PT Doctoral Students Apply Lessons to Real World Needs at LAGO Clinic

The Miller School of Medicine’s dedication to community involvement is flourishing in the Department of Physical Therapy. The Local and Global Outreach clinic (LAGO) opened a year ago as a pro-bono clinic that offers physical therapy services to underserved patients in Miami-Dade County. The clinic uses physical therapy doctoral students to strategize operations and deliver clinical care — all supervised by the University of Miami’s expert team of physical therapy practitioners.

Teresa K. Glynn, D.P.T., M.B.A., Vice Chair for Clinical Services for the Department of Physical Therapy, is proud of the students and their hard work. She explained that the seeds for the clinic were planted in 2010, after PTs from the department became members of the team of early responders to the devastating earthquake in Haiti. Because students were not able to participate in the relief efforts in Haiti, they were eager to create their own global outreach experience. So they began planning, and in 2014 went on a partnered mission trip to Costa Rica’s poorest communities — and LAGO was born.

“At the time,” Glynn said, “we were also thinking that in addition to going global, we should address concerns in our own community where we know needs are also quite great. Several students were very interested, and a small group came together to participate in the organization and development of the clinic, which opened within two years.”

Every Tuesday and Thursday from 7 to 9 p.m., students enrolled in the three-year physical therapy doctoral program — one of the top 10 such programs in America — are applying lessons from the classroom to real-world situations. They work with referring centers and doctors, schedule patients, create care plans, perform therapy and manage collection of quality outcomes.

The clinic’s primary medical partner and referral source is the San Juan Bosco medical clinic, which has been operated for more than two decades by the Sisters of St. Joseph Health Foundation. During their work, the students have had the opportunity to evaluate, diagnose and treat the San Juan Bosco patients. They have also been able to identify signs that may reflect more serious health concerns requiring further follow-up with San Juan Bosco.

“Every night we huddle before patient care starts, and we tell the students to be on the lookout for additional concerning symptoms in their patients,” said Michelle Tsiknakis, a 28-year-old 2017 physical therapy doctoral candidate who helps run the clinic. “There have been a couple times when the patient’s presentation led us to suspect a cancer, and we helped catch things earlier than might have been the case otherwise.”

Tsiknakis was born in Miami and raised in Baltimore. She came back to attend the University of Miami for undergraduate work, then lived for three years in Guatemala as a health, hygiene and HIV infection prevention volunteer for the Peace Corps. She said the Miller School was a natural choice for her, largely because of its focus on community involvement.

Jimmy Dhah, 28, is another 2017 physical therapy doctoral candidate. Raised in Fresno, California, his undergraduate studies were in environmental chemistry and he worked as a research associate in nano-engineering. He then got interested in physical therapy’s potential for research. The Miller School’s faculty and top rankings set it apart.

He shared that the LAGO clinic also offers the chance for physical therapy graduate students to work alongside post-graduate orthopedic physical therapy residents. The partnership has created a learning environment for the faculty, staff, and residents to share their advanced knowledge with participating students.

“We learn from all of them, including the residents, and they bring valuable lessons learned in prior clinical internships,” said Dhah. “The interaction also lets residents serve as clinical instructors, which is a deep interest for many of them.”

The patients seen in the clinic are low-income and underserved. Conditions are often chronic — aggravated by time. It’s common to treat osteoarthritis, sciatica, rotator cuff injuries and degenerative neck and back pain that has existed for years. The result is an unplanned crash course in caring for more complicated needs, and those needing longer-term care.

As the two student leaders get closer to graduation, they’ve been busy training and mentoring their second-year graduate peers to take over the LAGO reins. Tsiknakis reflected on the immersion experiences she has gained.

“I needed something like this,” Tsiknakis said. “I needed to know that I could do outreach for patients who could not afford me, but needed me. I love the cultures we are getting exposed to, and our patients are so grateful they are getting this service.”

Glynn added that the LAGO clinic has provided more than 500 visits in its first year, adding up to thousands of dollars in pro-bono care. She believes it is just the start.

“We would like to explore further innovations in health care, such as primary care participation for physical therapists and perhaps physical therapy telehealth,” she said. “We also want to create a vehicle for scholarly productivity.”

Glynn also shared her vision of evolving LAGO into a combination of the local evening clinic with more occasional trips overseas — the Dominican Republic and Cuba both have been discussed as potential destinations.

“We are just starting to gather outcomes data that will demonstrate how patients are actually benefiting from the service being provided in the pro-bono clinic,” said Glynn. “We expect to be able to show how a student run pro-bono clinic truly helps people, helps the students, and this helps a community. It’s a win-win-win.”

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