Re: St. Augustine to explore offering t-DPT to DC's?

[Guest guest]

SO what's next the MD's becoming Vets?

Chiropratic and physical therapy do not match, need to be separate and

should stay just that way.

Thanks,

Barker F. II

Clinical Director

Lakeway Aquatic Therapy & Wellness Center

P.O. Box 342348

1927 Lohmans Crossing, Suite 100

Austin, TX 78734

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www.lakewayaquatics.com

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St. Augustine to explore offering t-DPT to DC's?

PTManager listserv:

A chiropractor friend of mine sent me something of a distressing e-

mail. While I can see a possible benefit of creating a program of

this type for the right individual, it is somewhat alarming to see

that, if this is true, Dr. Paris may be reaching out to DC's at the

expense of his own profession. Many, if not most, DC's see PT's as

subordinate paraprofessionals and the DPT as an " online

certificate. " It may be a good thing. It may build a bridge between

our professions in a way that has previously not existed. On the

other hand, it may serve to allow DC's to use a t-DPT as a billing

tool, or to simply earn it so as to proclaim the " rigor " of their

degree and the infant education of ours (not that any of us would

agree). Finally, the fact that DC's so misunderstand the clinical

doctoring profession of physical therapy may lead to a high

application and acceptance rate, and an VERY high attrition rate

(read DC's not able to meet the demands of the program).

In any event, I find it somewhat distressing that Dr. Paris, known to

be a fierce and well respected leader in our profession, may be

considering selling out the new, young crop of DPT's and t-DPT's

before they've had an opportunity to make their mark and change, for

the better, the future of the profession. I feel that we as physical

therapists are owed some kind of explaination --- or are at least

owed the same respect offered to those in other professions.

This is the e-mail I received. Dr. Paris asks for the word to be

spread. I just don't think he expected for it to be spread within

his own profession before getting a little further along with his new

friends. I say that discussion and debate WITHIN our profession is

healthy, and necessary BEFORE CAPTE weighs in. Please read, and

respond, to the notes below:

Colleagues,

We have now set the date for the meeting where the University of St.

Augustine will host chiropractors interested in our plans to make a

DPT degree available through a combination of online learning with

weekend hands on seminars.

The date is Saturday 6th in St. Augustine and at the University.

There will be a reception at my home the night before at probably

6:00 pm.

An agenda will be sent to you in advance as well as possibly some

additional information. The day will no doubt begin with a

questionnaire (no name required) and then launch into a description

of the University and the DPT program

We will certainly cover such items as " advanced standing, transfer

credit etc. " I shall be in attendance along with the director of the

DPT program at the campus here in St.Augustine and the director of

the program in Boca Raton where the seminars are held. The director

of our online programming will also be present along with one or two

others. We will schedule to meet till I suspect mid afternoon. There

will be plenty of time for questions and discussion.

At this point I would ask that you " spread the word " to your

colleagues that might be interested. All email contacts will be to

individual email addresses and not to all at once so that your

interest and name is protected until of course we meet. I am aware

that some of the recipients of this email are very enthusiastic the

enter the program. Others may not be but simply wish to be informed

without being associated. Hence the reason for not putting you all on

one mailing list. I expect twenty to forty in attendance.

The nearest airport is ville FL at one hour away, compared to

Orlando which is two hour away.

So reserve the date. More to follow.

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

From and earlier communication

Colleagues,

Some weeks ago I responded to some interest shown by a number of

chiropractors who were interested in earning the Doctor of Physical

Therapy degree by sending an email with the following message.

" DC DPT

To those inquiring about the University of St.Augustine and its

interest in considering admitting DC's into its online and weekend

DPT program. The University is located in St. Augustine north east

Florida where it conducts PT and OT campus based programs. However it

has commenced a twelve semester online DPT program wherein all the

didactic education is conducted online and the laboratory sessions

are being conducted at its weekend campus in Boca Raton south east

Florida. At this point one chiropractor from Chicago has been

admitted into the program. He is taking the entire program and is not

testing out any of the courses nor asking that he be granted transfer

credit. Obviously these two issues are possibilities. Certainly in

the area of radiology, chiropractors have had more education than

physical therapists.

The online format is ideal for those who feel they already have the

knowledge. There is expected to they will be able to go online and

take the tests.

There are a number of issues that will need to be explored. Culture

is one of them. Physical therapy is increasingly evidenced based and

principally on the patho anatomical model moving to the disablement

NAGY model. The profession stresses professionalism and is not

hostile to medical and surgical practices other than at times being

competitive with them.

Our university will explore this issue very carefully in the

interests of patient care. You are now on our email list and we shall

keep you informed. In the meantime you may learn more by going to

www.usa.edu and clicking on the Flex Program. "

The appropriate group within the University has now met and we have

come to some conclusions including the following:

1. We know that such a move, admitting large numbers of chiropractors

could be a political hot potato in both professions. However if it is

best for the patient and best for the professional then it must be

considered.

2. We also consider that chiropractors know precious little about

physical therapy education and that many may be unaware that the

program is in fact quite rigorous and does for instance require a

bachelors degree as well as the Graduate Record Exam to be considered

for entry

3. Concerns were also expressed as to why a chiropractor would want

to earn the DPT degree. If it was solely to enhance billing

opportunities that would not be an acceptable reason

4. We also consider that our cultures are different and wonder if

chiropractors interested in this educational opportunity will still

see themselves as chiropractors at its conclusion or as physical

therapists or both

So here is our position for the present:

1. We will admit chiropractors on a case by case basis after the

usual interviews .

2. We would be willing to meet as early as next March (now May 6th)

with any group of chiropractors that would like to discuss the

program and how they might be considered for admission. So if someone

would like to make the move we will cooperate by informing inquiries

from chiropractors of such a meeting. In the meantime we will not be

advertising this opportunity. . In the meantime I think all inquiries

should be treated confidentially and individually.

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

************

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[Guest guest]

This is a disconcerting move, to say the least. The DPT is currently

considered the terminal degree for PTs and now DCs can skip right to

the terminal degree as an online option while " comping " out of classes

as well?! It would be nice (if not idealistic) if some resemblance of

academic integrity could be maintained now days. The two paradigms

are very different and it seems irresponsible to allow the cross over

between professions without more rigorous prior study before allowing

a candidate to enter the DPT program. I know there are many people who

still feel strongly against the DPT (that's another story) but this

seems like a blatant strategy to increase the market for Dr. Paris'

DPT program and allow DCs to improve their billing strategies as well.

Cohen PT, MS

[Guest guest]

I appreciate your comments and efforts to preserve your title protection.

However, it seems your arguments describe the PT as having a higher/better

education and more training than a chiropractor. Both professions are

highly knowledgeable, but you are mistaken if you think chiropractor is

below a PT. This debate reminds me of when PTs' wanted to and continue to

encroach on the field of sports medicine. ATCs' were miffed and rightfully

so. Another example is the advent of the DPT degree. Let's be honest, the

educational standards have not sufficiently changed. To call oneself a

" Doctor " in the medical setting is very misleading. As we all know this

maneuver of PTs' has stepped on the toes of MDs', DOs', and DOCs' - the real

" doctors "

There is common ground between all fields and everyone is positioning

himself or herself to make the most money.

" Can't we all just get along? "

Keating

St. Augustine to explore offering t-DPT to DC's?

This is most interesting. I want to make some comments and I am going to

get on a soap box, so bear with me.

I have been practicing physical therapy for almost 23 years now. I am

eternally grateful for the education I received at the University of Iowa.

It was so intense and so much training, I kept thinking that there was no

way there could possibly be anything else they could teach us. I was wrong.

It just kept coming. Upon graduating, I spent the first 15 years serving

patients in a hospital setting. This hospital was a Level II trauma center

and that quickly became my love. Over the years, I also worked in a rehab

unit, subacute unit, did home health, nursing homes, independent and

assisted living, outpatient clinics, and occupational medicine.

When I was at each setting, other than the outpatient setting, I had no

competitor other than my fellow physical therapists. What other profession

could compete with what I did? When I went to the outpatient setting, where

I currently have been for the past 7 years, I learned that I had another

competitor, the Chiropractor. Somehow, this professional has been equated

with what I do, or vice versa, and I have to ask myself, why?

In my neck of the woods, does a chiropractor know how to do pulmonary

function tests and pulmonary rehabilitation, pediatric

habilitation/rehabilitation, phases I, II, and III of cardiac rehab,

neurological rehab (you pick any number of categories here)? Work with a

patient who is in intensive care and has multiple trauma injuries, TBI, SCI,

CVA, MI, etc., and progress them through their rehab program from the death

bed to back to work? Orthopedic rehab (you pick any number of categories

here), fabricate orthotics and train clients in the use of adaptive

equipment, prosthetics and orthotics? Help rehabilitate patients with organ

transplants? Teach wellness and fitness other than selling your clients

vitamins, herbs, spices, and magnets? I don't think so. Does a chiropractor

know how to mobilize/manipulate a joint to relieve pain and improve

function? Yes, of course they do, and so do many physical therapists. I

don't see how that makes the two professions equal in their training and I

certainly don't see how expanding your knowledge and skill alone in joint

manipulation would earn you the privilege of being called a physical

therapist. The physical therapy profession has been on a course of

increasing and improving our education with the goal of not only being able

to improve our quality of care, but to also be able to compete against the

chiropractor's " doctor " title with the ultimate goal of autonomous practice

and increased reimbursement by third party payers. Many courses have sprung

up offering to train the physical therapist in the skill of joint

manipulation so we can be " like the chiropractor " . Interestingly, now it

seems that the chiropractor wants to be " like the physical therapist " with

encouragement from members of our profession.

