DPT degree in practice for PTs

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ProZackMI

ProZackMI

Psychiatrist/Attorney
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There have been posts on here before about the new DPT degree and many have said it's unnecessary, etc., but I actually encountered a PT with this degree today at a conference about special education services for children. This PT, a woman of about 45 or so, earned her DPT degree at Oakland University. She said that she had an MPT degree and had been practicing for many years and recently went back to school and got this transitional DPT (I believe that's what she called it) degree.

She sure introduced herself as "doctor" more than anyone else at the conference (MDs, PhDs, EdDs, PsyDs, DOs, etc.), but appeared quite knowledgeable. I guess my question is, are these new DPTs actually referring to themselves as "doctor" in clinical settings, whether in hospitals or clinics, or do they still go by their first names? I'm just wondering what PTs think of this and what patients think of the change. I'm sure it's not really confusing, but I really wonder if a doctorate is necessary for PT practice. It sure seems like every health care profession is jumping on the "doctor" bandwagon and I'm not sure it's the right move to be taking.

Audiologists (AuD) and occupational therapists (OTDs) seem to be doing the same thing. I've even seen discussion on this forum about DNP (Nursing Pract.) programs cropping up. Do you folks out there think this is a good thing? Do you think it's necessary to compete with MD/DOs? Do you think this will create better services for patients? Will it save money? Or is this just degree inflation? I'm not sure what to think about all these changes in health care. It seems to be somewhat of an overkill IMO.

Just curious.
Zack
 
Back to my pool and Barbeque........
P.S. - Happy Memorial Day Weekend!
 
Bottom line is everybody wants the doctor title without working for it.

I guarantee you in 5 years we'll have "PARAMEDICAL DOCTOR" where ******* paragod jockeys can run around calling themselves "doctor"

Its all quite ridiculous.

I'm sure the PA programs are also dreaming about transitioning to a "doctoral" program. They'll probably add on one extra year and then try to pass it off as a real doctorate.
 
MacGyver said:
Bottom line is everybody wants the doctor title without working for it.

I guarantee you in 5 years we'll have "PARAMEDICAL DOCTOR" where ******* paragod jockeys can run around calling themselves "doctor"

Its all quite ridiculous.

I'm sure the PA programs are also dreaming about transitioning to a "doctoral" program. They'll probably add on one extra year and then try to pass it off as a real doctorate.
Click to expand...

please dont insult me....
i wanna obtain a Doctorate in Physician Assistanting lol

aside
i dont see PAs doing that soon though, most "online" PAs find the DNP thing a tad "strange".
 
The (D)NPs have already blown their feet off on that one. "We're more cost efficient than MD's, yet we now want equal reimbursement because of our new paper". WTF?!!!! PAs = "Partner$ in Medicine" 🙂
 
ProZackMI said:
There have been posts on here before about the new DPT degree and many have said it's unnecessary, etc., but I actually encountered a PT with this degree today at a conference about special education services for children. This PT, a woman of about 45 or so, earned her DPT degree at Oakland University. She said that she had an MPT degree and had been practicing for many years and recently went back to school and got this transitional DPT (I believe that's what she called it) degree.

She sure introduced herself as "doctor" more than anyone else at the conference (MDs, PhDs, EdDs, PsyDs, DOs, etc.), but appeared quite knowledgeable. I guess my question is, are these new DPTs actually referring to themselves as "doctor" in clinical settings, whether in hospitals or clinics, or do they still go by their first names? I'm just wondering what PTs think of this and what patients think of the change. I'm sure it's not really confusing, but I really wonder if a doctorate is necessary for PT practice. It sure seems like every health care profession is jumping on the "doctor" bandwagon and I'm not sure it's the right move to be taking.

Audiologists (AuD) and occupational therapists (OTDs) seem to be doing the same thing. I've even seen discussion on this forum about DNP (Nursing Pract.) programs cropping up. Do you folks out there think this is a good thing? Do you think it's necessary to compete with MD/DOs? Do you think this will create better services for patients? Will it save money? Or is this just degree inflation? I'm not sure what to think about all these changes in health care. It seems to be somewhat of an overkill IMO.

