New grad bashing

[DesertPT]

Read this on a PT's blog recently:

"I suppose my angst in this post is truly directed at intra-professional degradation. Physical rehab professionals are the only group in healthcare that I see overtly bash on their new colleagues for graduating with shiny degrees. So many other professions couldn't be happier that their new-grad-colleagues are receiving higher degrees that more accurately reflect where the profession has been, should be, and is going to be. However, our profession seems to have tolerance to those who behave from the view point that "doctor" is giving new-grads far more credit than they deserve."

I'm not making any claims for or against this statement for now, but I certainly think he has a point. I would love to hear some opinions and get some reasons why people think this phenomenon may or may not actually be the case, if anyone has any.

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[engmedpt]

Employers who went directly from bachelors to the workforce without a prerec curriculum or a vast amount of volunteer hours before going into grad program where you do actual cadaver dissections in an incredibly intensive process next to med students should give respect in my opinion. (Ive been trying to find this......did the bachelors have such intensive anatomy and physio at all compared the doctorate? That's something new grads could use as leverage for their worth and value coming in to name just one.)

Here's some posts talking about school experience:
http://community.advanceweb.com/blo...14/the-value-of-cadaver-lab-in-pt-school.aspx
http://www.insightmagazine.org/career/article.asp?career_id=19

I think the issue is that since this is a relatively new transition that has effects which are not realized (hey, remember congress last night?) is going to cause a rift between employer perception and new grad perception. From the standpoint of the employer, well I definitely would think they are significantly better with patients through years and years of actual practice in their specific approach while the grad will come in focusing on very specific things and different approaches but still needs years and years to develop that.

I wonder if the employer looked at it like this:
Was I a lot more capable to tackle these tasks in a problem solving fashion when I was straight out of college or is this new grad more capable coming out of a significantly more intensive program that had an undergrad selection process simply to get in, relatively speaking?


Anybody wanna bash me?

 

[engmedpt]

Just thought of something else....

Is this guy referring to pts working directly in physician run practices for like the last 20-30 years? Considering the source of this post may put things in a better context.

 

[NewDPT31]

Most new grads are naive, as I was. They think people actually care that they got a doctorate(no offense-I have a DPT too and nobody will ever consider you a true DR-and why would i press the issue. Doesn't really affect anything with patient care. Pt. will either listen to you or not. And no other healthcare worker will ever call you Dr. That's a fact.)
Most all DPTs 3-5 years out, like me, realize that the DPT was, for the most part, a money grab.
Yes, we get it. PT school is very hard to get into, and very very very challenging. DPT school about killed me several times haha. But grades and rigors don't make a good therapist.

Most therapists realize that being a good therapist is a good balance between being clinically smart and sociable. If you are into research-that's a different story. Continuing education and experience, even if anecdotal, mixed with good outcomes and a good patient trust is what makes a good therapist.
Anybody can stay up to date with research.

 

[ptisfun2]

(Ive been trying to find this......did the bachelors have such intensive anatomy and physio at all compared the doctorate? That's something new grads could use as leverage for their worth and value coming in to name just one.)

Anybody wanna bash me?

Nope, but can answer the question you asked..at least about my BS in PT program. Our A&P was the same as what our DPT students are learning. In gross anatomy (taken in sophomore year), we have cadavers, and some of our lectures were combined with the med students. In Junior year I took neuroanatomy and physiology, and I failed (too much fun time with a fake ID!). I had to re-take the class at Univ of VT (not my undergrad school) over the summer, and that was with all medical students who had failed it at their medical school (so grad students), so at a fairly advanced level. I think the basic sciences did not change with the transition from BS to DPT. Rather I think the change was in the differential diagnosis and a move to a less reductionist treatment paradigm. So clinical sciences vs. basic sciences.

 

[DesertPT]

Rather I think the change was in the differential diagnosis and a move to a less reductionist treatment paradigm. So clinical sciences vs. basic sciences.

My impression with the faculty I have interacted with at a handful of schools is that faculty are largely in support of the move to the DPT and what it is supposed to represent, whereas practicing PTs largely like to hate on the fact that new PTs are getting a doctorate. Faculty like to talk about the DPT representing a shift in the focus of PT education towards more clinical reasoning skills for new PTs, but all practicing PTs want to talk about is that the DPT was a ruse to help line people's pockets. Do you agree? Has the move from MPT to DPT helped line your pockets as a faculty member?

I am by no means in support of the ridiculous growth of tuition prices over the past couple of decades. I understand that people think the DPT was money grab, just there to improve lobbying power, etc. etc., I just don't see why BSPTs and MPTs having such a poor attitude about the DPT helps anyone or the profession. This is obviously not representative of all PTs in the least, but there are certainly a lot out there who love to hate on the fact that new grads have "shiny degrees" which I think was the point of the original blog quote.

 

[brooklynyc]

Great topic Desert. I'm curious as well. Hope to hear more opinions.

 

[ptisfun2]

My impression with the faculty I have interacted with at a handful of schools is that faculty are largely in support of the move to the DPT and what it is supposed to represent, whereas practicing PTs largely like to hate on the fact that new PTs are getting a doctorate. Faculty like to talk about the DPT representing a shift in the focus of PT education towards more clinical reasoning skills for new PTs, but all practicing PTs want to talk about is that the DPT was a ruse to help line people's pockets. Do you agree? Has the move from MPT to DPT helped line your pockets as a faculty member?

I am by no means in support of the ridiculous growth of tuition prices over the past couple of decades. I understand that people think the DPT was money grab, just there to improve lobbying power, etc. etc., I just don't see why BSPTs and MPTs having such a poor attitude about the DPT helps anyone or the profession. This is obviously not representative of all PTs in the least, but there are certainly a lot out there who love to hate on the fact that new grads have "shiny degrees" which I think was the point of the original blog quote.

Hmmm I don't know. I have not heard anyone 'bashing' DPT or anything else. We all sign our name with only our professional credentials (per practice acts in a bunch of states....there may be states that allow degree as well), so ptisfun2, PT, so people may not know your education or degree for PT..just that you are licensed. There was a motion at the APTA HOD to change our professional designation to DPT vs. PT, but I think it failed (don't quote me on that though).

I missed the MSPT boat. I was merely a happy clinician during this transition. I was educated with a BS and started teaching in a DPT program. I think the move away from a BS was a good one. I think more maturity was needed to move the profession forward. I know for me and many of my classmates we just picked a major in undergrad (many of my classmates treated it as their 'pre-med' major and went on to med school). But most of us gave as much thought to PT as a major in undergrad as college students give majors now...so probably not much. Just seemed like a good way to have a job. My first job.. those with a MSPT made more starting than those with a BS, but just a bit more. Not a huge deal at all. My faculty salary is commensurate to what I would make clinically as a PT. I know lots of Bachelor's trained PTs, and they all say, 'That's cool" to the DPT, but the ones I know had too much fun in college with fake IDs, so a pretty chill group overall.

Tuition is ridiculous, and not just for PT. I have said it before and I will say it again....As long as we get 1000 applicants for a PT program, there is NO incentive for schools to think price is an issue. AT ALL. Tuition MAY only drop is there is less demand (but even then I do think tuition will drop, but will climb less slowly). If demand (high number of applicants stay high), schools will think students will pay whatever and raise tuition. I am no economist, but this is basic economics. Shoes only go in the clearance rack when no one wants them.

