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Marilyn,

I have been an advocate of either increasing educational levels or having some sort of subspecialty/certification for the PTA since 1998.  You are right the APTA has done little for the PTA's as a profession but they do offer certificates in some areas if you are a member of their organization and follow their rules.  I don't like their rules so I am not a member.  

The abstract brings up several points.  One, you saw immediately in that the PT was not discharging appropriately since they are responsible for the patient.  

The other point is that the APTA wants care extenders but the abstracts points out that there is an increase cost with them.  Not sure what the APTA was thinking with that one.

The rules for different therapy environments and reassessments seem asinine because each state has different rules which do not mean much when insurance companies dictate the pay structure and who and how much they will pay.  I can treat a Medicare Part A patient in home health and in a SNF but need a PT practically standing next to me holding my hand in an outpatient clinic.  

Cliff,

Egos in healthcare need to be checked at the door.  I had enough of those people. Rural areas in the country are still in need of skilled PTA's with your experience in all aspects of care including the ICU's.  

I had several PTA students that I instructed with oversight by a PT.  The PT would be the CI when I was not there so it worked out perfectly.  PT's may be good instructors but only a knowledgeable PTA should instruct another PTA student.  How else are they going to learn what they should and should not do and know what their limits are.  

Hi Jason,

I  work FT in New Jersey at a SNF as a LPTA & per diem in PA as a Indirect Sup. LPTA.

Regarding education;I feel the APTA has done little to adanced the PTA, so PT's could take on more specialties. The PTA could be certified in different medical areas like the LPN & work along with the PT in their specialty. In my 40 years of practicing as a PTA I have seen too many PT's are doing routine protcol PT servies that the PTA can and is doing.

The abstract doesn't seem to address the fact that the PT is the one that discharges  the pt., so the pt. may stay in-up staying longer if the PT don't step-up to be responsible for the pt. after they do the evaluation.

Then, there is the perspective payment system differences of working in a SNF vs a hospital vs private practice that has an any effect on how frequent a PT will reevaluate a pt.  

 I appreciate your blog & keep up the good work, we PTA's need people like you.

I've been a PTA for seven years,six in Chicago and almost one in New Orleans. I have to say my experiences practicing here in Chicago, have been mostly negative. Although, I've liked the facilities I've worked at, it's the PT/PTA relationship that has bothered me the most. I'm not making a blanket statement, but I have met with some disturbing situations. My last position, I was not allowed to work in the ICU or MICU,although I had done so throughout my career,including just after my completion of school. Previously, in Chicago, I'd worked in a Level 1 trauma facility,like my last position, and was able to work in the ICU. Also, when I was scheduled to have a student, they insisted that a PT have the student first along with me which was highly insulting to me, as I've had students in the past with no problems. I believe, I was the victim of two PT's enormous egos,as I witnessed them drive two other PT's away through their actions.I know this is more about human behavior/personality than anything, but it affects me as a person as well as a PTA. This hospital laid me off four months ago even though I'd been there three years,longer than some of the newly hired PT's.

Kathy,

The link site is www.ncbi.nlm.nih.gov/pmc/articles/PMC1797090.

I would like to get your feedback after you review the material.  

I have several opinions on your topics of use of support personnel, appropriate settings, and advancing PTA education levels, but I will heed your request and do some research first. The abstract link is not working; perhaps I have waited too long to access this Advance and your blog. Can you repair the link or email the article to me? Thanks!

Jonathan,

Thank you for the response. I worked acute care for many years and it is great experience to interact with MDs, nsg, social services, etc and see how each discipline interacts with patients and therapy.  

E-mail me at the address above and I can offer some advice and more thoughts about SNF's.  

Jason,

I like to follow your blog. I am a recent grad and am working in acute care as a PTA. I currently work on a cardiac service and will be cross trained on multiple services. I noticed you mentioned ICU's and PTAs. I work on on some of the ICU floors here and they treat us like any other therapist. I just do the follow ups. I'm at Hopkins now but am thinking of doing some PRN at a SNF. Can you offer any advice? See I did a couple affils at SNF but most my experience is in acute care where the billing and efficency is different.  Do you enjoy working at a SNF? A lot of classmates found jobs there and I was offered so many jobs but took less money to work initially at Hopkins. I hear skilled nursing has really turned into an assembly line. Your thoughts?