Drug Presciptions/ Imaging

[mtm34]

With 3 years of education now required why is there no privileged to prescribe certain classes of medications (i.e. muscle relaxers) or imaging ordering for non military PT's. There are required pharmacology and differential diagnosing courses in PT school now- If the DPT is expected to be fully autonomous will this change?

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[MotionDoc]

With 3 years of education now required why is there no privileged to prescribe certain classes of medications (i.e. muscle relaxers) or imaging ordering for non military PT's. There are required pharmacology and differential diagnosing courses in PT school now- If the DPT is expected to be fully autonomous will this change?

The idea is that adding this training to the profession's entry-level curriculum qualifies us to perform X, Y, or Z. Whether or not PTs are qualified is not the real issue...the problem is lobbying to add these privileges to state practice acts. As you can imagine, the medical community is split on this. From personal experience, for every two physicians I have spoken to that support PTs in these efforts, I meet another that disagrees with this route. I will tell you that after a brief face-to-face conversation (for those that I find willing), I find that their argument is made against a straw man physical therapist (the stereotypical, non-evidence based, ice-US-massage PT)...one that it becomes very clear to them I am not. When it becomes clear to them that I am not some prodigy and that my knowledge and thought process is a direct product of standard PT training, they find it hard pressed to argue that patients would be at any added risk if PTs truly did assume greater autonomy.

The recipe to effect change:
1) Support the APTA.
2) Support your local state PT association's efforts.
3) Take the time to educate individuals (medical professionals included) in your local community about what you, a doctored health care professional, can really do.

 

[facetguy]

A minority group in the chiropractic profession advocate for adding limited prescription rights. I believe it was Arizona (or maybe New Mexico...not sure) that did just get this passed into law. But PTs as a group are much more in the 'mainstream' and may have a better shot at getting something like this through.

 

[truthseeker]

personally, I would support our gaining imaging rights/priviledges but not medication prescription. Our 3 years of education does NOT give us sufficient knowledge to know when NOT to prescribe medications of any type other than maybe NSAIDS.

I feel like I would be able to order appropriate imaging as well as anyone. Motiondoc forgot to mention what the insurance company would be like as a filter. Remember, most states have direct access, but very few insurors will pay for it unless it is ordered by a MD/DO.

 

[MotionDoc]

personally, I would support our gaining imaging rights/priviledges but not medication prescription. Our 3 years of education does NOT give us sufficient knowledge to know when NOT to prescribe medications of any type other than maybe NSAIDS.

I recently met a PT that was written up for suggesting that a patient take Tylenol...like seriously?

 

[rcheeley]

I think this is out of our scope of practice, end of story. If there is a question about a patient needed something such as an anti-inflammatory, muscle relaxor, pain med, etc. Then they need to see a M.D. (medicinal doctor). This is what they do, prescribe drugs. We P.T.s are training at physical therapy.

 

[MinnDasota]

We aren't medical docs so it makes no sense that we should prescribe meds IMO. We just don't have the training, especially with the millions of meds out there. We should, however, know what our patients are taking and how they can affect treatment.

Would be nice to be able to prescribe imaging, but this in itself is already over utilized.

 

[MotionDoc]

We aren't medical docs so it makes no sense that we should prescribe meds IMO. We just don't have the training, especially with the millions of meds out there. We should, however, know what our patients are taking and how they can affect treatment.

Would be nice to be able to prescribe imaging, but this in itself is already over utilized.

http://www.thefreelibrary.com/The+r...ts+as+nonphysician+health+care+...-a016863109

No one is talking about prescribing chemotherapy, antibiotics, antivirals...etc.

The goal is to provide the most effective and efficient treatment...why should a patient have to jump through hoops to get a prescription for dexa for iontophoresis? Why should a good PT be criticized for suggesting a patient take Tylenol?

Yes, we are physical therapists and not medical doctors...but anyone can see that in certain situations, medications can absolutely enhance treatment. I understand if you are concerned about the "take this muscle relaxer and come back in 2 weeks" approach...but I think you'd be hard pressed to find a good PT succumb to that mentality...we are trained to correct underlying issues, not just treat impairments...a family doc is not privileged to our training (nor are we to theirs).

