Physical Therapy or Physician Assistant

[jles]

My school's DPT program is ~1500 hrs in the clinic, 113 credit hours, 120 weeks (includes clinic and didactic), 2.5 years (I said 3 before)...and I work my but off year round. I got a 1200 on the GRE, 1180 is the class avg., 4.0 prereqs (3.8 is class avg), 3.5 cum (I had a different undergrad degree).
Previous semesters I put in ~60-70 hours/week. Maybe that says more about my standards than anything, I don't know.

My school's PA program is 80 semester hours (40 clinical). .
(btw, doesn't require physics I and II, or bio.)

As if credit hours mean much anyway. Everyone has taken a 1 credit that seems like a 3 and vice versa, however it's usually the former situation in my program. I have found that hour for hour, all my classes take much more of my time than they should based on the 3 hours of outside class time = 1 credit hour. Just like when shopping around for schools you need to consider student:faculty ratios, faculty, etc…If credit hours = more money for the school then what is going to be the tendency?

My problem with what I have read on here is the gross overgeneralization of statements against PT in general. As I have said, there is a lack of standardization in education and clinical practice. It's only going to improve including for some of the reasons stated by Motiondoc in his recent post.

I believe there is a very bright future for the physical therapy profession, and that's not just my opinion.

As a side thought, think of the health care savings with the shift away from reactionary care to preventative. We play a huge role there too. We will be thought of as dentists, optometrists, podiatrists. Consumers will know who to see just as they know to go to their dentist for oral care. The motivation to refer when appropriate is there because of ethical and legal reasons - who wants to be sued, or wants to pt (patient) to get worse? Of course, there are PCPs who don't refer to a specialist when they should, and PTs that do the same. Another thought, I wonder if more harm is done by not having direct access and I'll explain aside from the standing argument about delaying patient care. If it's the PCPs job to rule-out, is a PT less likely to be concerned about catching a red flag and miss a chance to refer? If I'M seeing a patient first, I will be VIGILANT to rule-out any potential red-flags and refer IMMEDIATELY. You must also give the patient credit that they will not come to me for an obvious non-musculoskeletal issue. Right now they see their FP for that. That might be ridiculous but just throwing it out there. Also, there is a MD/DO shortage right? Once it's widely accepted that "consumer access" (the new buzz word for direct access) to PT is safe, and it will be, how many MD/DOs will be able to better care for their patients? We know how it goes with your typical visit to the physician, crazy wait time, then 15 minutes tops of frantic history taking and prescription writing. Perhaps taking more time will produce better outcomes, more compliant patients who don't wait to see their FP until it's too late. The current rep of FPs (family practitioners) is not so good as we all know. People are unsatisfied with their care from physicians.

Oh, and no **** I knew that one of my citations was an editorial, I wasn't trying to hide anything. It made for a good read and I stated that there was more/better research to come. It's not like there weren't 21 references including RCTs, etc... Unlike some NYtimes articles. Go on, keep being a hater.

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[jles]

by the way Lawguil, were you an APTA member, or a CI? Just curious

 

[lawguil]

My school's DPT program is ~1500 hrs in the clinic, 113 credit hours, 120 weeks (includes clinic and didactic), 2.5 years (I said 3 before)...and I work my but off year round. I got a 1200 on the GRE, 1180 is the class avg., 4.0 prereqs (3.8 is class avg), 3.5 cum (I had a different undergrad degree).
Previous semesters I put in ~60-70 hours/week. Maybe that says more about my standards than anything, I don't know.

My school's PA program is 80 semester hours (40 clinical). .
(btw, doesn't require physics I and II, or bio.)

As if credit hours mean much anyway. Everyone has taken a 1 credit that seems like a 3 and vice versa, however it's usually the former situation in my program. I have found that hour for hour, all my classes take much more of my time than they should based on the 3 hours of outside class time = 1 credit hour. Just like when shopping around for schools you need to consider student:faculty ratios, faculty, etc…If credit hours = more money for the school then what is going to be the tendency?

My problem with what I have read on here is the gross overgeneralization of statements against PT in general. As I have said, there is a lack of standardization in education and clinical practice. It's only going to improve including for some of the reasons stated by Motiondoc in his recent post.

I believe there is a very bright future for the physical therapy profession, and that's not just my opinion.

As a side thought, think of the health care savings with the shift away from reactionary care to preventative. We play a huge role there too. We will be thought of as dentists, optometrists, podiatrists. Consumers will know who to see just as they know to go to their dentist for oral care. The motivation to refer when appropriate is there because of ethical and legal reasons - who wants to be sued, or wants to pt (patient) to get worse? Of course, there are PCPs who don't refer to a specialist when they should, and PTs that do the same. Another thought, I wonder if more harm is done by not having direct access and I'll explain aside from the standing argument about delaying patient care. If it's the PCPs job to rule-out, is a PT less likely to be concerned about catching a red flag and miss a chance to refer? If I'M seeing a patient first, I will be VIGILANT to rule-out any potential red-flags and refer IMMEDIATELY. You must also give the patient credit that they will not come to me for an obvious non-musculoskeletal issue. Right now they see their FP for that. That might be ridiculous but just throwing it out there. Also, there is a MD/DO shortage right? Once it's widely accepted that "consumer access" (the new buzz word for direct access) to PT is safe, and it will be, how many MD/DOs will be able to better care for their patients? We know how it goes with your typical visit to the physician, crazy wait time, then 15 minutes tops of frantic history taking and prescription writing. Perhaps taking more time will produce better outcomes, more compliant patients who don't wait to see their FP until it's too late. The current rep of FPs (family practitioners) is not so good as we all know. People are unsatisfied with their care from physicians.

