Telerehabilitator, PT Storyteller|Sara Ansari

Uncertainty! As recent grads, we are not sure about what to do next, which specialization to choose, we don’t know if we will land a good-paying job, or we wonder whether to go abroad or stay back. We end up feeling confused and stuck. Trust me, I have been there! But what if we embrace this uncertainty? At every phase in our career, instead of looking for pitfalls, what if we look for opportunities to learn and grow? Well, Sara’s journey teaches you exactly that!

This week’s spotlight features Dr. Sara Ansari (PT) who is s Telerehabilitator and India’s first PT storyteller, PT Anecdote. In this spotlight, Sara writes about her experience as a PT so far. Sara touches upon her experiences in a variety of sets ups including Army Hospital in Delhi, a Corporate outpatient PT clinic, and a Telerehabilitation startup.

Personally, I found her each experience was completely different from the other. I think that is why her anecdotes, are so rich, diverse, and unique. Read this spotlight to learn more about her journey, her upcoming masterclass, and the advice she has for you.

What is your name and title, workplace?

 Dr. Sara Ansari PT

Tele-physiotherapist and India’s first PT storyteller (PT Anecdote)

What is your educational background? (Include the year of graduation)

BPT (Gold Medalist) 2015

MPT (Neuro) 2019

• Fellowship in spine rehabilitation 2019
• Certificate in Empathy in healthcare 2021
• Neurodynamic solution (NDS) certification 2017
• Certificate in Cognitive Behavioral Therapy (CBT) for back pain patients 2020
• Artificial Intelligence for Healthcare: Opportunities and challenges (Taipei Medical University) 2022
• Telemedicine: Tools to support growth disorders in a post-Covid Era (Taipei Medical University) 2022
• Virtual Exercise and Physical Activity for knee Osteoarthritis (The University of Melbourne) 2022

What made your base as a physio strong? (Internship experience in Army Hospital, Delhi)

Soon after my final exams, our university lined up a few interviews for an internship. I was selected in Yashoda Hospital, Ghaziabad, and was offered a small stipend too. However, I wanted to work somewhere I could attend to patients from all walks of life- from privileged class to unprivileged class of people. I enquired and got a chance to give an interview in Army hospital research and referral, Delhi. This hospital is one of the largest and most equipped defense hospitals in Asia. The interview went smoothly, and they kept me waiting for two weeks until I got the call with the good news.

My experience in the army hospital was more than I expected. I attended to patients who were war survivors, bomb blasts, gunshot,s and post-trauma-induced mental disorders, and their physical manifestations. These stories were unique. I used to talk to their family members and feel privileged in the words of my patients. One of them said- you are a hero because you rehabilitate the heroes of the country. And as I write this, I feel the goosebumps. This is the time I started documentation of my journey. My daily journaling routine turned into PT anecdotes- the uncensored and never unpublished version.

On emotionally lighter days, I used to attend the elite people of the country- the president of India, his cabinet ministers, and their families. Everyone had a different version of how physiotherapy should grow in India. They all had a unique perception of pain. In each session, they reflected on a different aspect of living in India and living for India.

I must say, my patriotism has been the highest during that time.

What type of clinical cases did you get to treat there?

Besides seeing the two horizons of a social and financial class of people, I attended a high volume of special cases in the pediatric unit. Every day 150-200 special children used to walk to the OPD for rehabilitation. CP, Duchene muscular dystrophy, and infant hemiplegia were the most common causes. There were a few uncommon cases too, such as Pan cerebral syndrome.

My experience working in an Army hospital was clinically and emotionally very rich. I often rekindle those days and it only brings me one feeling- to feel proud of the profession I selected. Being a Physiotherapist.

Truth be told, and why not? It was during my internship I saw the wonders of physiotherapy. One of our patients survived a C3-4 fracture after falling while para-gliding. When we took over his case, he was a quadriplegic – distressed, frustrated, but stubborn to get better. He was married only for 6 months when he left for his duty to serve the nation. On my last day in the Army hospital, I went to meet him. He was now able to lift his hand and shake hands. The grip was not strong, but it was functional. I knew his gesture. Now, he could stand wearing his orthosis. He gave us sweets; he looked happy but more emotional than us. The batch which got him back on toes was finally getting their internship completed.

What did you do soon after your graduation? How long?

The experience at the army hospital made me volunteer there until I found a job at Max hospital. The work and life at Max hospital were different. I got to experience the end of both worlds. The government sector for defense and a private sector for civilians.

