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Re: Why don't most PT's give a ****?
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Re: Why don't most PT's give a ****? - July 1, 2002 3:18:00 PM
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Mark Hirsch
Posts: 101
Joined: December 11, 2001
From: USA
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Hi Diane,
I liked your post. I think it hits on a central idea. Personally I did not read the entirety of Bobcats soliloque. I don't have the time to respond to that kind of detailed prose...but this is a free country and anyone can spout of as they like. To me long drawn out posts are a turn off to lots of newcommers -- not that I have not posted a few long ones myself. [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] Maybe a good way to get people chatting would be to limit the posts to, say, 250 words or less? Just an idea. Cheers.
Mark
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Re: Why don't most PT's give a ****? - July 1, 2002 4:07:00 PM
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Diane
Posts: 1507
Joined: March 9, 2001
From: Vancouver, B.C., Canada
Status: offline
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Hello Mark, others,
I've cooled down considerably. I didn't say this before but Mark, I thought your points earlier in the thread were well taken.
I guess my biggest problem with this forum is the incongruity with what the forum calls itself ("RehabEdge: The Online Physical Therapy Community", right there on page one...) and the reality, which is that it is no community at all, in fact it seems to be nothing more than bunker mentality.
Diversity is not encouraged. Disparaging comments (about hippies etc,) are made about just about everything that isn't lockstep with the view of a few, most of whom we don't get to interact with on equal footing because they are hidden in their bunker.
There is one theme here, played over and over in a monotone. There is no divergence or diversity of opinion sought or allowed. It's like an orchestra that only allows brass and percussion to play, and only one note, ever. What "community" can survive this? Surely a one-note orchestra will fail because no one will come to listen, and unless they play the same note, they'll get shot at by you-know-who. From the bunker. (I've wondered from time to time what would happen if the name were changed to "RehabSmooth"? Maybe it would encourage change.)
A true community will change its shape a bit to accommodate people who might differ in age, outlook, experience, temperment, and accumulated wisdom. It might have a far-reaching goal, (nothing whatsoever wrong with that,) and accept that different members of said community might find different paths to arrive there, might have different sets of skills with which to build an online "community", and might not all like the same boring one-note music.
Diane
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Re: Why don't most PT's give a ****? - July 1, 2002 6:46:00 PM
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Diane
Posts: 1507
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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...silly, inane, frivolous...
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Re: Why don't most PT's give a ****? - July 1, 2002 7:26:00 PM
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Bournephysio
Posts: 585
Joined: April 25, 2002
From: Calgary
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I see what you mean.
But remember: Don't feed the trolls.
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Re: Why don't most PT's give a ****? - July 1, 2002 7:39:00 PM
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PTupdate.com
Posts: 1477
Joined: October 8, 2001
From: Pittsburgh, PA USA
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The responses so far have been quite diverse and interesting, but I am still not sure I any of us know the answer. Perhaps we are all biased, as we are here doing this, while others are out playing!
Marc, I certainly can understand your feelings about people needing to have thicker skins when participating in a forum such as this. So what if someone disagrees with you? I personally respect everybody participating in this. Our opinions may be different, but I think we are of the same mould. I think some of the banterings I have read sound more like siblings than enemies.
Marc, you mention lack of motivation due to pay problems. If a PT is in this strictly for pay, I don't want that person around. Pay is great, but there are other things that are more important, at least to me. If I wanted purely cash, I would have gone into something different, or would just see a ton of home care patients each day!
One point with pay does come to mind. Pay will usually increase as productivity and success in the clinic increase. Even though many of us work for large companies, I have yet to meet a PT employer that does not take very good care of productive employees. If a PT chooses to, he can be just a tech. However, he will be paid as a person who can be easily replaced with another warm body holding a PT license. If an employee hustles and strives to be a good clinician, person, and businessman, and the busines thrives, he becomes an asset. This asset, once established, is often free to pick up and take his business and succes with him elsewhere if not taken care of.
I have met many PT's that play that "why should I bust my a.. to make this company money if they aren't going to give me a cut or a raise" game. So many PT's believe that just showing up at the office earns their pay, and anything else they do should be compensated for.
