Do MDs respect physical therapists?

[Zembaphobia]

I remember when I was 14 and was so edgy

Not being edgy. Being a certified physician or physical therapist doesn't automatically warrant respect. There are enough bad physicians and physical therapists, that you have to earn respect with your actions

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[3member]

one of the best people i've met in the hospital when i was a volunteer was a PT. awesome guy, thought he was a doc

 

[jadedphysiotherapist]

Removed

 

[jadedphysiotherapist]

one of the best people i've met in the hospital when i was a volunteer was a PT. awesome guy, thought he was a doc

Every field in a hospital depends on the person, understanding of the application of their knowledge base, and respect when their knowledge base is not needed.....whether that application be an executive action, an allied action, or a janitorial action for patients.

You have a good attitude just make sure you understand the roles of a physician and a physical therapist in complementary roles for a service which exist in many many fields.........but don't have mainstream application

 

[Fiveoboy11]

"I feel uncomfortable trying to present myself as a physician (Doctor) as that's not my job and duty"

You're a physical therapy student, not a physician. Why would you try to present yourself as one?

The definition of a quack: a person who dishonestly claims to have special knowledge and skill in some field, typically in medicine. You "doctors" claim to have special knowledge re physical therapy. These claims are based on practice patterns re physical therapy. Unfortunately this is a literal impossibility given no real training re physical therapy. No physical therapy testing, no license, no classes, no critique, no demo of competence, not even an observation hour. Hell you guys don't even know who's who or what's what in the hospital, let alone the capability to gauge the quality of physical therapy care (insert invalid opinion of physical therapists here). Physical therapy is one of the gimmies for physicians. It was never earned or based on evidence. It is based on false assumptions (I.e. Physical therapists are dangerous without physicians, physicians are trained in physical therapy). It's historical or traditional. From there you have an immense and pervasive false sense of expertise (amongst physicians re physical therapy) combined with zero accountability. So, you're a quack. Just like your colleagues.

 

[W19]

My wife is a PT and from I've seen of their curriculum, it is comparable in difficulty, even though admittedly different in scope. But, for instance, my med school has a good majority of neuro taught by two DPTs, and the slides we got were the same as the PT program's neuro class.

Do you go to a US school?

 

[W19]

I am just a 3rd year med student and was a RN for almost 7 years... So I don't know a whole lot of what physicians think about PT in particular, but from what I have seen so far, many (if not most) physicians think other healthcare professionals (except pharmacists) in the hospital are not bright. I am trying to put that nicely so I don't offend anyone...

 

[Fiveoboy11]

I am just a 3rd year med student and was a RN for almost 7 years... So I don't know a whole lot of what physicians thinks about PT in particular, but from what I have seen so far, many (if not most) physicians think other healthcare professionals (except pharmacists) in the hospital are not bright. I am trying to put that nicely so I don't offend anyone...

I think you need to understand how "physical therapy" in medical jargon doesn't really mean anything accurate. Physical therapy to physicians means "walking down the hallway" or "working on strengthening" or "getting you up and moving a bit." None of which is true. Physical therapy to physicians also includes speech therapy, occupational therapy, cardiac rehab, and any other group who "kinda sorta looks like PT." Physical therapy is only physical therapy, it has nothing to do with OT or speech therapy, etc. There's no such thing as "PT/OT." Physical therapists also are not the only ones who provide "physical therapy" in a physicians view, it's also done by PTA's, OT's, COTA's, SLP's, exercise physiologists, etc. This is also inaccurate. Physical therapy is done only by PT's and PTA's under their supervision (literally, in all 50 states, by law). Other professions are their own and have nothing to do with "PT." So, if you have any intelligence you'd grasp that the opinions of physicians re physician therapy and physical therapists are invalid garbage.

 

[Fiveoboy11]

I've seen dozens of patients who were told by PT that their mechanical back pain was actually lumbar radiculitis, because when they "pushed on the sciatic nerve" (AKA palpated the SI joint) the pain was worse. PT has it's place, but that place is not to inform the MD as to the diagnosis.

Wow, that's a nifty anecdote that (according to you) proves something. MD has it's place and it's sure as hell not to make NMSK diagnoses in > 95% of cases that they do or guide "PT." Physicians as a whole are flagrantly incompetent in dealing with NMSK and rehab issues.

 

[Fiveoboy11]

"We've all taken the basics" LOL

Some of us actually take physical therapy classes...you "doctors" should try that given that it's supposedly in your scope and your responsibility and all. lol

 

[Stagg737]

The definition of a quack: a person who dishonestly claims to have special knowledge and skill in some field, typically in medicine. You "doctors" claim to have special knowledge re physical therapy. These claims are based on practice patterns re physical therapy. Unfortunately this is a literal impossibility given no real training re physical therapy. No physical therapy testing, no license, no classes, no critique, no demo of competence, not even an observation hour. Hell you guys don't even know who's who or what's what in the hospital, let alone the capability to gauge the quality of physical therapy care (insert invalid opinion of physical therapists here). Physical therapy is one of the gimmies for physicians. It was never earned or based on evidence. It is based on false assumptions (I.e. Physical therapists are dangerous without physicians, physicians are trained in physical therapy). It's historical or traditional. From there you have an immense and pervasive false sense of expertise (amongst physicians re physical therapy) combined with zero accountability. So, you're a quack. Just like your colleagues.

