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RE: PTA's as "Therapists"

 
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RE: PTA's as "Therapists" - December 13, 2007 6:21:40 AM   
plhunter

 

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quote:

[In the orthopaedic world, I'd take a certified athletic trainer any day.  An ATC has more in-depth orthopaedic training. /quote]

SJBird,
I am so glad that I don't work with physical therapist like you!  I would also like to point out that Medicare doesn't agree with you either as they do not allow a certified athletic trainer to treat and bill for the care of their patients, they must feel that the training and education of a physical therapist assistant is better than a athletic trainer.  The physical therapist that I work with treat me with the utmost respect and have never made me feel that would rather trust the care of their patients to someone else. 

(in reply to SJBird55)
Post #: 41
RE: PTA's as "Therapists" - December 13, 2007 12:35:03 PM   
SJBird55

 

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An athletic trainer is awesome in orthopaedics.... just lacking the training for the elderly patient population.  I wouldn't desire a trainer to be working with Medicare patients either (same as my feelings toward a PTA), but for the rest of the population that is mainly healthy and normal, I would prefer an athletic trainer to a PTA.  An athletic trainer has a 4 year degree and has excellent experience, can think very quickly on his/her feet and does an excellent job progressing patients and motivating patients (generally).  A PTA doesn't have the necessary training with the elderly either though, unless programs have changed.  To my knowledge, a PTA isn't trained in their 2 year program on the normal aging process.  Neither an ATC nor a PTA are fully qualified to truly understand the elderly population, co-morbidities, effect of co-morbidities, effect of medications...

Well, Peggy... that's fine by me.  I have no plans to hire a PTA.  :) 

(in reply to plhunter)
Post #: 42
RE: PTA's as "Therapists" - December 13, 2007 1:34:34 PM   
proud

 

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quote:

ORIGINAL: plhunter

I would also like to point out that Medicare doesn't agree with you either as they do not allow a certified athletic trainer to treat and bill for the care of their patients, they must feel that the training and education of a physical therapist assistant is better than a athletic trainer. 


No intended disrespect Plhunter, but your above statement essentially demonstrates your lack of understanding of your very own role. Now you can take that as an insult, or actually listen to what a few here are going to tell you.

A certified athletic trainer has more educational training than a PTA. In an orthopeadic setting, any clear minded Physical therapists would rather utilize a ATC than a PTA. It's just a fact Pl.

Perhaps not in a hospital setting for walking patients around or gait training etc of course. But academically......ATC have more training.

< Message edited by proud -- December 13, 2007 1:48:22 PM >

(in reply to plhunter)
Post #: 43
RE: PTA's as "Therapists" - December 13, 2007 2:38:25 PM   
proud

 

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quote:

ORIGINAL: plhunter

I would also like to point out that Medicare doesn't agree with you either as they do not allow a certified athletic trainer to treat and bill for the care of their patients, they must feel that the training and education of a physical therapist assistant is better than a athletic trainer. 


No intended disrespect Plhunter, but your above statement essentially demonstrates your lack of understanding of your very own role. Now you can take that as an insult, or actually listen to what a few here are going to tell you.

A certified athletic trainer has more educational training than a PTA. In an orthopeadic setting, any clear minded Physical therapists would rather utilize a ATC than a PTA. It's just a fact.

Perhaps not in a hospital setting for walking patients around or gait training etc of course. But academically......ATC have more training. As an example, I will attach a university program in Canada. In that is a link to CATA( Canadian Athletic Therapy assosiation).

[url]http://www.umanitoba.ca/faculties/kinrec/undergrad/athletic_therapy/[/url]

< Message edited by proud -- December 13, 2007 2:41:23 PM >

(in reply to proud)
Post #: 44
RE: PTA's as "Therapists" - December 13, 2007 4:17:04 PM   
buckeye

 

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sjbird -

I am not opposing or supporting your opinion on PTAs. But I recall the Medicare limitation on PTAs treating Part B patients with direct supervision applies to PTs in private practice. If it is a hospital-based outpatient clinic, the PTAs can provide treatment without direct supervision.

Sorry - I missed the post in which you realized the error. My bad.

< Message edited by buckeye -- December 13, 2007 4:22:17 PM >

(in reply to SJBird55)
Post #: 45
RE: PTA's as "Therapists" - December 13, 2007 6:09:53 PM   
orthotherapist

 

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I would have to say that I have worked with PTAs as well as ATCs and from my experience the PTAs I have had the pleasure to work with have known their roles, introduced themselves appropraitely to the patients, and have assisted in the provision of quality care.  The ATCs I have worked with have been wannabe therapists that would misrepresent themselves to the patients (if called doctor/therapist by a patient they would not correct the patient), as well as physicians. 

Now I am not going to label ATCs as bad based oon my limited experience.  I am sure with the right population they are great but as SJ pointed out earlier an ethical issue arises when you are using certain criteria with one payor and yet a different set of criteria with other payors.

Whenever a less qualified professional is used in the provision of care we as Physical Therapists must ensure that what has been delegated is appropriate based on patient presentation and the training of the care extender so as not to shortchange the patient.  If the treatment requires teh skill of a therapist then we should be the ones providing it. 