Doug, you hit an interesting point with regards to the US/Canada differences. While Canadian PT's may not make the same money, I find them to be far more interested in clinical skills than Americans! Approximately 50% of my site members are Canadian, and I have never even marketed one PT there!
Bobcat, after reading your big reply I had to go listen to the Dark Star from '69 Avalon Dead show, then come back and read it again with a changed perspective! However, I think you give most PT's too much credit. They don't strive to learn because they are just lazy people, not because of the perplexities and the challenges. They're just lazy.
When I posted the question I was in an angry mood. I have talked to other PT's, and while most are like us and realize there is a problem, we don't know why. Perhaps, as Drew indicates, the DPT will weed out the ones just looking for a job. The high debt incurred with the schooling and mediocre pay some get may be enough to bring in some more motivated persons. It could go the other way, if they are out moonlighting to pay the bills, they won't have the time to participate!
I do find it interesting that my orthopaedic surgeon collegues work harder and longer hours than any PT I know, yet still take the time to do rounds (as Doug indicates) and read a slew of journals to keep up. Perhaps I will ask them why they do it, and post the response here.
Duffy
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Re: Why don't most PT's give a ****? - July 2, 2002 4:14:00 AM
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gilbertthomson
Posts: 33
Joined: July 1, 2002
From: Elka Park, NY USA
Status: offline
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[QUOTE]Originally posted by Andrew M. Ball MS MBA PT:
[B]Duff,
The true benefit of the DPT isn't going to be in evidence-based practice, technique, or diagnosis . . . their value is simple. They CARE a whole like more about being a professional (as opposed to a technician) and moving to "the next level" than do the majority of rank-and-file PT's.
That passion and ambition, in and of itself, is deserving in my opinion, of the title Clinical Doctor of Physical Therapy.
[/QUOTE]
I disagree with that! I care a lot about my profession and I don't think DPTs will automatically have so much more passion just because they go to school for one more year than I did and because they get to have people call them "doctor"!
I would personally rather be a PT with a bachelor's degree who does really care about learning and growing in the profession than a self-satisfied DPT who does not.
This is a very good and important thread. I've also noticed the lack of interest that is so prevalent among PTs. To me it really comes down to individual attitude. I think schools could put more emphasis on selecting people who demonstrate passion, enthusiasm, and a love of learning.
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Re: Why don't most PT's give a ****? - July 2, 2002 6:54:00 AM
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mcap
Posts: 652
Joined: February 8, 2000
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Group:
I don't think you can continue to ignore the extrinsic factors. I know too many PTs who were very motivated when they graduated only to loose their motivation due to factors beyond their control.
You mention productivity and good companies taking care of their employees. Where? Perhaps you are referring to the odd clinic that actually cares about quality. Don't forget how many PTs labor in school systems, hospitals and nursing homes. They are caught on the lower rungs of a healthcare heiracrchy that doesn't value their services. I would imagine that PT brings in a lot of money at local hospitals. However, PTs are payed less than pharmacicsts, PAs, NPs, nurses......substantial differences in many cases.
As for productivity....you are right....it may be rewarded in some cases. However, there is a big difference between quality of care and productivity.
People need either monetary motivation or motivation by other factors such as prestige, respect, etc. These factors are lacking. Why, without any of these, would you expect someone who is smart and talented to pay for three years of graduate school?
The answer is that they won't!!
If you think I am wrong, then have a visit to your local PT program where enrollments are declining quickly and where the quality of applicant is nothing like it was about 5 years ago.
Respectfully,
mcap
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Re: Why don't most PT's give a ****? - July 2, 2002 7:01:00 AM
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Andrew M. Ball MS MBA PT
Posts: 271
Joined: September 30, 2001
From: Chapel Hill
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Gilbert,
Welcome to the forum. I didn't mean to offend. Certainly there are some truly passionate evidence-based clinical scientists among MPT's, but there is (at least in my experience) a much higher percentage among DPT's and DPT students. You are correct to point out that having a DPT doesn't automatically produce this, but the statistical trends are clear.
