You should probably contact the APTA and look into the situation further. Most of the groups you mentioned were actually included in the task force. The transition period will be ample - as in you’re probably near retirement when it’s all said and done.
And no, vision comes first. Would anyone here choose your path in Google maps before having a destination? Does that sound logical? If you’re concerned about the how stage and truly passionate about the subject, you should become a very active contributor in the APTA, and voice your concerns; volunteer to be a committee member, etc.
2020 was conceived way before the ACA (aka Obamacare), how many institutions expected that? That was a game changer and we have to adapt for the best of our profession.
I’m all for those in between PT and MD to look more closely at MD. I want people entering PT to put more thought into it. I like more barriers to entry and having to prove our knowledge-base on paper. It gives us more clout and say in determining fees. It will also standardize our education and hopefully produce better prepared new clinicians. It will also make these for-profit schools think twice about opening up a subpar PT school to make a quick buck.
Your comment is well taken.
ACA actually isn't the problem I see. It's medicare negotiation since other insurances model medicare. More commercial insurances have opened up to DA actually and to be honest, it's in their best interest. Medicare reimbursements are the issue I see.
The didactic from school would be irrespective of the clinical training tho. I don't see this stopping schools unless it becomes an accreditation standard that an institution must have x contracts to match intern year for x positions. I see the possibility of didactic credit load just being charged a higher rate. I should become more familiar with capte accreditation standards though and that's my fault.
There are several ways to correct the situation that the speaker didn't mention:
-Accept fewer students into PT school. Raise standards and only accept the best of the best. Lower tuition. If you want to attract better PT's, quit charging $100k+ tuition. More PT's would consider residencies after PT school or a low-paying position in a private practice.
-2 years of didactic education+ 1 year residency. Keep core classes only: ther ex, anatomy, orthopedics, neuromuscular, etc. Stop teaching wound care, ultrasound, MMTs, most special tests, etc. There's a lot of fat in the PT curriculum. I believe there was a report in JOSPT in spring 2015 that clearly showed improved clinical outcomes among PT's who went through a residency. A fellowship had little effect.
-A drive towards more cash-based PT. Medicare is an unsustainable system and we can expect more reimbursement cuts in the future. It will become more and more frugal in the future. If PT's had to compete directly for the customer's dollar, bad PT's would be weeded out really fast.
I know plenty who would've done residency if not for the debt. Also many others making careers in travel and home health due to necessity.
The problem with accepting fewer is that there is already an increasing vacuum for skilled labor that will balloon when the boomer generation really starts falling apart here in the next 10 to 15 years. Add to this the idea of "best of the best" pushes schools to be overly focused on GPA which has little to zero correlation to bedside manor - something that further study will likely show to prove a critical part of patient outcomes.
I have thought differently about it - leave it 3 years, but add a little more pathology and pharma into the coursework and try to have the same legal abilities as PTs in the military. Direct access, ability to prescribe low level, and ability to order imaging. Army has had this since what, the 70's?
And during shadowing I have already seen the same behaviors as mentioned above - all too frequently a student intern becomes a practitioner who is more or less operating with autonomy with occasional "check ins" to the primary therapist who is supposed to be supervising. This has little to do with the supervising PT as much as once again, administration being involved and seeing a quick way to get free labor and temporarily increase production. This is hardly mentorship, and for the APTA to realize their goals there would be no choice but to have clear cut raw expectations and established standards for what constitutes a residency program... But putting that into place and ensuring adherence to best practices would be about as likely as making america gun free.
As long as you have overblown administration looking at health care from a pure financial (business) perspective with little focus on patient outcome or quality of care the trend will continue to be to push the envelope to increase margin while decreasing overhead.
The GPA metric is used to screen for applicants to withhold massive amounts of information and think analytically for difficult problem solving. It isnt completely cut and dry though as other students can still matriculate through personal statement, observation hours, or interview and field understanding.
You have to have that first before clinical development. GPA from undergrad and test scores ensure the higher portion of the bell curve gets in and won't fail out...leading to much worse prospects than just originally never going to school.
Also, the phys, anatomy, biomechanics, EBP, and psych (depending how hard science based) are incredibly difficult in school, particularly not being paper-based application. Earning high scores for a prerequisite GPA for mostly paper-based tests of similar content serves as a prediction. Bedside manner helps with rapport, but it's not science foundation which is necessary
What's astounding when you think about it is that that vacuum still won't increase the salary ceiling. It's the perfect example of what third party and reimbursement restriction leads to....an inverse in Basic laws of supply and demand. You'd think that vacuum would drive salaries up.
I have to completely disagree on pharma. If we had that right, it would be used at a higher frequency and actual therapy would decrease.
Look at MD practices that employ heavy amounts of midlevels and have a legal practice overlap with a conservative treatment. The pharma is always the business model because it can be done quickly.
Our pharmacology coursework is meant to make us cognizant of peak timeframes that may amplify or mask impairments as well as side effects and differentiating them from physiological responses.
I could actually see imaging rights decreasing costs in the system as a whole as the patient would stay with the one provider instead of going to different contact points and then back. The problem is making sure it isn't overordered.
If this has any chance of going through, it would be great news for every therapist currently licensed as there would more chimpanzees applying to PT school than people. Being a good clinician has less to do with education and credentials and more to do with how you present and interact with patients. Is the lack of self-awareness of the APTA board of directors crazy to anyone else? "With reimbursement rates continuing to decline and education costs rising every year, I have an idea - lets make it harder to earn 75k/yr!" Proposals like this is why the APTA remains a joke of an organization that gets no looks by the people it supposedly represents or those actually affecting health care legislation.
No, it's not crazy, because the clinical education system needs reform.