Oh, and no **** I knew that one of my citations was an editorial, I wasn't trying to hide anything. It made for a good read and I stated that there was more/better research to come. It's not like there weren't 21 references including RCTs, etc... Unlike some NYtimes articles. Go on, keep being a hater.

Hi folks,

Thanks for the interesting discussion
I'm afraid I'm probably going to disapear now that school is back in session
Perhaps i'll be back this summer....
You're a great group
Best of luck to Lee, Motiondoc, jles, soccer and the rest

You'll all represent the profession well and seem to be very genuine. I admire your generation a great deal for the people you are....Truly!

Best Regards!

 

[lee9786]

I agree, this is a glaring fact...but this does not necessarily imply that there was no change in the programs themselves.

True. To not implement an advanced NPTE to support the DPT educational standards challenges the credibility of the degree IMO. It makes a rebuttal to the concepts of degree creep and degree inflation more difficult to defend.

I don't have time to find a better link, but a majority of medical interventions do not even have much strong evidence behind them: http://www.shef.ac.uk/scharr/ir/percent.html

With that said, PTs that rely heavily on those modalities are not the type of PTs you will see graduating from many DPT programs who, nowadays, frown on non-evidence based interventions except as a last resort.

I've heard about the lack of evidence supporting medical interventions but haven't seen it. Thanks for the link. My concern is with the lack of evidence in PT though. It seems to me PT has a whole lot more "selling" to the public then say medicine and pharm. With this they need more ammo to go up against the medical heirarchy that runs this country. PTs have more pressure to show quantitative results that they are cost effective. Costs are going to be a very big concern very soon.

Trust me, compared with how much fraud is out there in surgery and medical practice, with how relatively little PTs get paid for the interventions they provide, unethical overtreatment is not a huge issue (but to address your statement, ethical practice is addressed ad nauseum in DPT curriculum...but you can't change a rotten apple.)

http://www.aboutlawsuits.com/st-joseph-hospital-implanted-heart-stents-not-needed-7669/

Are the overtreatment police more concerned with hundreds of $20,000 fraudulent surgeries that put hundreds of honest people on anti-coagulants the rest of their lives, or the hundreds of people getting $50 ice and stim.

Good point. PT is cheap in comparision. What type of system of checks and balances would be in place if reimbursement for direct access would occur? Caps?

Are you ready to make the general assumption that a vast majority of PTs are unethical? If not, then do you think the fraudulent actions of a few should be enough to keep the profession from advancing?

no and no. I do think the financial pressures of running an outpatient ortho clinic puts more pressure on clinicians to make decisions more based on financial terms than on patient care terms. I can speak from one volunteer experience where I can say hot/cold packs, estim, and usound were used quite a bit. I would have never guessed some of these modalities' effectiveness would be put into question.

It is easy to make this an either/or decision, but think about it a little more...I don't believe it will ever be that simple. In the acute care setting for example: "Patient X" has necessary surgery for "Lower-Extremity Condition Y," but since there is no money to pay for proper rehabilitation post-op in this new medicare-less society, "Patient X" lives with lifelong pain from a debilitating fall after trying to walk up the stairs of his home on an atrophied and osteoporetic leg that has been unweighted and in a cast for 4 months. Surgical medicine has progressed to the point that incredibly invasive orthopedic surgeries, that they themselves would have put people out of commission for life, are made feasible only because advances in rehabilitation science allow for post-op care that will restore whatever was lost. Or, consider stroke, SCI, TBI or any other post-neurological disorder...what do we do with these people if no one can afford to enter rehabilitation anymore...etc, etc, etc. I believe PT has already proven itself to be a critical player on the healthcare team.

I agree. The question is do policy makers. Big pharm and medicine rule this country. Does the APTA have enough money to throw at the feet of our beloved leaders? I find the trend mentioned in my last post coupled with an increasingly obese population across all ages coupled with all the healthcare costs associated with the comorbidities that follow very troublesome. Nobody wants to lose weight so the options are apparently medication and surgery. Where is exercise be on the priority list? We all know where it should be. Will there be any money left for PT?

http://www.donohoe-wellmon.com/pt/evidence_based_pracitice.htm

If you are not familiar with the early '90s article: "One bum knee meets five physical therapists," check out the link above. This was the catalyst needed to get the profession on the "evidence-based practice" bandwagon. The profession has made huge strides since...I think the question really is: "Is it working?"

My thoughts: the "new and improved" profession is still incredibly young and it is therefore difficult to truly assess. Still, considering the incredible vision set by the APTA, the many devoted individuals across the nation committed to it, the growing number of new applicants and DPT graduates, and the retirement of those in the profession who just refuse to accept evidence-based intervention and would prefer sticking to the good ole' heat pack, ultrasound, stretch, ice + stim routine, I believe that: YES, it is working.

And this potential and reasoning is why I currently continue on the PT path despite having a number of concerns. good post.

 

[lee9786]

Hi folks,

Thanks for the interesting discussion
I'm afraid I'm probably going to disapear now that school is back in session
Perhaps i'll be back this summer....
You're a great group
Best of luck to Lee, Motiondoc, jles, soccer and the rest

You'll all represent the profession well and seem to be very genuine. I admire your generation a great deal for the people you are....Truly!