 

[jesspt]

I don't think that most of my non-DPT peers hate on those who recieve the DPT. Speaking for myself, I do get tired of DPT students, or recent DPT gradautes who seem to think that their preperation was markedly different or better than the typical MSPT school. I was a memeber of the second-to-last MSPT program at my school and they added one clinical and two behavioral science classes to the curriculum initially (if I am recalling that correctly - it was quite some time ago). That's it. And, my impression is that this increased emphasis on differential diagnosis is largely overstated. Direct access has been around for longer than the MSPT degrees, and our NPTE needed to assess recent graduates ability to practice safely in those states regardless of the degree they recieved. PT schools have been teaching screening for red flags and referring out for longer than I have been a therapist. I had a radiology course. Differential diagnosis/medical screening. Problem-based learning. Cadaver gross anatomy.

I'm not against the DPT or those that obain it, but let's try for a little perspective. The difference between the preperation between a DPT and an MSPT is not that great. Here is a great editorial on the DPT from PT Journal by Jules Rothstein: http://ptjournal.apta.org/content/78/5/454.full.pdf+html

 

[DesertPT]

Thank you @ptisfun2 and @jesspt for excellent replies. And thank you jess for pointing me to that excellent article, it was highly informative.

It seems to me then that one big issue why people don't take the DPT seriously is that they don't feel that most programs are that much more "doctoral" in nature than the master's programs of the past were. From my experience from schools I interviewed at and visited, there is quite a bit of variability in just how "doctoral" various programs are. Some are 3 full years with no summer breaks and substantial research requirements, whereas some are 2.5 years or have summers off and don't involve students in research at all.

 

[Azimuthal]

PT is PT. I have not met one student who goes around boasting their DPT might. I have observed a BSPT mock a new grad but believe that particular experience was more of a reflection on that PT's insecurity.

The track towards a clinical doctorates made sense to me. A good majority of MSPT credits requirements were far from a typical master's. I received my graduate's degree with 64 "quarter" units... I'd wager that most MSPT's surpassed 80 units easily. The most likely explanation of why there is such little difference between the MSPT and DPT.

I personally don't even know why this is a thing. I'm proud to have been trained and mentored by great clinicians, whether BS, MS, or DPT.

 

[engmedpt]

Most new grads are naive, as I was. They think people actually care that they got a doctorate(no offense-I have a DPT too and nobody will ever consider you a true DR-and why would i press the issue. Doesn't really affect anything with patient care. Pt. will either listen to you or not. And no other healthcare worker will ever call you Dr. That's a fact.)
Most all DPTs 3-5 years out, like me, realize that the DPT was, for the most part, a money grab.
Yes, we get it. PT school is very hard to get into, and very very very challenging. DPT school about killed me several times haha. But grades and rigors don't make a good therapist.

Most therapists realize that being a good therapist is a good balance between being clinically smart and sociable. If you are into research-that's a different story. Continuing education and experience, even if anecdotal, mixed with good outcomes and a good patient trust is what makes a good therapist.
Anybody can stay up to date with research.

Nope, but can answer the question you asked..at least about my BS in PT program. Our A&P was the same as what our DPT students are learning. In gross anatomy (taken in sophomore year), we have cadavers, and some of our lectures were combined with the med students. In Junior year I took neuroanatomy and physiology, and I failed (too much fun time with a fake ID!). I had to re-take the class at Univ of VT (not my undergrad school) over the summer, and that was with all medical students who had failed it at their medical school (so grad students), so at a fairly advanced level. I think the basic sciences did not change with the transition from BS to DPT. Rather I think the change was in the differential diagnosis and a move to a less reductionist treatment paradigm. So clinical sciences vs. basic sciences.

I don't think that most of my non-DPT peers hate on those who recieve the DPT. Speaking for myself, I do get tired of DPT students, or recent DPT gradautes who seem to think that their preperation was markedly different or better than the typical MSPT school. I was a memeber of the second-to-last MSPT program at my school and they added one clinical and two behavioral science classes to the curriculum initially (if I am recalling that correctly - it was quite some time ago). That's it. And, my impression is that this increased emphasis on differential diagnosis is largely overstated. Direct access has been around for longer than the MSPT degrees, and our NPTE needed to assess recent graduates ability to practice safely in those states regardless of the degree they recieved. PT schools have been teaching screening for red flags and referring out for longer than I have been a therapist. I had a radiology course. Differential diagnosis/medical screening. Problem-based learning. Cadaver gross anatomy.

I'm not against the DPT or those that obain it, but let's try for a little perspective. The difference between the preperation between a DPT and an MSPT is not that great. Here is a great editorial on the DPT from PT Journal by Jules Rothstein: http://ptjournal.apta.org/content/78/5/454.full.pdf html

PT is PT. I have not met one student who goes around boasting their DPT might. I have observed a BSPT mock a new grad but believe that particular experience was more of a reflection on that PT's insecurity.

The track towards a clinical doctorates made sense to me. A good majority of MSPT credits requirements were far from a typical master's. I received my graduate's degree with 64 "quarter" units... I'd wager that most MPT's surpassed 80 units easily. The most likely explanation of why there is such little difference between the MSPT and DPT.

I personally don't even know why this is a thing. I'm proud to have been trained and mentored by great clinicians, whether BS, MS, or DPT.

This is depressing.

For the good of everyone about to start and the profession, say specifically the answer to this question so this perception will not come through:


How is the DPT not a "money grab" for many schools to suck money out of students trying to get into a market where education has simply become a selection factor to get to a decent profession without any actual progress of the profession itself?

I'm waiting and reasoning should be presented ethically speaking.

 

[DesertPT]

A good majority of MSPT credits requirements were far from a typical master's. I received my graduate's degree with 64 "quarter" units... I'd wager that most MPT's surpassed 80 units easily. The most likely explanation of why there is such little difference between the MSPT and DPT.

Thanks for pointing this out. I don't think most people realize this when they talk about how the DPT wasn't much of a change from the MPT as far as content. They fail to realize that MPTs were already some of the most rigorous master's degrees out their and probably deserved to be called doctorates.

 

[DesertPT]

How is the DPT not a scam to suck money out of students trying to get into a market where education has simply become a selection factor to get to a decent profession without any actual progress of the profession itself?

Perhaps the move from MPT to DPT is as much of a change in nomenclature as anything, as described above. It's likely tuition would have risen just as rapidly if the naming convention hadn't changed.

 

[engmedpt]

Perhaps the move from MPT to DPT is as much of a change in nomenclature as anything, as described above. It's likely tuition would have risen just as rapidly if the naming convention hadn't changed.

Is there information somewhere of the tuition hikes that occurred right after the transition? Like one to three years after?

 

[engmedpt]

Tuition is ridiculous, and not just for PT. I have said it before and I will say it again....As long as we get 1000 applicants for a PT program, there is NO incentive for schools to think price is an issue. AT ALL. Tuition MAY only drop is there is less demand (but even then I do think tuition will drop, but will climb less slowly). If demand (high number of applicants stay high), schools will think students will pay whatever and raise tuition. I am no economist, but this is basic economics. Shoes only go in the clearance rack when no one wants them.

Do you have any power at your institution to stop whoever is drowning hopefuls in debt from decreasing their quality of life for an entire decade?

