Anja Bliss

27MAY2022

Journal 2

Dr. Grossnickle

Though it is week 2, I was able to start my first day on Monday. The contract between the

school and hospital was official in the late morning, so I was able to come in a little after 10. I

was able to see the tail end of Heather’s second patient and then get filled in on who she was

seeing next. It was interesting seeing how things differ from state to state. The billing system for

the state of Texas is different than Michigan. They use the 8-minute rules for both commercial

and federal billing. There are also special rules when you see 2-3 patients at the same time. If

both patients have federal insurance that cover group, they have 25 min each to work with for

billing even if you see both for the hour. They can be billed for 3 units though because they

automatically get 8 min of group. The entire thing was confusing the first few days because it

was different than our system in MI.

Other than the billing, I noticed discrepancies with MMT procedures and ROM norms.

That was a tough thing to work through because I wanted to make sure that Heather knew that I

wasn’t stupid when I said a different ROM norm than her. I even pulled up the lectures to show

my source. She told me “Just practice what you were taught, so that you can pass your tests at

school, but I don’t agree.” It was kind of funny but also concerning. I was glad that she validated

that I knew what I was taught, but it was upsetting to know that the ROM norms aren’t universal

like I had previously understood them to be.

 The MMT procedures were also slightly different which was less of a surprise but there

were still surprising aspects. Heather did not perform break tests on anyone, and she used a

greater scale than we were taught, including 4+/4-. I didn’t know how to grade a make test on the

normal MMT scale, so I had trouble getting a feel for what I needed to do at first. It slowly got

easier, but it felt like I was quickly learning a new language.