Best Regards!

Thank you for the kind words and discussion

 

[PTtoBe]

The credit hours lawgui mentioned are a fair bit less than what I'm used to seeing at schools (including the one I'm attending). I've seen around 140 more as the norm.

Edit: probably because I'm looking at quarterly credit hours...

 

[MotionDoc]

Hi folks,

Thanks for the interesting discussion
I'm afraid I'm probably going to disapear now that school is back in session
Perhaps i'll be back this summer....
You're a great group
Best of luck to Lee, Motiondoc, jles, soccer and the rest

You'll all represent the profession well and seem to be very genuine. I admire your generation a great deal for the people you are....Truly!

Best Regards!

Have a great semester Lawguil. Be well friend.

 

[jles]

Thanks Lawguil, take care and have a great semester!

 

[MotionDoc]

...I don't have time to find a better link, but a majority of medical interventions do not even have much strong evidence behind them: http://www.shef.ac.uk/scharr/ir/percent.html

just wanted to throw this up here http://www.apta.org/AM/Template.cfm?Section=Letters1&CONTENTID=67938&TEMPLATE=/CM/ContentDisplay.cfm , and would encourage anyone interested to check out the cochrane review referenced in the link.

 

[jles]

Something to consider after you read the 2004 document put out by MedPAC:

Out of 17 members, all were MDs, except 2 Ph.D.s and one RN.

There were no PTs on the board - ZERO

Having representation means something when it comes to public policy.

I'm not bringing this back, just came across this bit of info in a class presentation and wanted to post up here.

I don't appreciate comments regarding being "misinformed", especially from a pre-professional/PT student. If you disagree with my opinion...that's fine. I was really trying to avoid this debate....and I will unless you educate yourself regarding the issues. Below is a link that outlines the real issues regarding direct access for therapy services. If there are points of this comprehensive review of therapy services you would like to debate in an orderly and professional fashion....I'm interested. But you must read and learn about the issues first....both sides of the debate. What is written above by you is frankly making us less informed decision makers by use of old talking points and an overly simplified analysis. It appears to me that you have a great deal of 'un-learning' to do before you accurately understand the issues.

PLEASE READ IF YOU REALLY WANT TO UNDERSTAND. MORE INFORMATION FORTHCOMING!

http://www.medpac.gov/publications/congressional_reports/Dec04_PTaccess.pdf

These issues haven't changed since 2004 and scholars (such as myself) consider this the best analysis I've read!

Best, L.

 

[lee9786]

One thing to think about. Is there any way possible Medicare doesn't go bankrupt? From what I've seen, it doesn't seem there's any way to make it sustainable. Maybe the priority shouldn't be reimbursement of direct access for medicare beneficiaries. It's 2010 now and medicare is scheduled for bankruptcy in 2017. What's after medicare? Another government program?

 

[jles]

Bottom line, if you save money, a lot of it, with direct access you're helping the situation.

The rest of your post is far too time consuming to respond.

 

[elle147]

Hi,

I'm having the same problem. I came to school thinking I was going to do physical therapy. I'm going to be a junior but I just recently was introduced to the idea of becoming a PA. Well that and going to Med school, but I think that's not really on the table for now. So I've been asking around alot about why people want to become PA's vs. anything else in the healthcare field. I read alot about the flexibility of being a PA; you can change the kinds of fields you work in, whereas PT's seem like it's already pretty specialized. I really don't mind the whole "assistant" that most people are afraid of having in their job title.
But there are some things that are making me think twice about becoming a PA...
I've heard they work on a set salary, and are not paid for working overtime no matter how many hours you have to work.
and... It seems as though once your a PA, you can work in different areas such as surgery, pediatrics, etc., but is there any advancement up, rather than just at the same level but in different specialties?

 

[Kdog]

I have read through most of the pages and appreciate the amount of effort which was put into answering questions and the experiences that people shared. I have also come to a fork and am having trouble deciding my path. I would like to know why more people are not considering NP however! Although the benefits of being an NP over PA are not momentous, they still do get a bit more autonomy, no assistant in their name (for those who are worried about it), the same opportunities as a PA, and no exam requirement every 6 years. I realize the schooling requirement is higher for NPs than PAs but I dont think that is enough to cross NP off the list. Also while many see the DNP as unnecessary and a way for nursing to catch up with other fields in the war for professionalism, I see it as a positive thing. More knowledge about a field which you wish to practice is never negative, especially if it is health care related and deals with the life of individuals. Plus the DNP provides an opportunity for advancement into administrative settings. Is there something I am failing to see?

Elle147: By advancement up are you referring to managerial or administrative positions? You can always make the switch to health care administration if you decide and I believe having worked as a PA or PT would make you a better candidate. Also an interesting fact is that 3% of PAs own their own practice. I did not think PAs had that capability but apparently I was wrong. PAs are always under the supervision of a doctor. Even if that does not mean your supervising physician will always be checking on you or going over your notes, it does mean that you will never advance to his/her level of authority. That's not necessary a bad thing however. With more power comes more responsibility.

 

[chadwickctt]

Although the benefits of being an NP over PA are not momentous, they still do get a bit more autonomy, no assistant in their name (for those who are worried about it), the same opportunities as a PA, and no exam requirement every 6 years. I realize the schooling requirement is higher for NPs than PAs but I dont think that is enough to cross NP off the list.