Just curious.
Zack
Click to expand...

Zack,
Since nobody has answered any of your questions, I have a friend who is a DPT and she laughs at the idea of anyone calling her "doctor". The DPT is just the new requirement that the APTA is calling for the physical therapy programs to implement in case their wishes to have "direct patient care" is passed through legislation. They are hoping to one day have patients come directly to PTs, like they do a chiropractor, to be treated without your initial referral.

It may possibly be degree inflation and in some cases I feel it is hurting our local physical therapy program because many students do not want to go to school for a total of 8 years to just become a practicing PT making the same salary as their BS and MS counterparts. I would say the majority of PTs just want to treat patients and the DPT is just the path they need to follow. Unfortunately, like the lady you encountered at the conference, there will be people who expect to be called "doctor" and maybe that is just her way of being proud of her hard work to actually get the doctorate degree.

Is it good for health care in my opinion? No. But a lot of things aren't good for health care in my opinion.
 
In addition, a DPT is required by some PT schools to teach. The APTA is pushing to have the DPT as the entry level degree, but they only just made the MS the entry level degree in 2000. Likely, the DPT won't be an entry level degree for some time. Different DPT programs emphasize different things, because the APTA only requires specific courses for the MS degree. This can be advantageous to the student that knows exactly what they want to do out of school.
Calling yourself a doctor is a silly notion to begin with, no matter what your educational background. Mostly this causes superiority/inferiority complexes, and sometimes confuses people. Should I introduce myself as "doctor" with my PhD? How about a DPM? What constitutes the requirements to push a professional title on someone else. Why not just serve another person professionally and passionately?
 
guetzow said:
"MD"s are called 'Doctor'.
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When I meet someone, anyone, socially or at a conference, and they introduce themself to me as "Dr. X" I immediately have a sense that they need to somehow try to impress me with their station. It shows lack of humility or worse, a lack of self-esteem. As if they aren't good enough to stand on their own and have to augment their personality with a title. If I ask someone what they do for a living and they say they are a doctor, I then ask what kind of a doctor.

Sometimes they say veterinarian, sometimes chiro, sometimes physician. The term doctor is becoming an antiquated term representing only academic achievement, not a profession.

I have a DPT and never ask to be called, or introduce myself as doctor. It is misleading and the woman ProZack mentioned above is a loser with no self-esteem and I would say, not the norm.
 
It's natural for an MD to call themselves 'Doctor', because that's what they are...... "they need to somehow try to impress me with their station. It shows lack of humility or worse, a lack of self-esteem". Uh.....that would be people who are "Not" MDs. Are DPTs practicing psyche now, too? 😉
 
You agree that Medical Doctors should not introduce themselves as Doctor?
 
Two things:
1) folks who get hung up on this generally hang their self-esteem on the title.
2) define "medical doctor"
 
guetzow said:
You agree that Medical Doctors should not introduce themselves as Doctor?
Click to expand...

In their work setting, they should or could introduce themselves as doctor. However, at the golf course for example, if someone introduces themself as doctor, I would think that would be a bit over the top.

How about if you are meeting someone socially and they say to you, "Hi, I am Mr. so-and-so" Is that not a bit off-putting?

I have no problem giving the MDs and DOs their due respect. They have training that I do not have and did not seek to have. They deal with life and death and chronic disease etc . . . I have a different skill set. I have reached a terminal degree. My self esteem does not rest with my degree.

The DPT was not established or recommended to be a threat to anyone. I don't get the defensiveness.

Why do you think DCs introduce themselves as Dr X? I think that for those who do, it is because the title confers automatic authority. Many of my patients have called me doctor well before I got my DPT. I always corrected them. If someone calls me doctor now, I say that the real doctors work over there (indicating the medical clinic).

And frankly, if someone says that "Dr. Y said . . ." referring to a chiropractor, I tell them that they are no more a doctor than I am.
 
guetzow said:
It's natural for an MD to call themselves 'Doctor', because that's what they are...... "they need to somehow try to impress me with their station. It shows lack of humility or worse, a lack of self-esteem". Uh.....that would be people who are "Not" MDs. Are DPTs practicing psyche now, too? 😉
Click to expand...

