It might be a pipe dream but I honestly believe DPTs will be able to order scans and write prescriptions. Military PTs already can, and from what i've heard, once more states grant direct access the APTA is going to focus all their energy towards bringing these responsibilities to civilian PTs.
No. They will never order prescriptions. That would change rehabilitation treatment directly to pharmaceutical treatment as drugs have the highest reimbursement and it would be gamed. If there is any remote point of a medical residency with 30 HR shifts outside of cheap hospital labor then it is to monitor patients from admission to discharge while taking care of their body's physiological response to pharmaceutical or heavy procedural intervention.
This would be physician infringement and is NOT a therapists place. Graded exposure to physical stress allows adaptation, compensation, substitution, and neuroplasticity to all come into play. That is the science of rehab. Unfortunately, unless payment goes to value less readmissions or less use of pharma and surgery, then reimbursements for therapy will not climb and pay scales will only fluctuate with inflation, geography, and supply and demand.
Nowadays, lobbying is everything.
If it represents valid and rigorous taxpayer funded education, then definitely.
Imaging for every joint in the body is integrated into programs now as students linearly learn msk for every joint following complete cadaver dissection with the 600+ muscle OINA emphasis for a biomechanics and functional approach, as well as the kinesiology and movement system coursework. At least a program with good structure.
In real practice, the therapists I see in sports and Ortho (both very different depending on the rehab stage) are having the imaging sent to them via emr and they educate patients and start rehab progressions altering lever arms and exercises to stay within certain ranges and one dimensional planes before transitioning to triple plane movements. Add in modalities and manual therapy and voile!
Neuro therapists receive and use neuroimaging to see where damage appears on the homunculus as well as which lobes have damage to better predict visuospatial deficits, Neurocognitive disorders that will require neuropsych or referral if in outpatient, or auditory or fine and smooth motor planning as signals travel downward to the spine, first being modulated in the cerebellum, then descending the brainstem to the spinal cord.
The problem: They aren't being paid for this. PCPs can order imaging for patients reporting possible Ortho issues but may never look at it and simply send them to the surgeon yet they receive compensation from insurance to my understanding. This is not all encompassing, but I know that interpretation of imaging will place serious workflow roadblocks in 10-30 min (max) visits....so it is simply passed off.
Over utilization of tests, excess imaging, and procedures make the U.S. a haven for waste compared to other countries. The problem is that the healthcare system rewards waste and legalities block and leave out certain servicers from having practice rights.
If there is decreased cost to a consumer in having a therapist receive imaging reimbursement which may decrease excess points of contact for the consumer as a whole then there are serious flaws in the system. Which is my thought personally. If not...then imaging may simply be over utilized by other workers and simply add to more waste if practice acts changed. If lobbying were to lead to the former then it would be ethical. If it would only lead to the latter then people would be paid more but clinics would get rampantly audited more, which could result in payers adding more paperwork to professions.
That being said a slight breakdown in referral and contact barriers for conservative management my be positive for the healthcare system. Consumers go directly to psychologists for behavioral and environmental management of psych conditions for example. Psychotherapy in long time lengths can produce the same outcomes as some of the psychopharmacology treatments.
Yes he loves ot so much that he started two separate threads on the psych subsection about ways in which he can transition out of ot and into a clinical psych career
I thought it was PA? Maybe that's the new one. Only took a glance.
Are there moderators on this subforum?
As for me, I believe that PTs will sprout wings and be able to fly.
Seriously - APTA is weak, compared to AMA for the docs, and ACA (not that ACA) for the chiros. Just look at how much APTA spends on lobbying and compare it to how much AMA & ACA spend. In a climate where decreased reimbursements from Medicare and insurance agencies are unrelenting, each profession will fight tooth and nail to defend its turf.
Only certain sections of the AMA are strong. Surgeons are for certain. Primary care doesn't do well to protect them from nursing.
ACA and acupuncturists primarily attack physical therapists, to my understanding, since the therapists allied with physicians historically and would drive them out of business through capitalistic competition. Defending placebo seems to be the name of the game there.
I hope that this actually happens! If we, PTs/PAs/others, can learn anything from Nurse practitioners it's that: effective lobbying = results. They're able to practice w/o physician oversight in some states due to their ability to lobby effectively. I think that at least x-ray imaging should be under the scope of a DPT assuming that the appropriate coursework was added... I guess it would be difficult to figure out how this would work - for example, would future DPTs have to apply through the state board of medicine and be under a Physician in order to perform such duties?
Therapists at my institution receive significantly more imaging coursework than the medical students. However, that's because it is directly linear to what is currently being done in practice. MD/DOs can only learn so much of literally every system in the body without failing out before they match their specialty.
Personally, I'm not a fan of the nurse practitioner lobby since legally, they are indistinguishable from physician treatment excluding a signature and "supervision." The field is taking over primary care due to physicians matching higher paying specialties and having an extended out training period under one system which, debatable but true, may or may not be the best path. Discuss the hours put in of a practicing PCP in residency under close supervision and compare that to the NP training model. Personally, if it isn't a flu shot at a minute clinic then I wouldn't want physician treatment to be independent without a close supervision role during training.
The nursing lobby is massive. It's probably one, if not the most represented.
Other professions have different practices but do lack the representation.
Ok... Well military PTs already have the responsibility, so it's not a huge stretch of the imagination to think that civilian dpt's will soon have it also. Also as far as money goes, yes AMA and ACA have more money to play with, but these big 100+ Practice PT franchises have tons of new money to throw around. They're the ones who also benefit most from lobbying. ATI had advertising in the world series this year, it was beautiful to see.
Big franchise interests exist in siphoning insurance through productivity to benefit administration primarily. I don't necessarily see the ones running it to really want to focus on a professions changing practice or what is good for patients. Sorry, I'm not a fan of franchises and I see all healthcare professionals that bill insurance getting pushed around. It's sad. That being said, that is purely my opinion.