It is very frustrating to have patients ask " So what is the difference

between a physical therapist and chiropractor and should they go see a

chiropractor " . But it is also a great opportunity to tell them what exactly

the difference is. We don't just mobilize/manipulate joints like the

chiropractors do, we are so much more as I mentioned above. I have had

hundreds of patients come to me post chiropractic treatment, and I can

literally say that I can count on one hand the number of times a

chiropractor instructed a patient in exercises to help stabilize and improve

their problem. Our simply doing so helped solve the problems of many of

those where this was not part of their previous treatment. The chiropractic

profession seems to be a passive program, the patient is to keep coming to

the chiropractor to be helped. Physical therapy is an active treatment

program, the patient is taught how to take care of themselves so we don't

have to see them again. This difference can be summed up in this old

analogy " Give a man a fish and he will eat for a day. Teach a man how to

fish and he will eat for a lifetime " . I believe our treatment concept is

the one that will eventually survive the reimbursement issues we all face.

I had one patient call and complain about receiving a bill for physical

therapy services. She didn't recall ever receiving therapy from me. I

pulled her file and showed her the doctor's order for " instruct in a home

exercise back strengthening program " , her signed consent forms, the date

this was done, and a copy of the exercise pictures she was given. She

stated that she remembers doing this, and despite the overwhelming evidence,

she insisted that she never received physical therapy. She went on to

explain that some time ago, she hurt her lower back and went to physical

therapy where they treated her with moist heat, ultrasound, and

massage...sound familiar? She emphatically stated, " Now that is physical

therapy " ! She never got that from me and ergo, never received physical

therapy. Ouch!!! She was still required to pay the bill.

Not long after that, I had a client present with complaint of severe neck

pain from a MVA. She had gone to physical therapy first and that didn't

help

(hot packs, ultrasound, and massage). A friend told her to go to a

chiropractor and after several manipulations (never any exercises) her neck

pain intensified with each treatment. After we worked with her for about two

weeks using a combination of manual therapy techniques, soft tissue

mobilization, and exercises (including instruction in home exercises and

work/home management techniques), her pain was substantially reduced and her

function significantly increased. Interestingly enough, she questioned why

the other therapy place didn't do this and why the chiropractic

manipulations were hurting instead of helping. What goes around, comes

around... I was able to boldly tell her that what she had before was not

physical therapy, what we did, now this is physical therapy! She had also

just experienced what the difference between chiropractic and physical

therapy is. Therefore, go forth and spread the word!

Our profession is progressively changing in order to keep up with the needs

of the people we serve, and to hold onto our share of the reimbursement $$$.

Continuous improvement needs to happen and that involves change. Maybe the

two professions, chiropractic and physical therapy will eventually evolve

into one distinct profession, or break off and become a totally new

profession. Weren't the first physical therapists nurses? Yet, the nursing

profession remains. The point I want to make is this, what we are trained

to do is multifaceted. We don't just compete with the chiropractor for back

care patients. I know that there are several professionals that have both

their physical therapy and D.C. degrees. They earned each one from distinct

training programs and have earned the privilege of using the titles of

physical therapist and chiropractor. I would believe (based on their time

spent actually being in a classroom interacting with the teacher and other

students, always having a ready resource to verify or correct techniques of

training) that their scope of knowledge and training would be far more than

what individual study and an occasional weekend hands on training session in

manual therapy techniques can give and this minimal training cannot be

equivalent to any degree in physical therapy.

Bob Lueke, PT

Madonna TherapyPlus

Lincoln, Nebraska

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[Guest guest]

As we all know the term doctor primarily was used to define a teacher

Doctor \Doc " tor\, n. [OF. doctur, L. doctor, teacher, fr. docere

to teach. See _Docile_ (http://dict.die.net/docile/) .]

1. A teacher; one skilled in a profession, or branch of

knowledge learned man. [Obs.]

A physician describes one who practices

phy·si·cian (fĭ-zĭsh'ən)

n.

1. A person licensed to practice medicine; a medical doctor.

2. A person who practices general medicine as distinct from surgery.

3. A person who heals or exerts a healing influence.

Attaining the doctor degree defines the academic standard to which it is

attained. The criteria for a " doctor " degree is established within the

academic

setting. If a person attains that level then they are deserved of the title

" doctor " , not to be confused with physician.

The comment " The real doctors " is incorrect in that anyone attaining the

educational level is a real doctor. Confusing a physician who is called a

doctor and a physical therapist who is called a doctor occurs often.

Just think, if you were in England and were an orthopedic surgeon you would

be called " Mister "

Kunkel MSPT, MLD-CDT

Not a Doctor but in the process of attaining a " doctorate " in physical

therapy and won't be called a " doctor " in the clinical setting just the

educational and research setting. Interesting!

[Guest guest]

could someone put the letter that Dr. Paris sent out to the Chiro's back on

the list serve. I would really like to hear more opinions on this issue. I

feel this would start with Chiro's, then any other profession that wanted to

get

a DPT. This would further put us behind other professions in the sense a

chiro who has a DPT is better than a PT without a DC. I could see this being

the

marketing tool as well as the fact they will tell people they are physical

therapist. I don't care if some gets a DPT but you have to apply and go

through the entire school program like any other physical therapist had to. If

I

want to go to DC school they are not going to let me do it number one through

correspondence and number too substitute some of my PT courses. I have to

complete the full DC program if that is what I want to do. I feel that as a

group along with the APTA something as to be done about this. We have enough

problems with everyone trying to get a piece of physical therapy everyday and

now we are just going to give them a reason now because they have a DPT that

they did not get starting and completing a full physical therapy school

program. This does such a disservice to the DPT students who are coming out

and

what happens when we reach critical numbers of DPT and get state law to accept

the DPT will those chiro's that have earned a DPT on the side essentially be

placed in this group. I think this will be a big mess if he continues

forward with this and someone will need to put a stop to it but as a group in

order

to protect the profession.

Onuwa Terry, PT

DPT student

[Guest guest]

I agree that is why in most states the name tag has to delineate the

profession not just the name

i.e Dr. M

Physical Therapist

or

Dr. M

Orthopedic Surgeon

Some hospitals have established policies that only the Physicians can use

the title " Doctor " for the purposes of avoiding confusion by the Patient.

Our facility employs a DPT and she does use the term " Doctor " but must

identify herself as a physical therapist.

Kentucky has place restrictions on its use

311.375 Conditions governing use of title " Doctor " or " Dr. "

<NOBR>(1) No person shall, in connection with the practice of medicine,

surgery, osteo

<NOBR>optometry, dentistry, podiatry, pharmacy, chiropractic, psychology or

psych

<NOBR>nursing, anesthesiology, physio or physical therapy, or any other

professio

<NOBR>business having for its purpose the diagnosis, treatment, correction

or cure

<NOBR>human ailment, condition, disease, injury or infirmity, hold himself

outdoctor

<NOBR>or empluse in any manner the title " Doctor " or " Dr., " unless he

actually has

<NOBR>graduated and hodoctor degree from a school, college, university or

institution

<NOBR>authorized by its governing body to confer such d

<NOBR>(2) No person who hodoctor degree, as provided in subsection (1) of

this section,

<NOBR>use or employ the title " Doctor " or " Dr. " in or upon any letter,

statement, card,

<NOBR>prescription, sign, listing or other writing without affixing suitable

words or l

<NOBR>designating the partidoctor degree held by such person.

History: Amended 1968 Ky. Acts ch. 152, sec. 145. -- Created 1952 Ky. Acts

ch. 198,

<NOBR>sec

[Guest guest]

Great point. However, I don't' think we all know that the term " doctor means

teacher. " Most importantly, the people who don't know this are the

consumer/patient. The point being is that it may be misleading in the clinical

setting. Being married to a physician, I find it incredibly disturbing that I

have peers who are recent DPT grads. and request their patients to refer to them

as Doctor. Especially, due to the fact that our setting is a hospital based

sports medicine clinic that has physicians on staff. Bottom line, what is the

perception of the patient/consumer? The term doctor in a medical setting should

probably be reserved for physicians, podiatrists, chiropractors, osteopaths and

dentists. An educational doctorate degree in this setting does not warrant the

use of the term doctor and is misleading to the patient. My wife has a PA who

has an EdD., yet she would never use the term doctor in front of her name in the

hospital/clinic setting. If she were to be teaching in the academic or research

world this would be perfectly fine, but not when seeing patients.

I hope you can see that there needs to be title protection, but remember and

appreciate the fact that even as PTs' we have and continue to encroach on other

professions.

Just my 2 cents.

M. Keating

Re: St. Augustine to explore offering t-DPT to DC's?

As we all know the term doctor primarily was used to define a teacher

Doctor \Doc " tor\, n. [OF. doctur, L. doctor, teacher, fr. docere

to teach. See _Docile_ (http://dict.die.net/docile/) .]

1. A teacher; one skilled in a profession, or branch of

knowledge learned man. [Obs.]

A physician describes one who practices

phy·si·cian (fĭ-zĭsh'ən)

n.

1. A person licensed to practice medicine; a medical doctor.

2. A person who practices general medicine as distinct from surgery.

3. A person who heals or exerts a healing influence.

Attaining the doctor degree defines the academic standard to which it is

attained. The criteria for a " doctor " degree is established within the

academic

setting. If a person attains that level then they are deserved of the title

" doctor " , not to be confused with physician.

The comment " The real doctors " is incorrect in that anyone attaining the

educational level is a real doctor. Confusing a physician who is called a

doctor and a physical therapist who is called a doctor occurs often.

Just think, if you were in England and were an orthopedic surgeon you would

be called " Mister "

Kunkel MSPT, MLD-CDT

Not a Doctor but in the process of attaining a " doctorate " in physical

therapy and won't be called a " doctor " in the clinical setting just the

educational and research setting. Interesting!

[Guest guest]

I think we all may be over reacting a bit, he is not offering them a

tdpt he is offering a dpt, the same entry level dpt that anyone with

a bachelors degree can attain if they meet the entry requirements.

the chiros, if they meet entry requirements, would be required to

take most, if not all of the courses anyone else would take as well

as complete internship hours just like any other student would. The

program still must meet CAPTE requirements if the individual

completeing is to sit for the boards and be liscensed as a PT, I

dont see what the concern is. chiro's can and do decide to attend PT

school very often, this would just be the first time ST augustine

would be an option for them.