Elle147: Also an interesting fact is that 3% of PAs own their own practice. I did not think PAs had that capability but apparently I was wrong. PAs are always under the supervision of a doctor. Even if that does not mean your supervising physician will always be checking on you or going over your notes, it does mean that you will never advance to his/her level of authority. That's not necessary a bad thing however. With more power comes more responsibility.

Actually I think you'll find that PAs have more opportunities than an NP. The lateral mobility of a PA is something that NO other health field profession can offer. The ability to work in a different specialty whenever you choose, or even at the same time is unique to the PA career. Also, the autonomy level is, for all intense and purposes, the same for both PA and NP. The "independence" of the NP, if they choose to pursue it, limits their abilities and scope of practice compared to the NP that works with an MD/DO. And the education requirements for NP and PA are the same. Master's level.

Furthermore, an NP will never advance to the level of a physician either. So I fail to see what the point of that comment was. And yes, the percentage of NPs and PAs who own their own practices is approximately equal at 2-3%.

 

[Kdog]

Actually I think you'll find that PAs have more opportunities than an NP. The lateral mobility of a PA is something that NO other health field profession can offer. The ability to work in a different specialty whenever you choose, or even at the same time is unique to the PA career. Also, the autonomy level is, for all intense and purposes, the same for both PA and NP. The "independence" of the NP, if they choose to pursue it, limits their abilities and scope of practice compared to the NP that works with an MD/DO. And the education requirements for NP and PA are the same. Master's level.

Furthermore, an NP will never advance to the level of a physician either. So I fail to see what the point of that comment was. And yes, the percentage of NPs and PAs who own their own practices is approximately equal at 2-3%.

I was in the mindset that NPs require doctorate degrees soon which would increase educational requirements. Also as you know a person with any BA/BS could decide to pursue a PA degree while a BS in nursing is required before advancement to MSN. So that is the reason why I said NPs need more education, especially for individuals trying to enter the field with other degrees.

I was not under the impression that NPs could advance to a level of a physican. I was responding to elle147s question regarding advancement opportunities.

I am not trying to start a NP/PA battle. They are both wonderful professions with great opportunities. I was just trying to mention that if someone is looking to become a PA then perhaps they should consider the NP route as well.

 

[PharmBound2011]

I was in the mindset that NPs require doctorate degrees soon which would increase educational requirements. Also as you know a person with any BA/BS could decide to pursue a PA degree while a BS in nursing is required before advancement to MSN. So that is the reason why I said NPs need more education, especially for individuals trying to enter the field with other degrees.

I was not under the impression that NPs could advance to a level of a physican. I was responding to elle147s question regarding advancement opportunities.

I am not trying to start a NP/PA battle. They are both wonderful professions with great opportunities. I was just trying to mention that if someone is looking to become a PA then perhaps they should consider the NP route as well.

The only way it would make sense to go NP is if you already have a BSN. And, don't fall for the degree creep between these professions. While the DNP is a "doctorate," it only has 650 clinical hours in it's curriculum and 90% of the classes are on-line. More then 60% of their classes are complete fluff and have no application to being a diagnostician (nursing theory, community perspectives, health policy). They openly advertise that applicants can work full-time while taking full-time classes.

Compare that to the "lowly masters" degree for PAs. PAs get on-average 2400 clinical hours, actual hard sciences (pathophys, physio, pharm, biochem, cell genetics) which generally happen to be taken alongside med students (in colleges that offer both MD & PA). Every single PA school writes on their page "Applicants are strongly advised to not consider employment during PA school." Essentially, you are forbidden to work because it's quite rigorous. Average program length is about 2.5 years (some are 2 yrs/3yrs), but most of the newly accredited programs are creeping towards the 3yr mark.

Not putting down NPs to any degree; my PCP is a NP, but people need to look beyond the degree and see what education someone has. PAs most definitely get more education then NPs, and they still have a 'lower' degree. Mainly has to do with PAs being licensed by the Board of Medicine and NPs being licensed by the Board of Nursing. BOM just has higher standards then BON. Also, medicine is a "competency based field," where ones competency has nothing to do with the degree they hold (like foreign doctors with a bachelors in medicine being equivalent to an MD), while nursing has evolved to be the opposite, where credentials seem to be more important.


If I had a BSN, I would pick NP not doubt; just seems the way to go. But with a bachelors in Bio, chem or any other field, I would sway towards PA school

 

[Cyrus44]

Regarding NHSC, it's extermely common in underserved communities (rural and urban). My understanding is If you're willing to work in an underserved area, there is a spot available. Granted, many PA's sometimes prefer a higher paying specialty practice or to live in a community of thier choice. Generally, there are more spots for healthcare providers than they can fill. This is generally the case for the PA profession.....and they expect more opportunities.

Just a quick story: I recently met a PA at the office I go to as a patient. I didn't know her and thought she was new to the practice. Her husband has a job in which he has to travel throughout different parts of the country. She said she basically leaves a practice one day and can have a job within a few days to a week at her new destination. She said most of the time she just goes to a local hospital and asks managment if their are any opportunities....the management take her resume and put it out to the MD/DO's....and she usually gets a phone call. I generally feel I could do this as a PT as well in a lot of areas....so who knows....for some reason I was impressed with the story.

I've been a traveling PT for awhile now. You can go anywhere you want, its great. I'm currently in Naples FL for the next 3 months. If money is what is keeping you from deciding, I can say you make a lot of money doing it.

