Do MDs respect physical therapists?

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PTlife2015

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Hey guys! I'm obviously going into physical therapy as you can tell by my name. I just wanted to start of by saying I have great respect for physicians and I respect the amount of knowledge you have. I was wondering why a lot of physicians don't respect physical therapists. I know many do, but from what I have heard from many pts is that physicians aren't aware of the amount of schooling we go through now and the amount of knowledge we have in the rehabilitation setting. So I just wanted to ask the physicians who don't respect physical therapists a lot is why don't you? Thanks! P.S. I'm not trying to start a turf war or anything and I'm not trying to say pts are smarter than MDs!

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Never met anyone who cared. We consult you and forget about it
 
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Hey guys! I'm obviously going into physical therapy as you can tell by my name. I just wanted to start of by saying I have great respect for physicians and I respect the amount of knowledge you have. I was wondering why a lot of physicians don't respect physical therapists. I know many do, but from what I have heard from many pts is that physicians aren't aware of the amount of schooling we go through now and the amount of knowledge we have in the rehabilitation setting. So I just wanted to ask the physicians who don't respect physical therapists a lot is why don't you? Thanks! P.S. I'm not trying to start a turf war or anything and I'm not trying to say pts are smarter than MDs!

You're nothing more than a glorified yoga instructor. This is based on first hand experience from PT treatment.
 
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Hey guys! I'm obviously going into physical therapy as you can tell by my name. I just wanted to start of by saying I have great respect for physicians and I respect the amount of knowledge you have. I was wondering why a lot of physicians don't respect physical therapists. I know many do, but from what I have heard from many pts is that physicians aren't aware of the amount of schooling we go through now and the amount of knowledge we have in the rehabilitation setting. So I just wanted to ask the physicians who don't respect physical therapists a lot is why don't you? Thanks! P.S. I'm not trying to start a turf war or anything and I'm not trying to say pts are smarter than MDs!
define respect...it feels like you have a specific thought in mind
 
define respect...it feels like you have a specific thought in mind
Many therapists have told me that a lot of physicians have questioned the ways they rehabilated patients. Many of the therapist say they get referrals from many family med and internal doctors who just ask for heat and stem for complex injuries and when the pt tries to correct them they says the physicians don't like that so that shows that the physician in these cases don't show much respect to the work and knowledge physical therapists have.
 
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Many therapists have told me that a lot of physicians have questioned the ways they rehabilated patients. Many of the therapist say they get referrals from many family med and internal doctors who just ask for heat and stem for complex injuries and when the pt tries to correct them they says the physicians don't like that so that shows that the physician in these cases don't show much respect to the work and knowledge physical therapists have.
yeah, the physician knows more and is primary medical authority for that patient. On another front, they are also your customer as they control the referrals....it's best to keep the customers happy and stop assuming that it's disrespectful to disagree with you
 
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What was the treatment for? Could have just been a bad pt?

The guy has zero compassion. He accused me of faking my symptoms in order to milk the system for disability even though multiple physicians including a neuro specialist have diagnosed me with disc herniation and nerve impingement. It was a joke.
 
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Most of your referrals will come from PCP's, who aren't the best at working up MSK problems and just refer to PT for "eval and treat." I don't send a prescription to my pharmacist that says "start a blood pressure medication--figure out which one," and I sure don't send PT referrals that say the same thing. This is even more critical if we're referring to a PT who doesn't have access to our notes because while you do your own eval, we want to make sure you address the pathology that we diagnosed.

I'm a physiatrist (well, still in residency, so technically not one yet), and you won't find anyone in my field who doesn't respect PT as a profession. There are definitely some PT groups we don't respect much because they're not good at what they do, but this is true whether we're talking about MD's, PT's, cashiers, etc. The above poster who likens PT's to "glorified yoga instructors" must of dealt with one of these types of PT's. I disagree with another poster above--we (physiatrists) don't refer to you and then forget about it. We follow-up. We read your notes (assuming we have access), we will talk directly with you, etc. A good PCP will do the same.

