I have been doing a little research lately about the topic of direct access. This discussion truly embodies the discussions that are taking place between several different medical professions vs Physical Therapist. As PT has grown to MPT and then to DPT over the course of 10 or more years now, there have been disagreements and blurred lines, which is seen in the varied laws from state to state. In the end, it seem that no single profession is trying to take over another, yes there is some overlap. The biggest concerns are about patient care, who is best suited for what. Will a DPT miss the signs of a stroke or heart attack? Doctors of other professions that have the ability to medically diagnose and to write prescriptions are acting protective, which could be interpreted poorly, but should be celebrated. It should be viewed as great for the pt, right? I want my doc to be looking out for me AND I want to be able to chose which path my medical care takes, what is good for me, may not be what is good for another. Eastern, Western, Holistic, ect... pt's should be able to be proactive in their care. And as a DPT we need to be aware of medical issues that are beyond our scope and know when to send the pt to a better qualified professional.
Further support for direct access, in current research data shows, people that are using direct access or "self referral" are more inclined to stick to their home exercise programs, take less time off of work, cancel less, and get better faster. In addition, research shows that pt that can self refer, and do not see an MD first are less likely to undergo costly imaging and therefor surgery for back pain (which is sometimes unnecessary). However, I sure would feel bad if I missed one of these big ones and it cost someone quality of life or worse, should I have misdiagnosed or felt I could treat a condition that I was beyond my scope of practice.
It is my understanding that the main push for the DPT degree (rather than Bachelors or Masters PT degrees) is to create graduates and professionals with the training to provide a more viable medical practice, DOCTORS. It is going to take time, as any growth does. Personally, I am becoming a DPT because I desired more knowledge (beyond my current position), and I love all aspects of Physical Therapy, growing pains included. It is important to remember that even with direct access or "self referral", many pt still pay a cash rate because it is still not recognized by some insurance companies. They will NOT pay for PT without a MD (or other medical doctor rx). Typically the rate is more than a pt can afford. This battle is not won yet. Additionally, PT practice is still not being recognized for some government funding that other forms of medicine are benefiting from, ie help in the transition to EMR, which will make the communications between different doctors easier and ergo better for the patients overall care.
To the OP, you should ask yourself what you love. If you are unclear of the myriad of different avenues that DPT can take, do some more observation hours. Maybe you have dollar signs in your eyes... In the sports clinic I worked in as an Aide/Tech, the ATC was on the same rate of pay that I was (no letters after my name yet), and it was not very much. But the education to get a DPT is not cheap either. DPT still has alot of kinks to work out, but the research is being done. Are you willing to stand behind the profession that you chose? You will figure it out, no rush until you do.
