What are the threats to the Physical Therapy profession?
March 102010
With an increasing number of demand for therapeutic services with a lack of DPT professionals to provide this service how will these demands be met?
More use of PT assistants?
Physiotherapists?
DCs?
Massage Therapists?
Will the trend go in favor of "cheaper" therapeutic alternatives while the DPT profession decreases in value due to their high costs? How will health care reform affect DPT reimbursement in the future? How will it affect the PTA profession?
On the outside it looks as if the PT profession is very bright. But what if there is a more "Universal Health care" system that arises from this economic crisis. Obama has mentioned health care reform as a primary issue. How do you see the PT profession ten and twenty years from now?
I agree with Mistify. I will add that there is an increased demand for PTs as the population ages and the premature infants that are born earlier and earlier. An increase in PTAs are a good thing. PT should be the primary person in musc-skeletal problems.
I do not see PT going away. I think another big threat is ATC used as PTA. This is not legal but happens. PT are getting more efficient with evidence based medicine. Patients are getting better sooner. We also need to empower our paitents to take ownership on their rehab.
March 10th, 2010 at 4:39 pm
I’m not a fortune teller, but more and more seniors are having
knee and hip replacements, that need some kind of therapy
after the operations. More and more young people are active
and as a result have more accidents, pulled muscles, or broken
bones, and therefore need therapy afterwards. I’d say to get
into that field as the time is ripe now. We don’t know what could
be down the road in twenty years but start thinking of the
tomorrows, not years. good luck.
References :
March 10th, 2010 at 5:16 pm
First, I think one of the threats to the PT profession are POPTS or "physician owned physical therapy clinics." These are clinics where the physician obtains a profit based on sending his own clients to physical therapy. It’s sort of an act of "double dipping." First, the patient is charged to see the physician, then the physician refers them to PT. In these clinics, there is often no consideration for "less is more" and the longer someone stays in physical therapy, the more money the physician makes. This is referral for profit. Although already outlawed in many states, POPTS still exist to a great extent.
This leads to unfair competition with PT owned clinics.
In the meantime, yes, reform is emminent…and needed. There are still too many incentives to provide uncessary medical treatment…this may mean keeping patients in therapy for longer than they need to, or adding on unproven treatments such as ultrasound or electrical stimulation.
We are all striving to make what we do better…the right treatment for the right person. If the government wants to get involved with healthcare, they will surely invest in ongoing PT research (you’d hope) so we can eliminate unecessary costs. What we will have in the end will hopefully be a more effecient and streamlined course of care. I only fear that "outliers" or people who fall beyond the "normal" range of a problem will not get the appropriate treatment. Medicare is noctorious for this…hence the whole $1750 cap on outpatient services a year…great if you have a small problem, but if you’ve have a stroke, tough luck.
Will other professionals threaten the practice of PT? Let’s take a look at each:
1. PTAs: I’d consider that there will be more use of PTA and PTs will fall into a more formal "diagnostic" and assessment role. However, there are studies that suggest that treatment by a PTA results in less efficient care. I’d say the jury is still out on this one.
2. Physiotherapist….well, there the same thing as a PT
3. DCs? Hardly, DCs are so caught up in their political warefare over trying to obtain exclusive rights to "manipulate" that they are falling behind on continuing to improve their practice. The subluxation theory has never been proven and we now know that correlation between x-ray findings and palpatory findings (two of the DCs top diagnostic tools) has really little correlation with symptoms. Meanwhile, we now know that manipulation is rarely needed or even indicated. An internationally known physio, Robin McKenzie has argued that only 4% of those with spinal pain require a manipulation…I’d argue it’s even less than that.
4. Massage therapists? Heck no…very little VALID research to support what they do leads to long term improvements…in fact, this is why most insurance companies stopped paying for massage years ago.
In ten to twenty years, I HOPE that PTs will be recognized as the "best first choice" in musculoskeletal care. Considering that 85% of medical school graduates failed in a study to demonstrate competency in a musculoskeletal exam and that only 1/3 of American medical schools require physicians to take ANY class in musucloskeletal medicine, and that this is one of THEE major foci in a PTs education, this only makes sense that PTs…especially those with the DPT… are qualified to be a portal of entry into the medical system for musculoskeletal complaints and to screen for medical conditions and refer to the physician when appropriate.
References :
I am a PT
March 10th, 2010 at 5:54 pm
I agree with Mistify. I will add that there is an increased demand for PTs as the population ages and the premature infants that are born earlier and earlier. An increase in PTAs are a good thing. PT should be the primary person in musc-skeletal problems.
I do not see PT going away. I think another big threat is ATC used as PTA. This is not legal but happens. PT are getting more efficient with evidence based medicine. Patients are getting better sooner. We also need to empower our paitents to take ownership on their rehab.
References :
PT, DPT, PCS