PT (and therapy in general) is one of our best and strongest treatments, whether it's for hemiplegia or back pain--PT is what will potentiate neuroplasticity, functional rehabilitation, and correct biomechanical deficits. If you're good at what you do, working to correct those deficits and you can effectively teach patients a home exercise program (if it's an outpatient referral, success/failure mostly depends on their adherence to the HEP) you'll provide a lot of relief for your patients. Just don't rely on modalities and other things that just make the patient feel good in the short-term. The main point of modalities is to make the exercises doable/easier to do, and to enhance their effectiveness. The teaching you do is what will really get them better.
 
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Many therapists have told me that a lot of physicians have questioned the ways they rehabilated patients. Many of the therapist say they get referrals from many family med and internal doctors who just ask for heat and stem for complex injuries and when the pt tries to correct them they says the physicians don't like that so that shows that the physician in these cases don't show much respect to the work and knowledge physical therapists have.
I've seen physicians question physicians. Is that a sign of disrespect? (And if you like your field, just go for it and be the best you can be)
 
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Many therapists have told me that a lot of physicians have questioned the ways they rehabilated patients. Many of the therapist say they get referrals from many family med and internal doctors who just ask for heat and stem for complex injuries and when the pt tries to correct them they says the physicians don't like that so that shows that the physician in these cases don't show much respect to the work and knowledge physical therapists have.

They should go to medical school and become a PMR physician then.
 
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The guy has zero compassion. He accused me of faking my symptoms in order to milk the system for disability even though multiple physicians including a neuro specialist have diagnosed me with disc herniation and nerve impingement. It was a joke.
Yeah that sounds like a bad experience. There are a lot of bad pts just like there a lot of bad physicians, podiatrists, pharmacists, etc.
 
I've seen physicians question physicians. Is that a sign of disrespect? (And if you like your field, just go for it and be the best you can be)
No it's not, but when a physician tells a patient "listen to me I'm the Doctor he is just a therapist"then it is going a little too far. Especially when it is just a family med doc and not an ortho specialist.
 
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No it's not, but when a physician tells a patient "listen to me I'm the Doctor he is just a therapist"then it is going a little too far. Especially when it is just a family med doc and not an ortho specialist.
that family med doc is still 100% correct though, they really do know more about medicine and the human body than you do. That's not disrespectful.
 
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My ex who is a pt loves the idea of direct visit (no referral needed from doctor), and she ****s in Drs a lot. I hope that's an n=1

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If they refer to you they probably see value in pt.

Direct access probably does not mean much. You need a physician referral for Medicare and other insurances.
 
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Not minted yet, but I respect those that have the moxie to earn their DPT. I know that when I refer my [future] patients to you they'll be in good hands for the type of treatment necessary.
 
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that family med doc is still 100% correct though, they really do know more about medicine and the human body than you do. That's not disrespectful.
Yes they do and I'm not scared to admit that, but they don't know more about rehab science than us. Some specialty doctors do of course like pmr, but not many family docs know much about rehab especially the ones that just want modalities on patients. If you refer to the pmr resident on this thread, he himself stated that that bad pts are the ones who just use modalities and sometimes that's all they can do if that's all the MD allows them to do
 
PT does great things, but physicians outside of a few specialties don't really have a close working relationship with them, it's more behind the scenes. Not going to comment on direct access.

that family med doc is still 100% correct though, they really do know more about medicine and the human body than you do. That's not disrespectful.

If they have a specific medical reason they don't want a particular therapy (eg older lady on a dronate and want to minimize excessive impact), sure. But in general in choosing between different rehabilitative therapies, you really think a pcp does better than a PT? I think that's really putting the p(hysician) on a pedestal
 
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PT does great things, but physicians outside of a few specialties don't really have a close working relationship with them, it's more behind the scenes. Not going to comment on direct access.



If they have a specific medical reason they don't want a particular therapy (eg older lady on a dronate and want to minimize excessive impact), sure. But in general in choosing between different rehabilitative therapies, you really think a pcp does better than a PT? I think that's really putting the p(hysician) on a pedestal
I'm saying I looked into both quite extensively....and yeah, the doc knows more
 
I'm saying I looked into both quite extensively....and yeah, the doc knows more
But knows more what? Does knowing more about treating common colds, screening for UTIs, and keeping diabetes under control really make family medicine docs superior at rehabilitation than physical therapist?

I don't think anybody would argue that PTs would have more general medical knowledge than the average physician, but then again nobody here is talking about general medical knowledge. The conversation is specifically about PT/rehab.