^Please elaborate on the politics of this issue if you can and feel comfortable being anonymous. What would happen to a faculty member that says "Um, inflation didn't increase, stop charging more to line your pockets while these students fight to get into something?" I would like to know the behind the scenes conversations occurring.

 

[engmedpt]

Most all DPTs 3-5 years out, like me, realize that the DPT was, for the most part, a money grab.

Then why have lawsuits not been filed?

 

[engmedpt]

PT is PT. I have not met one student who goes around boasting their DPT might. I have observed a BSPT mock a new grad but believe that particular experience was more of a reflection on that PT's insecurity.

I already was fine with the fact that I would not introduce myself as Doctor, and would only say "I'm a Dr. of Physical Therapy IF APTA required it to patients to argue specifically the I'm an expert and to instill confidence while then stating "I'm not a physician though."

If the degree itself has not in any way actually increased capability, then that is absurd and must simply show that it is a political move which for the last 20 years hasn't even gained the goal recognition it needed although it has made steps little by little.

 

[Azimuthal]

This is depressing.

EVERY SINGLE ONE OF YOU should for the good of everyone about to start and the profession, say specifically the answer to this question:


How is the DPT not a scam to suck money out of students trying to get into a market where education has simply become a selection factor to get to a decent profession without any actual progress of the profession itself?

I'm waiting. Seething right now. Completely...

I believe I made my point. If it remains unacceptable to you, you may continue reading below.

You can’t handle the truth! …Son, we live in a world that has walls, and those walls have to be guarded by men and women with gait belts and goniometers. Who’s gonna do it? You? You, engmedpt? The APTA has a greater responsibility than you could possibly fathom. You weep for the MSPT degree, and you curse the APTA for creating a tuition disaster. You have that luxury. You have the luxury of not knowing what the APTA knows. That the MSPT’s death, while tragic, probably was necessary to award a degree that reflects the appropriate rigor and credit hours. And the APTA's existence, while grotesque and incomprehensible to you, stand by those credit hours. You don’t want the truth because deep down in places you don’t talk about at parties, you want the APTA on that wall, you need the APTA on that wall. We use words like direct access, differential diagnosis, clinical skills. We use these words as the backbone of a life spent defending something. You use them as a punchline. I have neither the time nor the inclination to explain myself to a man who rises and sleeps under the blanket of the direct access that the APTA thrives to provide, and then questions the manner in which the APTA provides it. I would rather you just said thank you, and went on your way. Otherwise, I suggest you pick up a pen and run a campaign to be an APTA board member. Either way, I don’t give a damn what you think you are entitled to.

 

[engmedpt]

We use words like direct access, differential diagnosis, clinical skills. We use these words as the backbone of a life spent defending something. You use them as a punchline. I have neither the time nor the inclination to explain myself to a man who rises and sleeps under the blanket of the direct access that the APTA thrives to provide, and then questions the manner in which the APTA provides it. I would rather you just said thank you, and went on your way. Otherwise, I suggest you pick up a pen and run a campaign to be an APTA board member. Either way, I don’t give a damn what you think you are entitled to

Excuse me, but what? I wasn't using them as a punchline. You misinterpreted what I said. Let me rephrase, I don't care about being called a doctor. I would only put letters after my name if it weren't overinflated So that my education would represent my role in society that Apta claims to represent and the title would simply denote expertise to give the general public solace and ease in approaching a physical therapist.

"The DPT should be no more expensive
than a master's degree of equal quality."

^This is directly quoted from JessPT's article......those aren't my words.

You don’t want the truth because deep down in places you don’t talk about at parties, you want the APTA on that wall, you need the APTA on that wall.

Wut??

Legitimately, I misspelled that on purpose to denote how asinine this statement is.

Outside of my immediate and I mean IMMEDIATE social circle almost all of my acquantainces have absolutely no idea that I'm going to PT school so nice try in arguing that I'm getting this degree to go and hang on my wall. I could care less about the prestige. What I want is a degree that isn't simply overinflated and lacking in extra content and I'm wanting for the responders above to answer that question.

Thank you for the quick judgment.

 

[Azimuthal]

Excuse me, but what? I wasn't using them as a punchline. You misinterpreted what I said. Let me rephrase, I DON'T FREAKING CARE ABOUT BEING CALLED A DOCTOR. I WOULD ONLY PUT LETTERS AFTER MY NAME POST GRAD IF THE EDUCATION ITSELF MEANT SOMETHING AND WASN'T OVERINFLATED BS So THAT MY EDUCATION WOULD REFLECT THE ROLE IN SOCIETY THAT APTA CLAIMS TO REPRESENT AND THE TITLE WOULD SIMPLY DENOTE EXPERTISE TO GIVE THE GENERAL PUBLIC SOLACE AND EASE IN APPROACHING A PHYSICAL THERAPIST

"The DPT should be no more expensive
than a master's degree of equal quality."

^This is directly quoted from JessPT's article......those aren't my words.




Wut??

Legitimately, I misspelled that on purpose to denote how asinine this statement is. Just so you know, I haven't been to a party in months because I've been too busy COMPLETING MY DEGREE TO GO TO PT SCHOOL.

When I was accepted, you know what I did???

I said "great, I can keep working hard for something."

THAT'S IT. Outside of my immediate and I mean IMMEDIATE social circle almost all of my acquantainces have absolutely no idea that I'm going to PT school so nice try in arguing that I'm getting this degree to go and hang on my wall. I could care less about the prestige. What I want is a degree that isn't simply overinflated and lacking in extra content and I'm wanting for the responders above to answer that question.

Thank you for the quick judgment.

Ahahahahahahahahahahahahahahahahahahahahahahahahahahahaha!!!!!!!! Remember that last sentence.

 

[engmedpt]

Now I get it.........

The track towards a clinical doctorates made sense to me

How so?

 

[engmedpt]

I wonder if the employer looked at it like this:
Was I a lot more capable to tackle these tasks in a problem solving fashion when I was straight out of college or is this new grad more capable coming out of a significantly more intensive program that had an undergrad selection process simply to get in, relatively speaking?

^This is the perception that was shattered in this post and is the cause of my frustration...

 

[engmedpt]

I would rather you just said thank you, and went on your way. Otherwise, I suggest you pick up a pen and run a campaign to be an APTA board member. Either way, I don’t give a damn what you think you are entitled to.

Last thing.

I'm pretty sure I've been starting some threads discussing the APTA and trying to get the current issues understood and shown to a few people in order to send emails, lobby, etc. If anything, that would be the most a soon to be student could possibly do to support the profession. You can't join if you can't pay the 500 dollar fee and (I believe..) are not a practicing pt.

 

[Azimuthal]

Last thing.

I'm pretty sure I've been starting some threads discussing the APTA and trying to get the current issues understood and shown to a few people in order to send emails, lobby, etc. If anything, that would be the most a soon to be student could possibly do to support the profession. You can't join if you can't pay the 500 dollar fee and (I believe..) are not a practicing pt.

Oh my. lol. That huge post was a joke. It kind of flew over your head. Watch this video.

 

[engmedpt]

-____-

Okay. Successful troll. Reverting to lower case.


I recognized the first part. After that I thought you were just legitimately being a punk. Now, I'm embarrassed. Guh.

I would appreciate it if you would answer my question though as this is actually a serious topic.

