Drug Presciptions/ Imaging

[facetguy]

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.

Now you know how chiropractors feel.

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[homeboysalute]

Don't cherrry pick my argument what about the pt with kidney disease and creatine levels? How do you interpret the bloodwork?...doesn't change that you don't know disease and therfore should not be writing scripts

Assume whatever you want, personal attacks make you look weak

I'm done, but I'm sure these "imaging" and pharmacology classes give you a peripheral knowledge at best

Again the military isn't a good comparison to the civilian world so go join

I concede that you use Ottawa ankle, but why then did the poster say to refer right to a radiologist?

 

[homeboysalute]

3 years of post bacc education doesn't prepare someone for these rights or "dr" title
signing off

 

[MotionDoc]

3 years of post bacc education doesn't prepare someone for these rights or "dr" title
signing off

You have already proven you know little about the Physical Therapy profession or its education...as such your arguments are moot.

 

[homeboysalute]

And you know little of medical education and the work that goes into writing scripts so so is yours

 

[truthseeker]

And you know little of medical education and the work that goes into writing scripts so so is yours

Read your posts and see who is snarky and is arguing with their back up.

You make valid points about prescription rights. I don't think we have enough training and don't know enough about pharmacology. HOWEVER, I do think we know enough about imaging studies. I can't tell you how many physicians order xrays to try and rule out stress fractures.

The article that motiondoc referenced about comparing the imaging recommended by family practice docs, orthopedists, and PTs is very telling.

Is there anything that you think PTs might know that you, in your infinite wisdom don't?

You will be the type of doctor that is a control freak. Insisting upon controlling everything healthcare. You will also be the one who complains about all of the paperwork that comes across your desk to sign (and rarely if ever read) essentially bequeathing control of the management of the patient to whoever send the paper to you to sign.

Actually, you will probably end up doing research. With a mission to prove that you are the smartest and only person capable of making a recommendation.

I hope you don't work anywhere near my patients.

 

[homeboysalute]

You're a physical therapist, do rehab

 

[homeboysalute]

Yea you're not snarky, douche, snarky? Seriously? Go back into your bag of insults for something else

 

[truthseeker]

Yea you're not snarky, douche, snarky? Seriously? Go back into your bag of insults for something else

that's the best you can do? thought you were smart.

 

[homeboysalute]

Douche is great and it gets through uncensored....notice I never claimed to be smarter than anyone, it's about professional boundaries and pt safety

 

[mtm34]

I'd like to thank you homeboy for turning my very productive post into a playground shoving match. Good luck to you. Does anyone else have any insight on this topic, and if it is being pushed for/will/will not end up being put into action?

 

[MinnDasota]

I concede that you use Ottawa ankle, but why then did the poster say to refer right to a radiologist?

You have to remember, you brought up the Ottawa Ankle rules. It wasn't even part of the discussion until then. So when I brought up the referral to a radiologist, we weren't talking specifics. You must have misread my post.

 

[truthseeker]

I'd like to thank you homeboy for turning my very productive post into a playground shoving match. Good luck to you. Does anyone else have any insight on this topic, and if it is being pushed for/will/will not end up being put into action?

Sorry for participating in the shoving match. I couldn't help myself. There are some rumblings but I don't think it is going to happen anytime soon.

 

[homeboysalute]

I gave my opinion that I don't think your whole 3 years now should give you these practice rights or that they should be in your scope of practice

Everyone else took it as who's smarter and got bitter...I in know way think education=intelligence, but I do believe it should dictacte practice rights

 

[jles]

On that last comment, even though homeboy has been exiled, the med and pharm students I talked with at my school aren't in class during the summer. So if you take the 8 consecutive semesters of the DPT program, and add summers you have 4 years compressed into 2.5 years. A Ph.D. candidate in rehab science with his DPT told me PT school is like 5 years compressed into 3.

Don't talk about something you know jack about.