E s, PT, DPT, OCS

www.douglasspt.com

>

> PTManager listserv:

>

> A chiropractor friend of mine sent me something of a distressing e-

> mail. While I can see a possible benefit of creating a program of

> this type for the right individual, it is somewhat alarming to see

> that, if this is true, Dr. Paris may be reaching out to DC's at

the

> expense of his own profession. Many, if not most, DC's see PT's

as

> subordinate paraprofessionals and the DPT as an " online

> certificate. " It may be a good thing. It may build a bridge

between

> our professions in a way that has previously not existed. On the

> other hand, it may serve to allow DC's to use a t-DPT as a billing

> tool, or to simply earn it so as to proclaim the " rigor " of their

> degree and the infant education of ours (not that any of us would

> agree). Finally, the fact that DC's so misunderstand the clinical

> doctoring profession of physical therapy may lead to a high

> application and acceptance rate, and an VERY high attrition rate

> (read DC's not able to meet the demands of the program).

>

> In any event, I find it somewhat distressing that Dr. Paris, known

to

> be a fierce and well respected leader in our profession, may be

> considering selling out the new, young crop of DPT's and t-DPT's

> before they've had an opportunity to make their mark and change,

for

> the better, the future of the profession. I feel that we as

physical

> therapists are owed some kind of explaination --- or are at least

> owed the same respect offered to those in other professions.

>

> This is the e-mail I received. Dr. Paris asks for the word to be

> spread. I just don't think he expected for it to be spread within

> his own profession before getting a little further along with his

new

> friends. I say that discussion and debate WITHIN our profession

is

> healthy, and necessary BEFORE CAPTE weighs in. Please read, and

> respond, to the notes below:

>

>

>

> Colleagues,

>

> We have now set the date for the meeting where the University of

St.

> Augustine will host chiropractors interested in our plans to make

a

> DPT degree available through a combination of online learning with

> weekend hands on seminars.

>

> The date is Saturday 6th in St. Augustine and at the University.

> There will be a reception at my home the night before at probably

> 6:00 pm.

>

> An agenda will be sent to you in advance as well as possibly some

> additional information. The day will no doubt begin with a

> questionnaire (no name required) and then launch into a

description

> of the University and the DPT program

>

> We will certainly cover such items as " advanced standing, transfer

> credit etc. " I shall be in attendance along with the director of

the

> DPT program at the campus here in St.Augustine and the director of

> the program in Boca Raton where the seminars are held. The

director

> of our online programming will also be present along with one or

two

> others. We will schedule to meet till I suspect mid afternoon.

There

> will be plenty of time for questions and discussion.

>

> At this point I would ask that you " spread the word " to your

> colleagues that might be interested. All email contacts will be to

> individual email addresses and not to all at once so that your

> interest and name is protected until of course we meet. I am aware

> that some of the recipients of this email are very enthusiastic

the

> enter the program. Others may not be but simply wish to be

informed

> without being associated. Hence the reason for not putting you all

on

> one mailing list. I expect twenty to forty in attendance.

>

> The nearest airport is ville FL at one hour away, compared

to

> Orlando which is two hour away.

>

> So reserve the date. More to follow.

>

> Stanley V. Paris PT., PhD., FAPTA

> President, University of St. Augustine,

> 1 University Blvd.,

> St. Augustine, FL 32086

> USA

> Voice

> Toll Free

>

> From and earlier communication

>

> Colleagues,

>

> Some weeks ago I responded to some interest shown by a number of

> chiropractors who were interested in earning the Doctor of

Physical

> Therapy degree by sending an email with the following message.

>

> " DC DPT

>

> To those inquiring about the University of St.Augustine and its

> interest in considering admitting DC's into its online and weekend

> DPT program. The University is located in St. Augustine north east

> Florida where it conducts PT and OT campus based programs. However

it

> has commenced a twelve semester online DPT program wherein all the

> didactic education is conducted online and the laboratory sessions

> are being conducted at its weekend campus in Boca Raton south east

> Florida. At this point one chiropractor from Chicago has been

> admitted into the program. He is taking the entire program and is

not

> testing out any of the courses nor asking that he be granted

transfer

> credit. Obviously these two issues are possibilities. Certainly in

> the area of radiology, chiropractors have had more education than

> physical therapists.

>

> The online format is ideal for those who feel they already have

the

> knowledge. There is expected to they will be able to go online and

> take the tests.

>

> There are a number of issues that will need to be explored.

Culture

> is one of them. Physical therapy is increasingly evidenced based

and

> principally on the patho anatomical model moving to the

disablement

> NAGY model. The profession stresses professionalism and is not

> hostile to medical and surgical practices other than at times

being

> competitive with them.

>

> Our university will explore this issue very carefully in the

> interests of patient care. You are now on our email list and we

shall

> keep you informed. In the meantime you may learn more by going to

> www.usa.edu and clicking on the Flex Program. "

>

> The appropriate group within the University has now met and we

have

> come to some conclusions including the following:

>

> 1. We know that such a move, admitting large numbers of

chiropractors

> could be a political hot potato in both professions. However if it

is

> best for the patient and best for the professional then it must be

> considered.

>

> 2. We also consider that chiropractors know precious little about

> physical therapy education and that many may be unaware that the

> program is in fact quite rigorous and does for instance require a

> bachelors degree as well as the Graduate Record Exam to be

considered

> for entry

>

> 3. Concerns were also expressed as to why a chiropractor would

want

> to earn the DPT degree. If it was solely to enhance billing

> opportunities that would not be an acceptable reason

>

> 4. We also consider that our cultures are different and wonder if

> chiropractors interested in this educational opportunity will

still

> see themselves as chiropractors at its conclusion or as physical

> therapists or both

>

> So here is our position for the present:

>

> 1. We will admit chiropractors on a case by case basis after the

> usual interviews .

>

> 2. We would be willing to meet as early as next March (now May

6th)

> with any group of chiropractors that would like to discuss the

> program and how they might be considered for admission. So if

someone

> would like to make the move we will cooperate by informing

inquiries

> from chiropractors of such a meeting. In the meantime we will not

be

> advertising this opportunity. . In the meantime I think all

inquiries

> should be treated confidentially and individually.

>

> Stanley V. Paris PT., PhD., FAPTA

> President, University of St. Augustine,

> 1 University Blvd.,

> St. Augustine, FL 32086

> USA

> Voice

> Toll Free

>

>

> Stanley V. Paris PT., PhD., FAPTA

> President, University of St. Augustine,

> 1 University Blvd.,

> St. Augustine, FL 32086

> USA

> Voice

> Toll Free

>

> ************

>

[Guest guest]

,

Thanks for bringing the discussion back to a place free of emotions.

Perhaps I mis-spoke when I used the term " t-DPT " to describe the

program. It is an entry-level program, unique in delivery, that

offers advanced standing to DC's. We shouldn't have any problem with

that. If a DC wants to become a DPT also, so be it.

The question is, do we WANT DC/DPT's among us? Think about it. With

hot-button issues of physical therapists performing grade V

manipulations, and with the questions of direct reimbursement, and

clinical doctoring practice on the table --- do we REALLY want to

create a class of DPT's who will be the legal " go to " experts for

resolution of these issues? Do we want to make obtaining a DPT in 12

trimesters of weekend and online work? Do we want to create a class

of DPT's whose first love is likely to chiropractic (with several

years of experience under their belt), with DPT as an afterthought,

an internal political rival to the mostly novice and inexperienced

entry-level DPT ranks? Can a handful (roughly 2000 or so) clinically

experienced t-DPT's steward the profession away from what could end

up being a very powerful group of DC/DPT's whose make it their

mission to LIMIT the practice scope of the rest of us? Serious

questions that deserve serious answers. Dr. Paris may owe the

profession a few answers, but by the same token, we owe him the

respect of simply asking, " Hey guy, what's up? " and not taking to

panic. I just think, and it's clear that I have support for the

notion, that as we struggle to re-define physical therapy as a

clinical doctoring, autonomous, interdependent profession; we must be

mindful of these arrangements --- and not allow a lone wolf to define

our future without more transparent discussion with the DPT's of 2020

whom it will most impact.

I've met Dr. Paris several times, and I don't mean to imply that

financial gain is the sole motivation behind exploring the value of a

program of this type. I'm sure that there are many theoretical

benefits of a program of this nature, and most importantly, a list of

rationale as to why, in the infancy of the DPT, a DC to DPT program

is a good idea. I just can't think of one. With so many disaster

scenarios possible, and as a DPT/PhD who fully expects to practice

well into 2020, I just think that some answers are in order. What is

the vision as to how such a program could benefit the profession at

large?

I'm asking, of course, primarily of Dr. Paris and his staff, but if

anyone has an supportive ideas as to how this COULD be a good

idea . . . I'm all ears.

M. Ball, PT, DPT, PhD

Doctor of Physical Therapy

P.S. As an experienced clinician with a transitional DPT, I'd weigh

in to the " doctor " discussion by saying that, like the first doctors

of podiatry --- we must be mindful of the fact that while DPT's ARE

doctors, wisdom, tact, and humilty must guide us as to WHEN to define

ourselves as such. It is an argument as to why we need MORE t-DPT's

to reign in, and help mentor/guide our inexperienced new-grad DPT

ranks. I've found that many new grads will pick and choose

the " wisdom of experience " advice given them by more experienced

clinicians --- writing off the elder's experiences as " dated " unless

it comes from a t-DPT. I say, therefore, to the elder stewards of

our profession, for the sake of our professional future, PLEASE do

not leave the profession in the hands of novice, entry-level DPT's.

PLEASE consider a t-DPT. Your profession needs you. Now more than

ever!

