PTs and pharmacology

[CmichStudent]

A friend and I were discussing this the other day, I'm interested in seeing what everyone here thinks. Do you think that there is the chance in the future of PTs being able to prescribe medicines related to physical therapy?

Perhaps they would have a limited list of drugs available to prescribe? This would also require more PT to Doctor interaction, which is something I think has been neglected more and more nowadays.

Obviously the PT would need to be trained in pharmacology, but if there was an optional "branch" of PT that you could take that would allow you to prescribe these physically-related medicines..would you?

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[PT Dad]

Since pharmacology is a required course in most DPT curriculums, I think that is what the long term plan is but doctors will fight this actually being implemented.

 

[jess818]

I doubt it would happen. Physical rehab is basically the opposite of using medicine. We do take courses on pharmacology but its more about being well rounded and informed. For example, some BP medications like beta blockers have an effect on heart rate so if you know your patient is taking that medication, you will have to make sure to watch them because they will not be responding to physical exercise like everyone else.

I know that even though we take two semesters of pharmacology my instructor has told us that we will always need to keep up on it because it is an ever changing area. There's no way pts could be informed enough to prescribe at least at this point.

Maybe someday but I really don't see it happening or even think it is part of the apta's agenda...

 

[TheOx777]

The only PTs who can prescribe medication are those in the U.S. Military. I also believe that they can order imaging as well, which civilians PTs cannot. I have heard at least one program director describe them as the "gatekeepers". What a PT gatekeeper entails is still obscure to me. I think that a thorough knowledge of pharmacology and medical imaging would be invaluable to all PTs.

 

[CmichStudent]

The only PTs who can prescribe medication are those in the U.S. Military. I also believe that they can order imaging as well, which civilians PTs cannot. I have heard at least one program director describe them as the "gatekeepers". What a PT gatekeeper entails is still obscure to me. I think that a thorough knowledge of pharmacology and medical imaging would be invaluable to all PTs.

I agree.

I've heard multiple times that military PT's are some of the best you can find, superb training and knowledge.

 

[hefe]

I'm going to post my thoughts against this topic later, but I need to ask to understand.

In what capacity or class of drug prescription are you suggesting be allowed... free reign of prescription privileges for PTs like MD/DO?

 

[Base14]

At the clinic I work at, and the PTs and PTAs are able to 'prescribe' Dexamethasone, which is a anti-inflammatory medication commonly used in iontophoresis and phonophoresis. We most use them in iontopatches primarily. That is the only medication that I am aware of that we can give out to patients without doctor's specific approval.

However, in order to get the medication, we need a doctor to sign off on a prescription so that we can keep a stock on hand. Having a urgent care in the same building as us, this is quite convienent.

 

[CmichStudent]

I'm going to post my thoughts against this topic later, but I need to ask to understand.

In what capacity or class of drug prescription are you suggesting be allowed... free reign of prescription privileges for PTs like MD/DO?

Not complete "free reign", but autonomy for the most part.

I would like to see PTs be able to prescribe...say pain relievers or muscle relaxers, just as a quick example. Like I said though, this would require communication with the PCP and a thorough knowledge of drugs to avoid any complications.

 

[MuscleHead]

i personally think its a little ridiculous that PTs cant tell patients to take over-the-counter products like NSAIDs or glucosamine. but we would need a serious addition to our education to be able to prescribe meds.

in addition...as PTs, i feel like its our job to treat without the use of drugs. too often, patients will want the drug before they want to put in the effort to ultimately relieve symptoms.

 

[puppypaws]

I don't think PT's should be able to prescibe drugs, maybe recommend over the counter drugs like taking advil or something, but I've looked at PT as a more natural way to recover without using drugs and all of their negative side effects. It's a part of what really appeals to me about physical therapy. I was even thinking about getting a BA or masters in nutrition later so I would know the best way to help patients nutritionally and therapeutically without using drugs.
But then again, PAs can perscribe some drugs. Does anyone know how much pharmacology they have?

 

[markelmarcel]

I don't think PT's should be able to prescibe drugs, maybe recommend over the counter drugs like taking advil or something, but I've looked at PT as a more natural way to recover without using drugs and all of their negative side effects. It's a part of what really appeals to me about physical therapy.

in addition...as PTs, i feel like its our job to treat without the use of drugs. too often, patients will want the drug before they want to put in the effort to ultimately relieve symptoms.

Agreed on both accounts.

 

[callmecrazy]

Personally, I don't like the idea of PTs prescribing meds. We receive enough pharmacology background to properly monitor our patients and know how side effects will alter our treatments plans. In no way do we learn enough to safely prescribe prescription medication. Even the most seemingly "safe" meds can have multi-system effects and critical interactions. That isn't part of the standard PT curriculum, and adequately including it would make PT school both longer and more expensive.

It's also not within the scope of our goals as a PT. There are other aspects of care that we can perform and others can't; that's the beauty of having multiple providers. Patients are receiving focused care from experts within a specific area. While direct access can be beneficial and it may seem that prescribing meds could help this process, we may want to step back as PTs and also acknowledge the fact that widening our scope to include doing so may not be in the best interest of our patients. If their needs (ie. meds) are not within our scope, I feel we would be doing a disservice to not advise that care to come from the "experts" in that area, which is not us as PTs.

 

[lkallen]

does anyone know of any research/articles/studies pertaining to this topic? podcasts/other debates? any reference materials at all? I want to look into this topic some more and see the pros and cons of both sides

 

[fozzy40]

What class of drugs would you propose physical therapists could write for?

 

[jesspt]

What class of drugs would you propose physical therapists could write for?

My assumption/opinion is that this is unlikely to occur, but if it did, I would assume it would look much like PT practice in the military, where PTs can prescribe some anti-inflammatory and pain meds, as well as order some imaging.