What is your full name and title?
Angela Forsyth, PT, DPT
REBUILD Program Director for Diplomat Specialty Infusion Group
Where did you go to PT school, and when did you graduate?
Where did you work when you first finished school, and for how long?
I worked at Thomas Jefferson University Hospital, a large tertiary care center. I did all of the rotations, from acute care to the rehab unit. I eventually landed in the outpatient department and also became the liaison to the hemophilia program. I was there about six years.
When did you first start carving out your niche?
Frankly, it all started because I had a supervisor who wasn’t interested in a new opportunity at our hospital. I was a newish grad (out for two years). Around that time, the Centers for Disease Control (CDC) was starting a surveillance program of blood products being used by patients with hemophilia.
When the CDC started scanning for blood safety, they also added a musculoskeletal component for data collection, which meant data and ROM measurements were required from us PTs.
I joke that my supervisor set me up for my dream career, but it’s true. I was at a hospital that had a department with a federally-funded hemophilia treatment center, so my supervisor figured the best solution was making one of the staff PTs figure it all out, and she was like, “This is a great project for a new grad!” (Translation: Here’s a project with a bunch of work that I don’t want to do!)
I can never thank her enough for having that attitude! My niche practice in hemophilia that I began in those days has literally taken me around the world.
After six years at Jefferson, I was asked to officially join the hemophilia team at the Hospital of the University of Pennsylvania when they moved there to set up a new center. I worked in the comprehensive care model with that team in the hemophilia and thrombosis program for 11 years.
Our team included a hematologist, nurse, social worker and physical therapist. Outside of work, I was very active in my local area and with both the National Hemophilia Foundation (NHF) and World Federation of Hemophilia (WFH), in leadership and faculty roles relating to the musculoskeletal complications on bleeding and working to improve physical therapy care for affected individuals.
When the leadership at Penn changed, I decided to move on as well, but always remained active in the hemophilia community with patient care as well as with the NHF and WFH.
Along with my job in home health, I started work as a consultant in the hemophilia centers at Christiana Hospital in Delaware and RUSH University Hospital in Chicago and also established a consulting relationship with several pharmaceutical companies that manufacture hemophilia infusion products.
At what point did you wind up pursuing a non-clinical role, and why?
I wasn’t actively seeking a non-clinical role. I had been treating for years with my specialty niche of hemophilia and working with patients with bleeding disorders and, as I mentioned, working my way more into consulting work. While I was doing this, one of the nurses from the hemophilia community was emailed a blast of recruiting info.
We hadn’t crossed paths in years, but this nurse thought of me when she saw one of the postings, and she contacted me. One thing led to another, and I wound up leaving clinical care for my current role!
What exactly is this non-clinical role?
I’m the Program Director for REBUILD at Diplomat Specialty Infusion Group. REBUILD is a leading-edge collaborative care program designed to enhance physical therapy services, and promote positive therapy outcomes for people with hemophilia.
At first, I wasn’t sure what to expect, but knew it would be a great opportunity to work in my niche practice and be able to help more patients than just the ones in my clinical practice.
It turned out to be a role with a national specialty pharmacy, Diplomat Specialty Infusion Group (DSIG), which is built on serving the unique needs of individuals who receive specialty infusion treatment. DSIG brought me on because they wanted to provide a value-added service to the community, and my role as the REBUILD program director is focused specifically on helping patients with bleeding disorders like hemophilia.
What was this service they wanted to add?
Lots and lots of support and education. Most patients with bleeding disorders have muscle and joint problems from bleeding. They bleed into their muscles, and also into synovial joint spaces.
This causes lots of short-term and long-term problems. Patients will wind up with lost ROM or function, and they might develop contractures or hemophilic arthropathy, which is similar to OA.
These patients need a physical therapist, but many of us PTs don’t learn much more than a cursory paragraph or two about the coagulation cascade and bleeding disorders during PT school. The company that hired me wanted to bridge that gap and provide this much-needed education to both patients and therapists.
So what exactly does your role as program director entail?
I mentor PTs who don’t have experience with bleeding disorders, and I provide them with educational resources in order to more confidently work with these patients.
My role is to support any patient who has a bleeding disorder and a musculoskeletal complication that is appropriate for PT services, and enroll them in this free program. There is no purchase or obligation to the patient or the therapist.
I then help these patients find a PT in the area who takes their insurance. I meet with these PTs one-on-one, and I work with them in the background to help the patients get the treatment they need, and help the therapists have the support and resources to give the best possible care to these patients.
So basically, I help other PTs successfully treat patients with bleeding disorders.
Program Director sounds like an incredible role for you! What do you love best about it?