It was just 8 months when I got a call from QI Spine Clinic, Greater Kailash, Delhi. Perhaps they picked my months-old resume from Indeed.com.

What was the interview process like?

I remember I failed the first round of interviews. All I answered during the technical round was bookish jargon. After a week, I got another call from HR, saying she wants me to reappear for a technical round. They called when I was in the hospital. I remember I went to the washroom to give an interview. That time I just answered logically than theoretically. It came as a surprise for me that I cleared the first round and the second round was scheduled with the head of human resources. She was kind and gentle. She asked me some managerial and interpersonal questions. And concluded in the same call that I am selected and handed over the call to their person for salary discussion.

They offered me 5 grants hike; the location was close to my residence and the thought of entering specialized care centered moved me. I agreed to join work as soon as I could finish the existing formalities from Max hospital.

Tell us more about your experience at Qi Spine?

QI is an organization that never fails to deliver quality care to patients. This comes only when the team is skilled enough to deliver such outcomes. The organization ran 3 months of training programs, and multiple exams and finally, I got my confirmation letter.

Fast forward 8 months, I got a call from their headquarters asking if I would like to relocate to Mumbai. The team needed support. I was fortunate to be welcomed as a guest clinician in Maharashtra. In two weeks, I landed in Mumbai, where most of my personality and skill development took place. It was this city where I got promoted from junior therapist to senior spine consultant, and in my last days, I even took the role of trainer where I trained the newly graduated and hired PTs.

My journey in QI was not only clinical but also academic. I published a scientific paper in the European Journal of physiotherapy, contributed a chapter in a textbook, and wrote many blogs on their website. I had a handful of experience, which made me who I am today.

My first and last date at work was the same- 12th December, just half a decade apart. A journey of preventing hundreds if not thousands of surgeries came to an end. It was only to travel, explore the possibilities of a PT career, and recover the burnt I experienced.

How did you start your journey as a telerehabilitator?

After 2 months of retreat, rest, and lots of social tie-ups. I got a text on LinkedIn from Dr. Ashwini asking if I am open to an opportunity. She asked me if I have ever done and would see myself in full-time tele rehabilitation. At that time, I already had 5 patients on tele. They all reported good clinical outcomes.

I found this offer as an opportunity to stay in my hometown and work in a start-up with the most revolutionary physiotherapy in the country. They paid me better and offered many benefits, such as insurance for my family, fix leaves for my festivals, and equipment/ set up for the work. I signed the confirmation letter and started working within a week.

The work was unfamiliar. I never heard of, seen, or did artificial intelligence-based physiotherapy. We had many rounds of training; we worked closely with the IT team and marketing team. Together we helped the engineers improve AI-based goniometer and app-based home exercise plan.

Tell us more about being a telerehabilitator, How does it work?

We learned the nitty-gritty of working with severe cases over a video call. It initially sounded difficult if not impossible, but with time, I learned the nuts and bolts of Virtual physiotherapy.

I recalled my UG professors used to say active exercises and movement modifications are magical. However, in the clinical settings, we relied more on big fancy stuff to get outcomes. In tele-rehab, what helped the acute patients get better was nothing but these active exercises as I was present virtually. I could neither perform manual therapy nor apply electro-modality. I demonstrated what was taught to me a decade ago.

In terms of non-clinical aspects, I got aware of various websites for a home exercise programs, such as Physitrack. I learned to use the 3D anatomy app to explain the biology to the patients so that they could connect with the treatment.

Virtual rehabilitation is very practical. The patient learns stair-climbing on the same stairs which he uses every day; he learns to sit ergonomically on his own desk. I can see the house and help them fix what is not helpful, and utilize household goods they never thought can become a probe in their rehab program.

Can you name books, courses, and workshops that helped you in your journey as a telerehabilitator?

The sky is the limit. I signed up for some paid courses in world-class university to upskill myself. I learned the lesser explored areas of telehealth through courses I did. Some of the courses I did are:

1. Artificial Intelligence for Healthcare: Opportunities and challenges (Taipei Medical University)

2. Telemedicine: Tools to support growth disorders in a post-Covid Era (Taipei Medical University)

3. Virtual Exercise and Physical Activity for knee Osteoarthritis (The University of Melbourne)

There is a book called narrative-based medicine.

Although this book has no mention of tele rehab, this book has been a game changer for me. This book talks about various narratives where effective communication turned a failed case into a successful case clinically. I utilized the art of narrative from this book and framed myself as a storyteller. This skill also overshadowed the limitations of tele-rehab.

As a telerehabilitator, what do you think can be improved? 

