Background: Physical therapy (PT) in the inpatient setting is a limited and valuable resource. Inappropriate PT consultation is costly and can lead to delays in care. Overutilization of inpatient PT services is an increasingly recognized problem. Patients with minimal or no functional limitations frequently receive PT evaluation, diverting resources and delaying care for the patients [...]

Case Presentation: A 34 year old male with a medical history of polysubstance abuse and hypothyroidism presented from subacute rehab after a combined thoracolumbar and sacral fixation surgery with worsening generalized weakness. The patient described deconditioning with increased difficulty standing despite 3-4 hours of daily physical therapy. Other acute symptoms included insomnia and mood swings. [...]