What are you even talking about? Most physicians prescribe PT with general instructions and let the PT do their thing until the patient is seen in follow-up. Most physicians don't want to do the PT's job otherwise they would have become a PT. The few that do want to incorporate it (PM&R and some sports med physicians) into their practice actually do get trained in PT techniques and even then they still consult PTs and work with them.

If you want to talk about people practicing outside their scope, aka 'quacks', we can talk about PTs attempting to create differential diagnoses or perform the job of a radiologist with less than a year of training in those areas. Or we can talk about physical therapists trying to manage their patient's medications after taking a single semester of pharmacology.

I think you need to understand how "physical therapy" in medical jargon doesn't really mean anything accurate. Physical therapy to physicians means "walking down the hallway" or "working on strengthening" or "getting you up and moving a bit." None of which is true. Physical therapy to physicians also includes speech therapy, occupational therapy, cardiac rehab, and any other group who "kinda sorta looks like PT." Physical therapy is only physical therapy, it has nothing to do with OT or speech therapy, etc. There's no such thing as "PT/OT." Physical therapists also are not the only ones who provide "physical therapy" in a physicians view, it's also done by PTA's, OT's, COTA's, SLP's, exercise physiologists, etc. This is also inaccurate. Physical therapy is done only by PT's and PTA's under their supervision (literally, in all 50 states, by law). Other professions are their own and have nothing to do with "PT." So, if you have any intelligence you'd grasp that the opinions of physicians re physician therapy and physical therapists are invalid garbage.

This is possibly the dumbest statement you've made and I don't know any physicians who think PTs are the same thing as OTs, speech therapists, or individuals involved in cardiac rehab. Either the physicians you work with are the dumbest physicians in the country, you're not talking to actual physicians, or you're completely delusional.

 

[68PGunner]

The definition of a quack: a person who dishonestly claims to have special knowledge and skill in some field, typically in medicine. You "doctors" claim to have special knowledge re physical therapy. These claims are based on practice patterns re physical therapy. Unfortunately this is a literal impossibility given no real training re physical therapy. No physical therapy testing, no license, no classes, no critique, no demo of competence, not even an observation hour. Hell you guys don't even know who's who or what's what in the hospital, let alone the capability to gauge the quality of physical therapy care (insert invalid opinion of physical therapists here). Physical therapy is one of the gimmies for physicians. It was never earned or based on evidence. It is based on false assumptions (I.e. Physical therapists are dangerous without physicians, physicians are trained in physical therapy). It's historical or traditional. From there you have an immense and pervasive false sense of expertise (amongst physicians re physical therapy) combined with zero accountability. So, you're a quack. Just like your colleagues.

Wrong. DO physicians know everything about physical therapy and more. Those guys and girls spend about 4-5 hrs a week in lab, practicing manipulative techniques. PT is a subset of OMM, not the other way around.

 

[Chillbo Baggins]

Do you go to a US school?

US allopathic.

 

[Psai]

I think you need to understand how "physical therapy" in medical jargon doesn't really mean anything accurate. Physical therapy to physicians means "walking down the hallway" or "working on strengthening" or "getting you up and moving a bit." None of which is true. Physical therapy to physicians also includes speech therapy, occupational therapy, cardiac rehab, and any other group who "kinda sorta looks like PT." Physical therapy is only physical therapy, it has nothing to do with OT or speech therapy, etc. There's no such thing as "PT/OT." Physical therapists also are not the only ones who provide "physical therapy" in a physicians view, it's also done by PTA's, OT's, COTA's, SLP's, exercise physiologists, etc. This is also inaccurate. Physical therapy is done only by PT's and PTA's under their supervision (literally, in all 50 states, by law). Other professions are their own and have nothing to do with "PT." So, if you have any intelligence you'd grasp that the opinions of physicians re physician therapy and physical therapists are invalid garbage.

How can you possibly help my patients ambulate with such a large chip on your shoulder?

 

[Bones26]

PT is a subset of OMM, not the other way around.

I disagree with this. Manual therapy is a small component of PT. OMM is not the same as the treatment utilized in women's health, neuro rehab, vestibular rehab, cardiac and pulmonary rehab, lymphedema mgmt, peds, and wound care. I doubt DO school goes into the nitty gritty of the assessments and interventions necessary for those populations. And, why would they? It's not something they need to know.