 

[Fiveoboy11]

I don't think that most of my non-DPT peers hate on those who recieve the DPT. Speaking for myself, I do get tired of DPT students, or recent DPT gradautes who seem to think that their preperation was markedly different or better than the typical MSPT school. I was a memeber of the second-to-last MSPT program at my school and they added one clinical and two behavioral science classes to the curriculum initially (if I am recalling that correctly - it was quite some time ago). That's it. And, my impression is that this increased emphasis on differential diagnosis is largely overstated. Direct access has been around for longer than the MSPT degrees, and our NPTE needed to assess recent graduates ability to practice safely in those states regardless of the degree they recieved. PT schools have been teaching screening for red flags and referring out for longer than I have been a therapist. I had a radiology course. Differential diagnosis/medical screening. Problem-based learning. Cadaver gross anatomy.

I'm not against the DPT or those that obain it, but let's try for a little perspective. The difference between the preperation between a DPT and an MSPT is not that great. Here is a great editorial on the DPT from PT Journal by Jules Rothstein: http://ptjournal.apta.org/content/78/5/454.full.pdf html

The article you cite is 17 years old, written when maybe 5% of PT programs were transitioned to a doctorate and some were even still a BSPT. In my mind, the physical therapy curriculum likely is markedly different now than it was in 1998. Similar to how that curriculum changed compared to 1981, and that to 1964, etc. Maybe you don't realize it or don't want to but it is there without doubt. I would argue that the profession of physical therapy has changed more in the past 20 years than it ever has overall, and in terms of education and research. Look at all the evidence we have now, the guidelines, the high quality journals, textbooks, physical therapy researchers and educators. How in the wide world could the profession 20 years ago compare to it now? How in the wide world could the average new PT grad 20 years ago compare to the new grad now? PT students 20 years ago didn't have as good of information to study, teachers didn't have as good of information to teach. Citing that when a school initially changed it only added 3 classes is not remotely persuasive. Physical therapy school now is 6 mo to 1 yr longer and YEAR ROUND. What's happening in that time, students are doing your 3 extra classes? The individual classes may still often have the same names but who says there isn't more and better information and more difficulty?

Find me a PhD professor in a physical therapy (i.e. Of education) school who will say now (in 2015) that the schooling is about the same as it was 20 years ago.

 

[NewTestament]

The schooling isn't the same but is the DPT producing better patient outcomes and physical therapists? Are we getting better results? Maybe, maybe not, but I'd like to see some research on this. I would like to think so, with the access to information we have now. I have professors who say they're amazed PT was reimbursed at all until the late 1990s. They were referring to the paucity of evidence to support what we did, but now we have that evidence.

 

[Azimuthal]

-____-

Okay. Successful troll. Reverting to lower case.


I recognized the first part. After that I thought you were just legitimately being a punk. Legitimately. Now, I'm embarrassed. Guh.

I would appreciate it if you would answer my question though as this is actually a serious topic.

Do you question the rigor of PT school? Not many people will. Its probably in the upper half of the rigor scale.

With that out of the way, how many units do you think is required for most accredited MS diplomas? As I used in my example, I got an MBA with 64 quarter units. An MS in the engineering field is typically 45 quarter units (cal poly SLO). Like many graduate curriculum, you also have to produce a capstone, research, or thesis presented and challenged by faculty and peers. How many units were required to obtain an MSPT? I'd bet it was a lot more than 64. Also, keep in mind that we don't get those summers off like many 4-year health doctorates and our current credit hours are very similar. As jesspt stated, all his program did was add a few courses and an additional clinical rotation. To me that states that the MSPT was already at the edge of the cumulative knowledge within our field and most likely already there. My own program consists of 122 semester units of didactics and clinicals are P/F. Therefore, there is very little, if any, difference in clinical knowledge between the two depending on what year the MSPT was awarded. There is obviously a substantial difference between now and 20 years ago.

Its easy to blame the APTA for mandating the DPT, however the aim was to change public perception with the promotion of direct access and to award entry-level clinicians with what they really earned. Direct access may have been available already, but how was it perceived by the public? The APTA's failure to promote the tDPT so that "all patients be treated by a doctor of physical therapy" does not discount the breathe of education and rigor required. Unfortunately, tuition hikes were a byproduct.

PT's have evolved so much. I'm 4 weeks from graduating and have began interviewing for entry-level positions. I asked an executive director of ambulatory services, who is a BSPT, "What are some of the weaknesses you have seen with new grads and what would you suggest a new grad do to become highly competent clinician?" His response was, [paraphrased] "I have a bachelors in PT from 196x, my license # is xxx, I have seen a lot of changes and I am impressed with how the profession has evolved. We never learned about differential diagnosis, medical management, pharmacology or imaging. It was very different back then. With that said, I think weakness is the wrong word to use, I think that if you can pass your licensure, you're very competent. I think that we just want to find a good fit for different personality types and I want to look for the person who's willing to keep learning and master their clinical reasoning skills."

To shorten a long winded answer, the clinical doctors was a good move for the answers provided and I wish that MSPT's were grandfathered in from a certain point. Their work experience is better than any clinical. It is unfortunate that the byproduct was a surge in tuition and fees but I do not believe it was the intention of the APTA.

 

[DesertPT]

I believe I made my point. If it remains unacceptable to you, you may continue reading below.

You can’t handle the truth! …Son, we live in a world that has walls, and those walls have to be guarded by men and women with gait belts and goniometers. Who’s gonna do it? You? You, engmedpt? The APTA has a greater responsibility than you could possibly fathom. You weep for the MSPT degree, and you curse the APTA for creating a tuition disaster. You have that luxury. You have the luxury of not knowing what the APTA knows. That the MSPT’s death, while tragic, probably was necessary to award a degree that reflects the appropriate rigor and credit hours. And the APTA's existence, while grotesque and incomprehensible to you, stand by those credit hours. You don’t want the truth because deep down in places you don’t talk about at parties, you want the APTA on that wall, you need the APTA on that wall. We use words like direct access, differential diagnosis, clinical skills. We use these words as the backbone of a life spent defending something. You use them as a punchline. I have neither the time nor the inclination to explain myself to a man who rises and sleeps under the blanket of the direct access that the APTA thrives to provide, and then questions the manner in which the APTA provides it. I would rather you just said thank you, and went on your way. Otherwise, I suggest you pick up a pen and run a campaign to be an APTA board member. Either way, I don’t give a damn what you think you are entitled to.

I believe this is the single best post in the history of SDN. I wish I could like this a thousand times, and experience the feeling of the stroke of genius that came to you when you wrote this.

 

[DesertPT]

Do you question the rigor of PT school? Not many people will. Its probably in the upper half of the rigor scale.

With that out of the way, how many units do you think is required for most accredited MS diplomas? As I used in my example, I got an MBA with 64 quarter units. An MS in the engineering field is typically 45 quarter units (cal poly SLO). Like many graduate curriculum, you also have to produce a capstone, research, or thesis presented and challenged by faculty and peers. How many units were required to obtain an MSPT? I'd bet it was a lot more than 64. Also, keep in mind that we don't get those summers off like many 4-year health doctorates and our current credit hours are very similar. As jesspt stated, all his program did was add a few courses and an additional clinical rotation. To me that states that the MSPT was already at the edge of the cumulative knowledge within our field and most likely already there. My own program consists of 122 semester units of didactics and clinicals are P/F. Therefore, there is very little, if any, difference in clinical knowledge between the two depending on what year the MSPT was awarded. There is obviously a substantial difference between now and 20 years ago.

