Tuesday, October 1, 2013

I am a Doctor of Physical Therapy

As a Physical Therapist {PT} who holds the degree "Doctor of Physical Therapy" {DPT} I come across many people who do not quite understand what that means. Don't get me wrong...it is confusing. I'm kind of like your dentist - he or she has a Doctor of Dental Medicine or DMD. We are not medical doctors, but are highly trained healthcare professionals in a speciality field. Right now there are PTs who hold Bachelors and Masters degrees still practicing. In time, everyone will be a DPT, however currently my profession is still in a transitional phase. It is important that we make this change and have the training to be primary care providers {aka - no MD referral needed} for musculoskeletal injuries as in almost every state patients have direct access to physical therapy {the ability to see a PT without a note from your physician}. I am reposting this blog entry originally from here in an effort to explain in a little more detail what it means to be a Doctor of Physical Therapy.

{especially since it's October and National Physical Therapy Month!}

"I am a Doctor of Physical Therapy"

Before we get started, take a second to watch this clip on “cutting edge physical therapy techniques” during a Dr. Oz Show (Dr Oz Cutting Edge Physical Therapy).   Kind of surprised they didn’t have the electrode shock device that builds 6-pack abs while sitting on the couch, or the vibrating belt machine that giggles away your fat. My initial reaction, eye roll.  My secondary reaction, concern.  Third, frustration.  Fourth, responsibility.  Let me explain this roller coaster of emotion in a bit more detail…

The “eye roll” – Ultrasound, Tiger Balm and a Bumpy Ball are cutting edge therapy techniques?  Kind of like representing an accountant with a multiplication table, an abacus and a quill pen.
The “concern” – Do people really think this is what physical therapy provides?  Or more concerning, is this the treatment people ARE receiving? If you are, I’ll be the first to say you need to find a new PT.
The “frustration” – Without getting into my true feelings about Dr. Oz, I’ll attempt to be succinct.  Dr. Oz has enough difficulty properly portraying physician practice and inferring physical therapy is passive modality-based treatment is erroneous, inaccurate and negligent.  Although I wish I could just take Raspberry Ketones, put on Tiger Balm and lay on my Bumpy Ball for a healthy, fit, pain-free life.
The “responsibility” – Physical Therapy has been historically poor at educating the general public on our expertise and scope of practice and all frustration aside, I need to focus on what I can do as a professional and what we can do as a profession to improve this.  Ultimately, we can not be overly frustrated with these poor stereotypes if we do nothing to reverse them.
So, let’s start with the basics.  Here are a few things I “am” as a Physical Therapist.
I am a Doctor – (4 year Bachelors degree) + (3 year Doctoral degree) = Doctor of Physical Therapy.  Here’s a crazy thought, from kindergarten to doctoral graduation I have spent 22 years of my 29 year life in school, ~76%.
I am a musculoskeletal expert – A comprehensive study of healthcare providers found that physical therapist knowledge of the musculoskeletal system is second only to specialized orthopedic physicians.  Just a thought next time you are divvy-ing up Trivial Pursuit teams or “phoning a friend” on Who Wants To Be a Millionaire.
I am a movement specialist – Along with extensive knowledge of the musculoskeletal system , I specialize in the kinesiology of our body as a dynamic and biomechanically moving system functioning in synergy to perform everything from daily activities to elite athletic competition.   Think Erector Set vs Legos.
I am direct access – In the state of Washington, you do not need a physician referral to see a physical therapist!  And in all states, physical therapists with their doctorates are educated in differential diagnosis and can properly diagnose and direct you to the appropriate healthcare provider if it falls outside our scope of practice.
I am cost-effective - Numerous studies show physical therapy is more effective and less expensive than medical care or surgery with results lasting longer.  Studies also show care is less expensive when going to a physical therapist FIRST versus being referred from your physician.
I am still learning – Continuing education is constant focus and forms the foundation of my evidence-enhanced practice.  Once a nerd, always a nerd.
I am cutting edge – I utilize manual therapy, triggerpoint dry needling, SFMA, and partner with FMS-certified trainers.  There is no therapeutic ultrasound machine, tiger balm or bumpy ball in our clinic.
Identity crisis averted.  For some of you this is common knowledge, but sadly for most of the general public these ‘basics’ are new to them.  Here is my challenge to you.  If you are a physical therapist, repost this or write your own informational post on Facebook, Twitter, website or blog.  Social media is huge, embrace it.  If you are someone who has had physical therapy and this isn’t new, then forward it to someone you have heard complaining of aches and pain who may not know.  If this is new to YOU, then next time you have musculoskeletal pain (back pain, knee pain, shoulder pain, neck pain, etc)…see a manual physical therapist FIRST!
Paul Killoren PT, DPT
If you have taken this challenge, leave a comment and let me know.  I could use the encouragement!  Follow me (@DPTwithNeedles) and my colleague (@AWoodsDPT) on Twitter to share more of your comments!  You can also find us @DoctorsofPT and on Facebook…
Thanks to Paul for allowing his article to be re-posted! 
To expand on one of Paul's points {Direct Access}, one of the neat things about my training to identify problems that are beyond my scope of practice {in other words, when someone's symptoms do not appear to be coming from the musculoskeletal system}. We call this process differential diagnosis and it is very important to be thorough {especially if you are seeing a patient via direct access/who has not seen a physician}. In just a short amount of time my training has successfully helped me appropriately refer people to physicians who had the following problems:
Complained of: "back pain" which I had several symptoms {in the groin} inconsistent with pain from the spine.
Referred to an MD --> diagnosis: hernia, surgery needed within days. 
Complained of: "twisting an ankle" with point tenderness in a spot on the lateral midfoot that indicated x-rays may be needed. 
Referred to an MD --> 5th metatarsal fracture, walking boot and bone stimulator required to avoid surgery.
Neither of these patients were appropriate for PT upon evaluation and both were immediately referred to physicians for further care. My training as a Doctor of Physical Therapy made that referral possible.

I hope this helps clarify part of my training as a Doctor of Physical Therapy. Of course, most of this information is specific to the outpatient orthopedic setting, and Physical Therapist work in many settings including the hospital, nursing homes, rehab centers, with athletic teams, at daycares, schools, etc. While our roles look different in each place the basic principles remain the same. 
Happy National Physical Therapy Month! 

On a pregnancy update...unless little lady makes a dramatic last minute appearance tonight, it looks like we will make it to FULL TERM tomorrow! 

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