 

[redroses1100]

I am a PA but debating whether I should go back to school for Physical Therapy. The problem is I am 5'1" and weigh 88 lbs. Do you think it would be hard for me in the long run?

 

[Fiveoboy11]

PT school is easier than PA school, but is just spread out over 3 years ay? LOL. Don't comment about how difficult a DPT program is, you never experienced it. It's comical to me how much BSPT's are in the dark regarding a DPT. I've experienced it again and again. No clue and no respect.

 

[NYCPT]

I think it depends on the role that you would like to play in patient care; it is two very different roles. I would spend time shadowing both to see which role you would like to play. Yes, PA school is less time and eventually you will make more $$, but if you don't want to practice medicine you will eventually be very unhappy. I have known for a long time that I didn't want to be a nurse practitioner, physician assistant, or doctor. I want to be the health care professional that gives hope (not to say that doctors don’t give hope) and is responsible for the manual restoration, maintenance, and promotion of health and wellness. Doctors and PA's are responsible for overall diagnosis and treatment plans. Physical therapy is sometimes just one part of an overall treatment plan; just one part of the puzzle.

The roles and scope of the professions are very different, so I would spend time with both professionals to see which the better fit is for you. It is not an easy decision, so I wish you the best of luck.

 

[hefe]

Most all PA schools require a good bit of direct patient contact clinical experience, along with some PA shadowing and pre-reqs. Most traditional 4 year bachelor students cannot apply their senior year anyway, unless they plan for it say beginning of junior year or sophomore year. Less competitive PA schools who are less established and likely more remote areas, may be easier to apply senior year. PA's definitely favor non-trad health workers.

So, for many trad bachelor's students it'll be at least a 3 year commitments to get in anyway (1-2 years working + 2 years PA school). For many it's not 6 years unless you really plan early and apply smartly.

Honestly, spend shadowing in a variety of settings and find the career that suits your interests.

 

[dg1984]

Please stop this insanity. It is clear that many of you don't have the slightest idea of what physical therapy is. If you really want to be educated on this topic just read everything motiondoc has to say and look at some research. He is one of the only people that makes any sense and generally backs his arguments with fact. It seems that most "arguments" on this terrible post/site are fueled by personal regret, anecdotal experiences and outright ignorance.

 

[dg1984]

The last post was meant for some of the bitter attitudes towards PT. The young DPT students and PTs that have been posting have provided some good information. Sorry for any confusion.

 

[redroses1100]

Hi everyone,

I am a PA but I am so close to switching my career; but before applying I would like to know how physically demanding is PT?

I am a petite asian girl, 5'1", 88 lbs. Do you think I will have lots of problem if I work as a PT and will my small frame force me to retire early?

 

[buruburudoku]

Hi everyone,

I am a PA but I am so close to switching my career; but before applying I would like to know how physically demanding is PT?

I am a petite asian girl, 5'1", 88 lbs. Do you think I will have lots of problem if I work as a PT and will my small frame force me to retire early?

When I was doing my hours at a joint disese hospiral, I shadowed a girl who is as small as you are. She had no problems working with ppl of any size and her co-workers would def be help when needed.
And some Ped PTs I met treated small kids and children.
I guess it depends on what you want to specialize though.

 

[FLsurferDPT]

redroses1100, why are you thinking of leaving the field of medicine, namely physician assistant? It seems like it's the hot career of our time with a lot of job outlook for the future? If you've already gone through 2 years of a masters in medical science I would love to hear why you want the switch?

A big problem I hear from nurses is that they actually become angry having to spend their extra time, that they don't have since they are overworked, helping the physical therapists. I've met a lot of nurses who don't understand why very petitite and not so strong women go into physical therapy. None of the men have to ask for help from the nurses in moving a patient, etc. All i'm saying is that there is a physical aspect of the job. I know this comment only applies to the inpatient setting but I would really investigate more about the physical requirements, such as how much you have to lift and such.

i would love to hear the response from redroses because I am also in a stage of my life where I need to decide if I want to pursue physical therapy or medicine.

 

[dg1984]

At Redroses: There are several smaller girls in my class as well as the class below me and they have done just fine on all their affils. I think that Acute Care could present as a challenge, but I have noticed that these smaller women have great body mechanics.

In my current pediatrics experience I wish I was 5' 1' (I am 5 11 and 180 lbs). Being on the ground with the kids and guarding the kids requires a lot of flexibility for me, but being smaller with kids could be a huge advantage.

As far as outpatient orthopedics goes, I think that the smaller girls in our class struggled with finding end range during joint play assessment and higher grade joint mobilizations. Some mobilizations do require a lot of force and strength; however, with proper body mechanics and practice I think you can do fine in nearly any setting.

Hope this helps.

 

[dancingdoctor13]

Hi everyone,

I am a PA but I am so close to switching my career; but before applying I would like to know how physically demanding is PT?

I am a petite asian girl, 5'1", 88 lbs. Do you think I will have lots of problem if I work as a PT and will my small frame force me to retire early?

I am also wondering why are you thinking about switching? I am planning on going to PA school, but as an undergrad exercise science major, i thought about PT. Why the change of heart?

 

[puppypaws]

A PA can work in physical medicine and rehabilitation if they are interested in movement and the other types of things involved with physical therapy.

