help........ (Full Version)

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Jax -> help........ (October 22, 2004 10:44:00 AM)

I now work with a PT who only believes in one type of treatment. I have always worked with PTs in the past that have been very open to teaching me new techniques, and have felt comfortable with me performing all techniques within the state law. The clinic I work in has always been a hands on type of clinic with a lot of manual therapy and exercise once appropriate. Now the PT I work with will not allow me to use my hands because he feels that all that manual therapy will do is make the patients dependent on therapy. I feel like my skills lie beyond just exercise and I am no longer doing my patients a justice by only one or two treatments of just exercise or the one type of treatment this PT really performs. I have worked with 5 PTs in 4 years and this is the only one I have found to feel this way. I feel that there should be a global approach to physical therapy and all aspects should be considered (mm, fascial, neurological, and joint involvement, etc). I do not feel that it is a justice to the patients to see them once or twice to teach them how to treat themselves, send them out the door, and expect them to always get better. I mean isn't that what physical therapy is all about? Us being here to help our patients reach their goals? I am confused as how to approach this PT about this issue. What is your input?




SJBird55 -> Re: help........ (October 22, 2004 1:59:00 PM)

Technically, as a PTA you need to follow that therapist's plan of care. The therapist you are currently working with had a definite point with his argument and I'm sure you have yours.

With the changes in reimbursement, I have had more and more patients choosing to use me more as a consultant. And yes, they do improve. I have my outcomes and my effect sizes to prove that patients do improve utilizing this kind of approach. There was some post here regarding I think something with cervical problems. One of the recent JOSPT had an article that was interesting. Everything that I have read in regard to manual treatments indicates very few sessions of manual treatments. With cervical diagnoses in general, literature supports a combined manual and exercise approach.

And, you have to also realize that there aren't any outcome studies out there to provide "gold standard" approaches for us to use with patients.

Every therapist's perspective is going to be different. No, I don't feel "we" need to be there continuously to help "our" patients reach their goals. I firmly believe in empowering them, educating them, their responsibility and me providing as small as a role as possible in a patient's care. I side on a patient having as active a role as possible in both problem-solving and reaching their goals.

So you have 3 choices.... sit back and give that therapist a chance and see if patients do reach their goals and learn via observation.... have an intellectual discussion regarding treatment philosophy and bring supporting documentation to discuss and question.... look for another position elsewhere.




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