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Re: DC: Crossing the Line??
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Re: DC: Crossing the Line?? - May 7, 2003 9:19:00 PM
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flexion
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I was thinking about PM&R MDs too Wagner...
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Re: DC: Crossing the Line?? - May 8, 2003 7:54:00 AM
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Andrew M. Ball PT PhD
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Physiatrists are doctors of rehabilitation too, but as medical physicians, their focus is at the pathology and impairment level. The good ones focus also upon coodrination of medical and allied heatlh care.
That's a completely different profession with really no overlap.
Drew
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Re: DC: Crossing the Line?? - May 8, 2003 9:07:00 AM
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Shill
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Geez Dck,
Next thing you will post is that your dad can beat up my dad. Your argument is nothing more than a bold typed "I know you are, but what am I" Grow up a bit eh?
The key word in your statement is "think". It is also interesting that you placed quotes around the word "Doctor". Would that be a Fraudian slip? Misspelling intended.
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Re: DC: Crossing the Line?? - May 8, 2003 3:18:00 PM
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DcK
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Shil
I'm not saying I agree with the attitude of DC's thinking they're superior to PT's, I'm just stating the facts. "Doctor" was intentially in quotes, because, "doctor" should be replaced with "technician" for most of the DC practitioners.
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Re: DC: Crossing the Line?? - May 8, 2003 8:13:00 PM
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Dr.Wagner
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OK perhaps I am being picky, but DPT's are not doctors of rehablitation (Physiatrists are) it is implicit in their title and training. A DPT is a clinical doctorate in physical therapy...there is a huge difference and let us not get confused about titles or responsiblities.
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Re: DC: Crossing the Line?? - May 8, 2003 9:23:00 PM
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PTstud
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Dr Wagner, my uncle is a physiatrist with his own succesful clinic, and believe me, he would have no clue on the BEST way to rehab a torn RTC, ACL, and other similar injuries. Im sure he would do OK, but not much better than anyone else with anatomy knowledge. WE are trained and educated on specifics and effective rehabilitation tecniques for specific injuries (as you know). My uncle provided the cortisone shots, epidurals, needle EMGs, and other physician only procedures. And dont knock my uncle, he was the chief resident during his residency. Im just trying to say that he has no clue about closed chain ACL precautions, manual therapy treatments, and RTC rehab progression (Im sure there is more, but im barely a 1st yr student). Now, who spends the most time REHABING the patient?
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Re: DC: Crossing the Line?? - May 9, 2003 3:42:00 AM
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Andrew M. Ball PT PhD
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I too have family that are ortho surgeons and physiatrists respectively. Bost concede that PM&R is better described as physicians of physical medicine as (as has been posted, PM%R don't usually get into functional rehabilitation and ability level care) DPT's and DSc's are are better described as doctors of functional rehabilitation. Either way, chiropractors don't enter the mix.
Being picky is one thing, I think we should say what we mean, but isn't this more accurate than your model?
Drew
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Re: DC: Crossing the Line?? - May 9, 2003 2:09:00 PM
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flexion
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I'm with Wagner on this one as would any other doctor out there. A nurse is often better than a MD at giving injections so we should start calling them injection doctors?
PM&Rs have the title not anyone else.
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Re: DC: Crossing the Line?? - May 9, 2003 3:55:00 PM
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Bournephysio
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Flexion: there is a huge flaw in your argument. The nurse is not the expert at diagnosing and assessing the problem, deciding on a treatment plan and implementing or ordering the implementaion of it, the doctor is. In rehabilitation (at least where you and I practice), physios are the experts at diagnosing and assessing the problem, on deciding the treatment plan and implementing it, not the PM&R doctor. With physios the experts at the non-surgical cases and orthopods the experts at the surgical cases, there is not much room left for PM&R except for being technicians (giving shots and emg) or managers of rehab departments.
Doug
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Re: DC: Crossing the Line?? - May 9, 2003 5:20:00 PM
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mcap56
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Doug:
As a P.T. (or "physio" for you all) I had the opportunity to treat several visiting students from Canada. They found it silly to have to see the doctor first. One said that no one in his family would consider going to a physician before the Physio for a M/S problem.
The fact is that direct access works extremely well in a number of countries and in specific circumstances here in the US. And yet, we keep hearing about how we just aren't ready.
mcap56
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Re: DC: Crossing the Line?? - May 9, 2003 5:21:00 PM
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mcap56
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Doug:
As a P.T. (or "physio" for you all) I had the opportunity to treat several visiting students from Canada. They found it silly to have to see the doctor first. One said that no one in his family would consider going to a physician before the Physio for a M/S problem.
The fact is that direct access works extremely well in a number of countries and in specific circumstances here in the US. And yet, we keep hearing about how we just aren't ready.
mcap56
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Re: DC: Crossing the Line?? - May 10, 2003 7:42:00 AM
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Dr.Wagner
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The problem with giving oneself a title is that someone already has the title. And what do you call an OT with a PhD? Then are they rehab docs as well? Come on now. Can't just "call" yourself something...if you want to be a Rehab doctor, go to med school. If you want a doctorate in PT, go to a DPT program. Simple.
As far as rehabing ACL's etc...they pretty much rehab themselves don't you think? Lots of orthopods (espcecially in Indy) have PT's give them just HEP's and have ATC's perform much of the work. Been there, did that.
As for Physiatrists, someone must be managing the case, that is one reason they are there. Too many chiefs in the tribe is a bad thing. And Physiatry just so happens to be an expanding field...not contracting. My suggestion is that if you are a PT and you want the challenge of medschool but want a nice pay off and cush schedule later on...go to Physiatry...especially in a DO program. Physiatrists have a great life and a cush residency (not like EM...oye).