Unfortunately, when a lot of people think of PT they think about outpatient ortho or mindlessly ambulating patients in the hospital (which may be a PT or might be a nurse, CNA or warm body).

 

[W19]

US allopathic.

Ok... My school only uses PhD and MD for classes that are relevant to medicine. I am just having a hard time believing that PT school curriculum is as hard as MD. But I trust your experience on that

 

[Chillbo Baggins]

Ok... My schools only uses PhD and MD for classes that are relevant to medicine.

>implying PTs are not relevant to medicine??

They have PhDs in neuroscience as well.

 

[W19]

T0 the OP, why do you care whether or not some random people (MD/DO) have respect for your profession?

 

[W19]

>implying PTs are not relevant to medicine??

They have PhDs in neuroscience as well.

I am not saying PTs are not relevant to medicine. If these PT have also PhD in neuroscience, that makes sense. I thought a PT teaching neuroscience would not fly by LCME rules...

 

[Chillbo Baggins]

I am just having a hard time believing that PT school curriculum is as hard as MD. But I trust your experience on that

And herein lies the problem: very few people are actually qualified to compare different health professions, such as those that go from RN to MD. Everyone else has their own limited perspectives. To be frank, most med students have no idea what goes into other degree programs, and are honestly somewhat arrogant sitting at the top of the totem pole as a result of this. I think this is why my school, at least, has been trying to promote interprofessionalism development between the programs.

 

[W19]

And herein lies the problem: very few people are actually qualified to compare different health professions, such as those that go from RN to MD. Everyone else has their own limited perspectives. To be frank, most med students have no idea what goes into other degree programs, and are honestly somewhat arrogant sitting at the top of the totem pole as a result of this. I think this is why my school, at least, has been trying to promote interprofessionalism development between the programs.

PT school being as hard as med school can be best answered by a PT who has become a doc or a PT who is attending med school. I can only compare RN to MD since I attended nursing school some years ago... All I can say: THERE IS NO COMPARISON!

 

[xffan624]

And herein lies the problem: very few people are actually qualified to compare different health professions, such as those that go from RN to MD. Everyone else has their own limited perspectives. To be frank, most med students have no idea what goes into other degree programs, and are honestly somewhat arrogant sitting at the top of the totem pole as a result of this. I think this is why my school, at least, has been trying to promote interprofessionalism development between the programs.

My program had the same classes with the PT's in the first year. They took a slightly modified (ie easier) test from us and had a couple added classes that were more MSK specific. I think they also had a different pass standard. After first year, we split. MS1 for my program is definitely the easier year. MS2 is when things get more intense.

 

[W19]

My program had the same classes with the PT's in the first year. They took a slightly modified (ie easier) test from us and had a couple added classes that were more MSK specific. I think they also had a different pass standard. After first year, we split. MS1 for my program is definitely the easier year. MS2 is when things get more intense.

What are the classes you had in MS1?

 

[xffan624]

What are the classes you had in MS1?

It's an integrated program. We covered normal biochem/MSK, Neuro, Cardio/Pulm, GI, and Reproductive. Pathology for all those systems is during MS2 year.

 

[ProfMD]

Never responded to my PM&R slaying. Time for debate!?!?!?!?! I also must inform you that general anatomy and physiological principles are heavier in the associated physiotherapy program Im attending compared to the PCP med school and subsequent application that they complete dependent on residency compared to the PT setting (I.e. Icu in which increased troponin levels....perhaps,with decreased hgb and hematocrit as cofactors), previous hx of heart attack and progression to anything too heavily aerobic will lead to an MI immediately following any type of dependent activity after stabilization in an ICU.

I am legitimately really interested on your take on the matter and like that you had solid positive opinions and that you also disagreed with me on a specific comment which attacked an entire subfield......so I'm referencing you again regardless of the rather vitriolic attack and childish attack on a physician subfield and the fact that this was commented on a while ago.

This could possibly lead to some excellent conversation or some realizations of why certain fields exist given certain services, population dynamics, comanagememt, or possible antiquity that is no longer necessary.

I am having a hard time parsing out your argument here. Your "PM&R slaying" was a lame attempt at disparaging a speciality of medicine. I did respond - that you do not understand the PM&R scope of practice.

I'm also not sure what "PCP med school" is. There is "med school" and there are residencies in various primary care specialities (IM, peds, FM). However, there is no special med school for people who go into primary care.

You also seem to imply that graduates of "PCP med school" do not understand troponin levels, hemoglobin, hematocrit, heart attacks, etc and the risks these pose for activity in the acute setting. Clearly this is wrong - any med school graduate knows about these issues, likely more than a PT does. In fact, the way you phrase your statement makes me think that you do not understand what you are talking about.

I am all for PT. As I said - I send patients to PT all the time, outpatient and inpatient. However, your posts are making my troll-o-meter approach the red zone.

