Joined: November 16, 2005
I just wanted to say that I attended Barretts confrence on Simple Contact today in Portland.It was Wonderful and very informative.When I came home I immediatley began to put to practice what I had learned.My husbands friend had stopped by and I recalled him mentioning that he had Chronic pain.So I asked him the 5 questions.He began to tell me that he had had the pain for awhile,it was in his feet and that it only bothered him when he wore certian shoes.I also asked him if he had back pain.He told me yes but that he didn't mention it because it was all gone now.He stated that the pain in his back had been there for so long that he just overcame it and now all he recognized was tha pain he felt in his shoes.I questoned him in why he didn't buy new shoes and he just gave excuses.I began to push the situation in that he is a friend and he just kept nodding his head as though to tellme he heard me but didn't care.Cause he would do as he saw fit.Being he liked the shoes and he didn't care that they caused him pain on a dily basis he would continue with what pattern he knew.My question is this.Hoe do you deal with those hard to reach patients.The ones that can easily take steps to correct the malfunction but choose not to?
Joined: August 25, 2000
Thats a tricky question. Unless you can correct it on the spot and have the patient "feel" the difference or notice a significant improvement with the symptoms right then and there, they will continue with what they have been used to all this time. If this particular person likes the shoes, can the symptoms be improved with orthotics if warranted? If so, then the person can still wear the shoes but with an orthotic in it. Don't know if this would apply or not. My 2 cents.
Joined: February 17, 2005
apathetic definately.....ignorant hardly. In fact your reply shows where the ignorance lies. I asked why someone would want a t -dpt and you immediately get your hackles up for some reason.
If someone wants to get their t dpt to advance their own knowledge and the challenge of learning then fine and dandy more power to them.
To state as fact that the DPT is the future of the profession is very premature, regardless of what the APTA says. Last I checked the folks who pay the bills(ins and medicare) couldnt care less what credentials we have.
last I checked those who consume healthcare services are flocking en mass to alternative providers and giving cash to those who have 6 months of education or less....see massage and personal training.
so other than personal advancement please tell me what the benfits of an additonal 10, 20, 30? thousand dollars of schooling is going to get somebody?
i think its very telling that in the same thread as a dpt topic there is a massage practicioner asking questions about the 'simple contact' :rolleyes: approach to treatment that was taught to her by a PT.
i think PT has a great future,,,any profession/practicioner that can help folks stay active and reduce pain is going to thrive in the next few decades ....how does a DPT give one an advantage?
access to patients? no elevated perception by the consumer? no. more money? no.
i ask again...why would someone with a fresh MPT want a tdpt?
Joined: November 20, 2003
"i think its very telling that in the same thread as a dpt topic there is a massage practicioner asking questions about the 'simple contact' approach to treatment that was taught to her by a PT."
mt, What exactly do you think is being told? I agree with you that with a t-dpt, there is no greater access to patients, and generally no more money. Some facilities do have clinical ladders that give pay increases based on certifications and advanced degrees, as far as elevated perception by the consumer, I'll have to disagree with you. Right or wrong, the patient views a doctoral degree as more advanced and more knowledgeable, than us with a masters or a bachelors. Scott
"Right or wrong, the patient views a doctoral degree as more advanced and more knowledgeable, than us with a masters or a bachelors."
Scott. I have to disagree with you here. From my very limited perspective - in a small (125,000) town, with 16 PT clinics for quite a few years: Most all of my clients are not even interested in what degree I have - they've been told by their doc or their relative/friend that they should see me. And this is all. I really believe that the T-DPT or DPT (we're going that way too) is NOT a biggie for the patients. It is for political clout maybe; in some instances for social status, but no more than that. I am not against it, but it should not be thought of as improving the patient flow in any way. Direct access will.
Joined: April 25, 2004
From: Amherst, WI
I think it is difficult to make blanket statements about what a person may think of someone's degree in comparison to another's similar degree, especially when they are understandably ignorant of what goes into either degree.
Joined: November 20, 2003
Jon/Sebastian, I know generalizations aren't applicable in many situations, but I've had quite a few patient's ask me if they should go see the PT across town who has a DPT, if they don't improve with me seeing them. I think alot of this stemmed from newspaper ads playing up the fact that his PT degree was the 1st PT doctorate in our area. Scott
Joined: April 25, 2004
From: Amherst, WI
I'm sure you're onto something with that newspaper ad. I'm suspicious that you might get the same question if the ad said that that PT was the first in your area to be certified in 'fill in the blank'. Or if everyone was of equal degree, that question wouldn't go away. You'd hear, "Do you suppose I should go to place B if I don't get better with you. I hear they have a 'fill in the blank'". Greener pastures are always on sale.
If the DPT has an effect on the profession it will be to change the job of PT's. What many people want is more hands-on care, more personalized attention, the DPT won't give you the means to provide that. You will essentially replace most of the role the physician plays today while other providers do the job PT's do today. Not everyone wants that.
Joined: November 8, 2005
Hi. As a recent graduate, my reason for wanting to pursue a T-DPT is to further my knowledge and skill. I know I probably won't make more money with the degree but it's just a personal goal of mine. I also believe that when you get out of school, you learn just enough to get by. But I'm interested in going a bit further and elaborating on specific areas of PT. Besides, the degree only takes about a year!!
Joined: January 25, 2003
Ya know, I think it kinda sucks that the APTA has this scam going...new grads graduate with ENOUGH debt to choke a horse, then they buy into the DPT thing and choose to pursue MORE school without a firm grasp of benefit. To think you graduate from a professional program and think "I know just enough to get by" is completely dangerous and does a disservice to all who graduate. Why offer a degree if it has been planned to replace said degree? What a shame.