The biggest challenge in tele-rehab is awareness. We can easily manage everything else. Building a strong referral system, closely monitoring the case, regular follow-up on HEP, and holistic care eventually help patients. The only challenge is to convince the patient to give virtual care a try. There is an absolute lack of awareness, but just in patients, but also among many healthcare providers. Most primary healthcare providers also discourage telemedicine and divert the patients even if they wish to begin the protocol.

This is the reason I thought to begin the awareness drills and start training the students. Of course, the large number of DMs I received on Instagram is the driving force. I guess I am ready to start my first masterclass.

Like many start-ups, PhytHealth could not service the market due to the high cost of maintenance of the AI-based rehab. The organization turned its vertical from clinical to wellness. We bid adieu to the organization

Do you work remotely or onsite?

I am a freelancer these days. I attend 4-5 virtual patients a day, one home visit, and the rest of the time I do paid copywriting for PT websites.

On weekends, I collaborate with like-minded growth mindset PTs over social media. We do lives, and QnA addressing the questions of young PTs.

As I mentioned earlier, I am in the process of collaborating with PT groups to organize a masterclass on tele rehab for PTs.

What is the pay like for a telerehabilitator?

I give 30-45 minutes per patient and charge per word for copywriting. Being a freelancer, I am enjoying the freedom of working out of time boundaries.

I realized freelancing as a tele-rehabilitator; I earn more than an average full-time onsite clinical job.

This is yet another benefit of tele-physiotherapy. Even if you charge marginal, your investment will always be less than your profit. For instance, if a person charges 500 INR for 30 minutes of a session. This one patient, if seen thrice a week, will be enough to pay your Wi-Fi bills. It saves on your travel time and money.

In comparison, conventional physiotherapy demands travel time, commute expenditure, physiotherapy equipment, and modalities as well as the uncertainty of external factors, such as pandemics, national holidays, strikes and protests done on road, and weather barriers such as rain and hailstorms.

Having said that, not all days are sunny for tele-rehabilitators. One has to be extremely, careful in taking care of seniors who are at risk of falls, conditions which need absolute physical care. In such a scenario, your reference skills come in play.

What is your advice for PTs and PT students?

Over time, I grew in various facets of PT, and for each phase, I only learned to appreciate the uncertainties of PT life.

Physiotherapy in India comes with various uncertainties. It scares a lot of students. I feel you as I have been there. I often find myself at the same crossroad again. It happens to the best of us.

Each career challenge that Allied Health Sciences gives us I see opportunities in it. This is what I would suggest the young PT focus on.

Every time they lack support, they must grow- and grow enough to become the support they once needed themselves.

Editor’s note: Sara speaks at length about the online presence for PTs in this article.

What is your advice for someone who wants to be a telerehabilitator?

In terms of tele-rehab, I believe it’s not optional but a must-learn skill. Whenever we as Physiotherapists can’t be present physically, we must attend to our patients virtually. This will happen when we know the right clinical techniques which work well virtually, knowledge of accurate clinical outcome measures, how to assist patients to select the right application, internet, and handle the camera.

If you ever feel overwhelmed, know that Rome was not built in a day. You have all the options but do not give up on yourself. Tele-rehab is the future of physiotherapy. The generation that entertains, learns, and retails virtually, would always prefer virtual care unless proved otherwise.

What do you love about what you do? 

Physiotherapists are artists. If I claim to have seen 1000s of patients, and written 10s of blogs, I know each treatment protocol, and each web content I generated was unique, proving no end to creativity. This breaks the monotonous nature of any health condition. Every day a new story, a new perspective, and a new meaning of health.

Do you think you have brought any impact on the PT community?

PT life has two aspects. 

1. Contributing to students and the scientific community, and 
2. To the patients.

I have been fortunate to counsel and guide female students in my hometown to take PT as a profession. It’s been 11 years since I got enrolled in BPT, and the next lot of female PTs in this small city of UP will be graduated next year. The gap was huge but I am glad I was able to bridge it. It took me a lot to bring awareness and absorb the taunts of society as they saw physiotherapy as a profession not fit for females. 

To my PT community, I have publications and upcoming masterclass where I would train students and professionals to become tele rehabilitators. 

Where can people reach you?

I am most active on Instagram, that’s where you can read my PT Anecdotes and have a one-to-one conversation with me. I have a small group of PT Anecdote Tribe mates, where we share ideas, cross-referrals, and stories without spamming anyone. 

For professional highlights and career updates, I am reachable on LinkedIn. 

For those who want to reach out to me directly, write me on sarawrites01@gmail.com