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Re: Eating my words . . .
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Re: Eating my words . . . - November 10, 2002 7:42:00 PM
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flexion
Posts: 151
Joined: August 7, 2002
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Thanks for the info SJ, I find this discussion quite interesting. I'm glad you posted the APTA info as its pretty representative of reality compared to what I've been reading.
I must commend you as well on your professional manners and restraint. [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]
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Re: Eating my words . . . - November 11, 2002 8:11:00 AM
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coloradojulie
Posts: 413
Joined: November 10, 2002
From: colorado usa
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Wow lots of topics!
First, my thoughts on walk-ins...(previous topic)...why not each morning fax a list of open appointment slots to your primary referral sources on an as needed basis? Then they know you are accomodating and as seen with some of your responses...you may gain increased referrals overall.
Second...the DPT thing. My recent experience with a new graduate of a DPT program in Colorado was enlightening. ( I was previously prepared to jump on the DPT band wagon.)
I was at a neuromuscular re-ed course sitting beside a guy who just graduated as a DPT. He described how strange it was to work at his new jobs with therapists who had been practicing for many years, and he was the "doctor". He didn't feel entitled to this designation and was gently teased for it. His book and test smarts may have included a pharmacology and radiology course, but clinically he was still a new grad. I am sure this transition will get more interesting in practice.
I have to wonder what I will gain from the DPT if I choose to do it. Currently nothing. Other than sometimes being called a doctor. I don't think it would change the way I practice or the way my referral sources treat me professionally...they may even become skeptical if I suddenly start calling my self "doctor". I prefer to master the professional aspects of being a PT. You know the saying...Jack of all trades master of none. I don't want to order x-rays, perscribe medication etc. I get people better when others haven't using techniques that only my professional counterparts understand. What is wrong with that.
Perhaps standards of practice is the real issue. Good and bad PTs you know? 4 patients an hour? Is that effective...in that case anyone can administer a cook-book and throw on a hot pack. That should be the target of our energy, not trying to get other people to think now that I am a DPT I have respect. You need to earn that.
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Re: Eating my words . . . - November 11, 2002 8:13:00 AM
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coloradojulie
Posts: 413
Joined: November 10, 2002
From: colorado usa
Status: offline
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Wow lots of topics!
First, my thoughts on walk-ins...(previous topic)...why not each morning fax a list of open appointment slots to your primary referral sources on an as needed basis? Then they know you are accomodating and as seen with some of your responses...you may gain increased referrals overall.
Second...the DPT thing. My recent experience with a new graduate of a DPT program in Colorado was enlightening. ( I was previously prepared to jump on the DPT band wagon.)
I was at a neuromuscular re-ed course sitting beside a guy who just graduated as a DPT. He described how strange it was to work at his new jobs with therapists who had been practicing for many years, and he was the "doctor". He didn't feel entitled to this designation and was gently teased for it. His book and test smarts may have included a pharmacology and radiology course, but clinically he was still a new grad. I am sure this transition will get more interesting in practice.
I have to wonder what I will gain from the DPT if I choose to do it. Currently nothing. Other than sometimes being called a doctor. I don't think it would change the way I practice or the way my referral sources treat me professionally...they may even become skeptical if I suddenly start calling my self "doctor". I prefer to master the professional aspects of being a PT. You know the saying...Jack of all trades master of none. I don't want to order x-rays, perscribe medication etc. I get people better when others haven't using techniques that only my professional counterparts understand. What is wrong with that.
Perhaps standards of practice is the real issue. Good and bad PTs you know? 4 patients an hour? Is that effective...in that case anyone can administer a cook-book and throw on a hot pack. That should be the target of our energy, not trying to get other people to think now that I am a DPT I have respect. You need to earn that.
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Re: Eating my words . . . - November 11, 2002 2:54:00 PM
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Andrew M. Ball PT PhD
Posts: 855
Joined: July 28, 2002
From: Charlotte, NC
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SJ,
Great question. I would be interested in knowing if most DC's respect the MD as the gatekeeper in that respect (even MD specialists have to ask "mother may I" of the PCP), or if they simply turn their back on the medical establishment.
I didn't ask that question in my research, but based on the tone of most interviews, I'd assume that it's about a 50/50 split.
Anthony, what do you think?
