Rehab

Paging Dr. PT: Getting a doctorate in PT might change your practice

Rehab Regs, May 28, 2003

Source: Briefings on Outpatient Rehabilitation Reimbursement and Regulations, May 2002

Within five years a larger wave of PTs will be leaving schools with doctorate degrees in physical therapy (DPT). These new DPTs might make it tough for current PTs, who lack doctorates, to compete for jobs. Not only therapists with bachelor's degrees, but therapists with a master's degrees, also might be at a disadvantage in the job market.

"More and more therapists are going to practice with a DPT, and I think that volume is going to come from the entry-level therapists. It will put pressure on the experienced therapist, because the public will see the word 'doctor,' and that has a certain credibility or prestige in our society. Consumers are going to ask about the difference between [a normal PT] and a DPT," explains Dale Avers, PT, MFEd, vice president of academic affairs-provost of Rocky Mountain University in Provo, UT.

A DPT is a postbaccalaureate degree awarded upon the completion of a doctoral-level professional, entry-level, or post-professional educational program. To move the profession forward, many people feel PTs need education at the doctoral level.

"We need to have a little bit broader education in terms of diagnosis, because if people are coming to you without seeing a physician, you need to know what you can take care of and what needs to be referred to someone else," says Cheryl Resnik, PT, DPT, assistant professor of clinical PT at the University of Southern California. "So it is really a patient protection mechanism, by ensuring that the education will give the practitioners what they need without having had a referral."

Being able to diagnose a patient is the crux of the DPT program. It allows you to recognize a condition when you don't have all of the information. This requires critical thinking and making judgments.

Besides an avenue for getting more information, being a DPT can spice up your practice. "It's really easy if you see 800 [anterior cruciate ligament injuries] to do the same thing," Resnik says. "Why not look for different ways to skin the cat? Maybe you can make the recovery time faster and better."

Leveling the playing field

There is no reason for students fresh out of college to get the jobs that you should be getting simply because they happen to be graduating college at a time when DPT courses are being offered. There are many things that experienced therapists can do to prepare themselves. The following are the most common:

    Continuing education. Resnik feels that post professional education should be done at a university that offers courses built upon scientific research. "There are a lot of people out there offering continuing education that is not evidenced-based," she explains. "When you go out and take continuing education courses, you may or may not be getting information based on research. It might be based on the therapist's anecdotal evidence of taking care of clients." Non-university- based continuing education courses should include a bibliography of the works that a professor uses while teaching.

    Transitional DPT. This degree brings a therapist's level of education up to the level of a new graduate. The American Physical Therapy Association (APTA) is looking for ways to give credit to PTs for life experiences.

    Listing your credentials throughout your entire career and assigning values for what you know can be excruciating work, so the APTA came up with the portfolio system. The costs is $300 and consists of self-analysis of any education that you learned following the completion of your entry-level degree-any continuing education course, writing skills, teaching, or public speaking-which is then sorted out and placed in the portfolio. Following that step, you apply to a DPT program, which will tell you how many credit units you need after giving you credit for your past performance. Different universities allow for different credits.

    Lock-step programs. Avers' school, Rocky Mountain University, subscribes to this theory. Schools that offer these programs do not want to deal with portfolios, analyze, and verify the practice skills of every therapist who applies for a DPT. "We have a program where you get 15 credits for being a PT and then come to school for a total of 11 days," she explains. "Six days for one session and five days for another, separated by four months. And then two independent study courses that you do over a four-month period."

    You can finish this program within eight months, and it has a one-size fits all approach, which means every therapist is equal-no extraneous experience is looked at. The program has the following advantages: You know how much it will cost ($9,000), how many credits you'll get, and when you will complete the course. A university will tell you what courses you need, but you may have to wait several semesters to take a course, simply because it is not offered when you want it.

    When the PTs come to take their courses at Rocky Mountain, they make their way to Provo, UT, and are put up in a hotel. For the next week, their entire time is taken up by physical therapy. "What happens is that they learn as much after class, with each other, in that collaborative peer-orientated environment" as they do in class, Avers says. "Going out to eat with their professors or each other, they discuss what they learn, their issues, and they interact with each other." Avers says students can cover the cost of the program through either financial aid, or a continuing education budget, if they work for a facility that allows that.

Life after you get your DPT

Many of Resnik's colleagues have their DPT degree and are looked at differently by physicians. Because of his familiarity with graduates of the DPT program, one physician Resnik knows negotiated a deal with his insurance company: His patients receive treatment from PTs approved by his insurance company. If their conditions don't improve in a certain amount of time, he sends them to a DPT.

As physical therapy becomes more of a medical profession, it will help the medical community to ac knowledge that PTs are responsible for their scope of practice, regardless of whether patients have referrals from a physician or walk.

The first day of school

If you want to get started, but your local college doesn't offer these courses, Cheryl Resnik, PT, DPT, assistant professor of clinical PT at the University of Southern California, says not to fear. "Distance education is becoming more prevalent," she says. "This is getting your degree either online or through satellite feeds. This is going to be the wave of the future."

Those who already have a PT license won't need as much "hands on" education. The following are courses that are suggested in order to get your Post Professional DPT:

  • Diagnosis

  • Pharmacology

  • Physiology

  • Biomechanics

  • Kinesiology

  • Pathophysiology

  • Radiology

These courses lend themselves well to distance education. Although expensive to put together, many medical school courses have gone online, Resnik says. And if they are from an accredited college, other colleges will accept these courses as well.

As a student, Resnik took one course each semester, and it took her about two-and-one-half years to complete her Post Professional DPT. The size of the workload at your practice will determine whether you finish earlier or later than she did.

"I recommend that if you are going to take courses, make sure they are university-based," she says. "If they are not university-based, be selective in the courses you choose. Ask how much evidence is being presented and what are you going to get in terms of that evidence. Are you going to be reading research papers, and how are you going to integrate critical thinking?"

Tips for choosing a DPT program

Dale Avers, PT, MFEd, vice president of academic affairs-provost of Rocky Mountain University in Provo, UT, says you should ask yourself the following questions to see which DPT program is best for you:

  • Learning style. Are you an independent learner, or do you like structure?

  • Time and cost. How much can you provide for each?

  • Control. Do you want a choice over the courses you take or do you prefer predictability?

  • Convenience. Could you leave your job for a week to study in another state, or would you rather stay around your home and take a bit longer?

  • Availability. Some universities only offer programs to their alumni. If that is happening at schools near you, you might have to look elsewhere.

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