Its easy to blame the APTA for mandating the DPT, however the aim was to change public perception with the promotion of direct access and to award entry-level clinicians with what they really earned. Direct access may have been available already, but how was it perceived by the public? The APTA's failure to promote the tDPT so that "all patients be treated by a doctor of physical therapy" does not discount the breathe of education and rigor required. Unfortunately, tuition hikes were a byproduct.

PT's have evolved so much. I'm 4 weeks from graduating and have began interviewing for entry-level positions. I asked an executive director of ambulatory services, who is a BSPT, "What are some of the weaknesses you have seen with new grads and what would you suggest a new grad do to become highly competent clinician?" His response was, [paraphrased] "I have a bachelors in PT from 196x, my license # is xxx, I have seen a lot of changes and I am impressed with how the profession has evolved. We never learned about differential diagnosis, medical management, pharmacology or imaging. It was very different back then. With that said, I think weakness is the wrong word to use, I think that if you can pass your licensure, you're very competent. I think that we just want to find a good fit for different personality types and I want to look for the person who's willing to keep learning and master their clinical reasoning skills."

To shorten a long winded answer, the clinical doctors was a good move for the answers provided and I wish that MSPT's were grandfathered in from a certain point. Their work experience is better than any clinical. It is unfortunate that the byproduct was a surge in tuition and fees but I do not believe it was the intention of the APTA.

Thank you for this excellent post.

And thanks everyone who has responded. This thread has changed my perspective on the DPT quite a bit actually, I'm glad I started it. The idea that perhaps the extensive MSPT degree was already deserving of doctorate nomenclature without the addition of much coursework hadn't really occurred to me.

 

[Fiveoboy11]

The schooling isn't the same but is the DPT producing better patient outcomes and physical therapists? Are we getting better results? Maybe, maybe not, but I'd like to see some research on this. I would like to think so, with the access to information we have now. I have professors who say they're amazed PT was reimbursed at all until the late 1990s. They were referring to the paucity of evidence to support what we did, but now we have that evidence.

There is research showing that experienced BSPT's have no better outcomes than DPT's with little experience. If we assume that individual PT's improve in their craft over time/experience then how would explain the equal outcomes? If the schooling is the same or close to the same then shouldn't more experienced PT's with less education have better outcomes? Is it possible that more and better quality education in physical therapy compared to 1980 training levels could also improve outcomes (like experience does) and thus make outcomes amongst novice/higher educated PT and more experienced/less educated PT's close to the same?

Add experience to better education and over time you get better outcomes. Compare the average 2015 DPT grad to the average 2005 grad or 1995 grad or 1985 grad and the difference gets wider and wider. This will likely continue significantly in physical therapy for the next ~ 50 years. In 2025 DPT education will be far and away superior to what it is now. In 2035 it will be better yet, and so will outcomes. Physical therapy education has evolved and is still evolving. It doesn't or hasn't happened at the flick of a switch. As others have said and most recognize, the MPT was at or very close to doctorate level to begin with. When the first DPT schools initially switched to DPT from MPT yes they were close to the same. That was then and this is now. If PT training was still MPT it would be better than it was in 1998, but IMO the transition to a DPT adds extra beyond what that would be.

 

[engmedpt]

Do you question the rigor of PT school? Not many people will. Its probably in the upper half of the rigor scale.

With that out of the way, how many units do you think is required for most accredited MS diplomas? As I used in my example, I got an MBA with 64 quarter units. An MS in the engineering field is typically 45 quarter units (cal poly SLO). Like many graduate curriculum, you also have to produce a capstone, research, or thesis presented and challenged by faculty and peers. How many units were required to obtain an MSPT? I'd bet it was a lot more than 64. Also, keep in mind that we don't get those summers off like many 4-year health doctorates and our current credit hours are very similar. As jesspt stated, all his program did was add a few courses and an additional clinical rotation. To me that states that the MSPT was already at the edge of the cumulative knowledge within our field and most likely already there. My own program consists of 122 semester units of didactics and clinicals are P/F. Therefore, there is very little, if any, difference in clinical knowledge between the two depending on what year the MSPT was awarded. There is obviously a substantial difference between now and 20 years ago.

Its easy to blame the APTA for mandating the DPT, however the aim was to change public perception with the promotion of direct access and to award entry-level clinicians with what they really earned. Direct access may have been available already, but how was it perceived by the public? The APTA's failure to promote the tDPT so that "all patients be treated by a doctor of physical therapy" does not discount the breathe of education and rigor required. Unfortunately, tuition hikes were a byproduct.

PT's have evolved so much. I'm 4 weeks from graduating and have began interviewing for entry-level positions. I asked an executive director of ambulatory services, who is a BSPT, "What are some of the weaknesses you have seen with new grads and what would you suggest a new grad do to become highly competent clinician?" His response was, [paraphrased] "I have a bachelors in PT from 196x, my license # is xxx, I have seen a lot of changes and I am impressed with how the profession has evolved. We never learned about differential diagnosis, medical management, pharmacology or imaging. It was very different back then. With that said, I think weakness is the wrong word to use, I think that if you can pass your licensure, you're very competent. I think that we just want to find a good fit for different personality types and I want to look for the person who's willing to keep learning and master their clinical reasoning skills."

To shorten a long winded answer, the clinical doctors was a good move for the answers provided and I wish that MSPT's were grandfathered in from a certain point. Their work experience is better than any clinical. It is unfortunate that the byproduct was a surge in tuition and fees but I do not believe it was the intention of the APTA.

These were the posts I needed. Thank you. I question, I argue, I look for biases and I've done as much research as I possibly can and have tried educating myself in every way possible before school starts. Because some anecdotes coupled with issues that have already arisen as an offset of the transition (i.e. tuition hikes, a few for profit schools, and some residencies, I know, I know, everyone thinks about this differently) then I just went off. When it comes down to it, I've haven't gone through the process yet and I'll be referencing these quotes for motivation and to keep perspective going forward.

@Azimuthal
In reference to your first post, I couldn't tell how much was joking and how much was serious. My responses were legitimate and I'll filter myself more as I begin school.

 

[DesertPT]

There is research showing that experienced BSPT's have no better outcomes than DPT's with little experience. If we assume that individual PT's improve in their craft over time/experience then how would explain the equal outcomes? If the schooling is the same or close to the same then shouldn't more experienced PT's with less education have better outcomes? Is it possible that more and better quality education in physical therapy compared to 1980 training levels could also improve outcomes (like experience does) and thus make outcomes amongst novice/higher educated PT and more experienced/less educated PT's close to the same?

Add experience to better education and over time you get better outcomes. Compare the average 2015 DPT grad to the average 2005 grad or 1995 grad or 1985 grad and the difference gets wider and wider. This will likely continue significantly in physical therapy for the next ~ 50 years. In 2025 DPT education will be far and away superior to what it is now. In 2035 it will be better yet, and so will outcomes. Physical therapy education has evolved and is still evolving. It doesn't or hasn't happened at the flick of a switch. As others have said and most recognize, the MPT was at or very close to doctorate level to begin with. When the first DPT schools initially switched to DPT from MPT yes they were close to the same. That was then and this is now. If PT training was still MPT it would be better than it was in 1998, but IMO the transition to a DPT adds extra beyond what that would be.

Thanks Fiveboy. This post sums up what I've learned from this thread so far quite well.

