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Toni Talks about PT Today

Guest Lecturing

Published July 20, 2010 9:56 AM by Toni Patt

I recently was a guest lecturer on stroke for a PTA neurology class. I guess it's been a long time since I've been exposed to what goes into becoming a PTA. I was shocked at how much was being crammed into the program. It reminded me of what I had to do when I went to PT school many, many years ago. I shouldn't have been surprised. I work with graduates of that school who are excellent therapists. Prior to the lecture, she told me not to dumb it down in any way. Talk to them like I'm talking to equals.

When I went to PT school, it was a master's-level program crammed into a bachelor's degree. That seems to be what is happening to PTAs now. It's been long enough that I don't clearly remember PT school. What I do remember is feeling overwhelmed by everything I was expected to learn.

There has been talk over the last several years of changing the PTA to a four-year degree. One opposing reason given was lack of enough material to support the change. Another was lack of change in the role of the PTA. I think both need to be revisited. Those statements aren't necessarily true now. There is more than enough material to lengthen the program and it keeps growing. PTAs need to learn the same things PTs are learning if they are going to be responsible for the treatment plans we are creating.

As Vision 2020 comes closer, the role of the PTA is going to change. Just like PTs, PTAs will be expected to do more and have more responsibilities. If practice without referral becomes a reality, PTAs will need to be able to recognize medical problems. Just because something doesn't come up when the PT does the evaluation doesn't mean it isn't there. PTAs are going to need to know what to look out for.

The only way the profession of physical therapy can move forward is if PTAs take on more responsibilities. I felt sorry for those "kids" I spoke to. I gave them a lot of information in a short period of time. I think I would have had difficulty processing it all. What I covered was one-third of their neuro exam. It will also cover TBI and SCI. That's a lot of information.

Today the biggest problem is how to make a change happen. Most, if not all, PTA programs are local in institutions that don't award four-year degrees. Nothing can happen until someone figures out how to get around that. I don't think it's feasible or realistic to expect those programs to simply move to other institutions. Nor will it be easy to change the degree programs of an institution. Some form of partnership with other institutions will be needed. I can't imagine how much work would be involved in something like that.

I hope our profession begins to take a serious look at this. I know several PTA students who chose the PTA over the DPT because of time and expense. Those people will make excellent therapists. Physical therapy should exploit their talents. It took over 20 years to switch from a bachelor's level to master's level for PTs. And that was after we realized we needed to do it. I hope we move a little faster with the PTAs.

4 comments

Well said Derek.  I agree if PTA's were given equal voting rights the move for improvements and advancements would occur.

Robert Foy July 27, 2010 8:32 AM
PA

Well said Derek and Jason. I taught at NYU's PTA program for 7 years (when they had a program, it is now closed). The amount of information that was required, at that time, was nearly impossible to impart to the students in a way that made them truly ready to treat upon completion of the program. I agree, it should become a bachelors program. I also agree that for the most part, the services of the PTA are underutilized and overlooked by the PTs and the rest of healthcare. With decreasing enrollment in DPT programs (as compared to the heyday of MSPT programs) and the necessary need to protect resources, the PTA should be playing a primary role moving forward in this field including full voting rights in the professional organizations and a voice in the development of the profession as a whole.

Dean Metz July 23, 2010 12:51 PM

Well said Derek. But I fear the few who can whole heartedly make this change a success won't.  I am a proponent of splintering from the APTA and create a new, better and cohesive organization.

Toni,

Cramming information in a short time happens in every school situation.  Perhaps a specialized PTA program could be made in which the first year is the basic A&P, movement sciences, pathologies, etc. and the second year could be a more intensive internship that will create a more focused PTA in which they can study more in depth about specific populations such as peds, outpatient, acute care, wound care , etc. This would allow the PT to eval and a very competent PTA to carry out the treatment.    

Jason Marketti July 21, 2010 1:02 AM

I am a physical therapist and taking a professional issues class in a t-DPT program (transitional DPT is another item I could write a whole other blog about, but...). We were challenged to find a professional issue we wished to change, then do something about it. I feel a major issue in our profession is the undervalue of the PTA. An editorial in the April issue of Advance magazine stated the basics of the argument eloquently; hopefully I can expand upon some items:

• Vision 2020 has been focused on aspects of improving the physical therapist quality: Instituting the DPT, pushing for direct access. Where has the push been for the PTA? There had been some discussion about converting it to a bachelor's program, but apparently no follow-through.

• There are 223 accredited PTA schools in the Unites States, there are 212 PT schools. Why is it then that PTs outnumber PTAs 3:1 in practice (based on Department of Labor statistics; 185,000 vs. 63,000)? My organization struggles and fights for new graduates from the two PTA schools in our region. With the lengthy waits many students have to better their position for PTA schools, many complete enough credit hours for a bachelor’s degree. The other obvious solution is to allow a controlled increase in the number of PTA programs or increase their enrollment (on average, PTA programs graduate only 17 per class)

• Why is it that PTAs get 1/2 vote at the APTA level and no say on various committees? At least slaves were recognized at 3/5 of a person in the Constitution! According to the Utah PT website, they could find no other organization that offers only half votes to some of its members. For PTs, the vote is not tied to level of education. Currently, PTA membership is approximately 10%--doesn’t it seem logical that a greater sense of inclusion would increase PTA participation? In Ohio, where I practice, PTA membership is at 6%. In my discussion with several directors, the main reason participation is so low is that PTAs feel like second-class citizens. Interstingly, in my class of 16, only two PTs agree with my position.

• The APTA is the American Physical Therapy Association, not the American Physical Therapist Association. If one read the blogs regard the proposal to give full voting rights to PTAs, you'd think there will be a revolution among a faction of PTs if this passes. PTAs also have mentioned forming a separate organization. I feel this is in no one's best interest-the fractioning of the field would only serve to weaken it. OTs and COTAs co-exist without incident in their organization (with each holding equal voting rights), why can't we?

• With an ever greater push to make PTs the first line of treatment, PTAs serve as the excellent cost solution. Where I work, it takes approximately three weeks to get an outpatient PT evaluation. Why? PTs are spending far too much time on treatment--and while most PTs like treating as much as they do evaluating, if "primary care" is the push, a three-week wait is unacceptable.

• In July of 2009, HCFA now claimed that for patients with Medicare in a private practice, PT supervision must be direct, meaning “in-room." This supervision is not required in any other settings, but could lead to a detrimental cascade if the APTA does not resolve this issue.

• There is little opportunity for the PTA to improve their education. There are only two PTA to PT programs while there are 13 such programs for OT and 15 weekend option OT programs. Reports show many PTAs leave the field if they choose to advance their careers.

In general, I feel we, as a profession, need to include PTAs more fully and show them the appreciation they deserve.

derek July 20, 2010 10:09 PM
OH

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