Possibly future DPT... questions

[lee9786]

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Hello everyone. I've been researching the possibility of entering the PT profession. The entry level degree is the DPT (Doctorate of PT). The APTA wants more autonomy among the PT profession and increase "direct access." The more research I do the more concerned I get. It seems as if the DPT is really just a big experiment. Other health professionals are feeling threatened by it. Some folks are saying that the DPT is even inadequate education to achieve what is asked by the APTA.

So my question to you is.... what do you think about the DPT mandate by the APTA? Do you think it will help the quality of patient care? Do you feel threatened in any way by this? Do you think the DPT will hold up (or go back to a Masters requirement) do to the increased cost to attain the degree without any increase in compensation?

Do you ultimately think the APTA has made a positive change for healthcare?

Thanks for your insight. Like I stated the more research I do the more uncertain I am that pursuing this career is a good idea. My thinking is that the DPT will not hold up because the barrier of entry to the profession is too high, the DPT means little to employers over the DPT or MPT, the cost of education exceeds the amount of compensation therefore making it difficult to simply pay off student loans after the eight years of being in school.

 

[2006MD]

There is a PT section in the "rehabilitation sciences" area of the SDN forum that should be able to help answer this question.

 

[ampaphb]

Hello everyone. I've been researching the possibility of entering the PT profession. The entry level degree is the DPT (Doctorate of PT). The APTA wants more autonomy among the PT profession and increase "direct access." The more research I do the more concerned I get. It seems as if the DPT is really just a big experiment. Other health professionals are feeling threatened by it. Some folks are saying that the DPT is even inadequate education to achieve what is asked by the APTA.

So my question to you is.... what do you think about the DPT mandate by the APTA? Do you think it will help the quality of patient care? Do you feel threatened in any way by this? Do you think the DPT will hold up (or go back to a Masters requirement) do to the increased cost to attain the degree without any increase in compensation?

Do you ultimately think the APTA has made a positive change for healthcare?

Thanks for your insight. Like I stated the more research I do the more uncertain I am that pursuing this career is a good idea. My thinking is that the DPT will not hold up because the barrier of entry to the profession is too high, the DPT means little to employers over the DPT or MPT, the cost of education exceeds the amount of compensation therefore making it difficult to simply pay off student loans after the eight years of being in school.

The DPT effort is all about "direct access". PTs want to no longer have to rely on physicians for there referrals. In the state of South Carolina, they convinced the state government to approve legislation making it illegal for physicians to employ therapists.

This has nothing to do with good medical practices, nor is it a "threat" any reasonable physician. Therapists get most of their referrals from orthopaedists or primary care physicians, not physiatrists. This is all about control, power, and money, not what's best for the patient.

 

[RUOkie]

There is one part of the direct access debate that does not get discussed. That is malpractice insurance. Most members of APTA have not given thought to what the insurance industry will do when the first spinal tumor is found after 2 months of ultrasound treatments. They get little to no training in diagnosing disease, they diagnose "dysfunction". Once any PT gets sued for malpractice or if their rates go up to what ours are, they will start insisting on physician referrals.

There is some degree of direct access here in OK. It is NEVER used by the PT's. In most cases in my community, if a patient calls one of the clinics without a MD/DO referral, they will have the patient call my office to make an appt.!! The PT's do not want the responsibility, and want good relationships with their physicians to build their businesses. In that respect APTA is out of touch with their own members.

This is an issue at AAPMR. At the last council of state societies meeting, direct access was the big topic. In states where direct access has been present for a long time, it is just not an issue.

 

[lobelsteve]

Talked to the PT in my office about this.

His thoughts:

PT in the military and overseas already orders imaging and has limited prescribing authority. They also do simple joint injections.

That baffles me.

 

[PMR 4 MSK]

There is one part of the direct access debate that does not get discussed. That is malpractice insurance. Most members of APTA have not given thought to what the insurance industry will do when the first spinal tumor is found after 2 months of ultrasound treatments. They get little to no training in diagnosing disease, they diagnose "dysfunction". Once any PT gets sued for malpractice or if their rates go up to what ours are, they will start insisting on physician referrals.

There is some degree of direct access here in OK. It is NEVER used by the PT's. In most cases in my community, if a patient calls one of the clinics without a MD/DO referral, they will have the patient call my office to make an appt.!! The PT's do not want the responsibility, and want good relationships with their physicians to build their businesses. In that respect APTA is out of touch with their own members.

This is an issue at AAPMR. At the last council of state societies meeting, direct access was the big topic. In states where direct access has been present for a long time, it is just not an issue.

Their insurance will never equal ours, because as a class, they will will not all do diagnosing. Many don't want the responsibility, so as a class, their risk will not be as high. The few that do may end up with higher insurance, but still may not be as high as ours.

