Why the switch?

Discussion in 'Physical Therapy' started by jles, May 4, 2007.

  1. jles

    jles Dr of Physical Therapy
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    Hi everyone, I've been exploring these boards for some time now, and this is my first post. Just a little background... I'm 28, and have a bachelors of music degree in jazz studies. I've worked various jobs, business, cruise ship gigs, and other musical gigs, none of which have brought satisfaction, and finally, I'm closing in on a calling in the medical field. It's a very exciting time for me right now, and I'm enjoying taking science prereqs and observing the field of physical therapy where I have about 70 hours. I have already taken the GRE, and was planning to apply to PT school in December with two prerequisite courses to complete in the spring.

    Something I've noticed on these boards, is that there are a number of PT's turned MD/DO, and although I've found where this has been discussed somewhat on SDN, I seek further explanation. What is it that is lacking which has moved many to pursue medicine? (I was thinking that the representation of PT's on this board might be skewed, since maybe the satisfied PT's have no need to be here, but that's just a thought.)

    Basically, I'm now looking at medicine for myself, and all aspects of such a career path, of which, as everyone knows, are many. This inquiry is partially the result of my readings here, which initiated exploration into medicine, but now comes from a genuine interest in the profession.

    I'll now stop the rambling, and appreciate any thoughts/links to posts I might have missed...

    Thanks
     
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  3. biogirl215

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    I've been wondering something similar but with regards to OTs, not PTs.
     
  4. lightthelamp4

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    I can only speak for myself, but I will tell you honestly how I feel.
    I am lucky enough to work at a place where I get to do a mix of acute care, transitional rehab, long term care and sports medicine/outpatient ortho pretty much every day.
    I find acute care and rehab to be very monotomous; although there is alot more to think about as far as acute medical contraindications and such, for the most part patients are treated in very similar fashions despite dx. Our full time outpatient therapists sometimes refer to it as "drag and drop" therapy. While I feel that is a pretty ****ty demeaning sort of thing to say; part of me agrees. Also, it is very easy to forget alot of therex and modalities that you learn in school in a short time working acute care.

    Outpatient work for me is generally pretty fullfilling. I get frustrated however dealing with chronic pain issues/recurring sx's. I do alot of aquatic therapy at our sports medicine facility; which is something I do enjoy.

    Long term care is definitly my least favorite environment to work in; I wont even bother to write too much but take what I wrote about acute care and multiply it by 1000.


    Its late and I have been doing chemistry for 2 hours, I will repost about why I chose medicine here tomorow
     
  5. bigdan

    bigdan SDN Donor
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    I'll share my thoughts, for what they're worth.

    I did OT for 7 years before medical school. I loved the work - rehabilitation is one of few professions where you do TRULY get to help people. Someone comes into the clinic and cannot dress/walk/talk/etc and YOU play a main role (or the main role) in improving that. I worked in an outpatient clinic to start, doing neurorehab most of the time, but also covering nursing home, preschool, early intervention, and home adaptation contracts. AWESOME experiences. Then I did administration (at the same place) - big boss, good money, nice to try my hand at organization and administration. Then a year working outpatient in Portugal. Then a year of mainly inpatient and acute care in a hospital.

    I was VERY PROACTIVE in pursuit of continuing education, but still found that I did not NEED to be up on things to practice my profession, and in fact, most of my peer group were not interested in advancing their education. While I enjoyed a broad range of experiences, I wanted a little more autonomy and a lot more satisfaction of my curiosities about the human body. I'd find myself starting to read a chapter on stroke rehab, but I would end up in a chapter on the mechanism of action of antispasticity drugs; or ask a doc about a type of splint, but then end up talking about the radiology of hand fractures. I just need more out of my day-to-day than I was getting.

    ABSOLUTELY made the right choice. I can't say I WANT to spend everyday in a cubicle for 12 hours (board exam prep now make this worse than ever!), but I am learning TONS about science and the human body. I like doing what I am doing. Yeah, I'll always work more than 40 hrs a week as an MD, and residency will suck, and I will be sued - none of those are/were isssues in OT. But I like the upside better.