To say that a family medicine doc knows more about PT than a PT would mean family medicine docs are pretty much medically omnipotent and if that's the case why would we need any specialists at all?

I do agree that the physician has access to more of the patient's general medical background and should probably direct the rehab if for no other reason than that. But the PT's opinion should always be taken into consideration and it shouldn't just be assumed that anybody with an MD behind their name knows absolutely every facet of medicine as well or better than any other specialist. It's about education and training, not the degree.

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Most of your referrals will come from PCP's, who aren't the best at working up MSK problems and just refer to PT for "eval and treat." I don't send a prescription to my pharmacist that says "start a blood pressure medication--figure out which one," and I sure don't send PT referrals that say the same thing. This is even more critical if we're referring to a PT who doesn't have access to our notes because while you do your own eval, we want to make sure you address the pathology that we diagnosed.

I'm a physiatrist (well, still in residency, so technically not one yet), and you won't find anyone in my field who doesn't respect PT as a profession. There are definitely some PT groups we don't respect much because they're not good at what they do, but this is true whether we're talking about MD's, PT's, cashiers, etc. The above poster who likens PT's to "glorified yoga instructors" must of dealt with one of these types of PT's. I disagree with another poster above--we (physiatrists) don't refer to you and then forget about it. We follow-up. We read your notes (assuming we have access), we will talk directly with you, etc. A good PCP will do the same.

PT (and therapy in general) is one of our best and strongest treatments, whether it's for hemiplegia or back pain--PT is what will potentiate neuroplasticity, functional rehabilitation, and correct biomechanical deficits. If you're good at what you do, working to correct those deficits and you can effectively teach patients a home exercise program (if it's an outpatient referral, success/failure mostly depends on their adherence to the HEP) you'll provide a lot of relief for your patients. Just don't rely on modalities and other things that just make the patient feel good in the short-term. The main point of modalities is to make the exercises doable/easier to do, and to enhance their effectiveness. The teaching you do is what will really get them better.

Yea but if you perscribe the wrong dose or a drug that interacts with an another drug, you're thrilled when the pharmacist calls to point it out and save you from a complication.
 
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But knows more what? Does knowing more about treating common colds, screening for UTIs, and keeping diabetes under control really make family medicine docs superior at rehabilitation than physical therapist?

I don't think anybody would argue that PTs would have more general medical knowledge that the average physician, but then again nobody here is talking about general medical knowledge. The conversation is specifically about PT/rehab.

To say that a family medicine doc knows more about PT than a PT would mean family medicine docs are pretty much medically omnipotent and if that's the case why would we need any specialists at all?

I do agree that the physician has access to more of the patient's general medical background and should probably direct the rehab if for no other reason than that. But the PT's opinion should always be taken into consideration and it shouldn't just be assumed that anybody with an MD behind their name knows absolutely every facet of medicine as well or better than any other specialist. It's about education and training, not the degree.

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Nothing I said implies the doctor shouldn't consider other opinions, just that the doctor is the primary medical responsibility with the most knowledge
 
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Hey guys! I'm obviously going into physical therapy as you can tell by my name. I just wanted to start of by saying I have great respect for physicians and I respect the amount of knowledge you have. I was wondering why a lot of physicians don't respect physical therapists. I know many do, but from what I have heard from many pts is that physicians aren't aware of the amount of schooling we go through now and the amount of knowledge we have in the rehabilitation setting. So I just wanted to ask the physicians who don't respect physical therapists a lot is why don't you? Thanks! P.S. I'm not trying to start a turf war or anything and I'm not trying to say pts are smarter than MDs!

That's like asking why a lot of PTs don't respect personal trainers or yoga instructors (or x, y, z). I respect the ones who are great. I don't have much respect for the ones who are average. Even less for the ones who suck. You could extrapolate that statement to almost any group.

Like any occupation there are folks who will value your skill set and others who won't. The ones who don't respect PTs won't have their opinions changed by "educating them" (lolz) re: our education, licensure, etc. That would most likely happen after a series of positive interactions and experiences. Don't worry about who respects your profession or who doesn't. Focus your attention on your education and becoming an exemplary PT. The rest will work itself out. PT isn't sexy or glamorous by any means. If you're seeking prestige strictly from your occupation, look somewhere else.
 