Dr. Wagner DO Moderator of Medical Complexity Forum
Joined: April 10, 2002
I am a BIG lurker/observer here, and enjoy all posts...so I think its time I "dip my foot in the water".
My opinion is that the whole DPT push in the USA is largely an 80% political campaign to put Physiotherapists in the USA on par with Chiropractors, Pharmacists, Optometrists, Naturopaths, etc. Hopefully, the DPT may do this and this would be excellent for the profession in the USA.
But I personally dont think that a DPT will make a better clinician. From what I can gather (via reading posts) is that not all states have direct access, and that some need physician referral for certain treatment, not to mention the whole re-imbursement medi-care system and what ever that entails...perhaps the DPT will eliminate some of these barriers, perhaps not.
But, at the end of the day, YOU as the physiotherapist are still the person encouraging the elderly/post op/injured to ambulate, cough, stretch, strengthen and mobilize. Do you need 4+ years of learning/training to do this?
Research is very important to the profession, I agree, and deciphering the best evidence from the worst is an excellent skill. But, are physiotherapists researchers? In my opinion...no. Even then, are typical MD's wrapped up and concerned in doing research? I don't really think so...they have to worry about their patients after all (as do we).
In the UK, Canada and Australia physiotherapists have direct access (all across the board as far as my understanding goes) and their is no talk of a DPT. Granted, in Canada I know they are converting to a Graduate program. But in the end we are all doing the same "things" as physiotherapists..no? There are even clinicians practicing with just a diploma in these countries, who are excellent clinicians that the newer degree/masters trained therapists are learning from.
So, what will a DPT get you? I think you will learn much in research and in spotting "red flags". Yes, if we are direct access, we should know when to refer out and know what is an MSK problem and what is referred pain...but how difficult is that? Do you need to invest thousands to be competent in such a practice? Clearly direct access works in other countries who have BSc/diploma trained therapists as the basic "standard".
The issues of reimbursement, direct access and physician referral are virtually non existent in other countries where as in the USA it is a huge barrier for physiotherapists. I think that is why the DPT is in the USA.
Joined: November 15, 2003
Physio G and others,
Physiotherapy in Australia is a degree course and has been for 30 years or so, about the same length of time as we have had direct access. That included all diplomates, automatically, and they were regarded as quite similar to those with the degrees during transition to the degree course, after which the diploma course was abolished.
I do not know about the 'basic' course in the USA - it seems to run short of a few things like recognition of red flags and so on, from what I have gathered on this bb. Given those shortcomings, I can understand there is a need to 'upgrade' skills, but does that necessarily require extensive and expensive postdiplomate study? More and more physios here are gaining their PhD, but they are still few and far between.
I have difficulty understanding the USA system with all of its nuances in skill acquisition; so I may be out of place here, but if just the basic training in the USA does eliminate the possibility of gaining direct access, then I can appreciate the problem.
And, I couldn't agree more with you on the topic of 4+ years to walk and cough patients, mobilise and strengthen, if that is all that is being done in hospitals, etc. That barely requires a physio, more a PT assistant.
Joined: May 9, 2004
From: West Palm Beach
I am truly sorry I do not have enough time to write right now, but you all are so the reason I am fuming about this. IT IS YOUR PROFESSIONAL RESPONSIBILITY TO OBTAIN THE HIGHEST DEGREE OUR PROFESSION OFFERS!!! That is like the person in a state that does not require CEU's saying then they shouldn't go to any CEU courses, or the person who practices in an orthopedic practice who does not think it is their responsibility to abotain their OCS. You owe it to yourself and your patients to have any and all knowledge regarding your field. Complacent PTs are what bring the profession down. I had on campus time recently with all my t_DPT partners and all of us are doing amazing niche practices, or overseeing an amazing amount of therapists or starting their own PT schools in different countries, etc. To say that this group of PTs were your average salaried health south PT would be a mistake. but, it is the average salaried health south PT that the general public associates PT with. The same one doing the same thing they did day one out of school and not keepoing up with the literature, not going to CEU's, not expanding their horizons...not actively taking a role in their profession. I mean if you want to be staff PT somewhere and contribute nothing but good to average care and get most of your patients better almost by chance then so be it. But, if you want to learn the most up to date information and put your effort into moving our profession away from the gray murky area it is heading towards with conflicts with exercise phys, atc, chiro, etc, then sit back and scoff the DPT. Really though, it is almost like a satirical political cartoon, all the reason;s you all give are the same reasons that all the nay sayers are giving, yet none if it holds water. It is rooted in the beleief that you may not be practicing to the best of your ability, it is fear, it is some weird form of jealousy, and some form of not wanting to go outside your comfort zone. If it is monetary or you have too much time committments to be enrolled in school, so be it, but to say you or OUR PROFESSION does not need this shift towards a doctoring profession then I am sorry to say you are wrong. And this is not very debatable. You are simply wrong, but keep warm inside your happy place and scoff the world of change, they say one day we may drive in motorized horses, wow are they crazy! Best of luck to all of you, and I hope one day the light in the attic turns on for you, and you are freed from your complacent reigns and learn to step it up and show the public and other health care professionals that we are more than stretchers and walkers, until then ,I'll do my part, and hope to set a stage for you all to enjoy the labors of others who do to. Much love, Ben Galin, MPT, OCS