I think you need to understand how "physical therapy" in medical jargon doesn't really mean anything accurate. Physical therapy to physicians means "walking down the hallway" or "working on strengthening" or "getting you up and moving a bit." None of which is true. Physical therapy to physicians also includes speech therapy, occupational therapy, cardiac rehab, and any other group who "kinda sorta looks like PT." Physical therapy is only physical therapy, it has nothing to do with OT or speech therapy, etc. There's no such thing as "PT/OT." Physical therapists also are not the only ones who provide "physical therapy" in a physicians view, it's also done by PTA's, OT's, COTA's, SLP's, exercise physiologists, etc. This is also inaccurate. Physical therapy is done only by PT's and PTA's under their supervision (literally, in all 50 states, by law). Other professions are their own and have nothing to do with "PT." So, if you have any intelligence you'd grasp that the opinions of physicians re physician therapy and physical therapists are invalid garbage.

I do not know a single physician who really thinks that PT encompassing all therapies. PT/OT is shorthand for PT and OT, not a request for one person who does both. Ever physician I work with knows PT, OT, SLP are all different. Even if they do not graduate med school with that knowledge, they learn quickly since the input of all three disciplines is usually needed to get a patient into a SNF or rehab facility and hence out of your hospital.

 

[Fiveoboy11]

I am having a hard time parsing out your argument here. Your "PM&R slaying" was a lame attempt at disparaging a speciality of medicine. I did respond - that you do not understand the PM&R scope of practice.

I'm also not sure what "PCP med school" is. There is "med school" and there are residencies in various primary care specialities (IM, peds, FM). However, there is no special med school for people who go into primary care.

You also seem to imply that graduates of "PCP med school" do not understand troponin levels, hemoglobin, hematocrit, heart attacks, etc and the risks these pose for activity in the acute setting. Clearly this is wrong - any med school graduate knows about these issues, likely more than a PT does. In fact, the way you phrase your statement makes me think that you do not understand what you are talking about.

I am all for PT. As I said - I send patients to PT all the time, outpatient and inpatient. However, your posts are making my troll-o-meter approach the red zone.



I do not know a single physician who really thinks that PT encompassing all therapies. PT/OT is shorthand for PT and OT, not a request for one person who does both. Ever physician I work with knows PT, OT, SLP are all different. Even if they do not graduate med school with that knowledge, they learn quickly since the input of all three disciplines is usually needed to get a patient into a SNF or rehab facility and hence out of your hospital.

Your last paragraph. Think about it, do you really think that your first sentence even makes sense? How do you know what they think? You guys definitely do not know the differences imo based on my nearly 10 years of licensed experience (big deal right?). I look forward to testifying against you guys some day and exposing your catastrophic ignorances and incompetences. Do you have any grasp whatsoever how much time and money is wasted by your lackadaisical "PT/OT" baloney?

 

[Fiveoboy11]

Your last paragraph. Think about it, do you really think that your first sentence even makes sense? How do you know what they think? You guys definitely do not know the differences imo based on my nearly 10 years of licensed experience (big deal right?). I look forward to testifying against you guys some day and exposing your catastrophic ignorances and incompetences.

Wrong. DO physicians know everything about physical therapy and more. Those guys and girls spend about 4-5 hrs a week in lab, practicing manipulative techniques. PT is a subset of OMM, not the other way around.

You don't know what you don't know. Yikes. What a quack to be

 

[ProfMD]

Your last paragraph. Think about it, do you really think that your first sentence even makes sense? How do you know what they think? You guys definitely do not know the differences imo based on my nearly 10 years of licensed experience (big deal right?). I look forward to testifying against you guys some day and exposing your catastrophic ignorances and incompetences. Do you have any grasp whatsoever how much time and money is wasted by your lackadaisical "PT/OT" baloney?

It is this antagonistic attitude that makes some people lose respect.

I have 14 years of experience (big deal, right?).

I literally just said that I consult PT, OT, SLP for their expert opinions within their scopes of practice. Is this the "catastrophic ignorance and incompetence" that you plan on testifying against me for? Are you suggesting that I should not be consulting you because it represents incompetence and ignorance?

My patients typically do need PT and OT. If they only need PT, I only request PT. A selected few of my patients need SLP in which case I consult them too.

 

[Fiveoboy11]

How can you possibly help my patients ambulate with such a large chip on your shoulder?

I start by avoiding the large troves of ***** physician residents who constantly interrupt me as if I'm a ghost. Such impressive "patient centered" physician skills. Such great work of improving the validity of a physical therapy assessment by stopping the patient while they're "walking down the hallway" "with PT" to ask stupid questions.

 

[Fiveoboy11]

What are you even talking about? Most physicians prescribe PT with general instructions and let the PT do their thing until the patient is seen in follow-up. Most physicians don't want to do the PT's job otherwise they would have become a PT. The few that do want to incorporate it (PM&R and some sports med physicians) into their practice actually do get trained in PT techniques and even then they still consult PTs and work with them.