I would also rather be a "PT with a bachelor's degree who does really care about learning and growing in the profession than a self-satisfied DPT who does not," but where are these people? Most only THINK that they are professionals, but do less than 50% of the things necessary to be deserving of that level of distinction. Of the handful that DO care about lifelong learning, there is an even smaller percentage of people who even know how to go about doing so without falling into the traps and pitfalls of corporate-driven continuing education without fact.
The problem is that roughly 80% of PT's find their primary source of new knowledge through continuing education ---- continuing education that may or may not have anything at all to do with researched fact. VERY FEW pick up a journal after graduation. The point is that "learning and growing" should consist of more than the sideshow and parlor tricks of refining BS techniques such as CST or strain-counterstrain. Continuing education is useful, but is NO SUBSTITUTE for practicing in an evidence-based manner and being able to tell BS from not when the guru preaches from his or her bully pulpit on the continuing education circuit. That goes, by the way, for people who attend my courses as well.
In the final analysis, those handful of non DPT PT's who really care about "learning" largely do so in a pseudoscientific manner that's not dissimilar from religious cults or the church of chiropractic. For this reason, the non DPT's able to sort out what to spend time learning, and what is nonsense BS, are few and far between --- but the MPT's better able to do this tend to be the more recent graduates. It's ironic that when "experienced" PT's state that DPT's aren't able to "back up their learning in the clinic," the PT is usually talking about faith-based interventions that have no basis in fact and no business in the clinic in the first place.
It's a sad, sad, state of affairs!
Drew
[This message has been edited by Andrew M. Ball MS MBA PT (edited July 02, 2002).]
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Re: Why don't most PT's give a ****? - July 2, 2002 7:41:00 AM
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ScottO
Posts: 31
Joined: May 3, 2002
From: Va
Status: offline
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Group,
Here's an opinion from an occasional poster to the BB. "Disclaimer" The following thoughts reflect the views of this poster, and do not nec. express the views of other occasional posters. That being said:
I post to simply gain knowledge, and to get feedback from my peers. I'm not interested in having a pissing contest, although this most recent one is very entertaining, and I'm not interested in being cyberspace pals. I simply post if the subject matter strikes a response. I have passion for my profession, and my motivation to learn and advance my education and skills comes fom pride, and wanting to be the best I can at what I do. Pay is important but doesn't affect my motivation one way or the other.
As far as the NOI group is concerned, I understand Drew's point of view, (hippie and sappy at times), but overall informative and very intellectual. Just like research and cont. ed., you have to weed out the superfolous info, and extrapolate the relevant info.
Bobcat, I call it a keiser blade, some people call it a slingblade.
Well, enough for now.
ScottO
[This message has been edited by ScottO (edited July 02, 2002).]
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Re: Why don't most PT's give a ****? - July 2, 2002 8:08:00 AM
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Andrew M. Ball MS MBA PT
Posts: 271
Joined: September 30, 2001
From: Chapel Hill
Status: offline
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Scott,
For the record, I never said that the NOI group was "hippie or sappy." I've only visited it once, and not very extensively at that.
I got a rather non-scientific, overly artistic tone from it, but again, that was just upon cursory passing and I'll reserve judgement until I play with the site a little more.
Art (as opposed to science) moves some people, and there is a place for that in physical therapy --- but personally I don't have time for that. So the closest thing that I've thought about NOI (though I've not yet said it), is that if my initial impression pans out, that NOI may be a waste of my time, but may fill a very real need for other therapists.
There is a very clear divide emerging between PT's who define themselves as artists, and those who define themselves as scientists. I've placed myslelf squalrely on the side of science, but that's not the philosophy of the majority of experienced, non DPT physical therapists. That's okay, but let's call it for what it is . . . many experienced PT's aren't against the DPT, they are against the death of art-based physical therapy. Personally, I understand and respect those therapists with those kinds of views, but it is, in my opinion, a short-sighted professional vision that does little more than protect individual professional ego isn't it?
Drew
P.S. Cat --- one of my fav movies. "I sure like me 'dem french fried purtaters, umm humm."