Rehabilitation physicians are nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move. Rehabilitation physicians have completed training in the medical specialty physical medicine and rehabilitation (PM&R).

As a PA working in this field, you can do many of the things that a PT would do, but are also able to prescribe medications to treat associated pain.

If after a while you decide you like the neuro aspect, work in neurology. If you like treating pain, work in pain management. If you like the ortho aspect, work in orthopedic surgery. If you still like motion, stick with PM&R. The fact is that there are many more areas of practice and options available for PAs compared to PTs.

As a PA, you are not an independent provider, but after a couple years in a given field you can practice with a great deal of autonomy, and earn a nice salary (80-100k/year) in the specialty of your choice. No wonder it is consistently ranked as one of the top careers in the U.S.

Okay, so according to this, what's the difference between a PA in PM&R and a PT? What would be the benefits of being a PT over a PA specialized in PM&R? Can a PA in this field really do what a PT can?
Kind of confused...

 

[dg1984]

A physical therapist is a physical therapist. No one, not a PM&R doc or a PA is trained the way that PTs are. That is the simple fact that no one on this site seems to realize. The huge advantage of PT is that you spend a significant amount of time with your patients 2 or 3 days a week. In doing so, you can truly attack the underlying causes and issues of MsK pain and decreased function (Limited joint mobility, muscle tightness, muscle weakness, poor posture, poor body mechanics at work, poor mechanics in a given sport, impaired muscle activation or even fear avoidant behavior).

As a PA you might see a patient with a MsK injury (i.e. an acute shoulder injury). Honestly, you will spend about 5 minutes with the patient, possibly prescribe some low level NSAIDs and then write a prescription for physical therapy. The physical therapist will likely read this prescription (shoulder strain) and the prescription will give him next to no useable information. The PT will then use his superior MsK examination skills (as evidenced by a litany of literature) to understand the underlying cause of the pathology. The therapist could deduce that the patient is experiencing a secondary impingement as a result of decreased muscular endurance of rotator cuff and scapular stabilization musculature. The therapist will guide a treatment program to initially help reduce pain and inflammation and then progress the patient into strengthening followed by a return to functional activity (work or sports).

The NSAIDs and possibly injections you provide as a PM&R PA can be imperative to success in PT. A good injection can make or break a patient’s recovery and rehabilitation as do appropriate medications (at times).

PT takes a lot of **** on this website for what it cannot do. Any PT knows the limits of what they are able to provide. An integral part of our schooling is knowing when to refer.

The argument of autonomy is irrelevant because no one else does what PTs do. I believe this is the heart of some of the bitter, anti-PT sediment found throughout this site. No residency or amount of medical school will give you the unique skill set and insight that we can provide. I am not saying it is better, just different. There is a huge disconnect between the sediment on this site (PT's have no autonomy and they have an inferior skill set) and what I have seen in real life (PTs practicing with a lot of autonomy and having a unique and effective skill set that is supported by an ever growing body of literature).

If you have to ask the question of PA vs. PT you should spend some time shadowing both because they couldn't be more different paths.

 

[puppypaws]

A physical therapist is a physical therapist. No one, not a PM&R doc or a PA is trained the way that PTs are. That is the simple fact that no one on this site seems to realize. The huge advantage of PT is that you spend a significant amount of time with your patients 2 or 3 days a week. In doing so, you can truly attack the underlying causes and issues of MsK pain and decreased function (Limited joint mobility, muscle tightness, muscle weakness, poor posture, poor body mechanics at work, poor mechanics in a given sport, impaired muscle activation or even fear avoidant behavior).

As a PA you might see a patient with a MsK injury (i.e. an acute shoulder injury). Honestly, you will spend about 5 minutes with the patient, possibly prescribe some low level NSAIDs and then write a prescription for physical therapy. The physical therapist will likely read this prescription (shoulder strain) and the prescription will give him next to no useable information. The PT will then use his superior MsK examination skills (as evidenced by a litany of literature) to understand the underlying cause of the pathology. The therapist could deduce that the patient is experiencing a secondary impingement as a result of decreased muscular endurance of rotator cuff and scapular stabilization musculature. The therapist will guide a treatment program to initially help reduce pain and inflammation and then progress the patient into strengthening followed by a return to functional activity (work or sports).

The NSAIDs and possibly injections you provide as a PM&R PA can be imperative to success in PT. A good injection can make or break a patient’s recovery and rehabilitation as do appropriate medications (at times).

PT takes a lot of **** on this website for what it cannot do. Any PT knows the limits of what they are able to provide. An integral part of our schooling is knowing when to refer.

The argument of autonomy is irrelevant because no one else does what PTs do. I believe this is the heart of some of the bitter, anti-PT sediment found throughout this site. No residency or amount of medical school will give you the unique skill set and insight that we can provide. I am not saying it is better, just different. There is a huge disconnect between the sediment on this site (PT's have no autonomy and they have an inferior skill set) and what I have seen in real life (PTs practicing with a lot of autonomy and having a unique and effective skill set that is supported by an ever growing body of literature).

If you have to ask the question of PA vs. PT you should spend some time shadowing both because they couldn't be more different paths.

Thank you for the insight, and I'm sorry if I offended you. I've shadowed a PT so I have a decent general idea of what PTs role in the medical field is, but I haven't been able to shadow a PA as the locations where PAs work close to me don't allow shadowing, so I'm not very familiar with their role in the medical field. I didn't mean to downsize PTs in any way. I'm trying to learn the specifics of each field.