 

[mtm34]

I can see the argument both ways when it comes to the meds but as far as imaging goes- if not MRI and beyond its kind of ridiculous a PT with direct access can't order for a simple x-ray.

 

[Cyres]

Medications: I think there's no question that we should have the right to prescribe the medications to be used with iontophoresis or phonophoresis. I am a proponent of an adaptation of the military model for therapists (which permits limit prescription rights of oral medications) in the civilian sector as therapists have proven themselves capable, safe and effective with the expanded scope.

Imaging: Again, the military model permits therapists imaging within their scope of practice. It's been safe and effective. If I recall correctly, the number of images for MSK injuries actually declined. I know the Wisconsin practice act permits therapists to order imaging, but I cannot speak for other states.

DME: Something that hasn't been discussed is durable medical equipment. Wheel chairs, walkers, canes, orthotics, TENS units, etc. Why therapists do not have full or at least limited prescription rights in this area? That has always baffled me.

 

[DancerFutureDPT]

DME: Something that hasn't been discussed is durable medical equipment. Wheel chairs, walkers, canes, orthotics, TENS units, etc. Why therapists do not have full or at least limited prescription rights in this area? That has always baffled me.

Point taken...all the PTs I work with who have patients who needs TENS units have to call the doctor, get him to write a script, fax it over to us, and then we can get the unit to the patients....in essence the PT is ordering it, the MD just has to write the script. That's really dumb. Cut out the middle man for stuff like that.

 

[homeboysalute]

Your education in no way prepares you to DX diseases and prescribe medications...it's not a straw man argument just compare the curriculums and the rigor of training between the two. It becomes a slippery slope as can be seen with other health care providers. Having to make a phone call and receive a fax? Is that really so difficult. Got to physical therapy to provide a PT with physical therapy. You want to practice medicine go to medical school. Every health profession under the sun is doing the same freakin thing. The lines are going to become very blurred and PTs will suffer.

 

[homeboysalute]

And the MD isn't just writing the script. There is alot of background on the PT and the medication that is taken into account before the script is written.

 

[mtm34]

fair enough homeboy, even though my question is only regarding very limited and restricted prescriptions...more importantly- what about imaging, I feel the biggest disadvantage PT's have to Chiro's is the ability to take/order radio-graphs...

 

[MotionDoc]

Your education in no way prepares you to DX diseases and prescribe medications...it's not a straw man argument just compare the curriculums and the rigor of training between the two. It becomes a slippery slope as can be seen with other health care providers. Having to make a phone call and receive a fax? Is that really so difficult. Got to physical therapy to provide a PT with physical therapy. You want to practice medicine go to medical school. Every health profession under the sun is doing the same freakin thing. The lines are going to become very blurred and PTs will suffer.

The ridiculous argument that a PT isn't capable of correctly prescribing (or even suggesting...which is OK for my grandmother to do may I add) simple analgesics and anti-inflammatories because in some way it would put patients at risk is a straw man argument for many physicians who still view physical therapists as techs that carry out a physical therapy prescription. Aside from all that, it has been shown in both the literature and in practice that patients are no worse off, and that it may actually benefit the healthcare system.

Your fear that "the lines are going to become very blurred" is perfectly understandable, but in my opinion rather dramatic. Considering the nature of physical therapy, limited prescription rights do fall within the realm of physical therapy...the problem is a territorial one, not about quality of care or practitioner ability.

 

[MotionDoc]

The ridiculous argument that a PT isn't capable of correctly prescribing (or even suggesting...which is OK for my grandmother to do may I add) simple analgesics and anti-inflammatories because in some way it would put patients at risk is a straw man argument for many physicians who still view physical therapists as techs that carry out a physical therapy prescription. Aside from all that, it has been shown in both the literature and in practice that patients are no worse off, and that it may actually benefit the healthcare system.