Patients do not expect a PT to be 100% accurate. They will ive them more leeway. They do hands-on treatment and build trust via that. That likely means less risk of being sued - people don't sue people they like and trust. They do expect it of doctors. "Get it right the first time, or I sue."

 

[lee9786]

There is a PT section in the "rehabilitation sciences" area of the SDN forum that should be able to help answer this question.

Yes it actually is a pretty good forum and I've gotten a lot of information from there. I currently have a number of posts where I'm trying to figure out more about the PT profession, their policies, what they think about the DPT. I'm just trying to get some viewpoints outside of PTs that of which may be biased. I'm in a position of research where the more I read and learn the more I question my decision to spend 80k+ to attain a doctorate in PT. I am an over analyzer though. I need to all the details. Thanks everyone.

 

[ampaphb]

Their insurance will never equal ours, because as a class, they will will not all do diagnosing. Many don't want the responsibility, so as a class, their risk will not be as high. The few that do may end up with higher insurance, but still may not be as high as ours.

Patients do not expect a PT to be 100% accurate. They will ive them more leeway. They do hands-on treatment and build trust via that. That likely means less risk of being sued - people don't sue people they like and trust. They do expect it of doctors. "Get it right the first time, or I sue."

They will get it wrong more frequently, due to an inherent lack of being able to see the whole picture (when all you have is a hammer ...). They will, as a result, get sued more often.

The current perception is, doctors are the deep pockets, and PTs are minor players, not worth personal injury attorney's time. the more successful PTs get, the more that perception will change.

Most doctors are loathe to tell patients another doctor screwed up. It is unlikely the same professional courtesy will be afforded independent PTs.

Insurance companies will not lump all PTs into one class, they will stratify the risk, just as they do with physicians. The same way neurosurgeons and OBs are charged dermatologists, PTs who accept patients through direct access will undoubtedly pay higher rates than those who don't.

 

[DPTErudition]

Have any of you known a physical therapist that later ascended to the rank of physiatrist? I have heard of several pts later going on to med school, and it is my thought that it would make a good amount of sense to do so. It seems to me that the apta has a goal to make therapists more knowledgeable, but there is no substitute for the large amount of information that med school students are held accountable for. Physiatrists have a much higher salary than pts, but don't get as much patient interaction.
I personally am keeping the option open to continue schooling later on down the road, would I most likely need to make all As in pt school?

 

[PMR 4 MSK]

Have any of you known a physical therapist that later ascended to the rank of physiatrist? I have heard of several pts later going on to med school, and it is my thought that it would make a good amount of sense to do so. It seems to me that the apta has a goal to make therapists more knowledgeable, but there is no substitute for the large amount of information that med school students are held accountable for. Physiatrists have a much higher salary than pts, but don't get as much patient interaction.
I personally am keeping the option open to continue schooling later on down the road, would I most likely need to make all As in pt school?

We had a couple in my residency - 1 before me, 1 after. Both were good assets and brought new perspectives and knowledge.

Not sure why there is the perception physiatrists don't have as much pt interaction - I see pts all day, every day. I think many PTs do more paperwork than I do, so they might spend less time with pts.

 

[DOctorJay]

Have any of you known a physical therapist that later ascended to the rank of physiatrist? I have heard of several pts later going on to med school, and it is my thought that it would make a good amount of sense to do so. It seems to me that the apta has a goal to make therapists more knowledgeable, but there is no substitute for the large amount of information that med school students are held accountable for. Physiatrists have a much higher salary than pts, but don't get as much patient interaction.
I personally am keeping the option open to continue schooling later on down the road, would I most likely need to make all As in pt school?

I'm an MSPT who went to DO school, is in internship now, and will start PM&R residency next year.👍

 

[Ludicolo]

We get a PT turned MD or DO every so often in our residency program. I had one former PT in my med school class. While the decision to transition from PT to med school and then PM&R seems natural, I know of some former PTs that ultimately decided to pursue other specialties like radiology, FP, or EM.

Not sure why there is the perception physiatrists don't have as much pt interaction - I see pts all day, every day. I think many PTs do more paperwork than I do, so they might spend less time with pts.

In the outpatient setting, PTs may see a given patient ~2x/week for 4-6 weeks. So yeah, they do interact more with an individual patient in that time frame than the physiatrist does. But a busy physiatrist sees a greater volume of patients, thus directing care to a larger overall patient population than a PT would. We also continue to follow a lot of these patients along their entire continuum of care, including chronic management of whatever disability these patients have. These patients are not plugged into PT forever. In this regard, we certainly establish lasting relationships with our patients.

And believe me, if you do this long enough, there are some patients with whom you would rather not interact at all…