You really seem to have either a lack of knowledge or a lack of respect for a member of your health care team. PTs take 17+ hours of psych before entry. Learning how to motivate a patient takes skill and training. So, yes, in a sense, we practice psych everyday. Do you disagree with the premise? Or do you think that the bricklayer who tells you how good he is will really be good or is he inflating his sense of self worth?
 
No, just sticking up for the as-you-have-painted-them, Lowly MDs 😉
 
This may be getting close to trolling.
I would say that we have a difference of opinion. That's okay.
 
guetzow said:
No, just sticking up for the as-you-have-painted-them, Lowly MD 😉
Click to expand...
I'm not saying anything about a "lowly MD" as you have characterized it. I have clearly stated above that I tell my patients that the real doctors work in the medical clinic. that means the MDs. I have the utmost respect for what they know and do. The problem I have is that some artificially create differences in station between themselves and others by insisting upon being called doctor in non-professional settings. I have a problem with that with optometrists, dentists, physical therapists, PhDs in theology etc . . . It is about pretension, not about an opinion that the are "lowly" that is your word and one I object to.
 
O-tay. I though you were bashing MDs. There was no distinction in your earlier posts. Those 'Other guys' ARE pretentious, because they're NOT MDs. My point exactly ! 🙂
 
guetzow said:
O-tay. I though you were bashing MDs. There was no distiction in your earlier posts. Those 'Other guys' ARE pretentious, because they're NOT MDs. My point exactly ! 🙂
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I think my earlier post was fairly clear. In fact I specifically discuss asking them what type of doctor they are. ANYONE who introduces themselves to me at the grocery store as Doctor X is pretentious. Their profession (in the case of MD or DO) is physician. There degree is doctor. So is mine.
"Hi, my name is Bill."

"Hi Bill, its nice to meet you, what do you do for a living?"

"I am a physician."

There, nice and friendly, no pretensiousness
 
Isn't this whole debate mind-numbing. Further, why is a person who deliberately avoids using the Dr. title anymore "secure" than a person who deliberately uses the title. Lets face it...in todays system, the title Dr. is in no way reflective of how smart or knowledgable an individual is!
 
lawguil said:
Isn't this whole debate mind-numbing. Further, why is a person who deliberately avoids using the Dr. title anymore "secure" than a person who deliberately uses the title. Lets face it...in todays system, the title Dr. is in no way reflective of how smart or knowledgable an individual is!
Click to expand...

Agreed
 
If you have a legitimate doctorate, then you call yourself Dr. so and so....simple as that. I do not mind anyone calling me by my given name, but do not think Mr. psisci is appropriate. Medical doctors have the least educational right to call themselves doctor the world around, but culture feels that Dr=MD. What about DO's, PhD's,DDS's DPT's??? Stop feeling insecure and Dr up.

🙂
 
psisci said:
If you have a legitimate doctorate, then you call yourself Dr. so and so....simple as that. I do not mind anyone calling me by my given name, but do not think Mr. psisci is appropriate. Medical doctors have the least educational right to call themselves doctor the world around, but culture feels that Dr=MD. What about DO's, PhD's,DDS's DPT's??? Stop feeling insecure and Dr up.

🙂
Click to expand...

People who go around using their title in non-work related situations are pompous -- this goes for MDs, PhDs, DPTs, DDSs, etc. No need for that level of formality outside your professional life.

I guess my whole point for making this post was to find out whether practicing DPTs actually prefer the new title, or if they find it confusing for their patients (and perhaps other medical practitioners). Personally, if one has earned a doctoral degree, he/she should be able to use the title when appropriate.

I also wonder if the DPT is really necessary for PT practice. It sure seems like so many professions are now requiring doctoral degrees without a legitimate need for the change in degree status. It also makes it harder for many entering certain professions to pay for school!
 
To answer your actuall question, no-DPT is in no way needed for PT practice. I am a PT (and now an M4) and I recieved a masters in PT. For what I actually did in practice I felt I was WAY over educated. PT should be a 4 year BS program. You will see a huge shortage of PT's because it is a rediculous investment to come out after 8 years and make 50 grand. The APTA is behind this and all members (like myself) should protest.
Oh, and since I have a masters, it is Master Farbar to you.
 
