Last edited:
Are you a PT?Just wondering how other PTs/PT students feel about this statement.
I work in a hospital setting and I find that in general PTs are like glorified personal trainers; although I have lots of skills and knowledge in assessment and treatment of neurological and MSK conditions, the large caseloads and time constraints make it impossible to spend quality time with neuro patients doing all the facilitation etc. It's more like bang bang get it done, get them up and move on.
I feel like I'm almost 'over educated' for what I'm doing. I understand best practices and what needs to be done but constraints outside my control prevent PTs from applying these skills to the full extent.
Does anyone else feel like this?
I understand the frustration as well and I feel you. I have many Pharmacist, Dental, & MD friends and we hang out all the time and it seems as though they're always complaining about one thing or another regarding their profession.Yup been one for several years. I find the problem is increasing lately with cuts to health care and more patients/less staff. I understand what you're saying. It gets frustrating when you know for instance for stroke patients they benefit from x amount of treatment, but other constraints prevent you from delivering that. I don't think saying lets diagnose/treat as fast as we can is right at all, or should just be accepted as the new norm. Guess I just got frustrated with what is happening.
Yes, definitely. Nothing PTs do except for maybe research requires three years of puffed-up education.Just wondering how other PTs/PT students feel about this statement.
I work in a hospital setting and I find that in general PTs are like glorified personal trainers; although I have lots of skills and knowledge in assessment and treatment of neurological and MSK conditions, the large caseloads and time constraints make it impossible to spend quality time with neuro patients doing all the facilitation etc. It's more like bang bang get it done, get them up and move on.
I feel like I'm almost 'over qualified" for what I'm doing. I understand best practices and what needs to be done but constraints outside my control prevent PTs from applying these skills to the full extent.
Does anyone else feel like this?
Just wondering how other PTs/PT students feel about this statement.
I work in a hospital setting and I find that in general PTs are like glorified personal trainers; although I have lots of skills and knowledge in assessment and treatment of neurological and MSK conditions, the large caseloads and time constraints make it impossible to spend quality time with neuro patients doing all the facilitation etc. It's more like bang bang get it done, get them up and move on.
I feel like I'm almost 'over qualified" for what I'm doing. I understand best practices and what needs to be done but constraints outside my control prevent PTs from applying these skills to the full extent.
Does anyone else feel like this?
Just wondering how other PTs/PT students feel about this statement.
I work in a hospital setting and I find that in general PTs are like glorified personal trainers; although I have lots of skills and knowledge in assessment and treatment of neurological and MSK conditions, the large caseloads and time constraints make it impossible to spend quality time with neuro patients doing all the facilitation etc. It's more like bang bang get it done, get them up and move on.
I feel like I'm almost 'over qualified" for what I'm doing. I understand best practices and what needs to be done but constraints outside my control prevent PTs from applying these skills to the full extent.
Does anyone else feel like this?
I've worked in SNF's, Acute, Acute Rehab, and OP. I'm glad I got out of SNF because, after 8 months, I literally felt like I was getting dumber and dumber. There's only so much you can do differently when you see nothing but TKA, THA, falls, etc. It was rewarding to see them get better and go home, yes...but very physically and mentally draining. I've talked to several PT friends who have done SNF for a bit as well, and they all agree that it really wouldn't take much training to do SNF treatment. Some of you might not like what I just said, but it's pretty true.
Oh and let's not forget about piss poor continuity of care in SNF's.
Fiveoboy makes some valid points. Having gone through the pt education, 100% yes, the dpt provides a wayyy overeducated person for what a pt is ALLOWED to do as defined by the scope of practice.
Differential diagnosis. The problem with PT today is that the whole direct access thing is rarely utilized and not respected by the majority of health insurance carriers. In an ideal world, considering PTs are sooo educated, the general public should have the knowledge, confidence, and ability to realize that if they have a pain related issue, they walk right in to see a PT, a PT does a differential, then treats if indicated, or refers out to another area of medicine if not indicated. However, this is not what occurs in the real world at all. What actually happens is patients have the confidence, awareness, and ability to see a physician, and then the physician diagnosis the problem and then ships the patient to PT if indicated. So in reality, the PT gets a patient, already knows the diagnosis, and just provides a symptom based approach to treatment. The lack of problem solving and rather the repetitive nature of executing treatment plans is what drove me to become non-stimulated and bored with this profession. Unfortunately, there was no way to realize this before accumulating student loans and investing in this as a career. Its definitely a job that lacks significant analytical thinking and is more geared towards individuals who are passionate about kinesiology, and who enjoy the ability to have small talk with patients while getting them to exercise.
Differential diagnosis. The problem with PT today is that the whole direct access thing is rarely utilized and not respected by the majority of health insurance carriers. In an ideal world, considering PTs are sooo educated, the general public should have the knowledge, confidence, and ability to realize that if they have a pain related issue, they walk right in to see a PT, a PT does a differential, then treats if indicated, or refers out to another area of medicine if not indicated. However, this is not what occurs in the real world at all. What actually happens is patients have the confidence, awareness, and ability to see a physician, and then the physician diagnosis the problem and then ships the patient to PT if indicated. So in reality, the PT gets a patient, already knows the diagnosis, and just provides a symptom based approach to treatment. The lack of problem solving and rather the repetitive nature of executing treatment plans is what drove me to become non-stimulated and bored with this profession. Unfortunately, there was no way to realize this before accumulating student loans and investing in this as a career. Its definitely a job that lacks significant analytical thinking and is more geared towards individuals who are passionate about kinesiology, and who enjoy the ability to have small talk with patients while getting them to exercise.
