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Toni Talks about PT Today

Is It Really About Autonomous PT Practice?

Published November 18, 2015 5:11 PM by Toni Patt

My post last month, "The DPT: How Did They Miss This?" has generated numerous comments on the ADVANCE website, almost entirely from readers who agreed with its content. One exception, however, was an assistant professor of physical therapy who stated that making the DPT a mandatory entry-level degree was necessary for the pursuit of autonomous practice.

Our friend Dean Metz, a former ADVANCE blogger who now lives in the United Kingdom, responded better than I ever could have. The following is a partial quote from his posted comment: "As for the assistant professor from Nevada, if it was all about autonomous practice, then why has the UK had direct access for nearly four decades while graduates still have bachelor's degrees? Membership in the CSP (the UK version of the APTA) is at 98% and is non-mandatory."

He makes valid points that no one seems to be addressing. I have one to add. Why are we so focused on autonomous practice, when even if we got it today nothing would change? The general public doesn't know what PTs do and payers wouldn't reimburse us.

Obviously there is something else going on. I have never understood why we put all our efforts into direct access. Wouldn't it be better to work on the payers to secure payment for direct access? We should also be putting more effort into educating the public. If the public demands direct access, lawmakers will notice.

Every Texas Physical Therapy Association meeting that I attend includes encouragement to get our patients to contact lawmakers. We're told one of the reasons we don't get traction from lawmakers is lack of public support.

If autonomous practice is really the goal, then our strategic planners got things backward. The UK is a good example. Why do we need doctorate degrees to obtain something they have achieved with bachelor's degrees? Someone needs to step back and ask what the real issues are. Autonomous practice is a nice idea but probably not what your average PT and PTA care about.

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3 comments

Thank you, Toni for stating what the APTA refuses to acknowledge... that the DPT was not about autonomous practice.  I would add that what it was really about was to attempt to elevate PTs status to that of MDs and DOs, it was about pride and the yearning for respect.

I agree our focus should be on educating the public as they are the consumer and the consumer will always drive business.

Julie, Physical Therapist November 27, 2015 7:08 PM

I have come across DPT that their professors have informed them that the PTA needs to be eradicated from the profession. This is done by refusing to do Evals for PTAs to treat, do not hire PTAs and inform friends and family to refuse treatment by PTAs. They are to contact insurance companies to have them refuse payment for treatments provided by PTAs. They consider PTs  with a bachelors an over educated PTA.

Roberta Abbott, PTA/COTA November 27, 2015 1:15 PM
Ocala FL

Wow!  I JUST sparked a FB thread on the fact that the public is utterly unaware of what PT is, what the credentials and qualifications of doctors of PT are, and why other healthcare professions are much more respected for their autonomy than we are.  It's a cryin shame.  The medical profession refers to chiropractors as DOCTORS and the public's eye is well tuned in to this.  Yet PTs are referred to by first name, no respect for what their educational and experiential background is, etc.  We in the USA are far behind other countries in autonomy and direct access would fall right into place once the public is educated.  That's a true APTA downfall.  After 29 years, I still remain an APTA member and am disappointed at where we are as professionals at this point.  

And salary?  Another whole topic within itself.... it's pathetic.

Tracy Urvater, DPT, OCS November 19, 2015 8:53 AM
New City NY

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