Prescription, LOL
It doesn't' matter if you want to incorporate it, it's not in your scope regardless of make believe training you have. You can't do PT unless you're a PT or PTA by law.

If you want to talk about people practicing outside their scope, aka 'quacks', we can talk about PTs attempting to create differential diagnoses or perform the job of a radiologist with less than a year of training in those areas. Or we can talk about physical therapists trying to manage their patient's medications after taking a single semester of pharmacology.

It's screening for conditions outside the scope of physical therapy or red flags, nothing to do with making a differential diagnosis or being a radiologist or prescribing/managing mess. Should we talk about physician laughable practice patterns re the use of imaging for NMSK conditions? I think pharmacists should play a much larger role in controlling patient med use given your guys absolute arrogance in doing so.

This is possibly the dumbest statement you've made and I don't know any physicians who think PTs are the same thing as OTs, speech therapists, or individuals involved in cardiac rehab. Either the physicians you work with are the dumbest physicians in the country, you're not talking to actual physicians, or you're completely delusional.

You clearly are not a PT in a hospital, there's relentless use of the term physical therapy to encompass anything that remotely resembles rehab of any kind. See above if you want

 

[3member]

And herein lies the problem: very few people are actually qualified to compare different health professions, such as those that go from RN to MD. Everyone else has their own limited perspectives. To be frank, most med students have no idea what goes into other degree programs, and are honestly somewhat arrogant sitting at the top of the totem pole as a result of this. I think this is why my school, at least, has been trying to promote interprofessionalism development between the programs.

I don't know whether the rigor of PT school is the same as medical school (i would assume medical school would be more difficult just due to the scope of knowledge needed to become a physician), but PT school definitely has an emphasis on anatomy and muscularskeletal system (obviously) and my friends in PT school knew their *hit regarding their scope of practice.

 

[Psai]

I start by avoiding the large troves of ***** physician residents who constantly interrupt me as if I'm a ghost. Such impressive "patient centered" physician skills. Such great work of improving the validity of a physical therapy assessment by stopping the patient while they're "walking down the hallway" "with PT" to ask stupid questions.

That 9-5 job of walking patients getting to ya? Or is it the jealousy from signing notes as PT, DPT but no one actually thinking you're actually a doctor?

 

[W19]

Why so much animosity toward physicians in the healthcare industry? Is it because of physicians' salary and/or perceived 'status'?

 

[ProfMD]

You clearly are not a PT in a hospital, there's relentless use of the term physical therapy to encompass anything that remotely resembles rehab of any kind. See above if you want

Sounds to me like the problem is not that physicians everywhere lack understanding, but rather that you and the physicians at your place do not play well together in the sandbox.

If they really do not understand, why don't you partner up with some of your OT and SLP colleagues and give a grand rounds presentation on what you do and what services you can provide for their patients?

 

[surfguy84]

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.

Maybe they get irritated by run on sentences.

 

[jadedphysiotherapist]

Removed. Not worth it

 

[jadedphysiotherapist]

That 9-5 job of walking patients getting to ya? Or is it the jealousy from signing notes as PT, DPT but no one actually thinking you're actually a doctor?

This actually isn't annoying to me.

What's annoying is when a person thinks someone wearing a white piece of fabric who works as a hospitalist, understands spinal cord injury from the mnemonic they made in med school.....and the fact that I can recite every tract off the top of my head and deficit presentation in dermatomes/myotomes since it's my job to assess and quantify damage to a patient....yet I or colleagues would be perceived as not having that knowledge base and the white fabric guy is.

 

[Stagg737]

I disagree with this. Manual therapy is a small component of PT. OMM is not the same as the treatment utilized in women's health, neuro rehab, vestibular rehab, cardiac and pulmonary rehab, lymphedema mgmt, peds, and wound care. I doubt DO school goes into the nitty gritty of the assessments and interventions necessary for those populations. And, why would they? It's not something they need to know.

Unfortunately, when a lot of people think of PT they think about outpatient ortho or mindlessly ambulating patients in the hospital (which may be a PT or might be a nurse, CNA or warm body).

Actually, we are trained in women's health and manipulation (which is the butt of a lot of jokes in lab), pulmonary rehab, cardiac treatment, and lymphedema mgmt. We go much farther into neuro diagnostics than PTs and do work on some treatment modalities, thought not nearly to the extent of PTs. That being said, I'd say OMM techniques are more of a subset of what PTs learn and practice. Are there some conditions we refer to PTs that I could easily handle myself, yes. However, there's a lot of conditions that I would either work with a PT on or just refer the whole thing to them and check in on patient progress every few weeks.

Your last paragraph. Think about it, do you really think that your first sentence even makes sense? How do you know what they think? You guys definitely do not know the differences imo based on my nearly 10 years of licensed experience (big deal right?). I look forward to testifying against you guys some day and exposing your catastrophic ignorances and incompetences. Do you have any grasp whatsoever how much time and money is wasted by your lackadaisical "PT/OT" baloney?