Your fear that "the lines are going to become very blurred" is perfectly understandable, but in my opinion rather dramatic. Considering the nature of physical therapy, limited prescription rights do fall within the realm of physical therapy...the problem is a territorial one, not about quality of care or practitioner ability.

May I also add: I too believe in distinct lines separating the health care professions, I am fully aware of the limits of PT practice, I acknowledge the rigorous training of physicians, and if my child fell sick I would be the first person pounding on the door of my local physician.

With all that said, I find no contradiction in my previous post.

 

[facetguy]

fair enough homeboy, even though my question is only regarding very limited and restricted prescriptions...more importantly- what about imaging, I feel the biggest disadvantage PT's have to Chiro's is the ability to take/order radio-graphs...

About 10 years ago, I shared office space with a PT (I'm a DC). He would frequently ask me to review patient xrays with him, which to me showed his level of interest in his patients (he was a good PT). But he said he had gotten very little education regarding imaging and was essentially clueless in that department. Now, perhaps things have changed in PT schooling, I don't know. But DCs get LOTS of training regarding imaging, so the comparison you make probably is not a fair one.

 

[MinnDasota]

About 10 years ago, I shared office space with a PT (I'm a DC). He would frequently ask me to review patient xrays with him, which to me showed his level of interest in his patients (he was a good PT). But he said he had gotten very little education regarding imaging and was essentially clueless in that department. Now, perhaps things have changed in PT schooling, I don't know. But DCs get LOTS of training regarding imaging, so the comparison you make probably is not a fair one.

Yes, the training for PTs in imaging has changed as it wasn't necessarily part of the curriculum 10 years ago.

 

[DancerFutureDPT]

About 10 years ago, I shared office space with a PT (I'm a DC). He would frequently ask me to review patient xrays with him, which to me showed his level of interest in his patients (he was a good PT). But he said he had gotten very little education regarding imaging and was essentially clueless in that department. Now, perhaps things have changed in PT schooling, I don't know. But DCs get LOTS of training regarding imaging, so the comparison you make probably is not a fair one.

There's a difference though between reading an x-ray and ordering one...even an orthopod doesn't dx a patient based on and MRI or CT scan without consulting a radiologist...I think the argument here is that the PT should be allowed to order imaging, not that the PT would read the scan without outside input from a radiologist...if I'm a PT and a patient comes in for a screen (which my clinic will do for free without a script) and I think they have torn their ACL and the Lachman test is positive, I should be able to order an MRI to confirm that finding, instead of having to send the pt to an MD (extra cost), and then have the MD order the MRI. Of course if the ACL was torn, they pt would need to see an MD anyway, so maybe this wasn't the best example, but you get the idea....if the ACL wasn't torn though, and the patient just needed PT to help rehab the knee, then the MD visit was just added cost to the patient that isn't necessary.

And it's my understanding that with the addition of the DPT degree, added courses in imaging are required in the curriculum. If you worked with the PT 10 years ago, chances are he didn't have the same radiology training as the newbies do nowadays.

 

[truthseeker]

About 10 years ago, I shared office space with a PT (I'm a DC). He would frequently ask me to review patient xrays with him, which to me showed his level of interest in his patients (he was a good PT). But he said he had gotten very little education regarding imaging and was essentially clueless in that department. Now, perhaps things have changed in PT schooling, I don't know. But DCs get LOTS of training regarding imaging, so the comparison you make probably is not a fair one.

There is a difference between knowing what to order and being able to interpret all images. Almost all of the xrays/MRI/CTs in our facility ordered by NPs, MDs, and PAs are over-read by radiologists.

There was a study comparing PT vs FP vs Orthopedist and the appropriateness of the ordering of imaging studies and the PT and the orthopod were just about the same.