[Guest guest]

I agree we should all make better attempts to get along...but try to

understand the current standing of PT's... and it's our own fault..but

it still stinks. We have been hit with the only abitrary cap in

Medicare...we constantly have to explain that we go to school longer,,,

much longer, than massage therapists,, and than some DC's...etc...but

we're still called to give a massage....or ask to bring lunch for 50

people in order to consult the referring Dr. on a pt. it's

crazy...and again, it's our fault for not educating the public and

marketing better. Write columns for newspapers, do radio talk shows,

buy billboards,, in this time we live in we have to tell people what

they want and where to go...if we tell them who we are and why we

should be thier choice many will listen. Orville Reddenbacher told us

his popcorn was so much better...and we bought it...it was the same as

the other brand, but he told us it was better. Start talking

louder...tell people why PT should be their choice....it's costly...

and with the medicare cuts its scary...but we shouldn't give up just

yet....then if all else fails, open a Starbucks.

St. Augustine to explore offering t-DPT to DC's?

This is most interesting. I want to make some comments and I am going

to

get on a soap box, so bear with me.

I have been practicing physical therapy for almost 23 years now. I am

eternally grateful for the education I received at the University of

Iowa.

It was so intense and so much training, I kept thinking that there was

no

way there could possibly be anything else they could teach us. I was

wrong.

It just kept coming. Upon graduating, I spent the first 15 years serving

patients in a hospital setting. This hospital was a Level II trauma

center

and that quickly became my love. Over the years, I also worked in a

rehab

unit, subacute unit, did home health, nursing homes, independent and

assisted living, outpatient clinics, and occupational medicine.

When I was at each setting, other than the outpatient setting, I had no

competitor other than my fellow physical therapists. What other

profession

could compete with what I did? When I went to the outpatient setting,

where

I currently have been for the past 7 years, I learned that I had another

competitor, the Chiropractor. Somehow, this professional has been

equated

with what I do, or vice versa, and I have to ask myself, why?

In my neck of the woods, does a chiropractor know how to do pulmonary

function tests and pulmonary rehabilitation, pediatric

habilitation/rehabilitation, phases I, II, and III of cardiac rehab,

neurological rehab (you pick any number of categories here)? Work with a

patient who is in intensive care and has multiple trauma injuries, TBI,

SCI,

CVA, MI, etc., and progress them through their rehab program from the

death

bed to back to work? Orthopedic rehab (you pick any number of

categories

here), fabricate orthotics and train clients in the use of adaptive

equipment, prosthetics and orthotics? Help rehabilitate patients with

organ

transplants? Teach wellness and fitness other than selling your clients

vitamins, herbs, spices, and magnets? I don't think so. Does a

chiropractor

know how to mobilize/manipulate a joint to relieve pain and improve

function? Yes, of course they do, and so do many physical therapists. I

don't see how that makes the two professions equal in their training

and I

certainly don't see how expanding your knowledge and skill alone in

joint

manipulation would earn you the privilege of being called a physical

therapist. The physical therapy profession has been on a course of

increasing and improving our education with the goal of not only being

able

to improve our quality of care, but to also be able to compete against

the

chiropractor's " doctor " title with the ultimate goal of autonomous

practice

and increased reimbursement by third party payers. Many courses have

sprung

up offering to train the physical therapist in the skill of joint

manipulation so we can be " like the chiropractor " . Interestingly, now

it

seems that the chiropractor wants to be " like the physical therapist "

with

encouragement from members of our profession.

It is very frustrating to have patients ask " So what is the difference

between a physical therapist and chiropractor and should they go see a

chiropractor " . But it is also a great opportunity to tell them what

exactly

the difference is. We don't just mobilize/manipulate joints like the

chiropractors do, we are so much more as I mentioned above. I have had

hundreds of patients come to me post chiropractic treatment, and I can

literally say that I can count on one hand the number of times a

chiropractor instructed a patient in exercises to help stabilize and

improve

their problem. Our simply doing so helped solve the problems of many of

those where this was not part of their previous treatment. The

chiropractic

profession seems to be a passive program, the patient is to keep coming

to

the chiropractor to be helped. Physical therapy is an active treatment

program, the patient is taught how to take care of themselves so we

don't

have to see them again. This difference can be summed up in this old

analogy " Give a man a fish and he will eat for a day. Teach a man how

to

fish and he will eat for a lifetime " . I believe our treatment concept

is

the one that will eventually survive the reimbursement issues we all

face.

I had one patient call and complain about receiving a bill for physical

therapy services. She didn't recall ever receiving therapy from me. I

pulled her file and showed her the doctor's order for " instruct in a

home

exercise back strengthening program " , her signed consent forms, the date

this was done, and a copy of the exercise pictures she was given. She

stated that she remembers doing this, and despite the overwhelming

evidence,

she insisted that she never received physical therapy. She went on to

explain that some time ago, she hurt her lower back and went to physical

therapy where they treated her with moist heat, ultrasound, and

massage...sound familiar? She emphatically stated, " Now that is

physical

therapy " ! She never got that from me and ergo, never received physical

therapy. Ouch!!! She was still required to pay the bill.

Not long after that, I had a client present with complaint of severe

neck

pain from a MVA. She had gone to physical therapy first and that didn't

help

(hot packs, ultrasound, and massage). A friend told her to go to a

chiropractor and after several manipulations (never any exercises) her

neck

pain intensified with each treatment. After we worked with her for

about two

weeks using a combination of manual therapy techniques, soft tissue

mobilization, and exercises (including instruction in home exercises and

work/home management techniques), her pain was substantially reduced

and her

function significantly increased. Interestingly enough, she questioned

why

the other therapy place didn't do this and why the chiropractic

manipulations were hurting instead of helping. What goes around, comes

around... I was able to boldly tell her that what she had before was not

physical therapy, what we did, now this is physical therapy! She had

also

just experienced what the difference between chiropractic and physical

therapy is. Therefore, go forth and spread the word!

Our profession is progressively changing in order to keep up with the

needs

of the people we serve, and to hold onto our share of the reimbursement

$$$.

Continuous improvement needs to happen and that involves change. Maybe

the

two professions, chiropractic and physical therapy will eventually

evolve

into one distinct profession, or break off and become a totally new

profession. Weren't the first physical therapists nurses? Yet, the

nursing

profession remains. The point I want to make is this, what we are

trained

to do is multifaceted. We don't just compete with the chiropractor for

back

care patients. I know that there are several professionals that have

both

their physical therapy and D.C. degrees. They earned each one from

distinct

training programs and have earned the privilege of using the titles of

physical therapist and chiropractor. I would believe (based on their

time

spent actually being in a classroom interacting with the teacher and

other

students, always having a ready resource to verify or correct

techniques of

training) that their scope of knowledge and training would be far more

than

what individual study and an occasional weekend hands on training

session in

manual therapy techniques can give and this minimal training cannot be

equivalent to any degree in physical therapy.

Bob Lueke, PT

Madonna TherapyPlus

Lincoln, Nebraska

Looking to start and own 100% of your own Practice?

Visit www.InHomeRehab.com.

PTManager encourages participation in your professional association.

Join

and participate now!

Please identify yourself in all postings to PTManager.

[Guest guest]

Are there any PT to Chiro programs out there?

St. Augustine to explore offering t-DPT to DC's?

This is most interesting. I want to make some comments and I am going

to

get on a soap box, so bear with me.

I have been practicing physical therapy for almost 23 years now. I am

eternally grateful for the education I received at the University of

Iowa.

It was so intense and so much training, I kept thinking that there was

no

way there could possibly be anything else they could teach us. I was

wrong.

It just kept coming. Upon graduating, I spent the first 15 years serving

patients in a hospital setting. This hospital was a Level II trauma

center

and that quickly became my love. Over the years, I also worked in a

rehab

unit, subacute unit, did home health, nursing homes, independent and

assisted living, outpatient clinics, and occupational medicine.

When I was at each setting, other than the outpatient setting, I had no

competitor other than my fellow physical therapists. What other

profession

could compete with what I did? When I went to the outpatient setting,

where

I currently have been for the past 7 years, I learned that I had another

competitor, the Chiropractor. Somehow, this professional has been

equated

with what I do, or vice versa, and I have to ask myself, why?

In my neck of the woods, does a chiropractor know how to do pulmonary

function tests and pulmonary rehabilitation, pediatric

habilitation/rehabilitation, phases I, II, and III of cardiac rehab,

neurological rehab (you pick any number of categories here)? Work with a

patient who is in intensive care and has multiple trauma injuries, TBI,

SCI,

CVA, MI, etc., and progress them through their rehab program from the

death

bed to back to work? Orthopedic rehab (you pick any number of

categories

here), fabricate orthotics and train clients in the use of adaptive

equipment, prosthetics and orthotics? Help rehabilitate patients with

organ

transplants? Teach wellness and fitness other than selling your clients

vitamins, herbs, spices, and magnets? I don't think so. Does a

chiropractor

know how to mobilize/manipulate a joint to relieve pain and improve

function? Yes, of course they do, and so do many physical therapists. I

don't see how that makes the two professions equal in their training

and I

certainly don't see how expanding your knowledge and skill alone in

joint

manipulation would earn you the privilege of being called a physical

therapist. The physical therapy profession has been on a course of

increasing and improving our education with the goal of not only being

able

to improve our quality of care, but to also be able to compete against

the

chiropractor's " doctor " title with the ultimate goal of autonomous

practice

and increased reimbursement by third party payers. Many courses have

sprung

up offering to train the physical therapist in the skill of joint

manipulation so we can be " like the chiropractor " . Interestingly, now

it

seems that the chiropractor wants to be " like the physical therapist "

with

encouragement from members of our profession.