You don't know what you don't know. Yikes. What a quack to be

Hahaha, you're far more arrogant than any physician I've ever met. You think that anyone would take any testimony you give in court seriously with that attitude? Get over yourself. Most physicians don't disrespect PTs at all, but it's easy to see why people wouldn't respect you.

 

[surfguy84]

Example of what you don't learn:
There are rehab progressions for orthopaedics set in four different stages following injury that focus on muscle contractions in different positions and planes that are progressed at different stages for recovery. If progressed too quickly and the inflammatory process is still high (lots of edema, redness, pain from nociception stimulation from the immune system) then you stress tissue too quickly and lead to reinjury or retraining of a movement pattern with compensation.

If you want to degrade the practice to just "walking patients" then it's very easy to say IM is "just charting" or being an anesthesiologist is being "an overpaid surgeon butler"

A few things...

1. Yes, we do learn that. Just a few weeks ago a matter of fact. I could show you the ppts which are on my desktop right now.

2. Related, how do you know what DO students do and do not learn?

3. You seem like you have a Napoleon complex.

 

[surfguy84]

This actually isn't annoying to me.

What's annoying is when a person thinks someone wearing a white piece of fabric who works as a hospitalist, understands spinal cord injury from the mnemonic they made in med school.....and the fact that I can recite every tract off the top of my head and deficit presentation in dermatomes/myotomes since it's my job to assess and quantify damage to a patient

Of course there are some things you can recite that *some* doctors may not remember because they aren't using that info on a daily basis. You remember what you use. However, PMR and Neurologists can do exactly what you said and more. You're comparing apples to oranges.

 

[jadedphysiotherapist]

Removed. Not worth it.

 

[ProfMD]

To put things in perspective. Physical therapists are taught by PhDs with disciplines in exercise physiology, cardiopulmonary rehab, neuroscience, pharmacology, muscle physiology, etc. Med students are taught by PhDs as well.

Your emphasis is on putting things together for a differential on a disease process and associated Rx or testing that is needed plus referral to specialists. You keep patients alive or do some life saving procedure or maneuver.

Our emphasis is on the associated strength, musculoskeletal, functional (kinesiology, biomechanics of the body with respect to gravity and artho or osteokinematic motion at joints that decreases range of motion), cardiopulmonary, and neurological (sensory and motor) deficits following a disease process or due to direct injury. Emphasis is usually the healing process and preventing the body from degrading/wasting away.



No. They don't. And given actual practice when out, those practice hours of OMM are a waste of time because you treat with procedure or pharmaceuticals given the healthcare reimbursement system and the fact that DOs have a minimum of 2.5x the student debt I do.


Example of what you don't learn:
There are rehab progressions for orthopaedics set in four different stages following injury that focus on muscle contractions in different positions and planes that are progressed at different stages for recovery. If progressed too quickly and the inflammatory process is still high (lots of edema, redness, pain from nociception stimulation from the immune system) then you stress tissue too quickly and lead to reinjury or retraining of a movement pattern with compensation.



My bad. Happy hour was nice last night. I edited the post so it actually made sense and took out the heavy disparaging comments. The point was that you have to learn anatomy and physiology basics in medical school since you've never seen them as a premed since it isn't a requirement, rather than really delving into more application right away which is what we do. That usually starts on medical school systems blocks in second year. It came out as gibberish since I had beers earlier.

As for the troponin levels, hgb, hematocrit, etc. comment, therapists are the first ones doing any activity with a patient in an acute care setting. That's literally their job so I must disagree on whose knowledge base is heavier for that specific service since one person is actually implementing it and seeing patient response 3 inches away from them and another person is aware of it and adjusting things before activity occurs.



Yes, it's walking patients in an acute care subfield....but the skilled therapy aspect is watching for balance deficits from cognition, decreased somatosensation, vestibular issues, visual issues such as hemispatial neglect, neuromuscular issues impairing gait, strength issues from atrophy, dysmetria, ataxic gait patterns, management of clonus or spasticity, step length, cadence, trunk stability, etc.

You literally document those things. There are plenty of therapists who are lazy and just walk patients to Bill therapeutic activity for X minutes and then leave just like there are plenty of physicians that just sign scripts and send referrals in 7 minute office visits and leave by 5

If you want to degrade the practice to just "walking patients" then it's very easy to say IM is "just charting" or being an anesthesiologist is being "an overpaid surgeon butler"

Also, peds, derm, rads, PM&R, psych and other physician fields are "9-5" when done with training or excess fellowships since the market wasn't open and you had to pay your dues more.

I never suggested that PT anatomy/physiology education was not detailed. However, anatomy and physiology in med school is incredibly detailed. Also, physician education does not stop with med school. Doctors spend years after med school specializing. Orthopedic surgeons do 5 extra years. This PM&R docs you love to hate do 4 extra years.