 

[engmedpt]

There is research showing that experienced BSPT's have no better outcomes than DPT's with little experience. If we assume that individual PT's improve in their craft over time/experience then how would explain the equal outcomes? If the schooling is the same or close to the same then shouldn't more experienced PT's with less education have better outcomes? Is it possible that more and better quality education in physical therapy compared to 1980 training levels could also improve outcomes (like experience does) and thus make outcomes amongst novice/higher educated PT and more experienced/less educated PT's close to the same?

Can you provide the source for this so I can bookmark it?

 

[Sheldon]

This has made for an interesting Saturday afternoon read….

I'll say this: my good friend and I, both DPT graduates, were openly and consistently mocked for having our DPTs in our first job. We were mocked by older BSPTs, nursing staff, and some MS OTR/Ls. One of my CIs, who became my co-worker, mocked the DPT consistently in front of, and behind, my back. Neither my good friend nor I called ourselves "Doctor ____, PT" and we didn't ask to be addressed by anything more than our first names.

There is a massive insecurity out there in all settings about the DPT degree. It's sad.

My advice for anyone with a DPT: Act like you've been there before, don't be a snob, and let your patient care and the impact (READ: not necessarily OUTCOMES) do the talking.

 

[ptisfun2]

Do you have any power at your institution to stop whoever is drowning hopefuls in debt from decreasing their quality of life for an entire decade?

^Please elaborate on the politics of this issue if you can and feel comfortable being anonymous. What would happen to a faculty member that says "Um, inflation didn't increase, stop charging more to line your pockets while these students fight to get into something?" I would like to know the behind the scenes conversations occurring. Legitimately.

Not even a little. Tuition is set by those whose pay grade is WAY higher than mine, and then approved at my school, by the state legislature and Regents. I imagine this is the same at any state school. There is no conversation at all. The Departments find out tuition rates when students do.

If we had PT school tuition, the 'bean counters' will never raise the question about tuition hikes since we get so many applicants. Why would they even think to lower it as tuition does not seem to be a limiting factor for applicants? But I work at a state school, so tuition is a bit lower, and all grad students pay the same tuition (so history Masters pays the same amount of tuition as PT DPT, although we do have fees for courses in PT).

 

[engmedpt]

This has made for an interesting Saturday afternoon read….

I'll say this: my good friend and I, both DPT graduates, were openly and consistently mocked for having our DPTs in our first job. We were mocked by older BSPTs, nursing staff, and some MS OTR/Ls. One of my CIs, who became my co-worker, mocked the DPT consistently in front of, and behind, my back. Neither my good friend nor I called ourselves "Doctor ____, PT" and we didn't ask to be addressed by anything more than our first names.

There is a massive insecurity out there in all settings about the DPT degree. It's sad.

My advice for anyone with a DPT: Act like you've been there before, don't be a snob, and let your patient care and the impact (READ: not necessarily OUTCOMES) do the talking.

The question I have for this is....how do you describe your degree to the general public? Do you you say "I have received a clinical docotorate of physical therapy and specialize in musculoskeletal dysfunction. However, I am not a physician."

If the doctorate is to get more recognition for what the MS was, is to expand access, and to create more collaborative healthcare, then how do students and workers outside of the classroom discuss the semantics to people in a manor consistent with APTA's vision? There has to be a fine line between a foolishly narcissistic argument about using the Dr. title as a status symbol and discourse with the public as education and marketing for the profession.

From what I've learned, the battle at the state and national levels is a straight up turf war politically and is a long long procedure. Congress a few nights ago and students and physical therapists lobbying to Congress who also have influence from the AMA are in a massive battle. While realizing the goals politically is an ongoing procedure, I would think that students and DPTs would have to market and educate patients and the public (that isn't mean to sound bad if it did. I mean they need to be SEEN as the go to for musculoskeletal issues and recognized as competent and compassionate providers).

If workplace bashing of the degree is common then that can't be doing anyone any good.

My advice for anyone with a DPT: Act like you've been there before, don't be a snob, and let your patient care and the impact (READ: not necessarily OUTCOMES) do the talking.

^This may have answered most of the question I asked as well.....and yeah, snobiness would be awful, but respect would have to come from both ends....employer (knowing that if the DPT is great with people and has great practice then their education is to realize APTA's goal) and employee (a lack of pride or feeling somewhat better than the employer because of the degree). I like your outcomes comment. Focus on your care rather than just the evidence of outcomes. I guess the outcomes could be justification for the degree for employers, but much more importantly the impact and care is what would make you the best clinician for the public in need and their general perception of you (as well as staying compassionate).....does that sound right?

 

[engmedpt]

Not even a little. Tuition is set by those whose pay grade is WAY higher than mine, and then approved at my school, by the state legislature and Regents. I imagine this is the same at any state school. There is no conversation at all. The Departments find out tuition rates when students do.

If we had PT school tuition, the 'bean counters' will never raise the question about tuition hikes since we get so many applicants. Why would they even think to lower it as tuition does not seem to be a limiting factor for applicants? But I work at a state school, so tuition is a bit lower, and all grad students pay the same tuition (so history Masters pays the same amount of tuition as PT DPT, although we do have fees for courses in PT).

Thank you for revealing this. Knowing how the tuition is set and that not all faculty collaborate is interesting and also much more relieving to hear directly from a faculty member. It's like the CEO sets the price but the faculty below may disagree and are truly there to educate for the students while being able to sympathize with them over price tag deep down. Also, thank you for being involved on the discussions on this forum. Lots of respect.

 

[jblil]

"I have received a clinical doctorate of physical therapy and specialize in musculoskeletal dysfunction. However, I am not a physician."

I'd never introduce myself to a patient with the above words because:
- most people have no idea what a "clinical doctorate" is;
- "musculoskeletal dysfunction" is our own jargon; it's like mentioning "bond duration" to Joe Sixpack, his eyes will glaze over;
- "however, I am not a physician" - you have a "doctorate", but you're not a physician? This is confusing...

I'll simply say, "Hi, I am jblil, and I am a physical therapist."

 

[engmedpt]

I'd never introduce myself to a patient with the above words because:
- most people have no idea what a "clinical doctorate" is;
- "musculoskeletal dysfunction" is our own jargon; it's like mentioning "bond duration" to Joe Sixpack, his eyes will glaze over;
- "however, I am not a physician" - you have a "doctorate", but you're not a physician? This is confusing...

I'll simply say, "Hi, I am jblil, and I am a physical therapist."

I think I was more inclined to mean talking to people outside of work or someone questioning the education. Yeah, a two sentence intro. is ridiculous at work and screams for confusion. "Hi, I'm engmedpt, let's start on your rehab." is better and more personal.

Look at a PhD in history or something. They received a doctorate, but they are addressed as "Professor" (I'm aware people still say doctor but "professor" denotes their industry).

Doctorate is supposed to denote the highest level of competency and education in a field, right? So why does the same address have to get tacked onto everyone being addressed as so (DC, PharmD, PhD, MD, DO, DPM, DVM, naturopathic)?

Maybe the answer is simply to keep it as "physical therapist" and place the initials on at the end for competency's sake. Unfortunately, that simplicity was not what I saw being presented at my state's legislature meeting and I guess complaining about that won't really help as one has to climb a mountain before even thinking about having a hand in that. That being said, it was something that I noticed and is worth mentioning. If the outcome of realizing APTA's goals would be the same regardless of how to address someone, then that would make the most sense.