I gave my opinion that I don't think your whole 3 years now should give you these practice rights or that they should be in your scope of practice

Everyone else took it as who's smarter and got bitter...I in know way think education=intelligence, but I do believe it should dictacte practice rights

 

[Buckeye4life]

Med students do get their summers off after first and second years. They do, however, take around 50 credit hrs/semester those first two years. After that they have two straight years of clinicals with maybe a month off/year. There are constant exams (shelfs) that must be passed to advance, not to mention two 8 hour board exams thrown in there (step 3 taken after year 1 of residency). There's also incessant pimping and hazing from residents and attendings/nurses, presenting on rounds, never exactly knowing ur role on the medical team, as well as the pressure of having to outperform your peers to get competitive residencies. Residency then adds another 3-7 years, which must be completed in order to become board certified and recognized by insurance carriers. It takes on avg. about 10 years to produce a new physician. PT school is intense and covers a wide range of material, but let's not get carried away. It is not near the depth of understanding, or the mental/financial stress that physician training entails. I think that if PT wants more respected autonomy, they need like someone else mentioned, specialty certification and at least a year, maybe two, of supervised residency in a particular area.

 

[jles]

I mentioned the summers off simply to have a basis for saying that it's more like 4 years for PT school, not comparing med school with physical therapy. No one here, including myself is talking about PT training being the same or comparable with medical physicians. However, I think it is important for other professions to know that we're not just chillin' on the beach in the summer.

By the way, I counted 53 credits hours for the first year of med school at my university. Not 50/semester. For the record, we take 17 credit fall and spring semesters, and 13 in the summer = 47/year.

 

[Buckeye4life]

Actually, I don't know where u go to school or how they break down credits, but my med school requires almost 50 cr hrs/semester. I posted to not take away from PT education, but to maybe give perspective as to why physicians will feel that very few health care providers besides fully trained medical doctors should be allowed even limited prescription or imaging rights. If PTs can order imaging and prescribe NSAIDS, then I think athletic trainers and physical therapy assistants should be allowed to do initial evaluations and discharges.

 

[atstudent]

If PTs can order imaging and prescribe NSAIDS, then I think athletic trainers and physical therapy assistants should be allowed to do initial evaluations and discharges.

Athletic Trainers should be able to do anyway. It's in many states' practice acts except that insurance won't cover it. We do A LOT of initial evaluations and Return to Play decisions almost every day.

 

[Buckeye4life]

Athletic Trainers should be able to do anyway. It's in many states' practice acts except that insurance won't cover it. We do A LOT of initial evaluations and Return to Play decisions almost every day.

No they shouldn't. ATs do not have the same level of training to safely and efficiently take a referring dx and create a pt. specific POC as a PT. I only said that to make a point. Well, i'm tired of being in this hornet's nest, so good luck with everyone's careers.

 

[Danae00]

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?

Is the goal for DPTs to be fully autonomous? I'm not in a country where there are DPTs (it is ~2.5 years masters program up here) but we do have direct access.

I just have never had the impression that there was any desire to be able to "do it all". Rather up here they seem to stress the multidisciplinary approach to treating patients. I know we will be taking at least one course with the OTs, SLPs, med students, and nurses. The purpose is to do group work together in order to learn how we can give our patients the most comprehensive and superior care possible.

 

[sdpt]

I'm a student PT and doing a debate on this topic for class. It's interesting how heated this discussion became so quickly. Personally, being in the curriculum right now, we've had about ten hours of online pharmacology training built into our clinical medicine class. Make what you like of that, but the topics have run the gamut from cardio drugs to anti-seizure meds, including nsaids and analgesics. And, though I have not had it yet, I know for a fact that we have a class dedicated to imaging techniques.

I'm a newbie to the whole medical community. I know nothing about the money, where it goes and why, and I'm just getting introduced to the turf wars that are going on, which I still don't get. But I have a hard time understanding why we're learning these techniques and drugs if we're not even allowed to use them. Especially for OTC drugs. I find it hard to believe, given the education I am currently receiving, that I do not have the know-how to reccommend my patient take a mild NSAID, which they could decide to take of their own accord without my knowledge (or their MD's, for that matter). It just doesn't make sense.