As for the lab values, I would suggest that if the cardiologist thinks it is safe to ambulated an MI patient that it is not the place of PT to over-ride that decision. If you have concerns, by all means raise them. But the ultimate decision belongs to the physician.

Specifically to H/H, what are your lower limits of acceptable? Are you considering symptomatic vs asymptomatic? Are you keeping up with the latest literature on transfusion thresholds?

 

[jadedphysiotherapist]

Removed. Not worth it.

 

[Bones26]

Actually, we are trained in women's health and manipulation (which is the butt of a lot of jokes in lab), pulmonary rehab, cardiac treatment, and lymphedema mgmt. We go much farther into neuro diagnostics than PTs and do work on some treatment modalities, thought not nearly to the extent of PTs.

Thanks for the clarification. I had no idea.

 

[jadedphysiotherapist]

Removed. Not worth it

 

[ProfMD]

I know the extra specialization period. I'm not sure how much of it is purely market driven though and supply/demand restriction. Even a 10 thousand hour rule which I've heard quoted as a necessity before safe practice would take 3 years given the resident work hours.

My field I'm training to do is moving more towards a postgrad supervision period although your staying within the rehabilitation field.

Of course a cardiologist shouldn't be overridden! It's the therapist watching someone's RR, face, and HR when getting someone up though so any concerns would be good to have a discussion about.

As taught in school H/H levels differ M and F but the lower threshold is 8 g/dl for hgb and the hematocrit is 25% or so. That apparently differs based on institution. No, I do not currently follow literature on it as I'm in training and have too much to integrate, learn, and assignments to complete to reference data on everything.

Residency lengths are what they because that is what the people in each field determine the necessary training period to be. Has nothing to do with market forces.

Some specialities do limit the number of training spots so as not to over-saturate the market.

The 10,000 hour rule is a nice talking point but really is not applicable to specific situations. Even Malcolm Gladwell, the guy who wrote that book, says so.

If you see physiologic changes that are concerning while working with a patient, I agree 100% that you should stop and report your concerns. However, your initial alcohol induced post suggested that you would make your decision based on laboratory values that you knew how to interpret better than the physician.

I bring up H/H as an example because transfusion thresholds are constantly changing as the literature evolves. They vary based on the patients primary disease process, comorbidities, and symptoms. Again, you suggested that you would use H/H to determine if it was appropriate for you to work with a patient. This is why I asked if you are keeping up on this literature.

 

[surfguy84]

Specifically said hospitalist.....physicians are perceived by the public as having the same knowledge bases although their fields are completely different

Really?

Do people really think a psychiatrist and a transplant surgeon have the same knowledge base?

I realize there is a lot of graying of what people think certain doctors know, but I think most people are aware that there are specialities of medicine and that different specialities know different things.

 

[68PGunner]

God damn. These PT students are so smart. Thank god that I'm in med school instead of PT school. If I'm in PT school right now w/ these gunners, I would seriously fail out.

 

[Ho0v-man]

I just clicked on this thread so I could unsubscribe.

2. I've got friends...

^^Doubtful.

 

[PS2020]

Wow, where do I begin?!

Old but confused. Why do pre health students comment on practices they are clueless about? We literally had NSG consulting us today on how a postop patient was doing in our session....

Never responded to my PM&R disparaging. Wanted to let you know that general anatomy and physiological principles are heavier in the associated physiotherapy program Im attending compared to the med school simply due to the fact that you take A&P requirements in undergrad so you can start by going much more in depth from the get go rather than what depolarization is for the first time.

You may have attended a PT mill driven solely by efficiency and profit rather than getting to a patient's problem.......similar to how ER physicians hire medical scribes to do their work and run through Pts for a higher paycheck.....or dermatologists utilize PAs or NPs with their own panels to diffy dx pts without quality examination to derive profit off of population influx to the clinic

1. You make it sound like NSGY consulting you should validate all of your inflated notions. Of course they are going to ask you how the pt is doing! It's your job to work with the pt on PT!!!! They are busy, oh you know, doing brain and spine surgery all day, so it's kind of understandable that they'll delegate physical therapy to the physical therapists and then ask how the pt is doing. You have no point at all by saying "neurosurgery LITERALLY consulted us today".

2. Bruh what? You're just trolling. You think that you guys have more in-depth general A&P "simply due to the fact" that we spend an extra 12 minutes reviewing depolarization before spending the rest of the semester learning anatomy? Are you kidding me? A&P at my school went more in depth than it did for our PT students. Our A&P exam also had nothing to do with muscle physiology or neuroscience - we had a separate class for that. Not to even mention that half of the people already took A&P in undergrad, and that muscle physiology is a required component for most gen bio classes and the MCAT. We dissected our cadavers from head to toe while our PT counterparts only did MSK. Who knows more anatomy?