Average entry level pay now in CA is 70k.
The DPT degree is well suppported by the APTA in it's 2020 vision. The goal of this program is to have PTs be primary care for Pts. Allowing them to come to the DPT without a referral. The extra training includes xray, pharm, and extra diff dx. Some programs incl. extra research.
Having taught undergraduate students, my worst fear would be to have them treating Pts. I don't feel as though I'll be overtrained/educated, but if that is the case...then Pts will only be better for it. I believe that the cost/benefit ratio of DPT is well worth it over an MD. Less insurance coverage, and more pay for my years of education. If that is your only concern 😉

Mac
 
Toran said:
Average entry level pay now in CA is 70k.
The DPT degree is well suppported by the APTA in it's 2020 vision. The goal of this program is to have PTs be primary care for Pts. Allowing them to come to the DPT without a referral. The extra training includes xray, pharm, and extra diff dx. Some programs incl. extra research.
Having taught undergraduate students, my worst fear would be to have them treating Pts. I don't feel as though I'll be overtrained/educated, but if that is the case...then Pts will only be better for it. I believe that the cost/benefit ratio of DPT is well worth it over an MD. Less insurance coverage, and more pay for my years of education. If that is your only concern 😉

Mac
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don't get me wrong, i think PT is a great profession and very necessary. but, if you think PT's will ever become "primary care" and be reimbursed for direct access, you are living a dream. the bottom line with PT is "get them out of bed and moving so we can D/C them". sure, there are specialized areas with much greater skill level but this does not represent the majority of PT jobs. i practiced PT for 5 years and when i entered PT school in 1997 they were touting this direct access crap. no insurance company will ever reimburse PT's w/o an MD referral.
 
Farbar said:
don't get me wrong, i think PT is a great profession and very necessary. but, if you think PT's will ever become "primary care" and be reimbursed for direct access, you are living a dream. the bottom line with PT is "get them out of bed and moving so we can D/C them". sure, there are specialized areas with much greater skill level but this does not represent the majority of PT jobs. i practiced PT for 5 years and when i entered PT school in 1997 they were touting this direct access crap. no insurance company will ever reimburse PT's w/o an MD referral.
Click to expand...
This is a very narrow minded view of PT. I feel bad for you if this is all you were exposed to in your five years of practice. As far as the DPT goes, I agree that at this point the doctoral degree should not be mandatory and that it is completely ridiculous and misleading for any PT to call themselves doctors in any clinical situation. If the doctoral programs evolve into degrees that actually give the PT's better knowledge and skills to enter the clinic with, then I am all for it. In the meantime I personally would not spend the time or money to go back for my doctorate, as I do not see enough benefit vs. the cost of doing it.
 
Farbar said:
don't get me wrong, i think PT is a great profession and very necessary. but, if you think PT's will ever become "primary care" and be reimbursed for direct access, you are living a dream. the bottom line with PT is "get them out of bed and moving so we can D/C them". sure, there are specialized areas with much greater skill level but this does not represent the majority of PT jobs. i practiced PT for 5 years and when i entered PT school in 1997 they were touting this direct access crap. no insurance company will ever reimburse PT's w/o an MD referral.
Click to expand...

I work in a rural hospital with about 25 beds. I do see inpatients but the vast majority of my business is outpatient orthopedics. I have the luxury of working with 6 family practice MDs and two NPs who basically defer the ortho evaluations to our department. So, the comment about the "bottom line "as you put it is really off base.

Also, i disagree with you when you say that direct access will never happen. And, I don't really see that as primary care as implied in the posts above. I see it as a triage tool to take the lateral epicondylitis patients off of the MD's schedule and allow the patient to chose a different type of provider and save the $$ of the office visit. And BTW, there are already some insurance companies that reimburse without referral. What about the uninsured patient? this also potentially saves them time, and $$.
 
Tsk Tsk Tsk... Sounds like poorly trained (Or Lazy...) PCPs. Even FP folks should be able to eval/develop plan of care for MOST ortho/sports med conditions. This is very sad...














