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  • #31
    Hi Diane,

    That link didn't work for me but here's an article with his take on subluxations.

    Link
    "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

    Comment


    • #32
      Jon, try this link.
      It's a MP3 thingy. Too big to load directly I guess. You'll have to download it yourself. You should be able to from here. Click on the "download now securely" button.
      Last edited by Diane; 06-04-2007, 10:58 PM.
      Diane
      www.dermoneuromodulation.com
      SensibleSolutionsPhysiotherapy
      HumanAntiGravitySuit blog
      Neurotonics PT Teamblog
      Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
      Canadian Physiotherapy Association Pain Science Division Facebook page
      @PainPhysiosCan
      WCPT PhysiotherapyPainNetwork on Facebook
      @WCPTPTPN
      Neuroscience and Pain Science for Manual PTs Facebook page

      @dfjpt
      SomaSimple on Facebook
      @somasimple

      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

      Comment


      • #33
        Here is some more interesting news, that pertains to chiro, a letter from Stanley Paris of St. Augustine's, famous PT manipulator, instructor, keeper of the manipulation flame, Blower Upon It, guru with thousands of followers over many decades, He Who Would Have Created a Blended Profession called DPT Containing Chiros:

        Fellow Health care Professionals


        During the past year Dr. Gary Gorniak, Physical Therapy Program Director, and I as President of the University, have taken a long, hard look at enabling chiropractors who wish to become physical therapists to do so. We were considering chiropractors who had graduate education in the musculoskeletal area as prime candidates to receive transfer credit and testing by examination for a fair percentage of the program. The process has been exhaustive and has involved numerous meetings with chiropractic leaders and with individual chiropractors. There is no lack of interest on the part of many chiropractors.



        However, what also had to be considered was the community of physical therapists and its leadership. Many serious concerns were expressed. Foremost amongst them were: Do chiropractors just wish to add PT so they can bill for it?; How do we know that a DC will transition to being a PT and start thinking like a PT?; What will this do to the reputation of the University - how will we be viewed?; Even if a DC has more imaging hours than a PT, those hours were completed with a different philosophy often far removed from our movement science emphasis.



        While it is the stated interest of the University to help enable a change in careers, or the addition of a second professional license to a health care professional, it appears that the physical therapy community is not yet ready to extend such an opportunity to those who have (for want of a better phrase) "been educated outside of the traditional health science community." Therefore, we have reluctantly come to the conclusion that we cannot at this time allow any other form of credit reduction for chiropractic education.



        Presently, we have admitted three chiropractors into our on-line and weekend DPT "Flex" program based out of Boca Raton, FL. Those candidates completed the regular application process, participated in the standard interview process, and were admitted into this 12-semester on-line coursework with weekend lab sessions program. Of course, where their education parallels that of our other students they will no doubt fly through that portion of their education - but they are taking all the courses required to earn the DPT degree.



        To all those who took part in these meetings, I extend my heartfelt thanks and best wishes. I know the decision contained in this letter will be a disappointment to many but I hope also to have your understanding. We tried.



        Sincerely,


        Stanley V. Paris, PT, PhD, FAPTA
        President, University of St. Augustine
        1 University Boulevard
        St. Augustine, FL 32086
        USA
        www.usa.edu
        Stanley, reason prevailed. Thank you.
        Diane
        www.dermoneuromodulation.com
        SensibleSolutionsPhysiotherapy
        HumanAntiGravitySuit blog
        Neurotonics PT Teamblog
        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
        Canadian Physiotherapy Association Pain Science Division Facebook page
        @PainPhysiosCan
        WCPT PhysiotherapyPainNetwork on Facebook
        @WCPTPTPN
        Neuroscience and Pain Science for Manual PTs Facebook page

        @dfjpt
        SomaSimple on Facebook
        @somasimple

        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

        Comment


        • #34
          A market that I think is being missed is something bridging PTAs to PTs. I would like to see an effort to accommodate those within the profession prior to accommodating others. It may not be a rational desire but it's a natural one.
          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

          Comment


          • #35
            Jon, briefly....what does a PTA do? Or rather, what is it they cannot or should not do? Sounds as though they are quite skilled in matters physiotherapeutic.

            I'd rather see the psychologists aligned with PTs (a fervent wish of David B's) so we become a strong neuroscience team. No doubt that would not apply in some countries, but here I think it would work well.