It is very frustrating to have patients ask " So what is the difference

between a physical therapist and chiropractor and should they go see a

chiropractor " . But it is also a great opportunity to tell them what

exactly

the difference is. We don't just mobilize/manipulate joints like the

chiropractors do, we are so much more as I mentioned above. I have had

hundreds of patients come to me post chiropractic treatment, and I can

literally say that I can count on one hand the number of times a

chiropractor instructed a patient in exercises to help stabilize and

improve

their problem. Our simply doing so helped solve the problems of many of

those where this was not part of their previous treatment. The

chiropractic

profession seems to be a passive program, the patient is to keep coming

to

the chiropractor to be helped. Physical therapy is an active treatment

program, the patient is taught how to take care of themselves so we

don't

have to see them again. This difference can be summed up in this old

analogy " Give a man a fish and he will eat for a day. Teach a man how

to

fish and he will eat for a lifetime " . I believe our treatment concept

is

the one that will eventually survive the reimbursement issues we all

face.

I had one patient call and complain about receiving a bill for physical

therapy services. She didn't recall ever receiving therapy from me. I

pulled her file and showed her the doctor's order for " instruct in a

home

exercise back strengthening program " , her signed consent forms, the date

this was done, and a copy of the exercise pictures she was given. She

stated that she remembers doing this, and despite the overwhelming

evidence,

she insisted that she never received physical therapy. She went on to

explain that some time ago, she hurt her lower back and went to physical

therapy where they treated her with moist heat, ultrasound, and

massage...sound familiar? She emphatically stated, " Now that is

physical

therapy " ! She never got that from me and ergo, never received physical

therapy. Ouch!!! She was still required to pay the bill.

Not long after that, I had a client present with complaint of severe

neck

pain from a MVA. She had gone to physical therapy first and that didn't

help

(hot packs, ultrasound, and massage). A friend told her to go to a

chiropractor and after several manipulations (never any exercises) her

neck

pain intensified with each treatment. After we worked with her for

about two

weeks using a combination of manual therapy techniques, soft tissue

mobilization, and exercises (including instruction in home exercises and

work/home management techniques), her pain was substantially reduced

and her

function significantly increased. Interestingly enough, she questioned

why

the other therapy place didn't do this and why the chiropractic

manipulations were hurting instead of helping. What goes around, comes

around... I was able to boldly tell her that what she had before was not

physical therapy, what we did, now this is physical therapy! She had

also

just experienced what the difference between chiropractic and physical

therapy is. Therefore, go forth and spread the word!

Our profession is progressively changing in order to keep up with the

needs

of the people we serve, and to hold onto our share of the reimbursement

$$$.

Continuous improvement needs to happen and that involves change. Maybe

the

two professions, chiropractic and physical therapy will eventually

evolve

into one distinct profession, or break off and become a totally new

profession. Weren't the first physical therapists nurses? Yet, the

nursing

profession remains. The point I want to make is this, what we are

trained

to do is multifaceted. We don't just compete with the chiropractor for

back

care patients. I know that there are several professionals that have

both

their physical therapy and D.C. degrees. They earned each one from

distinct

training programs and have earned the privilege of using the titles of

physical therapist and chiropractor. I would believe (based on their

time

spent actually being in a classroom interacting with the teacher and

other

students, always having a ready resource to verify or correct

techniques of

training) that their scope of knowledge and training would be far more

than

what individual study and an occasional weekend hands on training

session in

manual therapy techniques can give and this minimal training cannot be

equivalent to any degree in physical therapy.

Bob Lueke, PT

Madonna TherapyPlus

Lincoln, Nebraska

Looking to start and own 100% of your own Practice?

Visit www.InHomeRehab.com.

PTManager encourages participation in your professional association.

Join

and participate now!

Please identify yourself in all postings to PTManager.

[Guest guest]

This is an interesting discussion. If a person of any background wants

to continue their education through the proper channels then we should

not try to limit them. We should not allow short cuts for any profession

as this ultimately hurts the patients more than anyone. I have worked

closely with MD's and DO's. I have also worked as closely with

Chiropractors and PT's. Each has a different educational background

that makes their approach unique to patient care. Physical therapists

and chiropractors do not have the same level of training in pharmacology

as the physicians. Chiropractic has had a lead on differential diagnosis

training up to this time over physical therapy. Physical therapists have

a better understanding of the kinesiology and movement patterns of the

human body in all levels of care, than do chiropractors and most

physicians (outside of orthopedics and then it can be a wash at times)

the Chiropractors and physical therapist can do a better job of

clinically diagnosing muscular skeletal disorders than most family and

general practice physicians. The ATC's training is on emergency

management of athletic injury and the prevention thereof.

I have known of a number of practitioner that have tried to

" encroach on others territories. " I have known chiropractors who believe

themselves the equivalent of medical doctors and have tried to treat the

entire body, far outside their field of training. I know of athletic

trainers trying to become rehabilitation providers again far outside of

their training. There will be tDPT practitioner who will try to treat

systemic problems outside of there scope of practice. There are

orthopedic surgeon that try to rehab their own patient, outside the

scope of their own training. It is the attempts to work outside of the

scope of practice and the subsequent failure of these attempts that have

given each of the professions a bad name. Physical therapists are

currently looking for acknowledgment of their specialty of training.

They will be " real doctors " if you consider them the experts in their

unique realm of practice, training and research.

Mr Keating, I am sorry that you appear to be carrying a grudge

against the physical therapists. PT's can be great allies in the

movement sciences and mechanical diagnosis. The research and teaching in

the profession are improving and can not be rivaled in many areas at

this point. I have met many Chiropractors that are benefitting from the

work of Mulligan, McKenzie, Maitland and the Kendals. If each profession

concentrated on making their own body of knowledge stronger and learned

to appreciate the knowledge and work of those in similar (yet different)

fields, we could each grow and become stronger. The difficulty is when

we try to keep a profession from being recognized for its specialty

because we perceive it to be a threat. As long as each practices safely

within the scope of their training, research and knowledge base, the

patient or consumer will choose which practitioner best suits their

needs.

s PT, Cert MDT

Rehabilitation Educator

Bronson Rehabilitation Services, MI

>>> michaelkeating@... 1/28/2006 6:10:28 PM >>>

I appreciate your comments and efforts to preserve your title

protection.

However, it seems your arguments describe the PT as having a

higher/better

education and more training than a chiropractor. Both professions are

highly knowledgeable, but you are mistaken if you think chiropractor

is

below a PT. This debate reminds me of when PTs' wanted to and continue

to

encroach on the field of sports medicine. ATCs' were miffed and

rightfully

so. Another example is the advent of the DPT degree. Let's be honest,

the

educational standards have not sufficiently changed. To call oneself

a

" Doctor " in the medical setting is very misleading. As we all know

this

maneuver of PTs' has stepped on the toes of MDs', DOs', and DOCs' - the

real

" doctors "

There is common ground between all fields and everyone is positioning

himself or herself to make the most money.

" Can't we all just get along? "

Keating

St. Augustine to explore offering t-DPT to DC's?

This is most interesting. I want to make some comments and I am going

to

get on a soap box, so bear with me.

I have been practicing physical therapy for almost 23 years now. I am

eternally grateful for the education I received at the University of

Iowa.

It was so intense and so much training, I kept thinking that there was

no

way there could possibly be anything else they could teach us. I was

wrong.

It just kept coming. Upon graduating, I spent the first 15 years

serving

patients in a hospital setting. This hospital was a Level II trauma

center

and that quickly became my love. Over the years, I also worked in a

rehab

unit, subacute unit, did home health, nursing homes, independent and

assisted living, outpatient clinics, and occupational medicine.

When I was at each setting, other than the outpatient setting, I had

no

competitor other than my fellow physical therapists. What other

profession

could compete with what I did? When I went to the outpatient setting,

where

I currently have been for the past 7 years, I learned that I had

another

competitor, the Chiropractor. Somehow, this professional has been

equated

with what I do, or vice versa, and I have to ask myself, why?

In my neck of the woods, does a chiropractor know how to do pulmonary

function tests and pulmonary rehabilitation, pediatric

habilitation/rehabilitation, phases I, II, and III of cardiac rehab,

neurological rehab (you pick any number of categories here)? Work with

a

patient who is in intensive care and has multiple trauma injuries, TBI,

SCI,

CVA, MI, etc., and progress them through their rehab program from the

death

bed to back to work? Orthopedic rehab (you pick any number of

categories

here), fabricate orthotics and train clients in the use of adaptive

equipment, prosthetics and orthotics? Help rehabilitate patients with

organ

transplants? Teach wellness and fitness other than selling your

clients

vitamins, herbs, spices, and magnets? I don't think so. Does a

chiropractor

know how to mobilize/manipulate a joint to relieve pain and improve

function? Yes, of course they do, and so do many physical therapists.

I

don't see how that makes the two professions equal in their training

and I

certainly don't see how expanding your knowledge and skill alone in

joint

manipulation would earn you the privilege of being called a physical

therapist. The physical therapy profession has been on a course of

increasing and improving our education with the goal of not only being

able

to improve our quality of care, but to also be able to compete against

the

chiropractor's " doctor " title with the ultimate goal of autonomous

practice

and increased reimbursement by third party payers. Many courses have

sprung

up offering to train the physical therapist in the skill of joint

manipulation so we can be " like the chiropractor " . Interestingly, now

it

seems that the chiropractor wants to be " like the physical therapist "

with

encouragement from members of our profession.

It is very frustrating to have patients ask " So what is the difference

between a physical therapist and chiropractor and should they go see a

chiropractor " . But it is also a great opportunity to tell them what

exactly

the difference is. We don't just mobilize/manipulate joints like the

chiropractors do, we are so much more as I mentioned above. I have had

hundreds of patients come to me post chiropractic treatment, and I can

literally say that I can count on one hand the number of times a

chiropractor instructed a patient in exercises to help stabilize and

improve

their problem. Our simply doing so helped solve the problems of many

of

those where this was not part of their previous treatment. The

chiropractic

profession seems to be a passive program, the patient is to keep coming

to

the chiropractor to be helped. Physical therapy is an active

treatment

program, the patient is taught how to take care of themselves so we

don't

have to see them again. This difference can be summed up in this old

analogy " Give a man a fish and he will eat for a day. Teach a man how

to

fish and he will eat for a lifetime " . I believe our treatment concept

is

the one that will eventually survive the reimbursement issues we all

face.

