Phoenix,
Similar to Ryan, most of my posts in this thread were dedicated to knocking some sense into an individual.
Your post is very interesting to me because it has less to do with a physical therapist's ability to accurately screen for underlying pathology, and more to do with upsetting the balance of the healthcare team.
True. Medicine is hierarchial--always has been, always will be; I don't make the rules, I just play by them. To me, this is a classic example of having too many chiefs and not enough indians. The natural question, of course, is what gives the physician the right to be the chief? I'll argue it's because we have the most extensive training, but more importantly, the broadest, therefore allowing us the best vantage point of the big picture. PLEASE, PLEASE, PLEASE don't take this as me beating on my chest; in any team situation there has to be a leader, but an exceptional leader knows their strengths and weaknesses and brings in experts to complement the weaknesses.
I'd like to address a very important point in your message. Assuming they are in there right mind: 1) No physical therapist would ever compare their education with an MD's education, 2) No physical therapist would pretend to be able to do your job, and 3) Every physical therapist
will agree that a physician should be intimately involved in the care of complicated patients.
My rational mind tells me everyone believes this, but some of the posts by people on here sometimes will lead to me to feel otherwise. Ah the joys of internet forums
With these three points made, it is my opinion (and that of most PTs) that expanding a PT's scope to include the various elements discussed in these posts does not stand in contradiction...this expansion merely allows us to better serve the patient.
See above. I'm not 100% sold on the data that's currently out there about outcome and quality measures. I'm just not.
Of most healthcare professionals, by the very nature of their work, physical therapists spend the most time with patients.
Can't deny this.
As such, we have a unique opportunity to assess the subtle changes in a patient's condition or pick up on important findings that may have not presented at the time of evaluation. With this in mind, a better educated PT strengthens the team you described earlier. Would you not agree?
More education is alway better; I won't ever be against that. And I agree that you can pick up on more subtle findings over time--that's the beauty of the give and take I described in my first post. I'm just trying to say that having both parties involved is ALWAYS better, not just either or.
Similarly, in the typical PT outpatient setting, the "team" does not exist in the same manner as you described. Largely, it is how Ryan described it in an earlier post: useless script is received accompanied by pointless imaging, PT evaluates and determines cause of dysfunction, PT treats.