3. You think EM docs use scribes to do medical work? Lol wut. Are you also comparing ED scribes to how other specialists use NP's and PAs? Go learn what an ER scribe does.

Some of us actually take physical therapy classes...you "doctors" should try that given that it's supposedly in your scope and your responsibility and all. lol

Didn't they superficially change your degree title from "Master of Physical Therapy" to "Doctor of Physical Therapy" to help your egos and your insomnia? Why are you calling MD's ' "doctors" '. I see the word "doctor" is still a trigger point for you. Your PT experience would make for a great personal statement story for your medical school application. You should consider going to doctor school!

My program had the same classes with the PT's in the first year. They took a slightly modified (ie easier) test from us and had a couple added classes that were more MSK specific. I think they also had a different pass standard. After first year, we split. MS1 for my program is definitely the easier year. MS2 is when things get more intense.

Our school does the same thing with the dental students instead of PT like in your case. Despite being exposed to 80% of the material we are exposed to, their passing requirements are much lower and their questions on exams are much easier. They know they are not expected to absorb and learn a huge chunk of the material we are responsible for and that is reflected in their attitude and knowledge. I don't blame them for not wanting to memorize mechanisms for inborn errors of metabolism.

Your emphasis is on putting things together for a differential on a disease process and associated Rx or testing that is needed plus referral to specialists. You keep patients alive or do some life saving procedure or maneuver.

Our emphasis is on the associated strength, musculoskeletal, functional (kinesiology, biomechanics of the body with respect to gravity and artho or osteokinematic motion at joints that decreases range of motion), cardiopulmonary, and neurological (sensory and motor) deficits following a disease process or due to direct injury. Emphasis is usually the healing process and preventing the body from degrading/wasting away.

No. They don't. And given actual practice when out, those practice hours of OMM are a waste of time because you treat with procedure or pharmaceuticals given the healthcare reimbursement system and the fact that DOs have a minimum of 2.5x the student debt I do.

Example of what you don't learn:
There are rehab progressions for orthopaedics set in four different stages following injury that focus on muscle contractions in different positions and planes that are progressed at different stages for recovery. If progressed too quickly and the inflammatory process is still high (lots of edema, redness, pain from nociception stimulation from the immune system) then you stress tissue too quickly and lead to reinjury or retraining of a movement pattern with compensation.

My bad. Happy hour was nice last night. I edited the post so it actually made sense and took out the heavy disparaging comments. The point was that you have to learn anatomy and physiology basics in medical school since you've never seen them as a premed since it isn't a requirement, rather than really delving into more application right away which is what we do. That usually starts on medical school systems blocks in second year. It came out as gibberish since I had beers earlier.

As for the troponin levels, hgb, hematocrit, etc. comment, therapists are the first ones doing any activity with a patient in an acute care setting. That's literally their job so I must disagree on whose knowledge base is heavier for that specific service since one person is actually implementing it and seeing patient response 3 inches away from them and another person is aware of it and adjusting things before activity occurs.
.

1. Yep, clearly our focus is purely on doing a quick procedure, keeping the patient alive, and that's it. No chronic treatment. We don't focus on that boring ****. We only do the sexy emergency procedures and let suckers like you do the "real" medicine. Like you said, its only your job to have emphasis on the healing processes. /s

2. DOs also make a minimum 2.5x the income than you do.

3. This is funny, I have to re-quote it here. "pain from nociception stimulation from the immune system". Who talks like that?! You are trying to hard. Stop trying to use redundant words, it exposes your ignorance. I'll be sure to remind my mechanic that 'my car goes forward due to the chemical reaction creating internal combustion inside the cylinders of my engine'.

4. Are you arguing that you guys know the pathophys concerning tropinin, hgb, hct, etc more than even a second year med student?!?!?! All because you have to have physical contact with the patient?!?! I have to smoke whatever you are smoking. My grandmother had a lot of physical contact with me as a kid while I was sick, I guess she was also required to know a ton about troponin levels. Ridiculous statements deserve ridiculous comebacks.

1. That's interesting. Application on clinicals and practice is different tho. I know what corticosteroids do but I'm not going to be able to legally inject. That wouldn't be therapy practice. It would be medicine

2. I've got friends in MD, DO, DMD, RN, PharmD, OT. We talk a lot

3. In real life, not really. I can see how that comes across on here though

1. No you don't. You think you know what they really do, but reading wikipedia doesn't really make all the connections in your brain that you think you have. That is exactly why you can't legally inject it.

2. I can see why you are so self-conscious about defending your field now. With friends in MD, DO, DDS, PharmD... I'd also feel compelled to remind everyone that there is a "D" in DPT.

3. This is the only sentence that comes across as you being a genuinely decent guy. I realize my post is also harsh (this thread is inflammatory), so I can understand how in real life people may be different than how they come off on the internet. I wish there was more interaction between professional school students so that people wouldn't keep their misconceptions bottled up, but instead would have a lively discussion over dinner.