I had one patient call and complain about receiving a bill for

physical

therapy services. She didn't recall ever receiving therapy from me.

I

pulled her file and showed her the doctor's order for " instruct in a

home

exercise back strengthening program " , her signed consent forms, the

date

this was done, and a copy of the exercise pictures she was given. She

stated that she remembers doing this, and despite the overwhelming

evidence,

she insisted that she never received physical therapy. She went on to

explain that some time ago, she hurt her lower back and went to

physical

therapy where they treated her with moist heat, ultrasound, and

massage...sound familiar? She emphatically stated, " Now that is

physical

therapy " ! She never got that from me and ergo, never received

physical

therapy. Ouch!!! She was still required to pay the bill.

Not long after that, I had a client present with complaint of severe

neck

pain from a MVA. She had gone to physical therapy first and that

didn't

help

(hot packs, ultrasound, and massage). A friend told her to go to a

chiropractor and after several manipulations (never any exercises) her

neck

pain intensified with each treatment. After we worked with her for

about two

weeks using a combination of manual therapy techniques, soft tissue

mobilization, and exercises (including instruction in home exercises

and

work/home management techniques), her pain was substantially reduced

and her

function significantly increased. Interestingly enough, she questioned

why

the other therapy place didn't do this and why the chiropractic

manipulations were hurting instead of helping. What goes around,

comes

around... I was able to boldly tell her that what she had before was

not

physical therapy, what we did, now this is physical therapy! She had

also

just experienced what the difference between chiropractic and physical

therapy is. Therefore, go forth and spread the word!

Our profession is progressively changing in order to keep up with the

needs

of the people we serve, and to hold onto our share of the reimbursement

$$$.

Continuous improvement needs to happen and that involves change. Maybe

the

two professions, chiropractic and physical therapy will eventually

evolve

into one distinct profession, or break off and become a totally new

profession. Weren't the first physical therapists nurses? Yet, the

nursing

profession remains. The point I want to make is this, what we are

trained

to do is multifaceted. We don't just compete with the chiropractor for

back

care patients. I know that there are several professionals that have

both

their physical therapy and D.C. degrees. They earned each one from

distinct

training programs and have earned the privilege of using the titles of

physical therapist and chiropractor. I would believe (based on their

time

spent actually being in a classroom interacting with the teacher and

other

students, always having a ready resource to verify or correct

techniques of

training) that their scope of knowledge and training would be far more

than

what individual study and an occasional weekend hands on training

session in

manual therapy techniques can give and this minimal training cannot be

equivalent to any degree in physical therapy.

Bob Lueke, PT

Madonna TherapyPlus

Lincoln, Nebraska

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[Guest guest]

Does the APTA accredit this program? I don't see how they could, and if not

then they would be unable to bill for PT services right?

Joe Ruzich, PT

St. Augustine to explore offering t-DPT to DC's?

PTManager listserv:

A chiropractor friend of mine sent me something of a distressing e- mail.

While I can see a possible benefit of creating a program of this type for

the right individual, it is somewhat alarming to see that, if this is true,

Dr. Paris may be reaching out to DC's at the expense of his own profession.

Many, if not most, DC's see PT's as subordinate paraprofessionals and the

DPT as an " online certificate. " It may be a good thing. It may build a

bridge between our professions in a way that has previously not existed. On

the other hand, it may serve to allow DC's to use a t-DPT as a billing tool,

or to simply earn it so as to proclaim the " rigor " of their degree and the

infant education of ours (not that any of us would agree). Finally, the

fact that DC's so misunderstand the clinical doctoring profession of

physical therapy may lead to a high application and acceptance rate, and an

VERY high attrition rate (read DC's not able to meet the demands of the

program).

In any event, I find it somewhat distressing that Dr. Paris, known to be a

fierce and well respected leader in our profession, may be considering

selling out the new, young crop of DPT's and t-DPT's before they've had an

opportunity to make their mark and change, for the better, the future of the

profession. I feel that we as physical therapists are owed some kind of

explaination --- or are at least owed the same respect offered to those in

other professions.

This is the e-mail I received. Dr. Paris asks for the word to be spread. I

just don't think he expected for it to be spread within his own profession

before getting a little further along with his new friends. I say that

discussion and debate WITHIN our profession is healthy, and necessary BEFORE

CAPTE weighs in. Please read, and respond, to the notes below:

Colleagues,

We have now set the date for the meeting where the University of St.

Augustine will host chiropractors interested in our plans to make a DPT

degree available through a combination of online learning with weekend hands

on seminars.

The date is Saturday 6th in St. Augustine and at the University.

There will be a reception at my home the night before at probably 6:00 pm.

An agenda will be sent to you in advance as well as possibly some additional

information. The day will no doubt begin with a questionnaire (no name

required) and then launch into a description of the University and the DPT

program

We will certainly cover such items as " advanced standing, transfer credit

etc. " I shall be in attendance along with the director of the DPT program at

the campus here in St.Augustine and the director of the program in Boca

Raton where the seminars are held. The director of our online programming

will also be present along with one or two others. We will schedule to meet

till I suspect mid afternoon. There will be plenty of time for questions and

discussion.

At this point I would ask that you " spread the word " to your colleagues that

might be interested. All email contacts will be to individual email

addresses and not to all at once so that your interest and name is protected

until of course we meet. I am aware that some of the recipients of this

email are very enthusiastic the enter the program. Others may not be but

simply wish to be informed without being associated. Hence the reason for

not putting you all on one mailing list. I expect twenty to forty in

attendance.

The nearest airport is ville FL at one hour away, compared to Orlando

which is two hour away.

So reserve the date. More to follow.

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

From and earlier communication

Colleagues,

Some weeks ago I responded to some interest shown by a number of

chiropractors who were interested in earning the Doctor of Physical Therapy

degree by sending an email with the following message.

" DC DPT

To those inquiring about the University of St.Augustine and its interest in

considering admitting DC's into its online and weekend DPT program. The

University is located in St. Augustine north east Florida where it conducts

PT and OT campus based programs. However it has commenced a twelve semester

online DPT program wherein all the didactic education is conducted online

and the laboratory sessions are being conducted at its weekend campus in

Boca Raton south east Florida. At this point one chiropractor from Chicago

has been admitted into the program. He is taking the entire program and is

not testing out any of the courses nor asking that he be granted transfer

credit. Obviously these two issues are possibilities. Certainly in the area

of radiology, chiropractors have had more education than physical

therapists.

The online format is ideal for those who feel they already have the

knowledge. There is expected to they will be able to go online and take the

tests.

There are a number of issues that will need to be explored. Culture is one

of them. Physical therapy is increasingly evidenced based and principally on

the patho anatomical model moving to the disablement NAGY model. The

profession stresses professionalism and is not hostile to medical and

surgical practices other than at times being competitive with them.

Our university will explore this issue very carefully in the interests of

patient care. You are now on our email list and we shall keep you informed.

In the meantime you may learn more by going to www.usa.edu and clicking on

the Flex Program. "

The appropriate group within the University has now met and we have come to

some conclusions including the following:

1. We know that such a move, admitting large numbers of chiropractors could

be a political hot potato in both professions. However if it is best for the

patient and best for the professional then it must be considered.

2. We also consider that chiropractors know precious little about physical

therapy education and that many may be unaware that the program is in fact

quite rigorous and does for instance require a bachelors degree as well as

the Graduate Record Exam to be considered for entry

3. Concerns were also expressed as to why a chiropractor would want to earn

the DPT degree. If it was solely to enhance billing opportunities that would

not be an acceptable reason

4. We also consider that our cultures are different and wonder if

chiropractors interested in this educational opportunity will still see

themselves as chiropractors at its conclusion or as physical therapists or

both

So here is our position for the present:

1. We will admit chiropractors on a case by case basis after the usual

interviews .

2. We would be willing to meet as early as next March (now May 6th) with any

group of chiropractors that would like to discuss the program and how they

might be considered for admission. So if someone would like to make the move

we will cooperate by informing inquiries from chiropractors of such a

meeting. In the meantime we will not be advertising this opportunity. . In

the meantime I think all inquiries should be treated confidentially and

individually.

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

************

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PTManager encourages participation in your professional association. Join

and participate now!

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[Guest guest]

Todd,

Good point, there should be, I personally would rather be able to offer PT

and Chiropractic care combined than be a DPT since potential clients likely

will not know or understand how a PT differs from a DPT. However most if

not all patients know what a Chiropractor is. And lets face it, the core

issue here is obtaining market share, not providing better care, is it not.

The Chiros are looking for another avenue to firmly and permanently sink

their barbed hooks into potential patients. For St. Augustine to offer this

is a true stab in the back the way I see it and needs to be vehemently

opposed by all PT's. I cant even believe this is true and still question

its validity. Any forum member involved in the APTA care to let us know the

APTA's stance and assessment of this issue?

That being said I have to admit often being in envy of Chiros for their

ability to provide quick pain relief, or at least the public perception that

they can. The problem I have with them is the lack of ability or desire to

seek a long term solution. I would love to possess the " quick pain relief

ability " and combine it with my PT skills to actually then " cure " the

patient rather than have them permanently rely on me for long term pain

relief.

Of course I'm sure there is not a PT to Chiro program and never will be

since their lobby is so much more powerful than ours, I hope I'm wrong! How

to we unite and battle this thing?

Joe Ruzich, PT

St. Augustine to explore offering t-DPT to DC's?

This is most interesting. I want to make some comments and I am going

to

get on a soap box, so bear with me.

I have been practicing physical therapy for almost 23 years now. I am

eternally grateful for the education I received at the University of

Iowa.

It was so intense and so much training, I kept thinking that there was

no

way there could possibly be anything else they could teach us. I was

wrong.