Establish yourself as the go-to with both simple AND complex cases. The referring providers will start writing "eval and treat" vs. attempting to dx themselves. It takes time, but know your stuff, open a dialogue with the practitioners who refer to you normally, gain their confidence. It'll happen.
Differential diagnosis. The problem with PT today is that the whole direct access thing is rarely utilized and not respected by the majority of health insurance carriers. In an ideal world, considering PTs are sooo educated, the general public should have the knowledge, confidence, and ability to realize that if they have a pain related issue, they walk right in to see a PT, a PT does a differential, then treats if indicated, or refers out to another area of medicine if not indicated. However, this is not what occurs in the real world at all. What actually happens is patients have the confidence, awareness, and ability to see a physician, and then the physician diagnosis the problem and then ships the patient to PT if indicated. So in reality, the PT gets a patient, already knows the diagnosis, and just provides a symptom based approach to treatment. The lack of problem solving and rather the repetitive nature of executing treatment plans is what drove me to become non-stimulated and bored with this profession. Unfortunately, there was no way to realize this before accumulating student loans and investing in this as a career. Its definitely a job that lacks significant analytical thinking and is more geared towards individuals who are passionate about kinesiology, and who enjoy the ability to have small talk with patients while getting them to exercise.
Complete say over the PT POC, manipulation in some states, direct access in some states, PT diagnosis in some states, referral to other practitioners, x-rays when indicated, etc.Where is the disconnect between scope of practice and level of education? Specifically, what do we have the training for but are unable to perform?
Who has complete say over the PT plan of care? In my practice it's me. And while your list is accurate, it isn't applicable to all PTs. In fact, I believe that all 50 states allow PT evaluation without a referral now. And, if you're following best practices, your need to refer for an x-ray is pretty damn rare.Complete say over the PT POC, manipulation in some states, direct access in some states, PT diagnosis in some states, referral to other practitioners, x-rays when indicated, etc.
Any PT worth a damn also knows that a MD or DO diagnosis is often wrong or worthless, that screening for red flags is still necessary, and a thorough assessment and PT diagnosis is required. I think a lot of what you say here reflects poor practice patterns and approach to PT. The second half of your post is nonsense.
Who has complete say over the PT plan of care? In my practice it's me. And while your list is accurate, it isn't applicable to all PTs. In fact, I believe that all 50 states allow PT evaluation without a referral now. And, if you're following best practices, your need to refer for an x-ray is pretty damn rare.
I agree with you. But do insurances, other healthcare providers, referral sources understand and respect the PT as the person in charge of all aspects of PT? Certainly not always. This translates in the PT not having complete say.
All 50 states should allow unrestricted access with mandated insurance coverage with or without referral.
I agree with you. But do insurances, other healthcare providers, referral sources understand and respect the PT as the person in charge of all aspects of PT? Certainly not always. This translates in the PT not having complete say.
All 50 states should allow unrestricted access with mandated insurance coverage with or without referral.
I completely agree that in the majority of cases family MDs/ walk-in clinics will misdiagnose an ortho or neuro issue more than half the time. Think about it though - > med school doesn't teach ortho as comprehensively as PT school; sure students probably learn the types of joints and anatomy and maybe get an overview of the very common ailments (rotator cuff tear, ACL tear, ankle sprain etc), but do they know how to properly assess and differentiate low-back/SI pain vs pelvic floor issues or how to properly treat low back pain besides using their prescription pad? I think med schools rely on rotations to teach students the hands on skills. Most family MDs probably know less in regards to ortho ailments than a kinesiology grad. Unless they specifically did a residency/fellowship in sports medicine on top of family medicine. So we get patients who come in with "rotator cuff tear" on the referral when they actually have a cervical nerve impingement.
These patients learn the lesson, and next time they have an issue they come to us. But the vast majority of the public has no clue about the PT profession and they have also been raised with the mentality of "only the doctor knows best" so they go straight to MD. I've had many patients in clinic who come with a 3 month old injury because the MD said "take these pain killers, the tendonitis just resolves itself anyway, PT won't add anything" I've heard MULTIPLE times from patients that their MD told them that PT won't change things or doesn't really work. That's a big problem.
I've seen people with chronic back pain, finally come and start PT, and sadly it costs them but when they start to see results, they never again return to their family MD.
There's a huge disconnect. I think awareness of our profession is key, and I think that the government should provide SOME funding for PT services, this would even offset emergency costs etc, if the right patients just came directly to PT instead of wasting $$ and time in ER where they will get no actual treatment for their condition.
What therapy cap are we speaking of?
Fozzy,What therapy cap are we speaking of?
Great post. You are very much correct. Unfortunately, being realistic, there is likely minimal chance the general public will rid themselves of the "doctor must know all" mentality and will therefore always continue to see a MD and trust what they say as opposed to seeing PT. The reality is the reality, and I think the PT profession will continue to struggle with this and the fact that therapycap exists is a testement to poor lobbying in government. I am worried about this field in outpatient orthopedic especially years from now due to poor lobbying, poor overall position in healthcare, increased tuition, and decreased reimbursements.
Yes that is the correct therapy cap. I wonder, if PT has the whole vision 20/20 and dpt and all this EBM, then why are we seeing reimbursements DECLINE. To me it seems worrisome b/c the opposite should actually be occuring
Yes that is the correct therapy cap. I wonder, if PT has the whole vision 20/20 and dpt and all this EBM, then why are we seeing reimbursements DECLINE. To me it seems worrisome b/c the opposite should actually be occuring