 

[dg1984]

I should have explained that any frustrations demonstrated in my last post were by no means directed at you. It was directed at previously observed ignorance displayed by different posters on this and other threads and I did not make that clear. The only reason I decided to display the last post was to help someone like yourself. You should not be shortchanged by one-sided posts. We could all argue about lots of things until we are blue in the face but I wanted to give you a better sense of the job at hand.

I hope it helped and I apologize if any negative sediment in my last post was misinterpreted. Best of luck with your future.

 

[MotionDoc]

A physical therapist is a physical therapist. No one, not a PM&R doc or a PA is trained the way that PTs are. That is the simple fact that no one on this site seems to realize. The huge advantage of PT is that you spend a significant amount of time with your patients 2 or 3 days a week. In doing so, you can truly attack the underlying causes and issues of MsK pain and decreased function (Limited joint mobility, muscle tightness, muscle weakness, poor posture, poor body mechanics at work, poor mechanics in a given sport, impaired muscle activation or even fear avoidant behavior).

As a PA you might see a patient with a MsK injury (i.e. an acute shoulder injury). Honestly, you will spend about 5 minutes with the patient, possibly prescribe some low level NSAIDs and then write a prescription for physical therapy. The physical therapist will likely read this prescription (shoulder strain) and the prescription will give him next to no useable information. The PT will then use his superior MsK examination skills (as evidenced by a litany of literature) to understand the underlying cause of the pathology. The therapist could deduce that the patient is experiencing a secondary impingement as a result of decreased muscular endurance of rotator cuff and scapular stabilization musculature. The therapist will guide a treatment program to initially help reduce pain and inflammation and then progress the patient into strengthening followed by a return to functional activity (work or sports).

The NSAIDs and possibly injections you provide as a PM&R PA can be imperative to success in PT. A good injection can make or break a patient’s recovery and rehabilitation as do appropriate medications (at times).

PT takes a lot of **** on this website for what it cannot do. Any PT knows the limits of what they are able to provide. An integral part of our schooling is knowing when to refer.

The argument of autonomy is irrelevant because no one else does what PTs do. I believe this is the heart of some of the bitter, anti-PT sediment found throughout this site. No residency or amount of medical school will give you the unique skill set and insight that we can provide. I am not saying it is better, just different. There is a huge disconnect between the sediment on this site (PT's have no autonomy and they have an inferior skill set) and what I have seen in real life (PTs practicing with a lot of autonomy and having a unique and effective skill set that is supported by an ever growing body of literature).

If you have to ask the question of PA vs. PT you should spend some time shadowing both because they couldn't be more different paths.

Good stuff DG. I would have to agree that shadowing both professions is vital to making an informed decision. But, I will add that when shadowing, pick wisely as that person will be representing an entire profession. For PT, pick someone with a specialization (OCS, SCS, NCS, etc...) and a DPT. If they have publication experience, even better. Good luck to those in the midst of change.

 

[dg1984]

Good point.

 

[puppypaws]

Your post did definitely help me. I didn't think it was directed at me, but I just wanted to be sure. Thanks for the help. I'll definitely try to look more into finding a PA that I can shadow, if only for a day.

 

[redroses1100]

When I was doing my hours at a joint disese hospiral, I shadowed a girl who is as small as you are. She had no problems working with ppl of any size and her co-workers would def be help when needed.
And some Ped PTs I met treated small kids and children.
I guess it depends on what you want to specialize though.

Thank you so very much for your reply!

 

[redroses1100]

redroses1100, why are you thinking of leaving the field of medicine, namely physician assistant? It seems like it's the hot career of our time with a lot of job outlook for the future? If you've already gone through 2 years of a masters in medical science I would love to hear why you want the switch?

*** 1. Its super tough to look for job
2. MDs are not always respectful to you


A big problem I hear from nurses is that they actually become angry having to spend their extra time, that they don't have since they are overworked, helping the physical therapists. I've met a lot of nurses who don't understand why very petitite and not so strong women go into physical therapy. None of the men have to ask for help from the nurses in moving a patient, etc. All i'm saying is that there is a physical aspect of the job. I know this comment only applies to the inpatient setting but I would really investigate more about the physical requirements, such as how much you have to lift and such.

i would love to hear the response from redroses because I am also in a stage of my life where I need to decide if I want to pursue physical therapy or medicine.

*** So, have you decided what to do yet?

 

[redroses1100]

At Redroses: There are several smaller girls in my class as well as the class below me and they have done just fine on all their affils. I think that Acute Care could present as a challenge, but I have noticed that these smaller women have great body mechanics.

In my current pediatrics experience I wish I was 5' 1' (I am 5 11 and 180 lbs). Being on the ground with the kids and guarding the kids requires a lot of flexibility for me, but being smaller with kids could be a huge advantage.

As far as outpatient orthopedics goes, I think that the smaller girls in our class struggled with finding end range during joint play assessment and higher grade joint mobilizations. Some mobilizations do require a lot of force and strength; however, with proper body mechanics and practice I think you can do fine in nearly any setting.

Hope this helps.

*** Thank you for such a helpful information. Yeah, I love working with kids; so I think I might do that if I graduated from a PT program.

Are you currently working as PT now?

 

[redroses1100]

I am also wondering why are you thinking about switching? I am planning on going to PA school, but as an undergrad exercise science major, i thought about PT. Why the change of heart?