 

[Bones26]

This has made for an interesting Saturday afternoon read….

I'll say this: my good friend and I, both DPT graduates, were openly and consistently mocked for having our DPTs in our first job. We were mocked by older BSPTs, nursing staff, and some MS OTR/Ls. One of my CIs, who became my co-worker, mocked the DPT consistently in front of, and behind, my back. Neither my good friend nor I called ourselves "Doctor ____, PT" and we didn't ask to be addressed by anything more than our first names.

There is a massive insecurity out there in all settings about the DPT degree. It's sad.

My advice for anyone with a DPT: Act like you've been there before, don't be a snob, and let your patient care and the impact (READ: not necessarily OUTCOMES) do the talking.

^This may have answered most of the question I asked as well.....and yeah, snobiness would be awful, but respect would have to come from both ends....employer (knowing that if the DPT is great with people and has great practice then their education is to realize APTA's goal) and employee (a lack of pride or feeling somewhat better than the employer because of the degree). I like your outcomes comment. Focus on your care rather than just the evidence of outcomes. I guess the outcomes could be justification for the degree for employers, but much more importantly the impact and care is what would make you the best clinician for the public in need and their general perception of you (as well as staying compassionate).....does that sound right?[/QUOTE]

I agree with this. During my internships and as a new grad, I frequently heard, "Well, what do you think, DOCTOR?" in a mocking tone. I went into my internships and first job out of PT school with an open mind willing and happy to learn from more experienced and seasoned PTs, no matter the educational background. I never once mentioned the DPT to my CIs or with patients. Honestly, I just wanted to be a PT. I didn't care if it required a BSPT, MPT, or DPT. If I were the kind to get off on titles I would've gone to med school. The older PTs who think the DPT is frivolous or unnecessary are simply letting their insecurity show. They should be happy that our profession is attempting to better itself instead of remaining stagnant. Instead, some of them feel threatened by it.

The main difference I notice between PTs with a BSPT vs DPT is the emphasis on evidence based treatment and research. There are some dinosaurs out there who are running patients through heat/stim/ice with techs and don't even pretend to know how to critically appraise a piece of literature.

 

[Sheldon]

The question I have for this is....how do you describe your degree to the general public? Do you you say "I have received a clinical docotorate of physical therapy and specialize in musculoskeletal dysfunction. However, I am not a physician."

I don't bring up my degree to the general public or patients unless asked about it. If a patient, friend, or family member asks me about my degree, I take it as a great teaching opportunity. I'll explain that the entry-level requirement (nowadays) to be a physical therapist is the DPT, and I'll say that the "DPT is an earned, entry-level clinical doctorate much like the clinical doctorates of optometrists, chiropractors, occupational therapists." If prodded to further explain my clinical training I'll say, "I'm a doctorally-prepared, residency-trained, board certified specialist in orthopedic manual physical therapy." I don't ask my patients, friends, family, or colleagues to refer to me as "Dr. ____." However, I don't apologize to anyone for my DPT nor do I belittle colleagues without one.

If the doctorate is to get more recognition for what the MS was, is to expand access, and to create more collaborative healthcare, then how do students and workers outside of the classroom discuss the semantics to people in a manor consistent with APTA's vision? There has to be a fine line between a foolishly narcissistic argument about using the Dr. title as a status symbol and discourse with the public as education and marketing for the profession.

From what I've learned, the battle at the state and national levels is a straight up turf war politically and is a long long procedure. Congress a few nights ago and students and physical therapists lobbying to Congress who also have influence from the AMA are in a massive battle. While realizing the goals politically is an ongoing procedure, I would think that students and DPTs would have to market and educate patients and the public (that isn't mean to sound bad if it did. I mean they need to be SEEN as the go to for musculoskeletal issues and recognized as competent and compassionate providers).

If workplace bashing of the degree is common then that can't be doing anyone any good.

^This may have answered most of the question I asked as well.....and yeah, snobiness would be awful, but respect would have to come from both ends....employer (knowing that if the DPT is great with people and has great practice then their education is to realize APTA's goal) and employee (a lack of pride or feeling somewhat better than the employer because of the degree). I like your outcomes comment. Focus on your care rather than just the evidence of outcomes. I guess the outcomes could be justification for the degree for employers, but much more importantly the impact and care is what would make you the best clinician for the public in need and their general perception of you (as well as staying compassionate).....does that sound right?

I think it's important that we as PTs are honest about what we can and cannot accomplish. Outcomes get mentioned a lot, and in all honesty, as the evidence for what PTs can offer patients from a conservative, non-surgical perspective continues to grow, PT as a profession ought to strive to position itself as a science-based, evidence-enhanced profession. But PT can only help those patients that want to be helped. And we don't FIX anything. So, for example, we cannot make the patient with a two-pack-a-day habit who has uncontrolled DM and is sedentary meet the guidelines for physical activity but maybe we can increase their activity a little bit. We cannot stop the progression of ALS, but we can treat the patient afflicted with ALS and his/her family with compassion and empathy; in this situation the outcome (death) would be considered poor yet the impact of what we do and say with that patient and family has the potential to be immeasurable. There are so many examples where the outcome and impact are inverse of one another. We should strive for great outcomes in clinical situations where great outcomes are possible but we have to realize that impact is important too, and often forgot about.

 

[engmedpt]

^this message epitomizes what students should be trying to become

 

[noyceguy]

I think it's important that we as PTs are honest about what we can and cannot accomplish. Outcomes get mentioned a lot, and in all honesty, as the evidence for what PTs can offer patients from a conservative, non-surgical perspective continues to grow, PT as a profession ought to strive to position itself as a science-based, evidence-enhanced profession. But PT can only help those patients that want to be helped. And we don't FIX anything. So, for example, we cannot make the patient with a two-pack-a-day habit who has uncontrolled DM and is sedentary meet the guidelines for physical activity but maybe we can increase their activity a little bit. We cannot stop the progression of ALS, but we can treat the patient afflicted with ALS and his/her family with compassion and empathy; in this situation the outcome (death) would be considered poor yet the impact of what we do and say with that patient and family has the potential to be immeasurable. There are so many examples where the outcome and impact are inverse of one another. We should strive for great outcomes in clinical situations where great outcomes are possible but we have to realize that impact is important too, and often forgot about.

These are some great points and I agree with everything you said here. I just want to add to a few comments about the DPT and our impact on patients. This push toward evidence-based practice in PT is all fine and well in that it may lend some legitimacy to what we do in the eyes of other health professionals. But the fact is that what we do is really applied "applied science." What I mean by that is that you have your pure sciences like chemistry, biology, etc. This forms the fact-based context for what we do. Then you have the applied sciences like kinesiology, etc. which takes known scientific fact and applies it to the human body. Then you have clinical sciences like PT/OT which piggyback on the applied sciences. Then you have actual clinical practice which may or may not actually derive itself from clinical science. So when we talk about evidence-based practice in the clinic, what we are talking about is our interpretation of scientific fact which has been transmitted through several levels of application. At any and every point in that transmission of knowledge there is the potential for error or uncertainly. So when we talk about our practice being evidence-based, let's not forget this potential.