Drew
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Re: Eating my words . . . - November 11, 2002 4:05:00 PM
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swoodard23
Posts: 36
Joined: March 18, 2002
From: Abilene
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I am currently a student in an MSPT program and see clearly that there is no substitute for experience. I would much rather work with a seasoned PT than a new DPT graduate. However, I think the question is whether the education a new DPT graduate recieves is more comprehensive than the education other degrees had at time of graduation. I think it is clear that the DPT graduates with more tools than other practitioner have in the past. For that reason alone I think the DPT is a valuable asset to our profession.
In the future when battles for increased responsibility continue, the DPT degree offers a more homogenous base by which to look at education to "earn" increased rights. A PT practicing for 20 years with continuing education could be superior to a DPT in every way. The point is, though, that there is no easy distinction to tell that practitioner from one that still functions at a lower degree level. The DPT offers a stepping stone for us to demonstrate a higher minimal amount of knowledge by which decisions on our practice rights can be made. I think you can debate whether that bar was set high enough, but not whether it is a step in the right direction.
Thanks
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Re: Eating my words . . . - November 11, 2002 4:39:00 PM
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Andrew M. Ball PT PhD
Posts: 855
Joined: July 28, 2002
From: Charlotte, NC
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I don't think that anyone is arguing that they'd rather work with a seasoned PT than a novice DPT. The question, in my opinion, isn't a comparison of today's graduating MPT to today's DPT, for they should both be entry-level 2002. The question is the difference between the average MPT, who graduated up to ten years ago, and the average DPT, none of whom graduated before several years ago.
True experience, there is no substitute for, but I'm reminded of a nationally respected mentor that I had when in my post-graduate pediatrics fellowship years ago. He said, "Beware your colleagues with years of experience, more often than not, it's just the same year over and over again." I'm fortunate enough to know many skilled clinicians without a DPT, but I know far more with 1 year of experience, 20 times over.
Drew
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Re: Eating my words . . . - November 11, 2002 6:16:00 PM
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Andrew M. Ball PT PhD
Posts: 855
Joined: July 28, 2002
From: Charlotte, NC
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Speaking not as a PT, but as an MBA/Ph.D. in healthcare management, I'd remind all that the gatekeeping PCP looses money for each referral. Not knowing the difference between a DC using AK, crainosacral, strain-counterstrain, and magic healing crystals --- and one using only straight techniques for relief of spinal pain only --- I can understand why a gatekeeper would refrain from referral to a DC. There's no quality assurance in the ranks of DC in that respect. As such, there is more variation in competence, evidence-based approach, and quality of care in chiropractic than any other healthcare profession --- massage therapy included.
Given that uncertainly, why refer, ESPECIALLY if it means less money for the PCP?
I can't imagine that under similar conditions of uncertainty, that a DC would act any different if given gatekeeping responsibilty. In fact, given the anti-MD brainwashing that occurs in most DC schools, I'd fear that patients would be prevented from life-saving care by the more than a few quacks in chiropractic. The result --- litigation city!
DC's should, when it comes to the whole pie-in-the-sky gatekeeping wish, should be careful what they ask for!
Drew
[This message has been edited by Andrew M. Ball PT PhD (edited November 11, 2002).]
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Re: Eating my words . . . - November 11, 2002 6:18:00 PM
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coloradojulie
Posts: 413
Joined: November 10, 2002
From: colorado usa
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I agree with your point about practitioners who repeat the same approach year after year. That is certainly a weak spot in all medical practice. I am not certain that establishing a DPT would create standardized levels of practice either. Once we graduate from our universities we develop, often independently, into different types of therapists with different skills...there is no post graduate standard. Whether you are a PT, MPT or DPT. One of my professors told us you learn 35% of what you need to know in school, the other 65% you learn in clinical practice. I have to agree. If the role of PT has not expanded where will these new skills be useful? Or will they just be forgotton...like organic chem? [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]
I also agree that new grads have alot to offer...in fact in my practice, I hire new grads almost exclusively. They are open minded and keen.
The physician referral issue is touchy...for both PTs and Chiros. I am friends with one of my referring MDs who recently shared his frustration with a chiropractor whom I have a close working relationship. They had sent him a patient whom he subsequently ordered a cerebral MRI for. The doctors were miffed as they felt the referral was inappropriate and undermined their role as primary care physicians. They most likely were going to stop referring to this DC.
I have burned some referral bridges with MDs myself, standing up for my plan of care. There is alot of politics in health care and as much as we might not like it...we have to kiss up to keep some of them happy.
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