It just kept coming. Upon graduating, I spent the first 15 years serving

patients in a hospital setting. This hospital was a Level II trauma

center

and that quickly became my love. Over the years, I also worked in a

rehab

unit, subacute unit, did home health, nursing homes, independent and

assisted living, outpatient clinics, and occupational medicine.

When I was at each setting, other than the outpatient setting, I had no

competitor other than my fellow physical therapists. What other

profession

could compete with what I did? When I went to the outpatient setting,

where

I currently have been for the past 7 years, I learned that I had another

competitor, the Chiropractor. Somehow, this professional has been

equated

with what I do, or vice versa, and I have to ask myself, why?

In my neck of the woods, does a chiropractor know how to do pulmonary

function tests and pulmonary rehabilitation, pediatric

habilitation/rehabilitation, phases I, II, and III of cardiac rehab,

neurological rehab (you pick any number of categories here)? Work with a

patient who is in intensive care and has multiple trauma injuries, TBI,

SCI,

CVA, MI, etc., and progress them through their rehab program from the

death

bed to back to work? Orthopedic rehab (you pick any number of

categories

here), fabricate orthotics and train clients in the use of adaptive

equipment, prosthetics and orthotics? Help rehabilitate patients with

organ

transplants? Teach wellness and fitness other than selling your clients

vitamins, herbs, spices, and magnets? I don't think so. Does a

chiropractor

know how to mobilize/manipulate a joint to relieve pain and improve

function? Yes, of course they do, and so do many physical therapists. I

don't see how that makes the two professions equal in their training

and I

certainly don't see how expanding your knowledge and skill alone in

joint

manipulation would earn you the privilege of being called a physical

therapist. The physical therapy profession has been on a course of

increasing and improving our education with the goal of not only being

able

to improve our quality of care, but to also be able to compete against

the

chiropractor's " doctor " title with the ultimate goal of autonomous

practice

and increased reimbursement by third party payers. Many courses have

sprung

up offering to train the physical therapist in the skill of joint

manipulation so we can be " like the chiropractor " . Interestingly, now

it

seems that the chiropractor wants to be " like the physical therapist "

with

encouragement from members of our profession.

It is very frustrating to have patients ask " So what is the difference

between a physical therapist and chiropractor and should they go see a

chiropractor " . But it is also a great opportunity to tell them what

exactly

the difference is. We don't just mobilize/manipulate joints like the

chiropractors do, we are so much more as I mentioned above. I have had

hundreds of patients come to me post chiropractic treatment, and I can

literally say that I can count on one hand the number of times a

chiropractor instructed a patient in exercises to help stabilize and

improve

their problem. Our simply doing so helped solve the problems of many of

those where this was not part of their previous treatment. The

chiropractic

profession seems to be a passive program, the patient is to keep coming

to

the chiropractor to be helped. Physical therapy is an active treatment

program, the patient is taught how to take care of themselves so we

don't

have to see them again. This difference can be summed up in this old

analogy " Give a man a fish and he will eat for a day. Teach a man how

to

fish and he will eat for a lifetime " . I believe our treatment concept

is

the one that will eventually survive the reimbursement issues we all

face.

I had one patient call and complain about receiving a bill for physical

therapy services. She didn't recall ever receiving therapy from me. I

pulled her file and showed her the doctor's order for " instruct in a

home

exercise back strengthening program " , her signed consent forms, the date

this was done, and a copy of the exercise pictures she was given. She

stated that she remembers doing this, and despite the overwhelming

evidence,

she insisted that she never received physical therapy. She went on to

explain that some time ago, she hurt her lower back and went to physical

therapy where they treated her with moist heat, ultrasound, and

massage...sound familiar? She emphatically stated, " Now that is

physical

therapy " ! She never got that from me and ergo, never received physical

therapy. Ouch!!! She was still required to pay the bill.

Not long after that, I had a client present with complaint of severe

neck

pain from a MVA. She had gone to physical therapy first and that didn't

help

(hot packs, ultrasound, and massage). A friend told her to go to a

chiropractor and after several manipulations (never any exercises) her

neck

pain intensified with each treatment. After we worked with her for

about two

weeks using a combination of manual therapy techniques, soft tissue

mobilization, and exercises (including instruction in home exercises and

work/home management techniques), her pain was substantially reduced

and her

function significantly increased. Interestingly enough, she questioned

why

the other therapy place didn't do this and why the chiropractic

manipulations were hurting instead of helping. What goes around, comes

around... I was able to boldly tell her that what she had before was not

physical therapy, what we did, now this is physical therapy! She had

also

just experienced what the difference between chiropractic and physical

therapy is. Therefore, go forth and spread the word!

Our profession is progressively changing in order to keep up with the

needs

of the people we serve, and to hold onto our share of the reimbursement

$$$.

Continuous improvement needs to happen and that involves change. Maybe

the

two professions, chiropractic and physical therapy will eventually

evolve

into one distinct profession, or break off and become a totally new

profession. Weren't the first physical therapists nurses? Yet, the

nursing

profession remains. The point I want to make is this, what we are

trained

to do is multifaceted. We don't just compete with the chiropractor for

back

care patients. I know that there are several professionals that have

both

their physical therapy and D.C. degrees. They earned each one from

distinct

training programs and have earned the privilege of using the titles of

physical therapist and chiropractor. I would believe (based on their

time

spent actually being in a classroom interacting with the teacher and

other

students, always having a ready resource to verify or correct

techniques of

training) that their scope of knowledge and training would be far more

than

what individual study and an occasional weekend hands on training

session in

manual therapy techniques can give and this minimal training cannot be

equivalent to any degree in physical therapy.

Bob Lueke, PT

Madonna TherapyPlus

Lincoln, Nebraska

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PTManager encourages participation in your professional association.

Join

and participate now!

Please identify yourself in all postings to PTManager.

[Guest guest]

Sometimes I feel like people get caught up in form and posturing more than

substance. The goal of any PT, OT or SP is to focus on the patient and get them

the best treatment available. Sometimes that might be by someone within your

facility and sometimes it may not. In my case I decided to become a CPA

because I wanted to work in business and the CPA program offered the best avenue

to accomplish my goals. In my first year out of college I got to look over

many different companies financial records in many different industries without

having to lock in on any one industry. Over time I finally figured out the

direction I wanted to take.

It has been over 20 years since I graduated and very few people know that I

am a CPA unless I tell them. The only title I ever seem to hear is SIR, when

my son wants to borrow the car or FATTY, if I receive a bigger portion than he

does at the dinner table.

Jim <///><

[Guest guest]

While I personally agree that a prior chiropractic degree cannot exclude

someone from attaining a PT degree if they meet the requirements, the

combination

of a PT degree with a chiropractic degree does present some unique challenges.

First and foremost, (Disablement Model not withstanding) PT is based on the

medical model of health and disease while I believe chiropractic is still

founded on the alternative medicine philosophy of energy theory as a basis for

health and lack of health.I think it would be very difficult to reconcile such

divergent philosophies when we strive for evidence based intervention based on

interpretation of objective findings. Although a chiropractor and a PT may both

be performing the same or similar technique, their choice of treatment

approach would be for different reasons and with different expected outcomes and

measures.

Second, here in New York State ( and for many insurers nationwide), PT

practice still requires a physician referral while chiropractic does not.This

creates a legal dilemma as (theoretically) the chiropractor/PT would still need

a

physician referral for their PT treatment and yet could apply their chiropractic

interventions sans MD referral. It is not unlike the dilemma of a PT who

attains certification as a Licensed Massage Therapist. As I understand it, a

PT/LMT in New York State I would still need a referral to give a massage as I

would

be held to " the higher standard " of the PT and could not separate the two to

function as a PT in one instance and then a LMT in the next.

Any of you Lawyer/PT (PT,JD? Or perhaps Doctor JD?) out there who could take

a stab at the potential legal side of DPT/DC combo?

Pat Walaszek,PT

[Guest guest]

I referred to chiropractors as " Dr " because that is what they are and always

have been, a doctor of chiropractor. Not some new age degree that has been

invented. From now on should we call the ATCs' with doctorate degrees " Dr. " in

the clinical setting? Additionaly, most states include chiropractors in the

same practice act as MDs' and DOs'.

Listen, I am not siding with the chiropractors, just taking into account our

history as PTs' doing similar actions - i.e. DPT degree, direct access, etc.

Just food for thought before anyone goes off the deep end.

------- Re: St. Augustine to explore offering t-DPT to DC's?

>

> As we all know the term doctor primarily was used to define a teacher

>

> Doctor \Doc " tor\, n. [OF. doctur, L. doctor, teacher, fr. docere

> to teach. See _Docile_ (http://dict.die.net/docile/) .]

> 1. A teacher; one skilled in a profession, or branch of

> knowledge learned man. [Obs.]

>

> A physician describes one who practices

>

> phy·si·cian (fi-zish'?n)

> n.

> 1. A person licensed to practice medicine; a medical doctor.

> 2. A person who practices general medicine as distinct from surgery.

> 3. A person who heals or exerts a healing influence.

> Attaining the doctor degree defines the academic standard to which it is

> attained. The criteria for a " doctor " degree is established within the

> academic

> setting. If a person attains that level then they are deserved of the title

> " doctor " , not to be confused with physician.

>

> The comment " The real doctors " is incorrect in that anyone attaining the

> educational level is a real doctor. Confusing a physician who is called a

> doctor and a physical therapist who is called a doctor occurs often.

>

> Just think, if you were in England and were an orthopedic surgeon you would

> be called " Mister "

>

> Kunkel MSPT, MLD-CDT

>

> Not a Doctor but in the process of attaining a " doctorate " in physical

> therapy and won't be called a " doctor " in the clinical setting just the

> educational and research setting. Interesting!

>

>

>

[Guest guest]

Hi Mike, I'm not upset,,,just like the debate...it's interesting to watch

things change and see how they pan out and sometimes try to affect the change.