 

[homeboysalute]

First I'd like to see these studies because there is a dearth of any quality prospective study about Patient outcomes and I'm sure these studies are weak at best

There is already a ridiculous amount of imaging and these test do have a serious impact on the patient in terms of radiation and yet another health professional ordering them without knowing the patients history of imaging adds to the problem. It's not territory, a semester or two of "imaging" classes and anyone should order an MRI? Ridiculous. And the fact that other physicians continue to consult with radiologists only weakens your own point. Even when someone has had more extensive training they may still need a radiologist

And where is this improving patient safety? All you complain about is you having to consult someone else! Or having to make a phone call! Don't be such a hypocrite and pretend this is not a territory issue for you. At least more extensive clinical and didactic training supports the physicians territory. Don't pretend that you are not being self serving

 

[Skialta]

So, ordering simple analgesics sounds like it would be harmless right? There is a little more to it, do you know if the patient has undiagnosed kidney disease, what is their creatinine? Is it safe if they are on coumadin. There is a lot more to it than just giving someone a prescription. I am a former physical therapist so I understand your argument, but I think having the right to write RXs has more liability and responsibility than it would appear. You really don't have all the training you need to be safe. Yea, some 20 yr old healthy male maybe, but grandma with 10 comorbidities and polypharmacy is a different story.

 

[MotionDoc]

There is already a ridiculous amount of imaging and these test do have a serious impact on the patient in terms of radiation and yet another health professional ordering them without knowing the patients history of imaging adds to the problem. It's not territory, a semester or two of "imaging" classes and anyone should order an MRI? Ridiculous. And the fact that other physicians continue to consult with radiologists only weakens your own point. Even when someone has had more extensive training they may still need a radiologist

In the literature (military) PTs actually ordered less radiographs than medical counterparts...

From your view, is this argument really so simple that the thought of PTs capable of successfully ordering images can so easily be dismissed by you because you think "a few semesters" is not enough? If I were to provide you with written, affirmative statements by the orthopedic surgeons and sports med physicians that teach these courses would that mean anything to you? If I told you that imaging was ingrained into the 3 year PT curriculum from one day, would that mean anything to you? Or are you so completely shut against the thought? Well, that is the impression I get from your statement. Radiologists will always provide the radiographic report...the question is: can a PT successfully navigate the indications/contraindications of ordering images?

And where is this improving patient safety? All you complain about is you having to consult someone else! Or having to make a phone call! Don't be such a hypocrite and pretend this is not a territory issue for you. At least more extensive clinical and didactic training supports the physicians territory. Don't pretend that you are not being self serving

Of course it would be better for the profession...but please don't try to make it seem that this is all it's about. What is so horrible about seeking autonomy? The reality is, our training does prepare us (and its not just PTs shouting it from the rooftops). The reality is, in certain communities in this country, this would drastically improve available patient care. The reality is, a PT may actually better connect a clinical finding with a radiographic finding than physicians with a poor understanding of functional anatomy (there was an article in JPT about this...).

May I ask if you have worked with, dealt with, talked with many PTs?

 

[MotionDoc]

So, ordering simple analgesics sounds like it would be harmless right? There is a little more to it, do you know if the patient has undiagnosed kidney disease, what is their creatinine? Is it safe if they are on coumadin. There is a lot more to it than just giving someone a prescription. I am a former physical therapist so I understand your argument, but I think having the right to write RXs has more liability and responsibility than it would appear. You really don't have all the training you need to be safe. Yea, some 20 yr old healthy male maybe, but grandma with 10 comorbidities and polypharmacy is a different story.

And unless the physician in the same (I am assuming MSK) scenario had a strong suspicion of an underlying kidney issue, would they know about the patients creatinine levels?

You will not find many (if any) physical therapists that would not agree with you that a physician should be intricately involved in the care of (even if its just working on a bum knee) complicated patients...

 

[homeboysalute]

The thing is you wouldn't know when the patient I complicated and YES the physician would be aware and antcipate these kidney issues, YOU would not....and no I would care if you found some doc that agrees with you...adequate education and empirical evidence!

 

[homeboysalute]

*wouldn't care

 

[homeboysalute]

Haha JPT? Journal of physical therapy? Shocker there!

It's not functional anatomy, it's pathophysiology as well!