[This message has been edited by Andrew M. Ball MS MBA PT (edited July 02, 2002).]
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Re: Why don't most PT's give a ****? - July 2, 2002 10:15:00 AM
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ScottO
Posts: 31
Joined: May 3, 2002
From: Va
Status: offline
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Drew,
"Peace,love,drugs,and flowers were fun, but not terribly effective in political terms."
Sounds pretty hippie to me, I didn't mean to imply that sappy was your choice of words, that was mine.
On the next subject, I did begin my career being steered in the direction of SCS, and CST, secondary to that being the choice of my mentor,didn't make alot of sense to me, and I couldn't palpate the rhythm. That was 8 years ago I am now pursuing my MHSC and tDPT.
So my point is, some of us experienced BSPT's are attempting to swing into the future, that's one of the reasons I keep bugging you about that gamma efferent reference.
We live close enough where you could drop it off at the UNC library for me. (That's a joke, sort of)
thanks for your reply,
ScottO
[This message has been edited by ScottO (edited July 02, 2002).]
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Re: Why don't most PT's give a ****? - July 2, 2002 8:43:00 PM
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Diane
Posts: 1507
Joined: March 9, 2001
From: Vancouver, B.C., Canada
Status: offline
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Thanks, I doubt I could ever have adequately described your proclivities but it is far easier now for folks to understand what I tried to explain, now that you have so clearly proved my point. Why would anyone ever want to come on this board with this...thing running rampant?
Diane
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Re: Why don't most PT's give a ****? - July 3, 2002 3:53:00 AM
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gilbertthomson
Posts: 33
Joined: July 1, 2002
From: Elka Park, NY USA
Status: offline
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[QUOTE]Originally posted by Andrew M. Ball MS MBA PT:
Gilbert,
Welcome to the forum. I didn't mean to offend...
Continuing education is useful, but is NO SUBSTITUTE for practicing in an evidence-based manner and being able to tell BS from not when the guru preaches from his or her bully pulpit on the continuing education circuit. That goes, by the way, for people who attend my courses as well.
In the final analysis, those handful of non DPT PT's who really care about "learning" largely do so in a pseudoscientific manner that's not dissimilar from religious cults or the church of chiropractic. For this reason, the non DPT's able to sort out what to spend time learning, and what is nonsense BS, are few and far between --- but the MPT's better able to do this tend to be the more recent graduates....
Drew
[This message has been edited by Andrew M. Ball MS MBA PT (edited July 02, 2002).][/QUOTE]
You didn't offend. I'm just not convinced that more education automatically leads to more rational thought and a better ability to screen out the BS that is so widespread in our profession. I agree wholeheartedly that much of the continuing ed available is worthless (or worse, is pseudoscientific, misleading crap)
What ideas do you have for teaching the scientific method and critical thinking skills to PT students AND practicicing therapists in order to counteract this trend??
- Gilbert
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Re: Why don't most PT's give a ****? - July 3, 2002 8:09:00 AM
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mcap
Posts: 652
Joined: February 8, 2000
Status: offline
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Group:
I have had at a few well-reasoned, polite posts deleted from the pullpit. I think they disucss some very interesting topics but they view everything through the lens of their "deep" model. They are not really open to dissention and it is not the most tolerant place.
So.....I don't post there anymore or even bother to read the material. I wouldn't let that or one or two people disuade me from making my points. I honestly think that most in our profession need to toughen their skins. If they can't take questions from within what happens in the face of withering criticism from Dr.'s, Chiropractors, etc.
For example the New York Medical Society recently determined that only patients with fibromyaligia were suitable for direct access to PT because they just need "hand holding anyway."
The sound, rational practicioner could defend our position, or simply point out that evidence based practice is severely lacking among physicians as well. What we don't do is take it personally and get upset about it. In the internet age it is going to increasingly be self-educated patients who level criticism at us and other health professionals. What do we do then?