    Sorry for rambling...I spent (literally) years making the decision to switch, and so I would love to chew the fat with folks in the same spot that I was recently in.

    Best of luck to all, in whatever you choose to do!

    dc
     
  6. jles

    jles Dr of Physical Therapy
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    First off, sorry about taking so long to reply.
    Lightthelamp4, I would definately like to hear more about why you chose to pursue medicine. Bigdan, I appreciate the insight into your decision. As I continue to complete science prereqs, and application time draws nearer, I'm wondering if I might find myself as a physical therapist looking for more as you were. I'm looking to shadow some physicians if possible, as I feel that it is crucial to making a solid decision. Hopefully this will happen soon.

    Have either of you felt limited in your ability to help people as a PT/OT, with regards to knowledge, job scope, etc...?
     
  7. bigdan

    bigdan SDN Donor
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    j-

    I was limited in the sense that I wanted to know more. But there is a role we each play. If docs could do PT and OT, they would (read: they'd learn it if they could get paid well for it). So I did well with my role as an OT in rehab, even getting to the point where a couple of docs I got close with would call me about whether I thought I could help a patient before they referred that patient. My basic science knowledge was, compared to what docs learn(hell, even compared to what PTs learn) clearly quite a bit lower. But experience means TONS, and I did very well by learning on the fly, and being a creative thinker (which is the hallmark of a good OT, imho).

    The "knowledge thing" is interesting. Going thru the process of medical school now, I have yet to see where knowing about the phenylalanine mutation in the 508 position of chromosome 7 will ever help me treat a patient with CF, but I am willing to have my mind changed...

    dc
     
  8. delicatefade

    delicatefade ASA Member
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    For me, it had a lot to do with my personality. To be a PT/OT you have to really like spending extended periods of time with patients, particularly if you are going to work in acute care or inpatient rehab. Certain outpatient jobs may be an exception depending on how much you utilize PTA's and COTA's.

    I worked in inpatient spinal cord injury rehab. Very rewarding job; it was amazing to start working with a patient who could literally do nothing for himself and end up several months later with someone who had truly maximized his functional potential. Not everyone is like this, but my personality is such that I am drained by constant interaction with others. I need alone time to recharge. And I just couldn't get that when I was spending 1+hour per day with each patient. Then again, others love that and can't imagine doing anything else.

    That was part of it for me. I know there are other PT jobs that were unlike mine but I had also worked in general inpt rehab, outpatient, and acute care at my same job and didn't find much more satisfaction in any of them.

    The other issue was similar to bigdan's. It's not that PT/OT's don't know a lot. They really do. I just found myself uninterested by the fund of knowledge I had obtained, I had no desire to further my knowledge through continuing education, and like bigdan, I found that I actually didn't really need to further my knowledge in order to perform my job.

    Medical school was the best decision for me. I love what I'm doing, I love what I am learning, and I'm happy to be seeing patients again on rotations. Typically physicians don't spend as much time with patients, and for me that is a perfect fit. I truly enjoy helping people with their illnesses and problems but I just have more satisfaction in being able to do that in shorter blocks of time if that makes any sense.

    Don't let anything here persuade you either way. Shadow some PT's and try to imagine yourself doing that job 15 years from now. Shadow some physicians and do the same. Hopefully that will help. Good luck.
     
  9. jles

    jles Dr of Physical Therapy
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    I tell ya, it's like one day there is clarity in which way to go, and then a minute later, say, after reading two threads discussing whether physicians would go through med school, internship, residency etc...all over again, I'm swayed back. If anyone's interested, here are the threads I was referring to: (http://forums.studentdoctor.net/showthread.php?t=195799
    http://forums.studentdoctor.net/showthread.php?t=287350)

    Delicatefacade said it, "Don't let anything here persuade you either way. Shadow some PT's and try to imagine yourself doing that job 15 years from now. Shadow some physicians and do the same." This easily happens on here, as there are so many different perspectives available, with cogent arguments for each side.

    It's really the truth, and sure, as docwagner mentioned in another post, referring to the hard times in medicine: "Sure, when things sucked in school or residency, I would have LOVED an easier way...but when the LONG TERM goals are achieved...it really is fantastic." There will be good/bad, but eventually satisfaction with having achieved such a goal. Questions about would you do it again are perhaps unrealistic/fantasy, but soooooo interesting to read.

    Of course, this applies to life in general and everyone already knows this.

    Let's just say that I think that reading more on these boards to help with my decision is going to be the same experience from here on out: a roller coaster. Pretty much the point I'm at requires that I shadow a physician, and see how it really is for myself. PA/DO/MD/(D)PT, we'll see.

    I do appreciate everyone's input, and hearing your experiences is very helpful. I'm not going anywhere though, as I'm realizing this is sounding like I'm about to take a journey to a land far away perhaps...:laugh: farewell...
     
  10. DocWagner

    DocWagner Senior Member
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    I have spoken on a similar topic many times...but never really put it this way.


    I love PT...but there is a distinct identity problem. When I was a PT it was a BS, then MS, now DPT...yet licensure is the same and essentially the education is the same...the patients aren't any different, that is for sure...nor is the treatment. Why?
    I felt the CEU was all over the place, without evidence based practice...hell, we couldn't even define what physical therapy was and if we even made ANY difference in the treatment of back pain. I was so frustrated.
    Then there was the glass ceiling...I mean, how much higher in earning potential could I go?
    Lastly...I simply felt I could learn MORE and do MORE. I didn't feel done with school. And it was a good time to switch, I graduated with only 5k in debt (an impossibility now).
     
  11. Skialta

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    I completely agree with Doc Wagner on this one. I practiced for six years doing inpatient rehab, outpatient orthopedics and home health and although I was successful as a therapist I really didn't feel like I used that much knowledge on a daily basis; alot of the time I was a well paid cheerleader or psychologist.

    I had a really hard time getting excited for CEU, some of them were pretty borderline with little to no science to back them up. Many of the manual tests you learn in PT school have a sensitivity and specificity that is no better than flipping a coin. I found PT had little evidence based practices and personally felt it was a matter of time before insurance companies clamped down on reimbursements. I basically felt like stagnant water where I was no longer using my brain and felt that I could do a lot more for people if I went into medicine.

    PT is a great field for certain people, I have many friends that are pretty happy with what they do. I also have friends who tell me I made the right decision by going back to med school, but they don't have the drive to make the sacrifices for it to happen for them.

    I can truthfully say I am no longer board, and constantly feel challenged to increase my knowledge base and the best part is I get to use that knowledge base to help my patients. It is a tough decision, good luck.

    Skialta MS4
     
  12. jles

    jles Dr of Physical Therapy
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    Thanks for the response DocWagner and Skialta.

    I am considering applying to MPT programs, instead of going for the full DPT. I saw a number of MPT schools on the apta website. Two years of schooling, less debt(15-25K less), and 1 year of practice in the time it would take to get the DPT. Plus, some great exposure to the health care field, and who knows, I could love it...? The next step would be the transitional DPT/med school, but I couldn't see the trans DPT being absolutely necessary for some time right? With all of the licensed sub-DPT's currently in the profession, the APTA couldn't revoke/not renew licenses if a PT doesn't have the doctorate could they??

    Regarding evidence based practice, with Ph.D programs in PT/rehab, and the push from the APTA and the industry in general I would hope that EBP is making some significant progress to give the profession more credibility; although, I do realize that it has been some years since you [DocWagner] were in PT school and you were just stating it as a problem during that time. I know that the APTA is advocating EBP, and I hate to think that PT treatment is not substantially based on science. Does anyone feel it is lacking in this respect? Maybe I misunderstood?

    Basically, I'm the kind of guy that gets bored in a fairly short amount of time, at least in my previous jobs, and maybe life in general. I seek variety, knowledge, stimulation, challenge, meaning, and maybe who doesn't to some extent, but with me it's pretty strong. This could mean I need to learn to be content/haven't found a good job yet (cue:career in health field)... I do know that I found the corporate world to be personally meaningless, and money to not be a motivator in the slightest. Just a little prattling there.

    A question that comes to mind is, with your considerable exposure to the medical field, what do you feel are the qualities of a successful physician? Just curious what anyone might have to say on this one.

    thanks,
    J
     
  13. DocWagner

    DocWagner Senior Member
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    The EBP discussion can be lengthy...and very difficult. The question is not that it isn't effective, the question is what exactly works and how much etc. PT as a clinical science simply has not changed dramatically in 20 years...technology has come and gone, gained bells and whistles and in the same breath...there has been a turn AWAY from modalities. To be completely honest, there are distinct "fads" in PT. From manual techniques to exercises (closed chain vs Cybex vs aquatic vs plyometric vs isometric vs eccentric) there are a Million combinations. Therefor it is difficult to qualify anything. There are manual schools of thought (mobilization vs manipulation vs myofascial vs trigger point vs etc etc). Believe it or not...each is effective. Many times a Home Exercise program is just as effective...and this has been shown over and over.

    The field is great, you simply need to understand that there will never be unified theories and there will be a "million ways to skin a cat"...and you must be ok with that.
     
  14. PT2MD

    PT2MD Hold my beer...
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    I'd love to add to this discussion, but DocWagner and Skialta echo my sentiments exactly. If I don't make it into medical school (I will by the way :) ), I have a great career I can be proud of until the day I retire. However, the reasons cited already in this thread should provide you with a good perspective on why some PT's are considering moving to medicine.

    I know some PT's that are scared to death and intimidated by the medical profession. I tend to go the other way - I am excited to have more responsibility and want to have a broader impact on the lives of my patients. There are great reasons to be either a PT or MD/DO, you just have to do some soul-searching.

    ...and even then you may still change your mind five years after graduating from PT school! :cool:
     
  15. ftcnt

    ftcnt Junior Member
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    My experiences as OT have been in mental health. I find it rewarding that you get to spend a lot of 1 on 1 but like others have alluded to through their experiences, having that intimate knowledge and science to support your practice is a great asset. I am currently considering medical school as I find other therapists telling me after a few years, the work can get redundant. We shall see where it goes but I just wanted to share my perspectives as a new grad in rehab
     
  16. jles

    jles Dr of Physical Therapy
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    You're right PT2MD, I could change my mind. Who knows? I certainly have more soul-searching to do. (I just think it would wonderful to be able to treat the whole person :D...) We'll see how the prereqs continue, so far so good. Time to shadow asap!!

    Thanks everyone for your valued input. PT2MD, I wish you great success and multiple acceptances! :luck: Congratulations ftcnt on your graduation and embarking on your career as an OT! I would definitely like to hear updates on how you're doing down the road.

    J
     
  17. ftcnt

    ftcnt Junior Member
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    Thanks jles...you definitely do the same as well. I hope whatever career path you take, it is one you enjoy because that's what really counts
     
  18. delicatefade

    delicatefade ASA Member
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    I think everyone here should realize that everything gets redundant eventually, even medicine. There will always be aspects of every job that become monotonous. The problem for me was, I could no longer stand the monotony of PT. I'm confident that I'll enjoy the monotony of medicine.
     
  19. matotom

    matotom Junior Member
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    PT demands so much more personal interaction time with other people who are either needy or in a needy period of their lives. If encouraging and motivating people and developing realtionships that demand your time..... 3x a week for 4 -8 weeks, an hour at a time....do something else.

    this sets PT away from most other health professions where the encounters are much more brief or you have tools shoved in the patients mouth so they cannot talk ala dentistry.:D
     

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