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Focus on Susan Deusinger, PT, PhD, FAPTA

Susan (Susie) Deusinger, PT, PhD, FAPTA is a professor of physical therapy and neurology, director of the Program in Physical Therapy and former director for On the Move™ -- a physical therapy series with expertise in managing physical activity and exercise needs associated with obesity.

Dr. Deusinger sees patients at Washington University Physical Therapy Clinics - at 4444 Forest Park Ave., Suite 1210. St. Louis, MO, 63108.

FOR AN APPOINTMENT, PLEASE CALL 314-286-1940.

What happened in your course of schooling that influenced you to choose physical therapy as your specialty?

Following a good background in chemistry, physics and math at Kirkwood High School, I entered Grinnell College in Iowa as a math and physical science major. However, taking biology and human physiology courses during my first two years of college cemented my interest in biological science. This led to choosing biology as my major – even though connecting this major with an eventual career came later.

Because I had a friend who wanted to be a physical therapist, I volunteered as a candy striper at St. John’s Mercy in physical therapy (PT) after my sophomore year in college. I learned that physical therapy fit my interest in science, as well as a long-standing commitment to helping others have a better life. Physical therapy wasn’t like anything my family had done – my dad was an architect, my mom was a math major, and my sister is a teacher. After that summer at St. John’s, and seeing how valuable and interesting PT could be, I decided to become a physical therapist; it’s that simple. And I never have regretted my decision -- it’s been a wonderful career.
Drs. Susie and Bob Deusinger


What brought you to Washington University?

During the early years of my career, I had this undefined goal that maybe eventually I would work at a university helping students learn to be good physical therapists. I also knew that I wanted to be part of Washington University. I had worked with students from many universities and the best ones came from Washington University. These students actively analyzed their patients and creatively figured out what to do. This is the type of student I wanted to help develop a career in PT!

Before doing that, however, I wanted to work in every type of clinical facility that could offer PT so that I could understand a wide range of patients and their need(s) for PT. Although I almost made that in my 10 years of full-time clinical practice, I was offered the opportunity to work at Washington University earlier in my career than I had dreamed. I remember commenting to a professional colleague that she had the ideal academic position - directing PT clinical internships. So when she decided to leave that position, she remembered what I had said – I was interviewed and hired in 1978 as a faculty member.

I’ve stayed at Washington University for 31 years because my job has changed so much and so meaningfully over that time. From directing clinical education, advising the curriculum, fostering research and clinical practice, and now guiding the entire program in physical therapy – it’s never been boring. I believe I am still contributing actively to the practice of physical therapy and to the welfare of patients – so it fits my early and continuing goals.

Do you feel the role physical therapy plays in a person’s health or recovery has changed?

When I first entered physical therapy in the 1960’s, treatment by PT was episodic and fairly technical. We treated patients for a specific need, but we didn’t teach you how to take care of yourself later.

PT’s central focus has always been on movement. Today, the focus is on prevention, as well as rehabilitation, and we teach our students to attend closely to each. They must always be thinking about the patient’s life and independence, as well as immediate comfort. We now work with people who don’t have problems with movement, posture, pain or function now - the big change in physical therapy is to extend our attention to people who are not moving correctly and/or not moving enough.

People who are in their twenties may not have any pain patterns, disability or disease processes. But if they have poor posture, or incur multiple injuries from sports, problems may emerge later. They also may have exercise habits that lead them to be at risk for injury and therefore are not conducive to maintaining good musculoskeletal health for life.

We know a lot more about the development of osteoarthritis and about the functional risks that older people encounter. We can now think beyond a patient’s current problem which opens up a whole world of possibilities both for the patient and the practitioner. It puts physical therapists in a great position. I do regret that we may have missed, in the sixties and early seventies, opportunities to help our patients avoid problems later in their lives.

Why has obesity become an epidemic?