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I'm saying I looked into both quite extensively....and yeah, the doc knows more

I take it they also know more about OT than occupational therapists and optometry and optometrists etc
 
I take it they also know more about OT than occupational therapists and optometry and optometrists etc
Than OT? yes

optometrists? dear lord no....no one knows anything about eyes ;)
 
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I respect PTs. I refer patients to them all the time. They are much more valuable than yoga instructors.

I do disagree with the "refer and forget" mentality. PT is part of patient care. You would not forget about images or labs ordered, subspecialty consults requested, make changes to meds without following up. Therefore, do not forget about the PT referral.

While it is true that the PCP knows more about human anatomy, physiology, disease, and the particular patient than the PT does, most physicians know very little about what a PT has to offer. A good PCP will respect the PTs opinion and professional judgement. If there are legitimate concerns or limitations regarding a patient and his or her treatment, this should be addressed in a respectful manner.

I have had PTs tell patients or send notes convinced that the patient has a problem that they clearly do not. This is outside their scope and really irritates me. On the other hand, I also worry about doctors who do not admit their own limitations.
 
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Than OT? yes

optometrists? dear lord no....no one knows anything about eyes ;)

Amazing how much they learn in 3 years of residency with a little background education from med school. Beating out 5 years of dedicated postgraduate education built right in with learning all that medicine
 
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No it's not, but when a physician tells a patient "listen to me I'm the Doctor he is just a therapist"then it is going a little too far. Especially when it is just a family med doc and not an ortho specialist.

I would never refer to a PT as "just" a therapist, but remember that it wasn't too long ago that PTs had master's degrees; not DPTs.
 
Lot of variability with PTs. But the ones who are good have a strong understanding of the musculoskeletal system, and I've certainly worked with PTs I respect.
 
There are basically three kinds of patients that get sent to PT, (a) the patients who might actually benefit from PT, (b) the patients who probably won't benefit from PT but are going to pester their doctor until he gives them some answer or prescription for some course of action, and (c ) those patients for whom you need to justify having tried conservative measures before you take them into the OR to do something invasive. There's going to be a differing level of respect for what the PT is going to add in each of these scenarios.
 
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I'm an incoming M1 this year so take my advice with a grain of salt. I worked with several orthopedic surgeons as a medical scribe for about a year and got to know a few of them really well. As far as specialties go, I think that orthopedics is one that relies very closely on PT and an open network of communication between PT and physician. While none of the docs I worked with would ever say that they don't respect PTs, almost every single one got into several arguments with PTs throughout the time that I was working with them, and on several occasions the docs actually had to clearly explain to the patients that they were the ones in charge of the medical care and not the physical therapists. As I understand it, the reasons for those arguments and those kinds of statements was the following:

As was mentioned above, physicians by definition know more about the human body and the treatment of medical conditions. While the PT may know more about rehabilitation, that knowledge in the absence of an understanding of the patient's initial pathology, the pathophysiological mechanisms of their disease/injury, and the progression of their disease/injury is oftentimes only useful in so far as being skilled in applying a prescribed rehabilitation protocol. There are definitely many shades of grey particularly depending on a patients pathology and the risks posed to that patient as a result.

For example, I can't tell you how many times a patient would come for a post-op follow up complaining of severe pain after PT within a month of a rotator cuff repair. Some of them had been performing exercises that were not at all according to protocol and would even have severe anxiety because their physical therapists told them that they were behind schedule and that their shoulder would get stiff if they didn't move it more. Some might have even been told by their PT that their shoulder is the least mobile of any patient they have seen following a cuff repair. This is completely wrong and represents a crucial misunderstanding of the pathophysiology and natural history of cuff tears. For starters, everybody has a different biology of healing and no two people's rotator cuff tears are exactly the same. In these situations (and trust me I have plenty more of them) the physical therapist is not only overstepping their boundaries in providing care that wasn't prescribed by the treating physician, they are putting the patient at risk without even knowing it.