I feel like my work is my calling. I am always working with PTs who want to do more to help their patients. I enjoy making life easier on PTs, too. I give them research and specifics on treatments, which helps them feel more effective and empowered to provide the best possible care.
There are some hemophilia-specific quality-of-life and assessment tools, too. My role involves serving PTs the best information possible.
How was this role originally conceived?
The company is called BioRx, LLC, d.b.a. Diplomat Specialty Infusion Group. Diplomat is the nation’s largest independent provider of specialty pharmacy services, helping people with complex health conditions in all 50 states.
Diplomat Specialty Infusion Group (DSIG) like it sounds, is Diplomat’s specialty infusion division. DSIG is built on the combined experience of experts in a range of areas and holds to Diplomat’s tradition of compassionate care.
Creating this role is one example of that commitment. Diplomat is the only factor provider in the country to offer a nationwide physical therapy program to help patients, providers, physical therapists, and health insurers manage the complications and costs of hemophilia-related joint damage.
At the end of the day, when I was hired on, I was told that my job would be to do good things for the community.
What are some of those good things?
I’ve had to figure them out along the way! But my work experience definitely helped me know where to start. After 18 years of treating patients with bleeding disorders, I had identified a big problem to solve: many patients couldn’t see a PT with hemophilia knowledge for a variety of reasons.
Many patients with bleeding disorders needed specialized care, but they had to go to local therapists for convenience and/or insurance reasons. But then they’d come back to me with complications and bleeds.
I realized that was part of how I was able to create a niche from being a specialist in the first place. And I realized that I could take this specialty, niche education and experience I had, and I could spread it to many more PTs out there.
You can learn a bit more about how physical therapy helps patients with bleeding disorders here!
This is a very niche role. What department would you say you’re in?
Technically, I’m a member of the marketing department. I don’t have any clinical role at the company.
What do you outside of this role?
I am still active the conferences and projects with National Hemophilia Federation (NHF), and the World Federation of Hemophilia (WFH). I have had the opportunity to attend and speak at meetings and trainings all over the world, over 20 countries by this point.
What are some of the pros and cons of your role?
Pros – I love helping a much larger range of people by educating other therapists. I’m able to reach more people and provide a service to people who wouldn’t feel as safe in therapy otherwise. It’s a wonderful feeling to be supporting both patients and therapists!
Cons – There really aren’t any, but it is a transition as a PT to have full control over patient assessment and intervention to moving into an educational-only role. There are still times when I would still like to just do it myself!
What is one of the biggest challenges of the role?
I’d never worked in a sales or business model before, so now I work with sales people with that goal in mind. I am very aware of following all PT licensing regulations and compliance rules, and sometimes it’s a challenge for the sales staff not to see me as the patient’s health care provider.
What is a good person for this type of role?
This type of role is great for someone independent. Someone who is a self-starter, and is confident in his or her own decision-making skills and ability to think outside of the box.
There is no recipe for how the job works, so you’d need to be a good analytical thinker, organized, and efficient.
There was nothing to work from, so I had to create the whole job and design the program from ground up.
Is the company planning to expand the program?
Diplomat constantly evaluates the scope of our programs and services to best serve our patients, including whether to expand programs.
How is the pay in this role?
The pay is higher than I would receive at a university-setting hospital. It is probably comparable to home health.
What is the growth potential like in a role like this?
I get annual performance reviews every year, where I’m rated on a few elements, but not productivity! It’s more things like networking and teamwork.
Because I’m the only physical therapist on staff, and the only one in this role (and I LOVE my role), I don’t think much about what is next. I could probably move into another area in the specialty pharmacy. Also, there are education and sales departments, so in theory, I could transition into new roles in those departments…but I don’t want to!
Do you have any books, podcasts, or courses you’d recommend for those wanting to learn more about hemophilia, or about your type of role?
I was always involved with NHF or WFH, as well as local hemophilia support groups, which also helped. Nowadays there is a bigger network of hemophilia physical therapists, so I have a range of regional mentors that I use to connect other therapists who are interested in learning.
There are also more textbooks and research articles that are available for baseline hemophilia and PT information. I frequently offer free “Hemophilia and PT 101” webinar trainings to any PTs who are interested. If you’re interested, please reach out to me directly through the site!
Do you have any special advice for someone pursuing a role like this?
If you want to work outside of the clinical setting, find your niche! Find a type of patient or diagnosis that fascinates you, and start taking all the CEUs, weekend courses, etc. that you possibly can.
Read the latest research, and become the go-to resource for that particular diagnosis or patient population. Volunteer for patient associations or non-profit organizations by helping on a committee or project, or as faculty for an educational meeting. In short, get involved!
Thanks for your insight, Angie!