tag:blogger.com,1999:blog-393067768850767704.post173814131050132854..comments2014-08-15T19:08:33.862-05:00Comments on Evidence Based Rehab: My ResponseJason L. Harris, PT, DPThttp://www.blogger.com/profile/08892392535366579228noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-393067768850767704.post-34440211396008607052008-02-19T01:01:00.000-06:002008-02-19T01:01:00.000-06:00Jason,I just spent extensive time reading your blo...Jason,<BR/><BR/>I just spent extensive time reading your blog. I am impressed, you have a very fine product going. I will just make 2 quick comments regarding the NATA and APTA lawsuit.<BR/><BR/>First, would M.D.'s say that PT's are trying to expand into their field.<BR/>"This is just another example of people wanting more than they are willing to go to school and get the education for." <BR/>If PT's want to diagnose, treat, have direct access without a referral, should you not under your own argument go to Med School?<BR/><BR/>Second, I know that this is out of your control but the comment that was made below brings up several points worth discussion.<BR/><BR/>"It is called encroachment. ATC's are not satisfied with their current niche and naturally desire a need to expand. Are there too many ATC schools graduating a large number of ATC's? If there are no jobs for a new ATC, I understand their need to try to delve into other practice areas. This would be devastating for PT's if the ATC's pull this off. They are cheaper and the PT salary would suffer."<BR/><BR/>Point One: Generally, I do not think that most PT's know or bother to find out exactly what the education and training of other similar professions entail. It gives the impression PT's think and act like they are better than every other medical profession. You have done some homework and I applaud you.<BR/><BR/>Point Two: ATC's have been working right along side preforming the same duties as PT's for over 20 years. I have work in hospitals, clinics, colleges and high schools. This is not a new expansion we have always been there.<BR/><BR/>Point Three: Where is the discussion about what is good and best for the patient or the entire health care field? Are most PT's worried about their salaries or worried about a little competition?<BR/>There are several studies posted on the NATA website that provide evidence that ATC's patients; return to work quicker, at less cost and with better patient satisfaction than patients that did not work with an athletic trainer.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-393067768850767704.post-10875498779642726002008-02-16T09:19:00.000-06:002008-02-16T09:19:00.000-06:00It is called encroachment. ATC's are not satisfie...It is called encroachment. ATC's are not satisfied with their current niche and naturally desire a need to expand. Are there too many ATC schools graduating a large number of ATC's? If there are no jobs for a new ATC, I understand their need to try to delve into other practice areas. This would be devastating for PT's if the ATC's pull this off. They are cheaper and the PT salary would suffer.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-393067768850767704.post-15600489029662159922008-02-14T13:24:00.000-06:002008-02-14T13:24:00.000-06:00Jason,Thank you for posting my initial comments so...Jason,<BR/><BR/>Thank you for posting my initial comments so prominently on your website. Also, I appreciate you taking the time to feedback to my original comments. <BR/><BR/>First, the research article you reference does not compare the skills of the PT to the ATC so it really has little to no bearing on my initial argument. Additionally, the research design is flawed in that it has PT faculty scoring the responses to questions. Obviously, each profession is going to provide different answers to these questions based on their content expertise. PT faculty members are certain to score PT responses higher than MD or medical student responses. If the "judges" had been physicians, would the physical therapists have scored the same? Finally, the cases presented in the "exam" are not representative of what orthopedic physical therapists or athletic trainers encounter on a daily basis. Although an interesting study, I would argue that, like many research studies, it creates more questions than it answers. <BR/><BR/>Second, I would like to suggest that you re-read my original post since many of my comments were taken out of context. <BR/><BR/>All comments referencing the skills and knowledge of new PT and ATC professionals was in reference to the programs in which I teach, not in reference to Seton Hall. As I stated earlier, I would not presume to evaluate another institution’s curriculum without having significant knowledge of course content, delivery, assessment, etc. All of the comments regarding specific knowledge and application of evaluation and treatment skills were referenced to my institution only. Additionally, all of these comments were in regard to orthopedic assessment and intervention techniques only. As I mentioned in my initial posting, athletic training students focus the majority of their attention on the musculoskeletal system while physical therapy students invest a great deal of time on other systems in addition to the musculoskeletal system. This variation in the educational curricula provides each group of graduates with unique areas of expertise, yet similar skill sets. <BR/><BR/>Finally, I agree that each profession has its place in the evaluation and treatment of orthopedic and non-orthopedic conditions. I also agree that further investment should be made in (collaborative) research to benefit the patients who seek out our collective rehabilitation services and expertise. <BR/><BR/>So, although many clinicians would welcome the chance for ATC and PT to work side-by-side and even to compete for patient self-referral and physician referral in an open healthcare market, it is the APTA who opposes allowing this to happen through numerous legislative initiatives (including limiting AT practice patterns through state licensure laws, proposing changes to the CMS Incident-to Billing regulations, preventing dually-credentialed individuals from teaching courses to athletic trainers, etc). <BR/><BR/>Ultimately, the playing field is not level for each profession. Physical therapists enjoy a much longer history of acceptance into the traditional health care market, have enjoyed third-party reimbursement privileges for years and possess far more lobbying power in Washington. As a result, regardless of educational level, clinical competence or clinical outcome studies, physical therapy will continue to prosper…and athletic trainers will continue to fight for the right to practice the basic clinical skills that their entry-level education clearly qualifies them to provide.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-393067768850767704.post-48933514188648659402008-02-11T09:33:00.000-06:002008-02-11T09:33:00.000-06:00Jason,I thought that was a good response. Just wa...Jason,<BR/>I thought that was a good response. Just wanted to mention there are other articles in addition to John Childs 2005 (you referenced) that add to the strength of clinical comptetence of Physical Therapists:<BR/><BR/>http://www.ncbi.nlm.nih.gov/pubmed/17484321?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum<BR/><BR/>http://www.ncbi.nlm.nih.gov/pubmed/15773564?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum<BR/><BR/>http://www.ncbi.nlm.nih.gov/pubmed/16355913?ordinalpos=428&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum<BR/><BR/>http://www.ncbi.nlm.nih.gov/pubmed/17138843?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum<BR/><BR/>These are just a few... there are many other editorials that summarize/reference these and the one you mentioned as well. Some may show areas that need improvement across the board, but overall they at least establish a baseline. Maybe its true anectodally, but I think you would be hard-pressed to take what is in the literature and make an argument that AT's "depth of knowledge" is "far more superior" than that of physical therapists.Dan Rhonhttps://www.blogger.com/profile/07671712110092843288noreply@blogger.comtag:blogger.com,1999:blog-393067768850767704.post-76965331684704982422008-02-11T01:08:00.000-06:002008-02-11T01:08:00.000-06:00In addition, most entry-level ATC's are at an unde...In addition, most entry-level ATC's are at an undergraduate level as well. Shoot they just stopped the internship model less than 7 years ago. An entry level Masters in athletic training is not the norm. Generally I know we have more Masters programs for PT than Doctorate; but it would be interesting to compare over the past 5 years or so how many doctorate level PTs we have at entry level and Masters level ATC's.Anonymousnoreply@blogger.com