*** I switch because I love going back to school. I thought PT has more flexible schedule, isn't it?

 

[dg1984]

@redroses--> I am glad I could provide some helpful information. I am in my 3rd year of PT school, but I have completed an in house sports and orthopedics affil, neurological/older adult affil, and pediatrics affil. Currently I am on one of my two out of houes ortho affils. Feel free to shoot me a message if you have any further questions.

 

[dg1984]

@FLSURFER--> I don't think it is fair to question someone for going into physical therapy because they are small (in reference to the nurses in your story). Regardless of what other hospital professionals think, PTs are not dog-walkers. We can provide very great physical examinations in the inpatient setting (far better than some neurology PEs I have seen done, especially post-CVA). Again it is a skill, and just because you need an extra set of hands, doesn't mean you aren't qualified to work in that setting.

Again, part of PT is eval and treat. Although it may appear that dragging people out of bed is the bulk of our job, it is probably the easiest and least significant aspect of what we do.

 

[VeritasVitamEst]

Hey guys, this topic has been really interesting to read about a lot of insightful information on here. I just graduated college and am really interested in pursuing a master in PA, but before I can do that I need to get my bachelors. I've done some research and it looks like it doesn't matter whether you get a BA or a BS...which really surprised me. I'm going to be attending a Liberal Arts college in the Fall and go for a BA in liberal arts. I was just wondering if any of you in the PA field would know how I would be looked at applying for PA with a BA. (Junior and Senior years I would be working on the pre-requisite science courses).

 

[CursedtoFirst45]

Hey guys, this topic has been really interesting to read about a lot of insightful information on here. I just graduated college and am really interested in pursuing a master in PA, but before I can do that I need to get my bachelors. I've done some research and it looks like it doesn't matter whether you get a BA or a BS...which really surprised me. I'm going to be attending a Liberal Arts college in the Fall and go for a BA in liberal arts. I was just wondering if any of you in the PA field would know how I would be looked at applying for PA with a BA. (Junior and Senior years I would be working on the pre-requisite science courses).

Liberal arts is vague, you'd need a major. It doesn't matter whether BA or BS, but i'd recommend taking your science pre-reqs first because you'll want to apply with everything already taken care of for your application. Best of luck!

p.s. I'm assuming you just graduated from a community college? What was your field of interest there?

 

[VeritasVitamEst]

Hey thanks for the response. I just graduated from Highschool and I'm attending a college in the fall that offers a BA in Liberal Arts, I was going to take my pre-req science courses the summers between Junior and Senior years before I applied for Graduate school.

 

[joeymonotony]

That's true, but not everyone relies on referrals. If you're in a direct access state, then it's more word of mouth and visibility. I work in a corporate clinic right now, that is the official PT sponsor for a lot of professional sports teams and dance companies, so we get a lot of visibility that way. But, the PTs do have to do marketing tasks, and corporate has a marketing dept to get MDs to refer patients to our facility. But, there are a TON of local PT places, and none of them seem to be hurting for patients.

The only thing about having a private practice is most times you need the referrals from the Med doctors because they are the gate keepers to insurance companies being able to pay for the treatments.

 

[joeymonotony]

Hi,

I'm having the same problem. I came to school thinking I was going to do physical therapy. I'm going to be a junior but I just recently was introduced to the idea of becoming a PA. Well that and going to Med school, but I think that's not really on the table for now. So I've been asking around alot about why people want to become PA's vs. anything else in the healthcare field. I read alot about the flexibility of being a PA; you can change the kinds of fields you work in, whereas PT's seem like it's already pretty specialized. I really don't mind the whole "assistant" that most people are afraid of having in their job title.
But there are some things that are making me think twice about becoming a PA...
I've heard they work on a set salary, and are not paid for working overtime no matter how many hours you have to work.
and... It seems as though once your a PA, you can work in different areas such as surgery, pediatrics, etc., but is there any advancement up, rather than just at the same level but in different specialties?

Depends on whether you want to do physical medicine (rehabilitation) as opposed to internal medicine. I'm a PTA and basically it's like being in a PA position. We have to know just about everything the PT does so we can make critical decisions and whether we need to bring the PT on board. We learn to diagnose and all the special tests but aren't aloud to evaluate because it's outside the scope of practice. I love my job and position and even though it's a 2 year degree it's intensive training. I can do about 80% of what a PT can do and we mostly end up doing the overall treatments and we can make just as much as a PT but with less school debt.. If you go the way of the PA you'll end up in the same position, a little less schooling with a little less student debt but that's for you to decided. I love the PTs I work with and mutual respect is across the board within the rehab team I am a part of. Everyone has their places of expertise. Best luck with your decision. Either way the medical career field is very rewarding.

 

[Azimuthal]

Why...

 

[NewTestament]

I can do about 80% of what a PT can do and we mostly end up doing the overall treatments and we can make just as much as a PT but with less school debt.. If you go the way of the PA you'll end up in the same position, a little less schooling with a little less student debt but that's for you to decided.

I'm not quite sure what you're saying here. Are you saying PTs are redundant? Why would a physician even refer to a PT if he can have the PA look at the patient? I had no idea PAs are as qualified to handle NMSK disorders as PTs.

Kevin

 

[okramango]

The only thing about having a private practice is most times you need the referrals from the Med doctors because they are the gate keepers to insurance companies being able to pay for the treatments.

Hey, do you realize you responded to a post from 2009?