Later guys.
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Re: DC: Crossing the Line?? - May 10, 2003 12:46:00 PM
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Andrew M. Ball PT PhD
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Litte bit of a superiority God complex have we? Or are you simply having a problem with a possible erosion of reverence due to the professionalization of allied health occupations?
An OT with a PhD as a rehab doctor? Please.
Drew
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Re: DC: Crossing the Line?? - May 10, 2003 12:54:00 PM
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Bournephysio
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Funny how it is alright for medical doctors to claim they are specialists in an field where they have little expertise while there is a huge controversy over PTs claiming to be doctors in the area of their expertise.
Doug
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Re: DC: Crossing the Line?? - May 10, 2003 1:54:00 PM
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mcap56
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Dr. Wagner:
Let me see if I can sum up your arguments to date.
-PTs should never call themselves doctor
-We should not have direct access
-We should not want direct access
-We shouldn't look to expand the scope of practice in any way
-We shouldn't put initials after our names
-We shouldn't feel that we can do anything that ATCs can't.
-We should keep the referral relationhip exactly as it is
I am not sure what your agenda is. Many of the arguments ring hollow after the 500th LBP patient I evaluate that was given unecessary X-Rays, a specific diagnosis that has no clinical relevance, and was not screened for red flags or given an adequate neurological screen.
mcap
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Re: DC: Crossing the Line?? - May 10, 2003 1:56:00 PM
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mcap56
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And guess what.....some of those patients came from "specialist" physiatrists without much of a clue about the realities of LBP.
mcap
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Re: DC: Crossing the Line?? - May 10, 2003 1:58:00 PM
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Dr.Wagner
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What are you talking about?
I am not saying Physiatrist is an "exercise specialist" or a PT, rather, a manager of all rehabilitation specialists and by definition " a rehab doctor". By your definition...which apparently excludes OT's with doctorates, SLP's with doctorates, ATC's with doctorates can only be applied to PT.
My comments later reflect the fact that Physiatrists have an awesome lifestyle unmatched in recreation and hourly wage compared to ANY other medical profession. A PT that goes to medschool and pursues Physiatry would absolutely excel!
Listen, Drew...though I respect you, sometime you are gonna have to realize that if someone does not agree with you...that may be (just maybe)you are wrong and NOT that they have a God complex.
I realize I am on a PT board, but as a PT and a Physician (and a former post prfessional DScPT student), I am allowed to be here correct? And I can certainly make observations that very few people can make (because I have been through both programs and lived both lives) And though I do not feel I am obligated to defend myself... I will.
I am proud to be a PT, but it is a far cry from clinical medicine...and rightfully so...the responsibilities are totally different everything is different, and yes I can say it is much more challenging...but I am NOT saying any MD or DO could do your job. No way. Exercise prescription and manual treatment is something a PT does better than anyone else. Anyone. And a therapist has a clearly defined role and I truly believe Drew, you have an agenda (at times) and it rears it's political head frequently. I think your accomplishments are immense, certainly. But our roles are NOT interchangeable, they simply are not...and the more you begin focusing on what therapists do BEST and not what they MIGHT be able to do...the better it is for the patient.
MCap,
I have stated that in a hospital environment a DPT calling himself "Dr" creates confusion for the patient (PharmD's don't feel obligated to do so) and is NOT a good idea...in the same manner a massage therapist in the same environment as a PT may cause confusion (and you would be insulted)if they said they were the "therapist". Etc etc...this example could go on and on.
As for letters after ones name, put what ever you want behind your name, but remember that PT are the 2 letters that count...the rest is mental masturbation.
The rest of your points are silly.
I think I may say goodbye to this board for a while...
I wish you all the best of luck in the future and fulfillment of professional satisfaction.
Take care
Dr. Wagner
[This message has been edited by Dr.Wagner (edited May 10, 2003).]
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Re: DC: Crossing the Line?? - May 11, 2003 7:54:00 AM
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mcap56
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Dr. Wagner:
In reading some of your posts recently it is clear that YOU can't handle it when people disagree with you. We know that medicine requires a different set of sacrifices and challenges. But it doesn't validate your opinion more than anyone elses, a fact that you seem slow to recognize. Language like "the rest of your points are silly," "this sphere called earth," "mental masturbation" etc. indicate one thing......arrogance.
We love having input from other professionals.....but when the threads degenerate into.....I am doctor and you are not.....it becomes tiring.
Good luck with the rest of your endeavors......
mcap
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Re: DC: Crossing the Line?? - May 11, 2003 8:04:00 AM
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mcap56
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And...by the way.....
I have witnessed graduating classes for several years from a local DPT program. Not one of them has gone into the hosptial and referred to themselves as Doctor so I am not sure what your point is.
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Re: DC: Crossing the Line?? - May 11, 2003 1:05:00 PM
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swoodard23
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Dr. Wagner,
I would like to comment on the OT with a PhD point. As a former DScPT student, you should know the difference between a clinical and an academic doctorate. Your MD or DO does not make you equal to a PhD academically.
I also don't understand why you do not appreciate the importance of those letters after a PT's name. In referring to a PT, I would think it would be important to know what their specialty is and what treatment approach they prefer. While it might not mean anything to the public, a physician may prefer to refer out to a McKenzie therapist rather than a manual therapist or vice versa.
I hate that you feel ganged up on Dr. Wagner. Your input on this forum is appreciated although everything you say may not be agreed with, especially considering your audience. I personally hope you will continue to post on this forum.
Thanks,
Scott
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