However, I have seen the opposite side of the coin as well. I had the chance to see many patients who were suffering from chronic lower back pain who had seemingly tried everything under the sun to get better. After going to PT and spending time with therapists who not only worked with them on a specific protocol to get stronger, but listened to and acknowledged their complaints in a way that physicians sometimes forget to do in all the hustle and bustle of a work day, they started seeing dramatic improvements in their pain. (I apologize for any grammer/syntax mistakes, wrote this really quickly!)
 
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I'm saying I looked into both quite extensively....and yeah, the doc knows more

No we don't. The average doc knows nothing bout rehab and therapy. Even the surgeons aren't as well versed in rehab as the PT. A well trained orthopedist will admit this on a daily basis. Surgeons guide rehab by giving restrictions ( weight baring, rom, strength,etc), not by directing their rehab or really even overseeing the process.
 
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No we don't. The average doc knows nothing bout rehab and therapy. Even the surgeons aren't as well versed in rehab as the PT. A well trained orthopedist will admit this on a daily basis. Surgeons guide rehab by giving restrictions ( weight baring, rom, strength,etc), not by directing their rehab or really even overseeing the process.
Woah there smokey - you just done called out someone from Galt's Gulch
 
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I started in medicine as a PT tech. There are good PT's and bad PT's, just like there are good and bad doctors. If you feel like you're not being respected, then you're looking for the wrong thing. PT's are good for what they're good for. The only time you're going to ruffle feathers is if you start giving a doctor flak.
 
I feel lucky to have gone through residency in a system that has our own PT network.

I refer to PT often. I can't value them enough. My referring immensely picked up after I saw the relationship ortho and sports med have with them on rotations.
 
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There's a difference between respecting a profession and respecting an opinion, I think. Of course, (most) MDs respect PTs otherwise there would never be MD referrals to PT and MDs themselves would never go to a PT for therapy. At the same time, disagreeing with what the PT suggests is not the same thing as disrespecting the profession as a whole and I highly recommend not taking it that way unless you're aiming for a very paternalistic practice as a PT. If a MD disagrees with your recommendations then put forth your argument and discuss the best course of action; both of you will have the patient's best interest at heart in any case and understanding what the other party is thinking will ideally help both practices grow. But what do I know, I haven't even started MS1 yet haha
 
PTs are good at what they do. Like said above, we dont really have any idea of what the rehab process is.

The problem is when PTs disagree with diagnoses and send messages like oh I think they need a MRI brain or spine or whatever they might have a tumor. That's not their job and 100% of the time it's for some asinine reason that makes zero medical sense.
 
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No we don't. The average doc knows nothing bout rehab and therapy. Even the surgeons aren't as well versed in rehab as the PT. A well trained orthopedist will admit this on a daily basis. Surgeons guide rehab by giving restrictions ( weight baring, rom, strength,etc), not by directing their rehab or really even overseeing the process.


Exactly. About the only person that can comment really is PM&R. Ortho to a much lesser extent and everyone else even less so. As mentioned above we give activity restrictions post op to prevent activity related complications, but that's really it. If you're not PM&R and you're overseeing someone's rehab you probably don't have enough clinical responsibilities.

We rely on PT/OT to make disposition recommendations regarding discharge to home, SNF, SAR, etc among other important things. They are an integral part of the patient's care and most other residents I work with respect them...except the ones that make 1 attempt to see a patient/day and if a nurse/family member/patient is in the bathroom/patient has a stuffed animal in the room they leave a note saying "unable to eval/perform PT due to patient being busy. Will try tomorrow."
 
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We rely on PT/OT to make disposition recommendations regarding discharge to home, SNF, SAR, etc among other important things. They are an integral part of the patient's care and most other residents I work with respect them...except the ones that make 1 attempt to see a patient/day and if a nurse/family member/patient is in the bathroom/patient has a stuffed animal in the room they leave a note saying "unable to eval/perform PT due to patient being busy. Will try tomorrow."

Not to derail this thread, but as a PT I don't have respect for those people either. I find that it tends to be PRN therapists or ones who are just mailing it in. It's lazy and makes the rest of us look bad. Nothing drives me crazier than having a day or two off, coming back to work and seeing BS screens. "PT to hold as pt wants to eat prior to mobilization." Or "insert silly lab value here that doesn't affect PT treatment". So you're just going to let them stay in bed all day? Or decrease the possibility of their being accepted to IPR? That's lame.
 
