.

Along with being the founder and current education director of the IAOM-US, (www.iaom-us.com) she has lectured throughout the United States and Europe. Dr. Phelps has co-authored several books, book chapters, and numerous peer review journal articles. She is the founder and practice director of employee-owned Advanced Physical Therapy (www.aptak.com) in Anchorage, Fairbanks, the Mat-Su Valley, and the Kenai Peninsula, in Alaska.

What inspired you to pursue fellowship training? 

I am inspired by the profession of physical therapy, and I wanted to be the best that I could be for my patients.

What fellowship program did you attend and why?

I attended the International Academy of Orthopedic Medicine – Europe fellowship program, and then tested into recognition by the AAOMPT.  The IAOM program puts great emphasis on knowledge of anatomy, pathology, and the ability to determine a clinical diagnosis. The tools of treatment then become so much more effective when you know what you are treating. IAOM (present since 1977) has always emphasized explaining findings to the patient so that they can be reassured; I have found this to be essential in establishing rapport and starting the healing process with my patients.

I tested into recognition with my two colleagues, Dr. Jean Michel Brismee and Dr. Phil Sizer; we then went on to establish the IAOM-US Fellowship program that collaborates in some of the coursework with Texas Tech University in Lubbock, TX. This program is a distance learning opportunity for clinicians, and coursework completed in the fellowship program can be applied toward graduate school credits to achieve a terminal professional degree, a Doctorate of Science (ScD) in Physical Therapy.

What did your fellowship program entail (as far as specific training, etc.)?

The emphasis of the IAOM program was clinical diagnosis, with an underlying philosophy of looking for and recognizing clinical patterns that either lead to a diagnosis or lead one to look for new kinds of pathology. For instance, the IAOM was teaching about femoral acetabular impingement in the early 90’s, micro instability of the hip in the early 2000’s, ischemia reperfusion injury for the past 10 years. What we do not understand in the clinical setting, is not the patient’s fault; it’s our lack of knowledge. What we judged to be ‘malingering’ 35 years ago (I’ve been a physical therapist since 1981), research and anatomical/neurophysiological/etc discovery has clear explanations for today.

We also had a very strong biomechanics manual therapy emphasis as treatment of both myofascial and joint structures, and upon restoring structural integrity in the kinetic chain, then progressed to skills application and movement enhancement. 

Are you trained in any specific areas of manual therapy (e.g., Maitland, McKenzie, etc.)? If so, why did you choose that area?

As a young therapist, I went through periods of treating with a purely Maitland, then Barnes, then McKenzie, then Kaltenborn (and the list went on) approach. No single approach was successful with all patients. When I started studying with the IAOM, it was clear that if I knew what I was treating, I could select techniques from any of the ‘specific’ areas of manual therapy! Suddenly I had 100’s of tools to utilize based on patient selection. Treatment philosophy of the IAOM is that ‘it all fits’ – the expertise comes from knowing when and with which patient.

What advice would you give to new grads aspiring to pursue residency/fellowship training?

When I see new grads and novice clinicians 1) teaching the same exercises I taught to patients 37 years ago, and 2) teaching the same exercises to a patient whether they’re 18 or 80, I get heart-sink for the profession. I fear that some of this occurs when a new grad becomes quickly disengaged with patient care and goes into teaching before gaining clinical wisdom. When that happens, there is simply a regurgitation of basic information; this does not allow for elevation of knowledge in the profession.  We can choose to behave as technicians, which is what we were considered when I graduated 4 decades ago, or we can rise to become the first-line health care provider who efficiently and successfully helps a client through musculoskeletal injury and dysfunction. We align more with medical education when we accept the rigorous clinical experience of residency and fellowship, and we gather wisdom along the way.

By investing energy into a level of excellence and experience that allows you to bring day to day evaluation and treatment skills into an automatic function (which is a result of residency and fellowship), this leaves room in clinical reasoning for a much broader and higher level of thinking. Someone asked me last week: ‘you are always mentoring others, who mentors you?’. My answer: ‘My patients are my mentors; there is not one day that goes by that I don’t learn something new.’

As a result, I am as enthusiastic about my work as I was the week I graduated. Clinicians who have completed residency and/or fellowship are more confident in their day to day interactions with patients and they seem to really enjoy the blend of patient and colleague relationships. Critical thinking and clinical reasoning come more naturally, making every day exciting and fun, with perpetual growth in the profession.

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