Anyway, what I am getting around to saying is that when I practice PT, I see what I am doing as improving self-efficacy by interaction and manipulation of physical variables. I try to give my patients the tools and knowledge they need to take care of themselves. Now whether those tools are explicitly supported by the current available physical therapy body of knowledge is not really important to me. I usually assume that if my intervention is working, then my evaluation and rationale was sound and leave it at that. I use PT research to improve my ability to theoretically frame that evaluation. Everyone has to decide for themselves how and if they want to use the literature.

Lastly, any PT regardless of formal education level is able to approach their practice in this way if they choose. I have seen up-to-date PTs with bachelor's degrees and recent DPTs who are already outdated in their approach. But I feel that if a PT is making their patient more independent in the management of their problem, it almost doesn't matter if they are engaged with the literature.

 

[DjT3kN]

I think it's important that we as PTs are honest about what we can and cannot accomplish. Outcomes get mentioned a lot, and in all honesty, as the evidence for what PTs can offer patients from a conservative, non-surgical perspective continues to grow, PT as a profession ought to strive to position itself as a science-based, evidence-enhanced profession. But PT can only help those patients that want to be helped. And we don't FIX anything. So, for example, we cannot make the patient with a two-pack-a-day habit who has uncontrolled DM and is sedentary meet the guidelines for physical activity but maybe we can increase their activity a little bit. We cannot stop the progression of ALS, but we can treat the patient afflicted with ALS and his/her family with compassion and empathy; in this situation the outcome (death) would be considered poor yet the impact of what we do and say with that patient and family has the potential to be immeasurable. There are so many examples where the outcome and impact are inverse of one another. We should strive for great outcomes in clinical situations where great outcomes are possible but we have to realize that impact is important too, and often forgot about.

*thumbs up for this post* Well stated...

 

[Fiveoboy11]

This has made for an interesting Saturday afternoon read….

I'll say this: my good friend and I, both DPT graduates, were openly and consistently mocked for having our DPTs in our first job. We were mocked by older BSPTs, nursing staff, and some MS OTR/Ls. One of my CIs, who became my co-worker, mocked the DPT consistently in front of, and behind, my back. Neither my good friend nor I called ourselves "Doctor ____, PT" and we didn't ask to be addressed by anything more than our first names.

There is a massive insecurity out there in all settings about the DPT degree. It's sad.

My advice for anyone with a DPT: Act like you've been there before, don't be a snob, and let your patient care and the impact (READ: not necessarily OUTCOMES) do the talking.

I have seen a lot of DPT mocking as well during my clinical rotations while in school and with my jobs. You'd think that all seasoned PT's would recognize and respect that we had to go to school up to 3 years longer and pay far more to do the same job. Not only do many of them think and claim that there is no difference in education but I've actually heard it argued that a BSPT is a better education. We don't see PT's with less experience claiming they have the same experience as someone with more experience do we? We don't see PT's claiming more experience adds no value do we or that less experience is better? Flat out unprofessional and disrespectful if you ask me.

My advice to DPT's out there is to take the high road in the clinic, and then outperform all the bashers in every way possible (in my experience it often doesn't take much to outperform an intraprofessionist).

 

[ptisfun2]

Thank you for revealing this. Knowing how the tuition is set and that not all faculty collaborate is interesting and also much more relieving to hear directly from a faculty member. It's like the CEO sets the price but the faculty below may disagree and are truly there to educate for the students while being able to sympathize with them over price tag deep down. Also, thank you for being involved on the discussions on this forum. Lots of respect.

Faculty never collaborate on any financial decisions at a University, as far as I know. The analogy would be like a staff PT at a hospital having a say in room and board charges for patients. Most PTs in a hospital would have no idea even what the cost is, but certainly have no say in the price. Faculty are the 'staff PTs' of the University. The Departmet Chair get s a budget to spend, but faculty (even as a tenured faculty) have no idea what the money is used for I have a hard enough time knowing a bit about what my grant money is used for....

 

[DesertPT]

I agree with this. During my internships and as a new grad, I frequently heard, "Well, what do you think, DOCTOR?" in a mocking tone.

As has been mentioned by others, that really is incredibly unprofessional. I think the PTs making comments like this to grads who are in no way trying to flaunt their education should honestly be ashamed of themselves.

Thanks again everyone for the comments. Really quality thread so far.

 

[jesspt]

The article you cite is 17 years old, written when maybe 5% of PT programs were transitioned to a doctorate and some were even still a BSPT. In my mind, the physical therapy curriculum likely is markedly different now than it was in 1998. Similar to how that curriculum changed compared to 1981, and that to 1964, etc. Maybe you don't realize it or don't want to but it is there without doubt. I would argue that the profession of physical therapy has changed more in the past 20 years than it ever has overall, and in terms of education and research. Look at all the evidence we have now, the guidelines, the high quality journals, textbooks, physical therapy researchers and educators. How in the wide world could the profession 20 years ago compare to it now? How in the wide world could the average new PT grad 20 years ago compare to the new grad now? PT students 20 years ago didn't have as good of information to study, teachers didn't have as good of information to teach. Citing that when a school initially changed it only added 3 classes is not remotely persuasive. Physical therapy school now is 6 mo to 1 yr longer and YEAR ROUND. What's happening in that time, students are doing your 3 extra classes? The individual classes may still often have the same names but who says there isn't more and better information and more difficulty?

Find me a PhD professor in a physical therapy (i.e. Of education) school who will say now (in 2015) that the schooling is about the same as it was 20 years ago.

"The article you cite is 17 years old" - Well, technically it is an editorial, written by the Editor-in-Chief Emeritus of PTJ, God rest his soul.

"In my mind, the physical therapy curriculum likely is markedly different now than it was in 1998" - Your opinion, although I would agree that the curriculum at most schools is likely different than it was 17 years ago.

"Maybe you don't realize it or don't want to but it is there without doubt." - And now, you are proposing that your opinion is fact that cannot be doubted, even though you were not in a program in 1998 and do not provide any supporting evidence.

"How in the wide world could the profession 20 years ago compare to it now?" - I can't. And wouldn't. The profession has changed. We have more research which points to the efficacy of typical PT interventions.

"How in the wide world could the average new PT grad 20 years ago compare to the new grad now? PT students 20 years ago didn't have as good of information to study, teachers didn't have as good of information to teach." - Well, they can't, because as you accurately state, the BSPT graduate had less quality evidence to guide their clinical treatments. But you're comparing apples to oranges here.

"Citing that when a school initially changed it only added 3 classes is not remotely persuasive." Is your argument persuasive? You have provided only opinion, despite being educated as a DPT in an evidence-informed practice environment. *As an aside here, PT was embracing EBP as far back as the early 1990's - it existed prior to the DPT.

"Physical therapy school now is 6 mo to 1 yr longer and YEAR ROUND. What's happening in that time, students are doing your 3 extra classes?" Well, we went to school for 2.5 years, year round at my school. I can't speak for other schools at that time. But I believe that some DPT programs are not 3 years in length. USA and South College come to mind. Are they taking fewer classes than other DPT students? How does your statement apply to them?

"Find me a PhD professor in a physical therapy (i.e. Of education) school who will say now (in 2015) that the schooling is about the same as it was 20 years ago." - Of course they're not the same - the technological advances that have occurred in the last two decades have markedly improved our ability to disseminate information. Your average DPT student today has a wealth of information at their fingertips, power point presentations from the class lectures available 24-7, and online resources to relevant journal articles, none of which were available to the typical PT student in the late 1990's.