            Nari

            Comment


            • #36
              Jon,

              In the US, in my view, the PTA's will become PT's, they will occupy the slot that PT's currently fill and have filled in the last several decades. PT's will adopt the DPT and move themselves largely out of the slot they are currently in. PTA's will want more autonomy than they now have, will decide they need a Bachelor's at the entry level. Sound familiar?

              Already, in the home health field, we see PTA's acting largely independently. While they don't do formal assessments, they work for long periods, perhaps a month at a time, without the intervention of a PT. Their is also a price differential that is attractive to employers. It won't be long before the pressures of these two forces, the desire for more autonomy by the therapists and for less expensive, more available therapists by the employers leads to this occuring.

              Comment


              • #37
                As far as the chiropractic/PT issue is concerned. It is tempting to try to save the good fruit from the bad tree that is chiropractic by grafting some branches on to the PT tree (which itself could use some pruning) and I would think this would be a good idea if it meant the end of the bad tree. The problem is that chiropractic is in no danger of ending anytime soon, it is remaining popular and some of the worst fruit being the most popular. It is up to the Chiropractors themselves to clean up their profession, it is good that individuals themselves choose to practice in an ethical and scientific manner, but this doesn't absolve them of the responsibility to try and see that others who share their profession do as well.

                On that note, who has recieved a copy of "Today in PT: The Voice of the Profession". The feature article is "Psyche 101: A primer on personality and pain". Sounds kinda promising, doesn't it? Then it goes on to say "Before he touches the patient he that when physical pain is released , it may be accompanied by crying, laughing, or some other form of emotional release. He informs the patient: "If emotions come up, they are a memory, because emotions can be held in the tissue."

                That's the voice of the profession? The rest of the article is not as bad, but not much better. I would advise a rash of letters to the editor about this, but this is a slick magazine, an upscale Advanced, I don't even see a place for letters to be published.

                Comment


                • #38
                  If this statement is part of the voice of the PT profession...yikes.
                  Where's the evidence for this statement, seeing that EBP is the new buzzword for appropriate clinical practice?
                  Might be worth challenging them just on that point:
                  Where's the evidence, mate?


                  Nari

                  Comment


                  • #39
                    Randy,

                    When I saw Today in PT appear I felt it might finally represent a hard copy venue for my writing like The PT Forum was for me in the early 90s so I wrote the editor (a PT) and offered my services citing my past popularity, this web site and a few ideas for a regular column.

                    She wrote back so rapidly that I'm certain she couldn't have read any of my stuff beforehand saying: Thank you for your interest! We already have several free lancers writing for us and don't need anyone else. Good luck with your career!

                    I wrote back: OK!

                    I'm not sure she got the sarcasm of the !.

                    I've seen a couple more issues and several of the assertions about the body written by these free lancers make me want to throw up.
                    Barrett L. Dorko

                    Comment


                    • #40
                      Hi Nari,

                      A PTA is a Physical Therapist Assistant.

                      Here's a few things to help understand

                      Distinction between PT and PTA

                      The education is most commonly a two year associate degree. PTAs follow a code of ethics, have a professional association, are typically licensed and possess some specialized knowledge. On an interesting side note, all of these are hallmarks of a "profession."

                      Hi Randy you offered a lot for us to consider. My thoughts are:

                      I agree with your "chiropractor heal thyself" sentiment. I'm certainly not jealous of the task.

                      I don't think I understand your vision of shifting job descriptions regarding PTs and PTAs. Could you elaborate? Maybe some PTAs will chime in with their thoughts.

                      Does that new magazine list a website? Who is the editor and publisher? It sounds like perfect fodder for "Infuriating PT garbage"
                      "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                      Comment


                      • #41
                        One of the first attendees from your profession came up to me at the end and said, "You're a better chiropractor than I am."

                        I still haven't figured that out.
                        Barrett,
                        He must have been alluding to the chiropractic philosophy (borrowed from osteopathy) that the body is self-corrective.
                        Luke Rickards
                        Osteopath

                        Comment


                        • #42
                          Thanks Jon.
                          I have read in various posts, mainly on RE, that PTAs use modalities and seem to run exercise groups, using programs developed by PTs. If they do not "practice physical therapy" per se then no wonder there is confusion; it sounds like they do what many PTs do in the world anyway, which is to follow recipes. Sounds very mechanically-oriented, but that is only a view from a distance.
                          Would be interesting to hear from a PTA.