P.S.- "What about the uninsured patient?"......'Our' PTs are capitalists. They don't work for free (Freeee!!??? BooooHAHahahahaha!!!!).
 
guetzow said:
Tsk Tsk Tsk... Sounds like poorly trained (Or Lazy...) PCPs. Even FP folks should be able to eval/develop plan of care for MOST ortho/sports med conditions. This is very sad...
















P.S.- "What about the uninsured patient?"......'Our' PTs are capitalists. They don't work for free (Freeee!!??? BooooHAHahahahaha!!!!).
Click to expand...


No, not at all, its just that their area of expertise is elsewhere. Why should they be expected to know more about my area of expertise than I do?

Who in their right mind thinks that MDs should know everything??? They are smart and well trained. They do not have the time or inclination to determine SIJ pain from a facet pain. That is my job. Their job is to rule out medical pathology. If they come to me first, my job is to look for medical red flags and then finding none, to differentiate between different types of mechanical pain, then treat it.

Develop a plan of care? When I get those from MDs or PAs they are usually disregarded because rehab is what I do. What I want to know from the surgeons is what they specifically DON'T want me to do. Otherwise, I am responsible for my actions and will not be told how to do my job by someone from another profession.
 
Yes, that's what PCPs do. This includes whether or not they need PT. In fact, "Rural PCPs" have a long, proud REP of doint MORE, because of their location and lack of immediate access to resources. This includes, for example, LAC repair (In facial areas) and Derm procedures that City PCPs wouldn't touch with a ten foot pole.












P.S.- There is a TONNNN more to being a good PCP than a little IM and medication adjustments.
 
guetzow said:
Yes, that's what PCPs do. This includes whether or not they need PT. In fact, "Rural PCPs" have a long, proud REP of doint MORE, because of their location and lack of immediate access to resources. This includes, for example, LAC repair (In facial areas) and Derm procedures that City PCPs wouldn't touch with a ten foot pole.












P.S.- There is a TONNNN more to being a good PCP than a little IM and medication adjustments.
Click to expand...

Of course there is. Remember this is not a power grab. You seem to think that it is. Relax, we are part of the same team. You write as if you are threatened by something.
 
Who is threatened?... Besides, my scrips are usually "Evaluate and Tx", giving the PT full leverage to do 'Therapy' in their shop. However, this does not extend to ordering imaging/tests/labs/prescribing meds/Procedures/i.e. - "Practicing Medicine".
 
Currently, I'm working in one of the best hospitals in the country. This week the PM&R dep folks from PT had to convince the resident that Pt needed an xray after a fall. In fact the xray had been ordered, but not even done because the resident didn't think it made sense at the time. There was a clear Fx on film.
DCs can order films...Should PTs be able to?
Does it facilitate their ability to do their job (outpt, rehab, sports...to rule out Fx before referral?)

Mac
 
Toran said:
Currently, I'm working in one of the best hospitals in the country. This week the PM&R dep folks from PT had to convince the resident that Pt needed an xray after a fall. In fact the xray had been ordered, but not even done because the resident didn't think it made sense at the time. There was a clear Fx on film.
DCs can order films...Should PTs be able to?
Does it facilitate their ability to do their job (outpt, rehab, sports...to rule out Fx before referral?)

Mac
Click to expand...

DCs can order films, but they can't treat fractures. Neither can (in the acute phase) a PT. I don't see how being allowed to order a test on whose results you are unable to act serves the patient. In theory, chiropractors are ordering films to make chiropractic diagnoses, not to detect fractures.

Let me give you a realistic scenario based on PT ordering films. A film, let's say a hip, is ordered by a PT. The radiologist reads it as negative, but the PT feels it shows an impaction fracture of the humeral head. What now? If a physician orders the test, a referral can be made anyway (physician to physician) without the radiologist. Which physician will provide this for the PT (and if there is one who will, then that physician should order the film in the first place).

😎
 
Toran said:
Currently, I'm working in one of the best hospitals in the country. This week the PM&R dep folks from PT had to convince the resident that Pt needed an xray after a fall. In fact the xray had been ordered, but not even done because the resident didn't think it made sense at the time. There was a clear Fx on film.
DCs can order films...Should PTs be able to?
Does it facilitate their ability to do their job (outpt, rehab, sports...to rule out Fx before referral?)

