Fellow Jean Minkel

Jean L. Minkel, BS, PT

Born: April 9, 1958 - Boston, MA

Entry into the AT Field: 1982

I am a physical therapist who started in pediatrics. In school, I was trained on gait/ambulation. At my first job I was the primary therapist for 21 children with multiple disabilities. Much to my surprise, only one child ambulated, all the rest used a chair as their primary mobility device. I soon found I was just as happy with a socket wrench in my hand fixing chairs as I was trying to use "Bobath techniques" to "normalize tone". Finding RESNA was like a kid finding a candy store. Finally a group of professionals who shared my passion for trying to find functional solutions for people with long term disabilities.

The children of the Mass Hospital School (MHS) were my initial inspiration. MHS is a unique residential educational facility for children with multiple disabilities. I gained a 24/7 perspective of life with a disability. PT was only one piece to the complex puzzle of devices, supports, strategies and assistance needed for a young person to become a functional adult with a disability.

In pediatric PT, you need to be very patient. There is maturation, surgeries, orthotics, OT, PT, Speech, school, etc. Seeing results of your work can take a very long time. I am afraid I was not that patient. When I first had the opportunity to put a previously non-mobile child into a power chair and watch him "do donuts" with a huge grin - there was an immediate reward.

I have had three important mentors, all of whom I met through RESNA. Martin Ferguson-Pell enabled me to be part of creating the Center for Rehab Technology (CRT) at Helen Hayes Hospital in NY. CRT had a mission of providing service delivery, generating research questions and providing educational opportunities. Attracting a talented, multi-disciplinary staff, CRT quickly gained a national reputation. A superb example of the mission coming to life was CRT's contribution to the development and testing of interface pressure mapping systems. C. Gerald Warren was the visionary behind the RESNA credentialing program. My first contract was to develop Gerry's vision into a concrete program. Throughout the process, Gerry imparted his wisdom, integrity and total commitment to the high standards of "Quality Assurance" which had a huge impact on my practice. Mette Norgaard has been a professional coach and wonderful long-time friend. Our paths first "crossed" when Mette worked for E&J. I first viewed the video tape series on power mobility for children Metter produced while at MHS. Ten years later, I would be producing the videotapes, "Spending or Investing: Funding of Assistive Technology" in collaboration with Mette in her role as Chair of Industrial Relations Committee. Mette has been a wonderful mentor in the fine art of balancing life and the passion for AT (which can become all consuming).

I love to think we make a difference in people's lives. Twenty-five years after beginning this journey, I have the same belief. I was asked a similar question ten years ago and my answer is the same today, I work to assist people I work with to be as successful as possible. I strive to have our field be as successful as the people we serve.

Three years after leaving MHS to move to NY, Louie, a former non-verbal student with a diagnosis of cerebral palsy invited himself to NY for the weekend. (I lived in a third floor walk up.) No problem, Louie had it all worked out. We had a wonderful weekend using all kinds of assistive technology. The real thrill was just to be together in NYC having FUN! This young man's spirit and self-confidence was a thrill to experience and share. I consider myself part of the "second generation" of RESNA. I was the beneficiary of pioneers like McLaurin, Hobson, Trefler, Bergen, Milner, Warren, etc. I have made two solid contributions which will strengthen the foundation of our profession: Facilitating the creation of the ATP and ATS credentials from "blue print" to a reality and contributing to the creation of the CPT code for AT Assessment.

I once had a colleague, who when asked to define failure gave the following response; "I define failure as getting nothing out of a situation. Using that definition, I have never failed, as I always try and learn something from each situation." However, there was the time I recommended and delivered a new adaptive stroller system for a family who came to CRT. Brilliant technology I thought! Six months later they was back in the clinic for an adaptive stroller. They acted as if they had never seen me. Their daughter was in a traditional umbrella stroller. No mention of the recently delivered system was made. So I asked, "What about the system you received six months ago?" Apparently it was the system they sold at the yard sale! The family explained the "brilliant technology" was not functional for a family with several young children when in a parking lot in the grocery store. I learned a very valuable lesson about listening for true need and seeking truly functional solutions, not just falling for "brilliant technology."

In my "early days", when we had "no equipment," we had a lot of fun "making things." It was a great thrill to be apart of the R&D of so many "commercially available" products. In those early days, the RESNA Exhibit Hall was the showplace of a lot of "garage" inventors. Because AT relies on 3rd party payment, increasing restrictions on available funding has created new challenges. The time is right for increased collaboration with groups representing all the varied stakeholders, most importantly groups involving persons with disabilities. One of the greatest changes in the last 25 years is the overwhelming presence of technology in our everyday lives. Everyone expects access to "time saving" technologies. The general population's familiarity with technology has taken much of the "technophobia" away from assistive technology. Unfortunately, especially in the area of seating and mobility, just as more technology comes available, the quality of manufactured products is going down. Partly because of changes in the 3rd party payment system and partly due to changes in worldwide manufacturing, our durable medical products are not nearly as durable as they were 10-15 years ago.

There is no reason our future can not be bright if we are willing to be open and flexible to changes around us. The marked decrease in "technophobia" along with the increase in persons aging both into disability and with a disability, are two factors which create demand for our goods and services. We need to be open to evidence-based research. Change is not to be feared, but to be embraced and allowed to go on to create a larger, stronger field of service and product development.

I have been a long-standing member of the ANSI/RESNA W/C Standards Committee, Chair of the PSB and Treasurer. I serve as RESNA's representative to the Program Advisory and Oversight Committee on Competitive Acquisition for DEMPOS. Through my involvement in W/C Standards I have been able to establish an international network of colleagues. Because of my standards involvement I, along with my colleagues Peter Axelson and Rory Cooper, contributed to the development of the IBOT™ brought to the market by Johnson & Johnson. I have successfully managed an independent consulting company for 10 years by combining skills of technical translation of clinical need and visa versa. All of my activities within RESNA have contributed to the long-term success of this venture.

With sufficient focus, RESNA could greatly contribute to Evidenced Based Research influencing public policy. The field is in desperate need of research to support the products and services being provided by our members. A focused research agenda to support clinical practice and product reimbursement will be critical to our future as an organization and more importantly to the persons with disabilities in need of the highest quality goods and services.

Keep the passion in mind! What drew you to this field? Never lose sight of that goal. Always keep the functional independence of clients, so they can achieve maximal social participation, foremost in your mind. I consider myself incredibly fortunate to have found work I love to do! It is truly a gift. Keep looking for ways to have your own work be FUN, rewarding and Love doing IT!