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Toni Talks about PT Today

I Would Like to Respond

Published June 1, 2010 10:31 AM by Toni Patt

I read the comments on my post two weeks ago with interest. In that post I urged the powers that be not to grant the DPT title to therapists who would be grandfathered in to continue practicing. My main argument was the DPT title implies a level of education and knowledge. An individual who had not earned the degree does not have the knowledge. I never said those individuals weren't skilled therapists. Nor did I say there weren't therapists who religiously keep up on continuing education and skills. I said there is a difference between the two.

All along I have defended experienced therapists over newly graduated DPTs. The DPTs have knowledge but generally have little clue what to do with it. I've also commented on the lack of work ethic I've been seeing in newer graduates. The DPT doesn't make them better therapists. It simply means they have demonstrated a specific knowledge base. The APTA would like us to believe that knowledge base proves we are capable of practice without referral.

Right away that creates a problem. If the APTA says DPTs are capable of practice without referral, does that mean the remaining therapists aren't? That might be driving the discussion on a blanket granting of the title. Now lets ask ourselves, do we want practice without referral that badly? Wouldn't it be better to base the ability on something other than a degree? We've all worked with PTs who are book smart but lack clinical judgment. Having a DPT wouldn't make those therapists better clinicians.

Over the years I've worked with some excellent therapists. I've also worked with some who should stop practicing immediately. Currently I work in a large department and could say that about some of my coworkers. Doing the same thing, the same way because it worked before isn't true physical therapy. It is a cookbook approach that eliminates any clinical judgment. Those coworkers are fine in their current situation as long as nothing changes significantly. They keep going to continuing education courses. They meet all the requirements to practice. They get out exactly what they put into their profession. Is that someone who deserves a DPT?

There are therapists like that throughout Houston. I can extrapolate that into the entire country. Most of the facilities I've worked at had at least two or three of those. I can think of one SNF where the entire staff falls into that category. When I talk about this being a problem, I have personal knowledge of it. I can state for a fact none of the PTs I work with on rehab know how to search literature for evidence. That doesn't mean they don't use evidence. It means they can't find it without help. Others who know how to search lack access to a search engine. Again, they can use evidence but aren't able to find it themselves. That doesn't make them bad therapists.

To those who don't agree with me or my conclusion, I say ask yourself if you can find evidence. Can you pull the relevant information out of literature? Have you developed a specialized knowledge base or gone to whatever CEU option was available at the time on a regular basis? Are you current with the literature? If you can answer yes to these questions, I apologize. I know there are some of you out there who can answer yes without the benefit of a DPT. Those are some of the things I learned while working on my DPT that I wouldn't have learned any other way.



I've read many of your posts in the recent past and although it is difficult to ascertain the precise attitude/emotion behind your words this much seems fairly clear. You seem to have a lack of diplomacy skills in dealing with colleagues. If you're trying to motivate colleagues by demeaning them and essentially outing them without naming names you might as well have. I'm talking about statements like the following: "I've also worked with some who should stop practicing immediately. Currently I work in a large department and could say that about some of my coworkers". Surely you realize that these colleagues you've identified without actually identifying them read your posts. Of course other colleagues that you didin't intend to include in this group may feel that you're talking about them as well. This idle backhanded approach of talking about your colleagues via posting is certainly not therapeutic as far as staff morale is concerned and it reeks of elitism. Reagardless of whether one has a BS,MS and/or DPT without diplomacy in our profession you may find yourself working on an island without a raft.

Doug June 8, 2010 4:46 PM

I would like to comment on the grandfather issue for DPT.  I am currently working on my doctorate and I absolutely agree there is knowledge I would not have gained if it were not for returning to school.  It doesn't seem right to grant this title without people earning it.  If you want to be a DPT then go back to school and earn it.

Karen Harbison, Physical Therapy - PT June 2, 2010 8:16 AM
Loretto TN


Reread the comments from two weeks ago.  Not one person disagreed with your position.  Those who have not done the work shouldn't be gifted the title.  But we have an entitlement attitude in our country, so it doesn't surprise me that conferring a DPT to those who haven't earned it is being discussed.

All of the negative comments speak to your elitist attitude, which comes through louder than your message.  But you don't seem to recognize that at all.  

Your blogs remind me of a therapist I worked with.  She was the best ped therapist in the city.  But she was "too good" to be bothered with imparting her skills to co-workers or students.  Oh, she was a CI-she did her civic duty.  But the students were all scared of her and didn't learn a thing.  They could watch her treat, but couldn't touch a patient until the patient was almost ready for discharge.  This mega-star therapist couldn't risk jeopardizing her patient's progress by letting a lowly student (or even a graduated therapist on her team) touch a patient who required her skill and expertise.  Ring a bell?

She forgot that she used to be a student herself and had to learn from someone.  She also wasn't thinking of the thousands of patients who could have benefited by her expertise at the hands of someone she had mentored.  She was the best, but she still shortchanged the therapy world and patients across the US.  

Your posts have shown contempt for therapists who aren't you.  And an arrogance that YOUR patients are above having students - or even your co-workers - treat them.  

In that post two weeks ago you said, "Just who do they think is looking at the evidence in the first place, the DPTs or someone who hasn't looked at a journal in years? Except for an occasional journal club, none of the therapists I work with look at the literature. We have a disconnect because I use the literature and they don't believe I've learned anything different."

Maybe they don't believe you have learned anything different because you haven't taken the time to mentor them.  Maybe the disconnect is due more to your attitude than their perceived ineptitude.

I don't know you.  Never met you.  Maybe your attitude just doesn't translate well on paper.  But if the real you is anything like the picture the words in your posts paint, your co-workers view you as a PT snob.  If they are right, you are doing the PT profession a grave injustice.  And robbing untold patients across the globe the benefit of your expertise through the process of replication.  

I don't doubt that you are a brilliant clinician.  But just like a brilliant student doesn't necessarily translate into a great clinician, a brilliant clinician doesn't necessarily translate into a great therapist.  A truly great therapist is one who shares her passion and brilliance with others in a way that makes them better clinicians and therapists.  I believe you have that in you.

Janey Goude June 1, 2010 8:29 PM

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