Doctor of Physical Therapy (D.P.T.)

[PublicHealth]

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Anyone have any thoughts about the new Doctor of Physical Therapy programs? I've read that compared to Master of Physical Therapy programs, DPT programs offer additional training in differential diagnosis, pharmacology, radiology/imaging, healthcare management, prevention/wellness/health promotion, histology, and pathology. Many DPT programs also require students to engage in scholarly research suitable for publication in peer-reviewed journals.

What are the major differences between DPTs and PM&R physicians?

Do you think it's a good idea to have so many "Dr.'s" running around treating patients?

Thank you!

PH

 

[awdc]

Well, I'm not a PM&R doc, nor a PT, and I won't even start med school until this fall so take my opinion for what it's worth. My concern is if DPTs are going to be called "doctor" in the clinical setting. It might confuse the patient as to whether their "doctor" is a PT or a physiatrist. I think the public already has a hard enough time with being aware of the existence of PM&R physicians.

As to the major differences of DPTs and PM&R physicians. PTs whether they are MPTs or DPTs have the same scope of practice. The extra training serves to improve their skills.

The PM&R physician can act as the "primary" physician for the patient and thus order tests, prescribe meds, injections, take care of wounds and infections, collaborate/coordinate care with other physicians as needed, etc. PM&R docs are also trained in performing electromyography and nerve conduction studies.

PTs look like they are advancing themselves quite well. Many states already have direct access to PT's. Is the DPT a sign that PT's will become a limited medical practice profession such as optometry and podiatry?

 

[drusso]

I had a with cancer and multiple medical problems who needed to leave the rehab unit because of respiratory distress secondary to recurrent malignant pleural effusions. The patient went straight to a monitored bed. I'd like to see a PT manage that scenario.

 

[PublicHealth]

Originally posted by drusso
I had a with cancer and multiple medical problems who needed to leave the rehab unit because of respiratory distress secondary to recurrent malignant pleural effusions. The patient went straight to a monitored bed. I'd like to see a PT manage that scenario.

Of course PTs are not trained to manage such a scenario.

I'm just curious to know what you think about PTs gaining "Doctor" status.

 

[drusso]

On many rehab units there are neuropsychologists and speech-language pathologists who are PhD's and addressed as doctor. Patients seem to understand the difference between medical doctors and other doctors. If all else fails, the physiatrists are the ones carrying the stethescopes and reflex hammers---this is usually a dead give-away!

 

[bigdan]

Hi guys-
I, too, post with a disclaimer that I'm not a Physical Therapist, but I am intimately familiar with the profession - I work as an Occupational Therapist.
I - like many PTs and OTs - am very wary about the benefits and drawbacks of the DPT. As you know, the entry level degree of the PT profession is now a masters degree - the American Physical Therapy is pondering the enforcement of making the doctorate the entry level degree.
Numerous concerns abound. One is surely patient confusion. Another is level of "preparedness" of the DPT to handle direct access patients. Another is the actual benefit to the profession of PT.
Benefits will include greater access to PT services for the general public, a higher degree of (theoretical) knowledge of the clinical practitioner, and greater revenue possibilities for the PT.
They should never be confused with a PM&R physician. I would best call the DPT a "more educated PT" than any overlap with a PM&R (it is this very confusion that worries me about insisting on the DPT).
The actual concern I have is in regards to administration. In my geographic area, we'd pay a entry level PT between 38 -44K; I'm not sure how we'd be able to entertain a DPT, some up to 120K in debt from tuition loans, especially in light of ever shrinking reimbursement for rehabilitation services.
It will, no doubt, be intriguing to follow...

dc

 

[PublicHealth]

