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Re: drawing the line!!
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Re: drawing the line!! - January 26, 2007 12:57:00 PM
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Lehmkuhler
Posts: 69
Joined: December 14, 2005
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Savela;
If PT's collectively won't work for MD clinics, don't you think it will cause MD's to hire ATC's for their rehab? It's already happening some places...
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Re: drawing the line!! - January 26, 2007 4:51:00 PM
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savela
Posts: 63
Joined: October 7, 2004
From: toronto
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On student,
Go to the OPA web site and download the information. I am not sure, but I think if you are a student, you may may a cheap or free membership for OPA and CPA?
This paper is very important to new grads.
Lehmkuhler,
Yes, it may happen.ATC's services are not covered by most insurance companies in Ontario, so these clinics need a PT to supervise them.
Unfortunatly,
I worked for a clinic owned by MD's, and they had ATC's on staff. The ATC's were great, but they used my billing number when I was not working and did not have a PT (me) sign off on their charts (which is required in Ontario).
This negative experience has made me think carefully about who I work for and made me aware or referral for profit.
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Re: drawing the line!! - January 26, 2007 6:53:00 PM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
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Savela,
Wow this looks promising for the profession.
PTs being able to prescribe drugs, do cortisone injections, order diagnostic ultrasound, MRIs, cast fractures would be a big step forward.
CPA discussion paper on Advance Standing:
In addition changes to the Physiotherapy Act will be needed to establish the extended
class and the following additional authorized acts will need to be assigned to this class:
1. Setting or casting a fracture of a bone or a dislocation of a joint when:
• the fracture or dislocation is of a bone or joint in an extremity, and
• the fracture or dislocation is set without the use of surgical technique.
2. Applying or ordering the application of electricity for electromyography and
nerve conduction studies.
Ordering the application of:
• electromagnetism for magnetic resonance imaging
• sound waves for diagnostic ultrasound and
• other forms of energy prescribed in regulations made under this Act.
3. Prescribing drugs designated in the regulations.
4. Aspirating fluid from a joint.
Proposed Drugs that may be prescribed by Registered PTs in the Extended Class:
The following drugs are designated as drugs that may be prescribed by a member in the
course of engaging in the practise of PT(EC) on the member’s own responsibility for the
purpose of pain control or to reduce inflammation:
• Topical or injectable amino-ester type local anaesthetics (e.g. Lidocaine, Procaine),
• Topical or injectable corticosteroids (e.g. Celestone, Soluspan),
! Non-steroidal anti-inflammatories (NSAIDS) (e.g. Naproxen, Piroxicam) or COX-2
Inhibitors (e.g. Celebrex),
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Re: drawing the line!! - January 27, 2007 6:38:00 AM
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myr11
Posts: 6
Joined: January 24, 2007
Status: offline
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Are we talking about practe in Canada or the US. If physical therapists gain that status I than it will certainly danger the medical specialty of physical medicine and rehabilitation(at least for outpatient). Which makes sense to me at least if you aren't coordinating the rehab for a stroke pt or spinal injury etc. Basically it would just force the physiatrists who are just doing nerve conductions, injections, etc to go into more advaced areas like spinal cord injury or pain medicine(and from what I understand most of them are now going into pain medicine). If this is the case then this is very important for me because my decision of med school vs physical therapy would be a lot easier, since being a PT I would have enough scope of practice.
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Re: drawing the line!! - January 27, 2007 7:13:00 AM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
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This is in Canada .. I am not sure what the situation is in the US .. but this will be a huge step if it indeed goes through.. but like you said it will be interesting how this will be recieved by the sports medicine docs and physiatrists .. we will have to see what happens.
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Re: drawing the line!! - January 27, 2007 8:04:00 PM
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jbird007
Posts: 297
Joined: May 2, 2006
From: USA
Status: offline
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Picking the MD's pockets..I wonder how they might react.
Jbird
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Re: drawing the line!! - January 28, 2007 4:18:00 AM
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physioo
Posts: 184
Joined: June 26, 2006
From: Canada
Status: offline
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interesting but wont pass thr
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Re: drawing the line!! - January 28, 2007 5:01:00 AM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
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Well it probably won't be easy but hopefully it will happen eventually. It's in the best interest of the government and the public(save money and reduce wait times). I think the MDs will be just fine and if it does go through and the public is fully aware ... I dont think it will matter how the MDs react.. there are many other things they can do.
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Re: drawing the line!! - January 28, 2007 6:00:00 AM
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physioo
Posts: 184
Joined: June 26, 2006
From: Canada
Status: offline
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will boost physio wages to over 100k if this happens
and probably a DPT will be the way to go in Canada
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Re: drawing the line!! - January 28, 2007 7:30:00 AM
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steve
Posts: 470
Joined: May 14, 2003
From: Canada
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This is an interesting situation for physios in Ontario, I believe the same push is being made by Alberta therapists.
JBird, Canadian medicine has a much different atmosphere than American and most of the GPs I know would be happy to have the burden of msk diagnosis/treatment decreased.
Although theoretically it sounds great, there are a number of concerns that I can think of off the top of my head:
-what will be the educational requirements? What will happen to therapists who do not have these requirements?