I do think that ATC's with a doctorate should be called Dr. A psychologist with

a PhD is referred to as a Dr...professors with education PhD's are Dr's...and Dr

Schlessinger...the radio advice host.. is a Dr....of Statistics!, not

psychology. So, it is just all titles. It's all just a semantics game. A

politician running for office, who has a doctorate in political science or

theology or basket weaving will always run as " Dr " . I think the difference is

between the words Dr. and physician. " Physician " I think should be reserved for

MD's and DO's. Just my opinion

Re: St. Augustine to explore offering t-DPT to DC's?

I referred to chiropractors as " Dr " because that is what they are and always

have been, a doctor of chiropractor. Not some new age degree that has been

invented. From now on should we call the ATCs' with doctorate degrees " Dr. " in

the clinical setting? Additionaly, most states include chiropractors in the

same practice act as MDs' and DOs'.

Listen, I am not siding with the chiropractors, just taking into account our

history as PTs' doing similar actions - i.e. DPT degree, direct access, etc.

Just food for thought before anyone goes off the deep end.

------- Re: St. Augustine to explore offering t-DPT to DC's?

>

> As we all know the term doctor primarily was used to define a teacher

>

> Doctor \Doc " tor\, n. [OF. doctur, L. doctor, teacher, fr. docere

> to teach. See _Docile_ (http://dict.die.net/docile/) .]

> 1. A teacher; one skilled in a profession, or branch of

> knowledge learned man. [Obs.]

>

> A physician describes one who practices

>

> phy?i?ian (fi-zish'?n)

> n.

> 1. A person licensed to practice medicine; a medical doctor.

> 2. A person who practices general medicine as distinct from surgery.

> 3. A person who heals or exerts a healing influence.

> Attaining the doctor degree defines the academic standard to which it is

> attained. The criteria for a " doctor " degree is established within the

> academic

> setting. If a person attains that level then they are deserved of the title

> " doctor " , not to be confused with physician.

>

> The comment " The real doctors " is incorrect in that anyone attaining the

> educational level is a real doctor. Confusing a physician who is called a

> doctor and a physical therapist who is called a doctor occurs often.

>

> Just think, if you were in England and were an orthopedic surgeon you would

> be called " Mister "

>

> Kunkel MSPT, MLD-CDT

>

> Not a Doctor but in the process of attaining a " doctorate " in physical

> therapy and won't be called a " doctor " in the clinical setting just the

> educational and research setting. Interesting!

>

>

>

[Guest guest]

Mr. Keating;

In the interest of clarity and transparency, would you mind my asking what

your clinical background and credentials are? Proper etiquette generally

requires that we identify ourselves in our communications with one another.

Sincerely,

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

> Re: St. Augustine to explore offering t-DPT to DC's?

>

> I referred to chiropractors as " Dr " because that is what they are and

> always have been, a doctor of chiropractor. Not some new age degree that

> has been invented. From now on should we call the ATCs' with doctorate

> degrees " Dr. " in the clinical setting? Additionaly, most states include

> chiropractors in the same practice act as MDs' and DOs'.

>

> Listen, I am not siding with the chiropractors, just taking into account

> our history as PTs' doing similar actions - i.e. DPT degree, direct

> access, etc.

>

> Just food for thought before anyone goes off the deep end.

>

> ------- Re: St. Augustine to explore offering t-DPT to

> DC's?

> >

> > As we all know the term doctor primarily was used to define a teacher

> >

> > Doctor \Doc " tor\, n. [OF. doctur, L. doctor, teacher, fr. docere

> > to teach. See _Docile_ (http://dict.die.net/docile/) .]

> > 1. A teacher; one skilled in a profession, or branch of

> > knowledge learned man. [Obs.]

> >

> > A physician describes one who practices

> >

> > phy.si.cian (fi-zish'?n)

> > n.

> > 1. A person licensed to practice medicine; a medical doctor.

> > 2. A person who practices general medicine as distinct from surgery.

> > 3. A person who heals or exerts a healing influence.

> > Attaining the doctor degree defines the academic standard to which it is

> > attained. The criteria for a " doctor " degree is established within the

> > academic

> > setting. If a person attains that level then they are deserved of the

> title

> > " doctor " , not to be confused with physician.

> >

> > The comment " The real doctors " is incorrect in that anyone attaining the

> > educational level is a real doctor. Confusing a physician who is called

> a

> > doctor and a physical therapist who is called a doctor occurs often.

> >

> > Just think, if you were in England and were an orthopedic surgeon you

> would

> > be called " Mister "

> >

> > Kunkel MSPT, MLD-CDT

> >

> > Not a Doctor but in the process of attaining a " doctorate " in physical

> > therapy and won't be called a " doctor " in the clinical setting just the

> > educational and research setting. Interesting!

> >

> >

> >

[Guest guest]

This has been an interesting thread, and as often happens, the tangents are

equally so...

Here's one that interested me: Pat Walaszek said " First and foremost,

(Disablement Model not withstanding) PT is based on the medical model of

health and disease while I believe chiropractic is still founded on the

alternative medicine philosophy of energy theory as a basis for health and

lack of health. I think it would be very difficult to reconcile such

divergent philosophies when we strive for evidence based intervention based

on interpretation of objective findings. "

Two things about that.

First, The medical model is not the only evidence-based model---alternative

medicine can be very much, and often is, evidence-based. There are many and

myriad related western-style studies of non-medical approaches. Some

alternative models have the added support of anthropological studies which

provide very meaty regional longitudinal data. (From the anthropological

perspective, the medical model, occupying such a short span of human

history, is certainly the " alternative " approach, and in light of the

epidemic-sized rise of new diseases during this period while the medical

model is king, a rethinking of the medical model may be in order.)

Second, we should be brutally honest about our fears regarding a

chiropractic/PT mix. Based on the discussion so far, the substantive fears

look to be about turf. But patients have nothing to gain, and maybe

something to lose, by our turf protection. Who is to say that dual-trained

practitioners should not be available to those who want them. (The patients

who regularly visit my friend Phyllis, who is an MD trained in acupuncture,

would have something to say about that.) Yes, it may be sticky when it comes

to reimbursement, but God help us if that's the filter through which we

analyze every new idea.

And Jim, it's SIR for you as far as I'm concerned.

Dave Milano, PT, Director of Rehab Services

Laurel Health System

32-36 Central Ave.

Wellsboro, PA 16901

dmilano@...

Re: St. Augustine to explore offering t-DPT to

DC's?

Sometimes I feel like people get caught up in form and posturing more than

substance. The goal of any PT, OT or SP is to focus on the patient and get

them

the best treatment available. Sometimes that might be by someone within

your

facility and sometimes it may not. In my case I decided to become a CPA

because I wanted to work in business and the CPA program offered the best

avenue

to accomplish my goals. In my first year out of college I got to look over

many different companies financial records in many different industries

without

having to lock in on any one industry. Over time I finally figured out the

direction I wanted to take.

It has been over 20 years since I graduated and very few people know that I

am a CPA unless I tell them. The only title I ever seem to hear is SIR,

when

my son wants to borrow the car or FATTY, if I receive a bigger portion than

he

does at the dinner table.

Jim <///><

[Guest guest]

Hello,

I asked Dr. Stanley Paris to comment on this discussion and I received the

following email from him which he asked me to share with all of you. I

apologize if this is not the usual way to post information.

Thanks,

Steve Tepper

In a message dated 1/30/2006 2:38:52 PM Eastern Standard Time,

sparis@... writes:

Steve,

WHAT MIGHT NOT HAVE BEEN CLEAR IS THAT THIS IS NOT A T-DPT BUT A 12 SEMESTER

DPT FOR POST BACCALAUREATE - AN ENTRY LEVEL PROGRAM

I would appreciate this response being posted to anyone who has heard of the

meeting that we are planning to have with chiropractors interested in

transitioning to a DPT degree. For a start we are not the only school looking

at

this issue and the other program has been looking at it longer than us. While I

have historically fought chiropractic, no doubt more than any other

therapist, and have spent quite a few dollars and much time in the process

being sued

by them etc. both in New Zealand and the United States, I have always felt

that out best defense was to strengthen our own profession and defend against

incursions by them while at the same time not speaking ill of them.

Basically chiropractors are of three groups. The super straight, straight

and those using EBP. Most schools are tending towards the straight to EBP model

but most students are in the super straight and straight schools. There is a

growing realization in chiropractic that EBP is the way reimbursement and

practice is going and that where they need to be. The schools might be less

concerned than the clinicians. But today's EBP chiropractor, is at least in the

musculoskeletal area, not too far removed from physical therapy practices.

Given that five years after graduation only 50% are practicing as chiropractors

there are a great number that have left the profession for whatever

reason(s).

We already have one DC in our 12 semester online and weekend lab DPT program

based in Boca Raton. He is taking all the courses and not clepping out or

transferring credits in any way. He is a student in every sense. We are calling

the meeting to which you refer to look at all the issues involved in

allowing these persons to become PTs. Culture is foremost and so is EBP. Paying

attention to those aspects I b believe we will find many a candidate that will

make an ideal DPT. Today, sociologists predict that most young people will have

three careers. I am sure that if a DC wishes to become a DPT such a career

move will serve them well and serve well those in need of their services.

Do consider that if the likes of Erhard PT., DC who has worked and

researched with Tony Delitto as well as being a founding member of AAOMPT and

the first president of IFOMT (International Federation of Orthopaedic

Manipulative Therapists), then while there might not be other Dr. Erhards there

are

still many fine DC's that would make excellent DPTs. We are just considering

the process in reverse. Likewise both chiropractors and physical therapists

have applied to and be accepted into medical schools. So I have difficulty in

seeing what the problem is. We certainly are not teaching them seminars. We

have never knowingly admitted a chiropractor to our seminars.

There is no political agenda here but I am sure some will read such into

it. There certainly is no " selling out. " