"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Showing posts with label dpt. Show all posts
Showing posts with label dpt. Show all posts

Tuesday, October 15, 2013

Do doctors of physical therapy need to call themselves 'Doctor'?

I wonder how the rest of the profession should view my physical therapist colleague who, having earned her Doctor of Physical Therapy (DPT) degree from a prestigious university, won't call herself doctor.

Not only will she not call herself doctor in the clinic, she asks people who DO call her doctor NOT to do so again.

I feel disappointed in her, not just because of her behavior, but for the reason she gives people, such as the front desk clerks in the physical therapy clinic, the equipment vendors and the patients when they initially call her doctor.
"I'm not a medical doctor, like some of the physicians I work with, and I don't feel confident that my expertise compares to their expertise - even though we each claim separate bodies of knowledge."
She is still young - only about four years out of her DPT degree. She works in a setting where she is in close contact with physicians - a physician-owned physical therapy clinic.

This physician-owned practice claims they provide collaborative care.  They emphasize the close communication among the physicians and the physical therapists.  From my colleague's behavior however, I suspect her workplace has impaired the development of her professional autonomy.  The American Physical Therapy Association's Vision 2020 Statement states:
Physical Therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, activity limitations, participation restrictions, and environmental barriers related to movement, function, and health.
Do doctors of physical therapy need to call themselves Doctor? 

I believe physical therapists should call themselves doctor if they have earned the right.  Please note, I have not earned the right to call myself Doctor.  Many other physical therapists have learned the specialized knowledge and skills to achieve great results without earning the DPT credential.  However, according to Randall Collins' 1979 book The Credentialed Society:
"In a credential society, such certifications may become more important than actual skills or abilities.  
In some cases, employers may require formal credentials, such as an advanced academic degree, for a job that can be done perfectly well by applying skills acquired through experience or informal study.  
This type of credentialism is common in white-collar jobs, which require workers to have difficult-to-measure skills such as critical thinking.  
Rather than measure or evaluate those skills directly, employers assume that anyone able to earn a credential must possess those skills."
'Skilled physical therapy' is a phrase that can provoke endless discussions among bloggers and commenters. There is a link between greater education and better results for patients.  More importantly, the DPT credential is, I think, an important step in the social legitimization of the physical therapist skill set. Physical therapists need to use the term Doctor to fully capture their investment in the time and money, not to mention for the benefit of the physical therapy profession as a whole.

Physical therapists do have one of those hard-to-measure skill set noted by Collins. So do physicians.  In hospitals, the physician credential is NOT optional.  The culture of medicine does not allow physicians to communicate with patients using their first names.

What go me thinking about my DPT colleague is an article called The Power of Professionalism in the September 2013 PT in Motion magazine (featured at APTA.org) whose print version arrived a couple weeks ago.  In the article, new graduate DPT Jean Miles says...
"What professionalism boils down to for me is being the strongest advocate for your patient that you possibly can be... Not that you have to be a DPT to be a strong patient advocate but I personally gained so much confidence..."
American society will need doctor-level professionals to manage the burgeoning rolls of newly-insured patients who have just become eligible for health insurance coverage on October 1st, 2013 under ObamaCare.

America's 800,000 physicians will face an increase in demand for their services - that, in some cases, they may be unable to deliver.

I first wrote about this in  Can Physical Therapists Replace Physicians as Primary Care Providers in Hospitals? in a November 2011 blogpost on PhysicalTherapyDiagnosis.com.  This post got a good response and a lot of traffic.

Every day, I read about non-physician providers stepping up to fill the demand in America for appropriate, high-quality services the patients need.  Cost and risk are both considered when society shifts tasks away from what physicians have traditionally done.  This article describes Physician Assistants providing basic care to rural and underserved communities.

Physical therapists can fill those roles for patients with chronic pain, sports injuries and other, low-risk conditions.  But first, society needs to understand and accept that the profession of physical therapists is a doctoring profession.  We should call ourselves 'Doctor'.

The American Physical Therapy Association (APTA) maintains a professionalism webpage which contains the core documents defining and describing professionalism in physical therapy.

I wonder if commenters to this blog can help me? 

What can I say to my colleague to encourage her to call herself Doctor?  How can I help her gain confidence so her patients and the physicians she works with can call her Doctor, too?

Monday, March 29, 2010

Physical Therapists Meet at the Beach

Special thanks to Blaire Burton, DPT for organizing the Florida West Central District spring meeting, Saturday, March 27th at America's #1 beach!

America's #1 beach

The meeting agenda promoted the update to the Florida Physical Therapy Practice Act (FS 486) during the 2010 legislative session.

The update is designed to do the following:

FPTA_talking_points
Some of the outstanding moments at the meeting were the following:
  • A lucid and pointed rationale from Adele Carr, PT for why keeping statutory language affirming 'Physical Therapy Aides' in the practice act is a dangerous move for the profession.

  • An even-handed narrative from Sheila Nicholson, PT, JD, FPTA President on how and why the practice act is being updated.

  • Many, many passionate examples of members who care about their profession speaking up, voicing their ideas and trying to get involved.

  • At least two private practice owners I spoke to telling me how ALL their marketing is now Direct-to-Consumer, instead of the physician.

  • A lively fund-raising appeal for the FPTA Political Action Committee (PAC) that garnered several hundred dollars - we need to do more in this area since chiropractors and doctors still beat physical therapists 10-to-1 in donations.

    This year, our goal is $75,000 - about double last year's donations - and you can help us make it. Remember, patients can also be donors to the FPTA PAC - they want to help preserve their access to physical therapy, too!
These web links contain important, timely information for Florida physical therapists:

Florida PT PAC

The new, proposed PT practice act has been filed with the legislature: SB 2146.

Follow, in real-time, the process of SB 2146 as it makes its way through the legislative process.

What do YOU want to see in YOUR practice act?

Now's the time to speak up.

Tuesday, April 7, 2009

Physical Therapy Diagnosis Redefined

In updating my Facebook page I've rewritten the mission statement for the Physical Therapy Diagnosis blog.

As my knowledge and commitment to my physical therapy patients and practice deepen and broaden through years of study so has my understanding of this blog: it's purpose and it's power to educate and inform go both ways.

Many thanks to those of you who have chosen to respond and comment to my posts - your voices have enlightened me.

Many thanks also to the readers (500 strong each week) who choose to read only - your surfing helps this blog rank well in physical therapy web searches.

Physical Therapy Diagnosis Redefined
Physical Therapy Diagnosis blog is a forum that speaks to the difficulty in doctor-level decision-making for physical therapists.

By 2020, the APTA Vision Statement calls for all physical therapists to be educated at the level of the doctor of physical therapy.

Physical Therapy Diagnosis blog does not assume that today's practicing physical therapists are making daily decisions of sufficient complexity and riskiness to qualify physical therapists for the title of doctor.

Therefore, the format, quality and tone of the content on this blog will be aimed at improving daily decision-making among physical therapists.

Together, let's help physical therapists improve the quality of their decision-making and assume the title of doctor.
Recently, I have been told that I do not have the credentials (eg: DPT,PhD, etc) to undertake such a mission.

That may be so. Please, say so in the comments if you like.

I have also been told that my content is valuable, spot-on and relevant in today's ever-changing health care market.

If you like the content please sign up for the free Bulletproof tutorial below.

If not, thanks for reading.

Sunday, January 20, 2008

SIMPLE Template Data Collection

The 'how-to' videos are available at www.Physical-Therapy-Videos.com under the link 'Physical Therapy Diagnosis'.

This template is used for data collection.

The physical therapist puts the data into the plan of care and links the measured impairments to the measured functional limitations (using the OPTIMAL).

The data are impairments in ROM and strength that support the Medical Necessity for Physical Therapy.


SIMPLE Template
SIMPLE measurements-------Right Left Expected Normal (n=151)
1)Standing Trunk Sidebending--------------90 degrees
3)Supine FABER------------------------------22cm
4)Supine SLR----------------------------------65 degrees
5)Supine TKE----------------------------------0 degrees
6)Sidelying Hip External Rotation----------23cm
7)Sidelying Hip Internal Rotation-----------29cm
8)Sidelying Hip Extension------------------0 degrees
9)Sidelying Hip Abduction-----------------10 sec.
10)Sidelying Trunk Rotation----------------9cm

(note: this Word document renders poorly into Blogger so the columns for the Right/Left measurements do not show up well. For the PDF document in Word you can go to www.SimpleScore.com

SIMPLE diagnosis

Which measured values are lower than their expected normal values?

Which measured values are asymmetric?

Can you name the impaired motions?

Goal Setting

Improve [side, position, joint and motion] from [measured value] to [expected value].

Free Tutorial

Get free stuff at BulletproofPT.com

Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"


Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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American Physical Therapy Association

American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.