 

[jbizzle]

Oh man, great thread. I learned a lot just from reading this

 

[Donkeykiss]

I'm a student PT and doing a debate on this topic for class. It's interesting how heated this discussion became so quickly. Personally, being in the curriculum right now, we've had about ten hours of online pharmacology training built into our clinical medicine class. Make what you like of that, but the topics have run the gamet from cardio drugs to anti-seizure meds, including nsaids and analgesics. And, though I have not had it yet, I know for a fact that we have a class dedicated to imaging techniques.

I'm a newbie to the whole medical community. I know nothing about the money, where it goes and why, and I'm just getting introduced to the turf wars that are going on, which I still don't get. But I have a hard time understanding why we're learning these techniques and drugs if we're not even allowed to use them. Especially for OTC drugs. I find it hard to believe, given the education I am currently receiving, that I do not have the know-how to reccommend my patient take a mild NSAID, which they could decide to take of their own accord without my knowledge (or their MD's, for that matter). It just doesn't make sense.

Hahaha

 

[Flavoring Agent]

NSAIDs are not to be trifled with. They pose a problem to patients with kidney disease, cardiovascular problems, asthmatics and sulfa allergies.

Physical Therapist just don't have the adequate training to prescribe. I shudder to think of an NSAID being prescribed to an elderly lady with Rheumatoid Arthritis taking weekly methotrexate.

Finally, the DEA would hate it if more people are prescribing muscle relaxants.

 

[Fiveoboy11]

NSAIDs are not to be trifled with. They pose a problem to patients with kidney disease, cardiovascular problems, asthmatics and sulfa allergies.

Physical Therapist just don't have the adequate training to prescribe. I shudder to think of an NSAID being prescribed to an elderly lady with Rheumatoid Arthritis taking weekly methotrexate.

Finally, the DEA would hate it if more people are prescribing muscle relaxants.

First off, you probably know little to nothing about PT training. But I generally agree that PT's are not adequately trained to prescribe certain medications. I think additional training could certainly allow them to do so in a competent manner.

FWIW, I currently have a patient on Methotrexate and Prednisone due to his "polymyalgia rheumatica." Subsequently he has developed wrist pain and hand edema B and he phoned the physician who told him it has nothing to do with his medication. LOL. Above prescribed by an MD.

Also, I have a patient with balance disturbance and fall history with long standing depression. She is on Prozac, Wellbutrin, Effexor all above typical maximum doses. LOL, nice combo prescribed right there by an MD. Hmm, could your excessive medication usage be causing this problem, I wonder. Or should it be diagnosed as idiopathic falls and balance disturbance.

I see questionable medication prescriptions all day long. I have no doubt that with further training, a PT could do a much better job with limited prescriptive rights for select patients (i.e. limited to no comorbidities) to help manage MSK conditions on an acute basis.

 

[facetguy]

First off, you probably know little to nothing about PT training. But I generally agree that PT's are not adequately trained to prescribe certain medications. I think additional training could certainly allow them to do so in a competent manner.

FWIW, I currently have a patient on Methotrexate and Prednisone due to his "polymyalgia rheumatica." Subsequently he has developed wrist pain and hand edema B and he phoned the physician who told him it has nothing to do with his medication. LOL. Above prescribed by an MD.

Also, I have a patient with balance disturbance and fall history with long standing depression. She is on Prozac, Wellbutrin, Effexor all above typical maximum doses. LOL, nice combo prescribed right there by an MD. Hmm, could your excessive medication usage be causing this problem, I wonder. Or should it be diagnosed as idiopathic falls and balance disturbance.

I see questionable medication prescriptions all day long. I have no doubt that with further training, a PT could do a much better job with limited prescriptive rights for select patients (i.e. limited to no comorbidities) to help manage MSK conditions on an acute basis.

Whether true or not, it's not going to happen anytime soon (ever?).

 

[_FNG_]

Whether true or not, it's not going to happen anytime soon (ever?).

Unless you're in the military or working in a government hospital. Military PTs can order imaging and prescribe certain NSAIDs and analgesics.

The military model for managing musculoskeletal issues has been one that has been touted by some as what PT could look like in the US to help reduce healthcare costs and reduce physician caseloads (shortage supposedly coming) with aches/sprains/etc.

http://www.ncbi.nlm.nih.gov/pubmed/16294989

http://www.ncbi.nlm.nih.gov/pubmed/15773564