Motor problems stem from diseases as well! That's where you have no educational basis whatsoever

 

[MotionDoc]

Haha JPT? Journal of physical therapy? Shocker there!

Oh, I am sorry: I forgot that PTs just lack general credibility, and they along with a good chunk of the medical community just wants to see patients hurt . Discussion over friend.

 

[truthseeker]

Haha JPT? Journal of physical therapy? Shocker there!

It's not functional anatomy, it's pathophysiology as well!

Motor problems stem from diseases as well! That's where you have no educational basis whatsoever

I think maybe you are stepping over the line there. Its one thing to have a discussion about something, its quite another to belittle a profession that really is very well trained, perhaps better than you think. I know that I was a TA in anatomy lab and there were many people who are now physicians who struggled.

Of course some diseases cause MSK disorders. We do have an educational basis for understanding those. The thing is, we are often more well equipped to identify them as systemic than the MD/DO is because we spend a little (ok a LOT) more time with our patients and identify patterns that don't fit the normal mechanical pain patterns. We recognize the "other" and refer back to someone who can deal with the "other".

Are you getting your undies in a bunch because you feel threatened by us? That is absurd. PTs have always been team players. We are just trying to make the team better. The US military has done an experiment for years on PT ordering imaging. It has been effective at streamlining the healthcare of the military without adversely affecting the patients.

Even if every state and every insurance company allowed direct access to PT, and PT was allowed nationally, to order imaging, 75 percent of our patients would still probably come from their family doctor. If you think that you can do a better orthopedic eval than an orthopedic PT then you would be a very unusual physician. If you are telling me that when someone comes into your office with back pain and you immediately order all sorts of tests and screens, and imaging to rule out all of the potential causes of non-mechanical back pain before you refer to PT then I would say that you will not get many back pain patients after a while.

What usually happens: Pt. goes to their doc with complaints of LBP. Doc does Xray (useless) or orders MRI (often useless) and refers to PT with a diagnosis of LBP (duh, the patient already knew that) PT does clinical eval and comes up with actual actionable findings OR finds that the pain is not mechanical and refers back to the physician.

Get over yourself.

 

[homeboysalute]

Ohhh very mature move, but we can't ignore bias..

I thought people were over anxious when NPs and PAs got script rights and more autonomy but I was wrong

Diagnosing is not part of your scope, rehab is...imaging is a tool to DX and scripts are used after a DX

 

[truthseeker]

Ohhh very mature move, but we can't ignore bias..

I thought people were over anxious when NPs and PAs got script rights and more autonomy but I was wrong

Diagnosing is not part of your scope, rehab is...imaging is a tool to DX and scripts are used after a DX

OK then make a diagnosis.

I think you are the one who is over anxious.

What do you mean bias? and what exactly are you saying (mockingly) that is a very mature move? OR are you referring to motiondoc? Either way, I think you have to at least listen to the arguement. You are dismissing it without any thought. Foolish.

 

[homeboysalute]

I was replying to the post before you, didn't even read yours yet

 

[mtm34]

Wait... DX is not within the scope of a PT with direct access?

 

[Cyres]

The KISS answer: therapists diagnose dysfunction, physicians diagnose disease.

 

[Socrates25]

Please spare us this crap about how this is about "helping" patients.

It has nothing to do with patients and everything to do with money. Until you admit that fact, I would never even consider allowing you guys to expand your scope.

 

[homeboysalute]

No one belittled your profession....that's your own insecurity...like adding a doctorate to physical therapy education when just a masters is needed so people call you "doctor", oh are your undies in a bunch, I wear underwear by the way I'm not 3 years old

Enough with the military example...they are a younger and more homogeneous population...much more difficult to manage than a civilian with older pts and multiple comorbidities...they don't have to worry about the same liabilities as well and have better contiuous care, they are in hospitals and clinics as well with peripheral help from docs and other health professionals, not in a private office. It's like comparing why we should have Canadas healthcare system, poor example makes for weak argument

And pulling #s out of your ass like 75% of such and such does nothing either. It will absolutely increasing imaging orders and pt radiation exposure, but I'm not worried because I don't see Medicare reimbursing PTs for this. And get off chiropractors and what they do, docs only refer to them when nothing will assuage a pt and it is just giving them someone to babysit and get out of their hair, they are a step away for witch doctors...there now i have belittled since you invited it

See skialtas post for a perfect reason against script rights.