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Hey guys! I'm obviously going into physical therapy as you can tell by my name. I just wanted to start of by saying I have great respect for physicians and I respect the amount of knowledge you have. I was wondering why a lot of physicians don't respect physical therapists. I know many do, but from what I have heard from many pts is that physicians aren't aware of the amount of schooling we go through now and the amount of knowledge we have in the rehabilitation setting. So I just wanted to ask the physicians who don't respect physical therapists a lot is why don't you? Thanks! P.S. I'm not trying to start a turf war or anything and I'm not trying to say pts are smarter than MDs!

Incoming ortho resident here. We refer the majority of our patients to PT. We definitely have respect for you guys and the profession.
 
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Perhaps by respect OP meant "why aren't we treated as fellow physicians?"

My PT school friend somewhat has this view. "We take basically take a lot of the same classes and at the end of the day will both be called doctors." LOL

That said I love PT for what it is.
 
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Perhaps by respect OP meant "why aren't we treated as fellow physicians?"

Medical doctors go to medical school. It's a difficult concept for many, to be sure

...I was wondering why a lot of physicians don't respect physical therapists. I know many do, but from what I have heard from many pts is that physicians aren't aware of the amount of schooling we go through now and the amount of knowledge we have in the rehabilitation setting. So I just wanted to ask the physicians who don't respect physical therapists a lot is why don't you?

Many therapists have told me that a lot of physicians have questioned the ways they rehabilated patients. Many of the therapist say they get referrals from many family med and internal doctors who just ask for heat and stem for complex injuries and when the pt tries to correct them they says the physicians don't like that so that shows that the physician in these cases don't show much respect to the work and knowledge physical therapists have.

...when a physician tells a patient "listen to me I'm the Doctor he is just a therapist"then it is going a little too far. Especially when it is just a family med doc and not an ortho specialist.

Yes they do and I'm not scared to admit that, but they don't know more about rehab science than us. Some specialty doctors do of course like pmr, but not many family docs know much about rehab especially the ones that just want modalities on patients.

What OP meant is pretty clear. They meant "why do some physicians not treat PTs as rehabilitation experts commensurate with their education and training", not "why are PTs not treated like MDs".

It is obvious that OP has no delusions that your average physical therapist's general medical education and training is on par with that of your average physician, but they also have no delusions that your average physician's rehabilitative education and training is on par with that of your average physical therapist.

OP knows where PTs stand in this situation. There's no need to try to make OP out as some MD wannabe.
 
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Perhaps by respect OP meant "why aren't we treated as fellow physicians?"

My PT school friend somewhat has this view. "We take basically take a lot of the same classes and at the end of the day will both be called doctors." LOL

That said I love PT for what it is.

Oh yeah I have a PT friend that was trying to prove themselves as equal while i was in anatomy. Somewhere around the beginning of second year they got the picture though.
 
... "We take basically take a lot of the same classes ...

PT, PA, NP, Dentists all sometimes say this. It's not really true, and suggests to me such people have an insecurity about their own qualifications that they need to try and whip it out and measure against mine.

Sure there's some overlap (they all have to know the relevant anatomy) but really not enough to brag about, IMHO. But statements like this certainly can create negative views of the practitioners who are trying to exalt themselves to "practically Doctor" status without "Walking the walk". It's hard to respect someone who is constantly saying "you aren't all that".

So perhaps that's the answer to OPs question. If you are happy in your field and diligent and professional about it you'll earn respect; if your view is your referring physician doesn't know squat, I suspect the sentiment will be reciprocated. :)
 
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Perhaps by respect OP meant "why aren't we treated as fellow physicians?"

My PT school friend somewhat has this view. "We take basically take a lot of the same classes and at the end of the day will both be called doctors." LOL

That said I love PT for what it is.

These types of posts and statements are pre-meds with over-reaching egos about medicine and our role in the world. This egocentric view will get beaten out of you once you make it through medical school and into residency. We're really not that special. My wife is a PT. Most of her class had better grades than my medical school classmates (undergrad wise) and would have made fine physicians if they were interested in pursuing that path. Instead they went a different route, are highly trained and skilled, and work a hell of a lot less than we do with more job satisfaction and lower burnout.

Sounds like a smart decision.
 
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