(in reply to buckeye)
Post #: 46
RE: PTA's as "Therapists" - December 13, 2007 6:15:45 PM   
kiwi PT


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Physical therapy should be performed by licensed physical therapists, and licensed physical therapist assistants, that is what makes it physical therapy. Massage therapists doing some really good soft tissue work or a chiropractors doing some judisciously applied manipulation are NOT performing "physical therapy" even though they are using techniques that are used in physical therapy. The same is true of athletic trainers, they perform athletic training.  Perhaps the level of training of PTAs should be increased, I personally don't work with any right now, but the two I have worked with in past were good in the orthopedic setting, though I understand that 2 is hardly enough to make a judgement on. However going outside our profession is not the answer. I always thought ATC stood for Ankle Taping Clown

(in reply to proud)
Post #: 47
RE: PTA's as "Therapists" - December 14, 2007 6:02:32 AM   
plhunter

 

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Please understand, I am not saying that a PTA has more education than a ATC, I have a very clear understanding of my education compared to a ATC.   I am merely pointing out that when you are treating a Medicare patient that you can only bill for that treatment if you are a PT or a PTA.   With every discipline you have good and you have not so good, I am a good PTA, I know my limitations and I am proud of what I do and I enjoy my job.  I work in a outpatient  orthopedic Medicare population, I am a licensed massage therapist, certified lymphedema therapist and a physical therapist assistant, SJ Bird, my friend you are clearly missing out working with a profession that would clearly make you look good.

Peggy

(in reply to kiwi PT)
Post #: 48
RE: PTA's as "Therapists" - December 14, 2007 12:36:52 PM   
Sebastian Asselbergs

 

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Now, I KNOW I don't look good, so that is out of the way! But I agree with SJ - I work alone with my patients, one at a time. I have worked as the senior therapist in a large (12 PTs, 2 ATs, 2 assistants) clinic in the past, and even then, I never used them.  I am just much more involved with every step of the therapy session...Don't do ultrasound etc., do not do "protocolised" exercise routines - only instruct individuals for their individual needs and let them do their work at home or in their fitness club or their pool. Frankly, I have no place for assistants or such in my style of practice.  I like the direct communication on EVERY visit with every patient - maximizing the time they pay me for.
I am just not seeing the need for assistants, unless it is a financial issue to optimize bookings for re-imbursement - and that is something I do not do or feel very comfortable with in my cicumstance (patients pay for time with me, not for procedures....)

_____________________________

Mundi vult decipi

(in reply to plhunter)
Post #: 49
RE: PTA's as "Therapists" - December 14, 2007 12:45:22 PM   
SJBird55

 

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Yep, Peggy, I am very aware of who is considered qualified to treat Medicare patients. 

I choose not to use physical therapist assistants.  I do not believe the purpose of hiring staff is to make myself or anyone for that matter look good.  IF I were to choose to use a physical therapist assistant, the rationale would not be to "make myself look good."  I could care less about myself... the patient is who matters and I honestly do not believe that, in general, a physical therapist assistant is required.  I honestly believe with the changes that I am seeing with reimbursement and limitations in visits and different frequencies than back in the 80's combined with a less healthy society as a whole that a physical therapist is the best professional to be providing physical therapy services and more importantly with the geriatric population.

(in reply to plhunter)
Post #: 50
RE: PTA's as "Therapists" - December 14, 2007 1:41:35 PM   
proud

 

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Well I also agree with SJ. I stated that the PTA's that I previously worked with were helpful within a very very busy environment where cash was king. It was not an ideal setting for me and thus I left. But I did trust the judgement and critical thinking skills of the PTA's that I happended to work with.

I do not utilize a PTA in my practice. I do not utilize an ATC in my practice. I truly feel the only reason to employ these trades is to push more people through the system providing sub-optimal care. I work in an environment where exceptional outcomes are tracked and demanded by the employer.

However, with so many people in need of rehab services, a few of those clients may simply require very general exercises which does not require the special skills of a PT. In that situation, PTA's can be useful if they understand their role and are not confused with the term "therapist" and simply follow the guidance of the responsible PT.

(in reply to SJBird55)
Post #: 51
RE: PTA's as "Therapists" - February 8, 2008 5:43:01 AM   
blast7

 

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I have had very good experiences working with PTA's in outpatient and the acute care setting.  In both cases the PTA's/PT's were matched with similar personalities and professional beliefs and had excellent communication.  Thus the patient had improved outcomes because the PT/PTA were always working together and the patients were able to be more compliant with their visits as they had more available time slots.  In any case, New York state practice act states that it is the PT's decision to hand off patients that they feel the PTA is capable of caring for.  Therefor I can see that if someone works in a more involved outpatient clinic and they hire a PTA who does not match the knowledge and level of professional development, there could be an issue.  I do believe that as reimbursement decreases PT clinics will be looking more at using PTA's much like MD's use NP's/PA's.  If this is a reality then I do think the APTA needs to increase their efforts for PTA's or decide on increasing the reimbursement rate.

< Message edited by blast7 -- February 8, 2008 5:46:14 AM >

(in reply to proud)
Post #: 52
RE: PTA's as "Therapists" - February 9, 2008 4:58:47 AM   
Hitomi

 

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This thread has been interesting to me.  I am the only PTA working with 4 PT's in a private practice setting. My roll as a PTA is from one extreme to the other  (depending on the PT)...from having to politely stay within my Scope of Practice, to seldom being utilized (and if I am it is for Ther Ex with clear instructions to soley 'go over the exercises'..a compliment to me today from a patient was that I explained/taught the exercises better than the PT- but I am quite certain that the elderly man just thought that I was better looking, and I totally defended the PT).  Bottom line,  I respect the PT's that I work under, regardless of their views of my capabilities and strive to give the best possible care to the patients within the Scope of Practice of a PTA.

(in reply to blast7)
Post #: 53
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