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PTA Blog Talk

When the PTA Knows More

Published May 6, 2009 8:35 PM by Jason Marketti
I have worked with new grad PTs and those with many years of experience, and there will always be times when I know more than a PT, just as they will, at times, know more than me in relation to patient care and progression.

Over the years I have learned simple techniques that drastically improve patient care and have tried to pass that knowledge on to others who will listen and actively watch. Some PTs and PTAs do not want to be "taught" anything by me and that is fine, but it seems a disservice to the patient.

What I usually observe is that the therapist will try to copy techniques and treatments rather than ask me why I chose that particular one for a patient.  As with anyone who works, I find new ways to perform an activity to increase the challenge to my patients.   

One PT continued to have a patient perform seated LE exercises after a TKA (no weight bearing restrictions with this patient) and limited stretching until I came on the scene. This was about three weeks post op.

Not that I am the most knowledgeable with TKAs, but I realize how valuable increased mobility is with some patients.  So she was given HEPs and began standing LE exercises with a progressive stretching program.  A week later, cadence improved as did her perception of therapy.  She had never been challenged until I asked her to perform.

My first question is why was the patient still doing seated LE exercises with a PT when they should know increased mobility will increase the patients function?  Should I ask the PT why they didn't progress and challenge the patient when she was capable of it?

When a PTA is progressing patients and getting positive results how do you think the PT feels?  Or should it really matter because the bottom line is that the patient is getting better?  Do you think some PTs get jealous if the PTA is better at a skill set than them?

Let me know what you have observed.


Always communicate.  I don't think it would hurt to ask why the PT is hesitant for progression.  It is either you ask or the MD.  

CEU's can often make a difference as to who knows what.  As far as application of knowledge,  Tom is correct in that the PT is responsible for care.  

If the PTA is more knowledgable in an area this should be strengthened by the PT and encouraged in the department.  PT's should not be insecure if the PTA knows more - the PTA should be pushed in that direction so the patients will progress and the PT can shine in other areas.

Karen June 11, 2009 12:27 AM

We need to remember the PT is still rsponsible for the Pt. Any progression made , change in goal or treatment plan needs to be conveyed to the PT. You need to communicate more with your PT. It could be that her INR may possibly be very high thus the need to back off on the aggressiveness of her program which can become a life threatening situation was the reason , this is what you need to discuss .Jealousy is not the correct term, maybe there is a disconnect in communication between the PT and PTA. You should be working as a team and embrace each others strengths and support each others weaknesses

Tom May 8, 2009 1:11 PM

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About this Blog

    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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