Mac
Click to expand...

So you're a hero for a day! Perhaps we should give PT's script rights too.. You can always come up with all these little scenerios where it sounds like it would make sense, but it doesn't
 
lawguil said:
So you're a hero for a day! Perhaps we should give PT's script rights too.. You can always come up with all these little scenerios where it sounds like it would make sense, but it doesn't
Click to expand...

I'm sorry, but you only weaken your argument when you attack me after making a point (ad hominem).
I posed my post as a question, you went further.
The question of ordering films is not mine, but of my (PTs) organization. PTs are able to tx acute Fx....so, if there is an acute Fx detected on film.... Further, PTs in some DPT programs are extensively trained in radiology... they would send it off to the FP for further care... IF NECESSARY.
The FP could be cut off from the loop in some Fx cases, where the PT could take care of them out pt.

I think I left enough scenarios in there, with plenty of possibilities, that no one would be a "hero". We would all just be doing our job.
 
what exactly do you consider Tx for an acute Fx that a PT would be doing?

I think most would agree that a pt who has suffered an acute Fx would be in a significant amount of pain and would be best served by someone who can stabilize the Fx AND provide a strong analgesic (which requires a script) as well as follow up care/referral to ortho.
 
Osteoporosis Fxs would be an excellent example. My 76 yo pt comes in, with an extreme kyphosis. She says that she heard a crunch last night in her back..but has little pain to complain of today. Her hips are worn down, and she isn't as active as she once was.
I order a film to verify what I'm thinking is going on in her thoracal vert. (Fx) to tx accordingly. By positioning her I am able to put her in a position of comfort, and even prevent possible future Fx through extension exercises.

I have avoided the extreme expense to the pt of the FP.
This is not a comminuted, or complex, Fx... but geriatrics happen.. more often than you might want to think about.
 
Says who?....A 'Therapist'!?.... "This is not a comminuted, or complex, Fx..." (It's nice if you can read xrays, but An Orthopod or MD makes that call),"The FP could be cut off from the loop in some Fx cases" (It is NOT the role of a 'Therapist' to make that decision), "PTs in some DPT programs are extensively trained in radiology..." (And RNs are trained 'extensively' in pharm, but they don't practice medicine/write scrips...RTs are extensively trained in ventilator management, but they follow pulmonologists orders)


You can see where this is going folks..... This is exactly what I have posted about (PTs insinuating their way into practicing medicine). This guy has compleeeetely overstepped his bounds as a "THERAPIST".
 
Where is the problem with a PT/RN/RT treating patients? Are you afraid:
of losing money?
of losing power?
of quality pt tx?

I like this debate. I think that this is getting closer and closer to the heart of the DPT/primary care/MD debate. Although there sometimes appear to be egos envolved, where the pt should be in the "spotlight"
 
You, and obviously a few others, are not satisfied in your role as a "Therapist". Beating away at this sad old drum merely makes it harder for those who 'want' to be therapists. Trying to run a Sports Medicine or Orthopod practice as a PT is as ridiculous as a fish out of water. I'm sure there are many Orthopedic, or Sports Medicine "MD Programs" that would be thrilled to have applicants of your talent.
 
I recently graduated with a DPT and wish to never have the responsibility of a physician (while being a therapist). I do have to admit that a DPT's training in orthopedics is top notch. Those with the OCS certification tend to be even better. I would like to hear comments on this article

A description of physical therapists' knowledge in managing musculoskeletal conditions

http://www.biomedcentral.com/1471-2474/6/32

View in PDF as the charts are easier to read.
 
The study also made no mention of Sports Medicine Docs. Furthermore, ..."completed a standardized examination assessing knowledge in managing musculoskeletal conditions". Again, they were 'told' they were musculoskeletal conditions. What if they were Rheumatic, Neoplatic, or Infectious conditions? And Lastly, "This same examination has been previously been used to assess knowledge in musculoskeletal medicine.....across a variety of physician specialties" ; i.e.- Who cares if an ENT or Dermatologist knows Ortho? Garbage In, Garbage Out.....
 
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