No position, no paper, no opinion, no profession, no PERSON is unasailable. It is part of life. So....I do think that if you post here.....you should be able to tolerate whatever is said in response so long as it isn't offensive in some way. Their may be some odd personal attacks........but most people intrepret criticism of their position as a personal attack. This has got to stop!!!!!!!!!!!! Rigourous debate is an absolute must if our field is going to grow!!!
mcap
mcap
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Re: Why don't most PT's give a ****? - July 3, 2002 9:11:00 AM
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ChiroGuy
Posts: 63
Joined: January 24, 2002
From: Toronto, Ontario, Canada
Status: offline
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Hey all,
Thought I'd risk evoking the wrath of Bobcat on the chiropractic profession yet again by wading into the fray. This will just be a short lesson in irony for my old buddy BCat; for all his diatribe and complaining about a lack of scientific method in PT, it fascinates me that he can just sweep chiropractic under the table without any critical analysis. The fact of the matter is that high-quality double blind studies are becoming more and more common within the field which rival, if not exceed, the caliber of many medical studies. While professing disgust for practitioners who lack scientific method when assessing the value of therapies, he chooses to remain ignorant of the scientifically demonstrated effects chiropractic can have. And no, I’m not referring to curing infections or anything of the like.
I realize this does not pertain to the topic of this link, but thought it important to point out to Kitty that before he goes on criticizing his colleagues he should examine his own behaviour. I think he’ll find a blatant lack of respect for his own wisdom.
ChiroGuy
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Re: Why don't most PT's give a ****? - July 3, 2002 9:18:00 AM
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Bournephysio
Posts: 585
Joined: April 25, 2002
From: Calgary
Status: offline
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Bobcat: I know I probably shouldn't respond to your post but you might want to look at your argument with Mark on Balance. I have to give Mark the edge on that one. Get a hold of a basic motor control text and look up transfer of training.
Gilbert: Good point. I have always wondered about the ability of universitys to teach critical thinking. A strong science background is definately needed to provide the knowledge needed but I'm not sure how easy it is to teach people to use it.
I know a couple of therapists who have M.Sc.s(research) from very well respected university with very well respected supervisors. They are currently diving in to the shadier aspects of osteopathy.
I think that some people would rather be told what to do rather than strain a few brain cells. I'm sure these that people are less likely want to have their ideas challenged in a forum such as this. They are also less likely to try and follow the research.
Is there anyway to weed these people out before they get into physio school? I don't think that grades are a good way since university usually rewards straight regurgitation of ideas.
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Re: Why don't most PT's give a ****? - July 3, 2002 10:07:00 AM
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Mark Hirsch
Posts: 101
Joined: December 11, 2001
From: USA
Status: offline
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Response #1
Bobcat,
Thanks for the feedback on the ball -- I guess I must have hurt your feelings which I did not intend to do -- a nobody Professor from Germany claiming lack of scientific evidence that training on a spherical object does not tranfer to standing balance. Where's the threat? Sometimes I wonder why an opinion is such a big deal, in a Democratic society which feeds on divergent opinions. I don't get it.
Cheers. Mark
Mark A. Hirsch, Ph.D.
Assistant Professor of Physical Medicine and Rehabilitation
Johns Hopkins University
Baltimore, MD, USA
Researcher, Department of Neurology and Orthopaedics
Heinrich Heine Universität
Düsseldorf, Germany
Response #2
Go to feline hell you fur ball! [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]
[This message has been edited by Mark Hirsch (edited July 03, 2002).]
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Re: Why don't most PT's give a ****? - July 3, 2002 5:01:00 PM
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Bobcat
Posts: 493
Joined: July 13, 1999
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Anyway, I want to thank PTUpdate.com for this very interesting thread, and everyone for their stimulating responses. This has been a real Open Forum fray.
Actually Bournephysio, I would like to engage you on the topic of the balance ball because I do not fully understand the reference you made regarding motor control in the latter part of your last post. I've read you have acquired quite a mechanics background or are in the process of doing so, so it would be interesting to me.
Hirsch, I'm surprised you don't recognize me -- we've met. Was möchtest du einmal werden, wenn du groß bist? And always remember: "Mechanics more fundamental than neurology".
Happy Independence Day everybody.
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