-Who and how will these new services be paid?
-liability, liability, liability.
Although I like the idea of the profession advancing forward and taking a leadership role in NMSK conditions, I think that we need significantly greater education in diagnosis, imaging and pharmaceuticals. Providing these services will not come without a price; politically, legally and division within our profession.
Does anyone know what type of educational program (In Canada) is being developed to meet these requirements?
Steve
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Re: drawing the line!! - January 28, 2007 8:04:00 AM
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dfjpt
Posts: 238
Joined: April 9, 2006
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[QUOTE]Does anyone know what type of educational program (In Canada) is being developed to meet these requirements?[/QUOTE]In addition to what Steve asked, I'd love to know the historicity of this, who introduced it in Ontario as something to advance toward, and why. Instead of "Drawing the Line!" the title of this particular topic should be "Moving the Line!"
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Re: drawing the line!! - January 28, 2007 8:06:00 AM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
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Steve,
If you go on the OPA website and read the discussion paper it will outline the recommendations about the education requirements.. I know one of the conditions is that a PT will have to have at least 5 years of expereince working in MSK and then be able to upgrade thier education to be considered as a PT with advance status. I think this is a good thing and will open many new doors for PTs and help them in such competitive rehab environment.
I know that PAs in the US are able to prescribe drugs and they have Masters Degree. So with some additional training and education I dont see what the problem would be for us to be able to do this aswell.
I think its important that PTs stand united on this issue and support it. There is power and strength in unity.. I hope PTs can stand united on this issue.
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Re: drawing the line!! - January 28, 2007 7:11:00 PM
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jbird007
Posts: 297
Joined: May 2, 2006
From: USA
Status: offline
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Good points Steve. Except for script scribbling, many MD's (especially GP's) do not handle NMSK very good nor do they seem interested.
I would have to believe malpractice premiums (for the "new-age" PT's) would be quite excessive. Sometimes wanting more gets you less.
JBird
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Re: drawing the line!! - January 30, 2007 1:24:00 PM
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myr11
Posts: 6
Joined: January 24, 2007
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Does anyone know what kind of impact this could potentially have on United States physical therapy? I know the healthcare system is much different in Canada, but do you think this could penetrate outside of Canada. Have other healthcare fields in the US followed any movements from Canada, visa versa...?
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Re: drawing the line!! - February 7, 2007 5:38:00 PM
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orthotherapist
Posts: 218
Joined: February 6, 2007
Status: offline
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Well here goes.
I am sick of hearing about all the issues with regards to POPTS. I have worked for all types of settings in my 15 years as a therapist and currently the position I am in is the most satisfying for me professionally. It has has allowed me to provide the best/most appropriate care to the patients that I serve. Yes I work with physicians.
To give a little history of myself:
I have an advanced masters degree, plan on sitting for the OCS certification, am eligible to sit for the cert MDT designation, and attend a minimum of 4 CEU courses a year. Now I am the first to say that a degree/certifications do not make a threapist but I feel that I am a competent therapist.
My current position allows me the following:
1.I am able to devote 100% of my time to treating patients. (no need to worry about marketing referral sources - my marketing is ensuring a pleased patient). 2. I provide one on one care in a state of the art clinic without the use of aides. 3. I have instant access to medical records/operative reports. 4. I have a open communication with the physicians - they are always available to speak about a case and I would venture to say that they have learned as much about therapy as I have about medicine. I am free to do what i want with the patients. I have never been asked to overtreat etc.
I know the issues and agree that pulling patients from another facility, directing all patients to your facility thru the use of threats etc is not appropriate. This does not happen at the clinic I work at - if it did I would be the first out the door.
The old saying "do not base a book by its cover" applies in this situation. Just like there are bad apples with POPTS there are bad apples in private pratice/corporate therapy. My last position was with a large catholic health care system - at this system I was asked to do activities that bordered on unethical/illegal. I have worked in private practice and guess what? therapists were encouraged to overtreat if times were slow. Now I am smart enough to know that this is not the case in all private practice clinics so please do not draw conclusions about all POPTS clinics. Judge each for what it is.
There are more pressing issues for us as clinicians. Ensuring that ATCs, massage therapists, unlicensed physical therapists are not providing "therapy".
I could go on but ...it is what it is.
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Re: drawing the line!! - February 7, 2007 6:13:00 PM
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physioo
Posts: 184
Joined: June 26, 2006
From: Canada
Status: offline
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I spoke to a person on the board, a profs in Canada
He said
1. There is no talk for more renumeration after advanced status
2. Still being discussed whether a residency type ofprogram might be needed.
3. ALl ocurses wil be based in a University, and no experience is necessary.
4. Might be diferent branches of specialization, eg MSK, Neuro, Paeds..
4 Programs in CAnada will become DPT in the future (longer term)
CHeers
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Re: drawing the line!! - February 7, 2007 6:36:00 PM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
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Have you read the discussion paper?
The person who is the Chair, of the Advanced Practice Task Force is a professor at my school. She said that there will be 5 years of experience needed in MSK. Also there are PTs already in peliminary training for advance status and there should be an increase in renumeration. At least this is what has been conveyed by people who are directly involved in the process.
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