 

[homeboysalute]

*much less difficult to manage

Long day

 

[mtm34]

All very good points but back to my original point, all I'm saying is if you are going to give PT's direct access to patients I respectfully disagree with the assumption that X-rays and a very limited prescription list does anything other than simplify the system and give the patient the fastest access to appropriate care. I'm not saying PTs should be prescribing barbs and ordering CAT scans. Muscle relaxers, NSAIDs and Xrays just make too much sense.

 

[homeboysalute]

Yet again skialta gave an example how they're is never too simple a drug

 

[MinnDasota]

Please spare us this crap about how this is about "helping" patients.

It has nothing to do with patients and everything to do with money. Until you admit that fact, I would never even consider allowing you guys to expand your scope.

Explain to me how you think this is about money? PTs get paid by insurance reimbursements of our treatment sessions. We would not see another dime by ordering a radiograph as it isn't part of our treatment.

So this brings us back to helping the "patient" streamline through our inefficient health care system.

As a PT, I have been taught that imaging should only be ordered if the results could change the course of treatment. Is this train of thought different in med school? I thought imaging was used to rule in/out pathology and not necessarily to diagnose. All too often symptoms are chased through imaging, when a lot of the times, the radiographic results aren't the actual cause. Radiographs are great tools, however, they are not always specific or sensitive.

 

[MotionDoc]

Please spare us this crap about how this is about "helping" patients.

It has nothing to do with patients and everything to do with money. Until you admit that fact, I would never even consider allowing you guys to expand your scope.

What an ignorant post that only proves lack of familiarity with this topic (and if you are indeed familiar, than shame on you for purporting an invalid argument).

No one belittled your profession....that's your own insecurity...like adding a doctorate to physical therapy education when just a masters is needed so people call you "doctor", oh are your undies in a bunch, I wear underwear by the way I'm not 3 years old

How obvious that you have yet to begin your professional years. I (and your future patients) can only hope that your "I am mighty" attitude evolves out from under the rock it currently resides.

And pulling #s out of your ass like 75% of such and such does nothing either. It will absolutely increasing imaging orders and pt radiation exposure, but I'm not worried because I don't see Medicare reimbursing PTs for this. And get off chiropractors and what they do, docs only refer to them when nothing will assuage a pt and it is just giving them someone to babysit and get out of their hair, they are a step away for witch doctors...there now i have belittled since you invited it

Adding fuel to the fire friend. Are your medical "powers" so mighty that you have no need for other health care professionals? Odds are, a legitimate chiropractor will run circles around your ability to manage and treat the spine. Yet, why would you ever refer your patients to a witch doctor? They are better off in pain!!!! right?

Homeboy, grow up, your patients will appreciate it...

See skialtas post for a perfect reason against script rights.

Skialtas post was an excellent example...but truthseeker's response (if you had understood it) answers and expands on the reality. Unless you have a high index of suspicion of an underlying condition, YOU WILL THINK HORSES IF YOU HEAR HOOFS!! For skialta's renal function example, you would not order bloodwork for every patient that walks through the door unless a history indicates it necessary. PT education does not prepare me nearly well enough to order blood work or even narrow down to a potential medical issue, but it sure as heck prepares me well enough to recognize the indicators for potential "zebras." Red flags that set off "warning, non MSK" lights instantly trigger a referral to the medically trained physician whose expertise and training allow him to generate a medical diagnosis and formulate the medical intervention.

Are you so lost in your stubbornness that you believe PTs have any desire to that later part? I WANT TO BE A BETTER PT. I WANT THE ABILITY TO BETTER MANAGE MY PATIENTS. I don't imagine I can do my job without you doing yours...grow up and consider that the opposite may also be true.