                          Nari

                          Comment


                          • #43
                            Sounds to me like they are what PTs used to be before they became "doctors" themselves, ... go-fors for doctors, but the designation of "doctor"-ness is expanding - always got to have some other group forming the outer ring, orbiting around, following "orders"... I'm surprised to learn they are here in Canada too, along with 'de-listment' from the Canadian medicare system and the advent of American style multi-payer insurance billing. I guess it frees the PT up to do more important things like chase shrinking insurance dollars.
                            Diane
                            www.dermoneuromodulation.com
                            SensibleSolutionsPhysiotherapy
                            HumanAntiGravitySuit blog
                            Neurotonics PT Teamblog
                            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                            Canadian Physiotherapy Association Pain Science Division Facebook page
                            @PainPhysiosCan
                            WCPT PhysiotherapyPainNetwork on Facebook
                            @WCPTPTPN
                            Neuroscience and Pain Science for Manual PTs Facebook page

                            @dfjpt
                            SomaSimple on Facebook
                            @somasimple

                            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                            Comment


                            • #44
                              Well, since I'm both an american and a DPT, I suppose I should address the "doctor" thing.
                              There are a few simple facts of the american healthcare system that will help our international readers understand this transition. I'm not saying these facts are good or bad or the way I want them, just that they are what they are.
                              1. American PTs are still dependent in many ways upon referrals from other providers due to the historically referral-based nature of our practice
                              2. American PTs have a history of being legislated out of scope of practice and out of access to patients by two primary groups: orthopedic surgeons (who call themselves doctors) and chiropractors (who call themselves doctors).
                              3. The American public, when they are ill or in pain, want to see a 'doctor', and they quite clearly are not at all concerned if that person is a medical physician or not.
                              4. Legislative history in the US for PTs is marked by one group ('doctor' of something) telling another group ("mrs" or "mr" something) that they need to have their access and privileges restricted because they don't have enough training or education to do X, Y, or Z correctly. Regardless of whether any actual data can be marshaled to support these claims.

                              The DPT is what is required in the american system to allow consumers a true choice for direct access to quality care. As the pop culture joke goes "Don't hate the player, hate the game." The DPT is a required answer to a uniquely american problem.

                              Whether or not this is a good idea is certainly up for debate, though the reactions of those who like to restrict our practice the most is a useful indicator:
                              http://www.chiroweb.com/archives/24/16/11.html
                              This is a very funny article and it both exposes the fear of some factions of the chiropractic world as well as how little they understand how we practice. It seems the writing's on the wall, or at least many feel that way.

                              I was looking for a well-written article by Craig Leibenson DC (a very scientifically-based chiro who is well respected) about the impact of the DPT, but couldn't find it on chiroweb. Interestingly, when I entered the search term of "DPT" all that came up were many articles complaining about the diptheria-pertussis-tetanus vaccine and how supposedly dangerous it is. That makes my point for me better than Leibenson's article ever could have.

                              On the doctor vs therapist thing, I have spoken online with Randy before on this, and my understanding of his concern is that the DPT will move PTs away from hands-on treatment into a more supervisory type role with PTAs doing more actual treatment. Then he feels the cycle will continue and PTAs will want to break away and do their own thing like PTs did, etc, etc. I'm not sure this is accurate, I don't want to misrepresent what he's saying. Overall, I don't feel this is a big concern, as it certainly didn't happen that way with chiros or with podiatrists or psychologists. I think the procedure-based billing scheme most american PTs operate under has done far more damage than a new degree ever could.
                              Jason Silvernail DPT, DSc, FAAOMPT
                              Board-Certified in Orthopedic Physical Therapy
                              Fellowship-Trained in Orthopedic Manual Therapy

                              Certified Strength and Conditioning Specialist


                              The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                              Comment


                              • #45
                                Jason, your post #44 makes good sense; and helps non-North Americans to understand better the quandary most USA PTs (non-DPTs) are in, with regard to autonomy and lack of broad public profile.
                                What surprised me is that podiatrists and psychologists call themselves "Dr"?
                                All vets, dentists and chiros here do, but not the other two professions.

                                Without the tag of DPT, have the PTs any hope of action against this legislative ruling? Sounds like they don't...

                                Nari

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