You may be asking this because my newest career in patient care is obesity. One strong answer is that eating patterns and exercise behaviors have changed remarkably. Even though genetic influences can be a factor, food choices and lack of physical activity are definite influences in the obesity epidemic. There is a genetic influence to how we are built, but the rise in the prevalence of obesity doesn’t match a change in the gene pool.

We’ve seen the development of fattening fast food and the propensity of people to go out to eat -- because it’s more convenient. People make decisions about how they are going to use their time – and many don’t cook. It becomes a habit to eat energy dense foods such as sodas, french fries and hamburgers --rather than cooking a nutritious meal at home.

There have been some really interesting studies on portion sizes. If someone is served 150% of a normal portion, they’ll likely eat it all, thinking it’s a better value. Marketing clearly has affected our eating behaviors.

And then there is exercise -- not every child has physical education in school as we did when I entered school. Neighborhoods have changed – kids don’t ride their bikes to school, people don’t walk to the store, sometimes for very good safety reasons. Computers and television are permanent parts of our lives, and they have imposed a sedentary lifestyle.

Was there someone in particular who influenced your interest in obesity?

Yes, there was. A student was here in 1996 getting her master’s degree in PT. She happened to have a PhD in exercise physiology and was also teaching at the weight management center at Washington University for extra money while she was in school. I remember she came into my office and said “I think you ought to do something. We’re teaching, but we’re only talking -- you have got to do something about these patients’ exercise habits.”

It started a whole new career. Three of us -- this student, Bess Maxwell, Dr. Bob Deusinger (my faculty colleague and husband) and I created On the Move™  -- as a research project. It has since turned into a clinical program delivered in Washington University Physical Therapy Clinics that is based on key principles of safe and effective exercise to help people struggling with obesity improve their health through physical activity and exercise. We developed an entire curriculum that fits into the nutritional goals that are required to lose weight and enhance health.

What part of St. Louis are you from?

I grew up in Kirkwood. After two years at Grinnell College in Iowa, I transferred to the University of Kansas where I received my professional degree in physical therapy. My first job was in Kansas. I then lived in Washington, DC, California, Cape Girardeau, and Canada until I returned to St. Louis. I had a wonderful time observing differences in PT practice in all of those moves.

Is there a particular award or achievement that is most gratifying?

The privilege to help people is highest on my list. To have served others in a variety of ways through physical therapy has been most satisfying. Everyone cares when they move better --to help someone move better is a fabulous outcome of being a PT.

And working here at Washington University has been an absolute supreme opportunity. To help change things and to be involved in innovation -- you don’t accrue one award for that. Yes, I’ve had several awards, but I think career-wise, to have worked here and to have been chosen to lead the Program in Physical Therapy is probably the best professional opportunity I have had.

What is the best advice that you have ever received?

There are three pieces of advice that have been most important. The first message came both from my father and my husband. It was “you can do anything you want to do – just keep trying.” And if it doesn’t happen, you’ve not tried hard enough. Persistence and creativity are essential for change.

The second piece of advice came from two leaders at Washington University – Dr. William Danforth and Dr. Bill Beck. Both told me to “do the right thing.” To me that epitomizes what Washington University’s culture is all about. You are here to do the right thing and you are here to know what it is. And if you don’t know what the right thing is, then you need to find out.

Finally, our previous director told me to be loyal to my profession, not to my institution. What he meant was for me to always keep in mind the vision of physical therapy and health care as I grow in my career. That was easy for me because Washington University has always been very supportive of physical therapy and places a high value on patient care and innovation.

Naturally you’re a big advocate of exercise, what advice can you give for the average person?

Start slow, but start. Many people say, “I don’t have time, I’m too old, I’m too tired, I’ve never been an athlete, or I’d rather sit.” If we really connect movement to health and if people understood how powerful exercise is – not training for a marathon or fitting into a wedding dress – but for living longer and being healthier, I can’t imagine they wouldn’t be more motivated to make movement a priority.

There’s enough evidence that you will be functionally more independent if you are fit and not overweight. Exercise has to be regular and it has to be forever. We’re training for life.

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Copyright 2013 Washington University School of Medicine