 

[Skialta]

Back to my previous statement.... The point I was trying to make was if you as the provider were concerned about a possible interaction you would verify it by ordering a lab to check the creatinine. Going down this line of thinking where would you draw the line between physician and PT? My point being if you are going to prescribe medications you need to be able to follow labs, have the medical history available to you etc, basically be a physician. It's not that PTs can't figure out when an anti-inflammatory would be beneficial, or that you couldn't write a script for phonophoresis. I think it makes a lot of sense for it to be a team environment, if someone thinks a medication is going to be of help it is my job to think about the patient as a whole and put the "said" med in the context of the patients overall health and make a decision.

 

[homeboysalute]

Oh I understood his post and without the bloodwork and knowledge to order it and understand it you would put the patient in harm....how are you going to be suspicious of this scenario when you never encountered it or are prepared to understand it???? Your post as the others were littered with insults as well so don't play innocent

And money is involved when PTs get x Ray machines in their office (like chiropractors) and start filming away..maybe you should rethink your point

 

[homeboysalute]

You don't have adequate or any for all I know pharmacology background, how the hell are you going to understand drug interactions??? Especially when you deal with a mostly older pt population! You have know index of suspicion for the case skialta brought up because your training didn't prepare you

 

[homeboysalute]

His response does nothing to skialtas answer, the physician will know the pts medical history and depending on the scenario have or order bloodwork...PTs can't and don't have the background to do this...this guy was a PT and he is even saying this! I'm off this is just gonna go in loops and isn't gonna happen anyway...we'll see more independent NPs and PAs before this

 

[MinnDasota]

And money is involved when PTs get x Ray machines in their office (like chiropractors) and start filming away..maybe you should rethink your point

PTs would never get xray machine's in their offices. That's just silly talk. If we were able to order an xray, it would be so the pt could go directly to a radiologist without having to wait weeks to see their physician first. No money goes into the PTs pocket from this.

 

[homeboysalute]

Not silly at all..once a buck could be made off it...as can be in a chiros office, it would happen...that's just naive....besides the point though because even if not PTs don't have enough training with the use of imaging and would order inappropriately

 

[homeboysalute]

Also the pt would not want to go directly to the radiologist...another reason you shouldn't be ordering imaging...there are other less expensive ways to rule out things such as using the Ottawa ankle test to rule out fracture and the need for x Ray...finally getting the picture?

 

[soccer31]

You don't have adequate or any for all I know pharmacology background, how the hell are you going to understand drug interactions???

Also the pt would not want to go directly to the radiologist...another reason you shouldn't be ordering imaging...there are other less expensive ways to rule out things such as using the Ottawa ankle test to rule out fracture and the need for x Ray...finally getting the picture?

Your first statement just utterly prove your lack of knowledge about other professions and their education background. And don't tell me that a PT you know who graduated 10 years ago told you so, because our education changed dramatically in the past decade, including these courses (imaging, pharmacology, etc) that you think we don't learn!

As far as the 2nd statement, do you think the Ottawa Ankle Rules is exclusively available for physicians? Here is a short reading for you:

http://www.ncbi.nlm.nih.gov/pubmed/11101110

Bottom-line is PTs ordered x-rays as consistently as the orthopedic surgeons on this study. And I know there are other similar studies like this that some other people here wouldn't mind sharing with you.

Since you are still a MD student, I will give you the benefit of the doubt that you are still on your 1st or 2nd year and still have your head far up your *****. But for your and your patients sake, educate yourself better about other healthcare professionals.

 

[MinnDasota]

Not silly at all..once a buck could be made off it...as can be in a chiros office, it would happen...that's just naive....besides the point though because even if not PTs don't have enough training with the use of imaging and would order inappropriately

Now you are just showing how closed-minded you are about the PT profession. Again, silly talk. I will chalk it up to not knowing our education, our curriculum. If you're still a student, keep learning.

Ottawa Ankle rules? As a practicing orthopedic/sports PT, I use this very frequently on the sidelines. It is part of the PT curriculum.