Originally posted by bigdan
Hi guys-
I, too, post with a disclaimer that I'm not a Physical Therapist, but I am intimately familiar with the profession - I work as an Occupational Therapist.
I - like many PTs and OTs - am very wary about the benefits and drawbacks of the DPT. As you know, the entry level degree of the PT profession is now a masters degree - the American Physical Therapy is pondering the enforcement of making the doctorate the entry level degree.
Numerous concerns abound. One is surely patient confusion. Another is level of "preparedness" of the DPT to handle direct access patients. Another is the actual benefit to the profession of PT.
Benefits will include greater access to PT services for the general public, a higher degree of (theoretical) knowledge of the clinical practitioner, and greater revenue possibilities for the PT.
They should never be confused with a PM&R physician. I would best call the DPT a "more educated PT" than any overlap with a PM&R (it is this very confusion that worries me about insisting on the DPT).
The actual concern I have is in regards to administration. In my geographic area, we'd pay a entry level PT between 38 -44K; I'm not sure how we'd be able to entertain a DPT, some up to 120K in debt from tuition loans, especially in light of ever shrinking reimbursement for rehabilitation services.
It will, no doubt, be intriguing to follow...

dc

While the American Physical Therapy Association (APTA) may be pondering the ENFORCEMENT of an entry-level DPT degree, their website seems to suggest that it is already underway:

http://www.apta.org/Education/dpt/dpt_faq

Here's the rationale for having entry-level DPT programs:

The rationale for awarding the DPT is based on at least four factors, among others: 1) the level of practice inherent to the patient/client management model in the Guide to Physical Therapist Practice requires considerable breadth and depth in educational preparation, a breadth and depth not easily acquired within the time constraints of the typical MPT program; 2) societal expectations that the fully autonomous healthcare practitioner with a scope of practice consistent with the Guide to Physical Therapist Practice be a clinical doctor; 3) the realization of the profession's goals in the coming decades, including direct access, "physician status" for reimbursement purposes, and clinical competence consistent with the preferred outcomes of evidence-based practice, will require that practitioners possess the clinical doctorate (consistent with medicine, osteopathy, dentistry, veterinary medicine, optometry, and podiatry); and 4) many existing professional (entry-level) MPT programs already meet the requirements for the clinical doctorate; in such cases, the graduate of a professional (entry-level) MPT program is denied the degree most appropriate to the program of study.

 

[nvrsumr]

If you want to be a fully autonomous healthcare practioner managing patients and receiving physician reimbursement it begs the question-Why would we need PTs/DPTs? We already have someone in the above role-the MD.

 

[PublicHealth]

Originally posted by nvrsumr
If you want to be a fully autonomous healthcare practioner managing patients and receiving physician reimbursement it begs the question-Why would we need PTs/DPTs? We already have someone in the above role-the MD.

Find me an MD who spends his or her full-time schedule conducting range-of-motion and gait training exercises with physically disabled patients!

Physical therapy is a necessary and essential component of physical medicine and rehabilitation. The rehabilitative process involves many different aspects of care, including but not limited to neurorehabilitation, speech-language assessment/therapy, occupational therapy, audiology, and nursing. Sure the almighty MD/DO tends to run most aspects of clinical care, but please don't discount the important roles of allied health professionals in rehabilitation medicine.

The fact that PTs want to gain "doctor" status is indeed questionable, and I'm curious to know how this change will affect the practice of physical therapy and patient perceptions of healthcare providers. Patient confusion aside, will doctoral training in physical therapy better prepare PTs with regard to clinical training and research? Will the additional training translate into better patient outcomes?

PH

 

[Ohiobuddhist]

I find this a most interesting topic. I am a second-year D.O. student myself and my girlfriend is a second-year D.P.T. student at the same university. So far, from what I have seen the DPT, in practice, offers little more than some additional coursework. Some of her new courses include further work in radiology, pharm, and path, but at least in her department, it seems that professors don't know what the end result of the DPT will be, so they have little guidance to help them with instruction of their students. As far as their clinincal work, it seems that they still perform similar, although I think more time-consuming clinicals. They are also required to contribute research to the field, something all "doctors" must do.

My girlfriend and I have had the whole "who's a doctor" conversation repeatedly, and I have found it to be pretty worthless. There are "doctors" of almost everything, and in the end patients don't really give a crap about the titles as long as they feel better at the end of the day. So there will always be a little pride issue here, but my suggestion is forget about it.

As an osteopathic student who is keenly interested in integrating manipulation into my practice, I have had to make the realization that no PM&R, family doc, or OMM specialist can do/has time to do everything that a rehabilitation patient needs. As a previous poster mentioned, that's why it's a healthcare team.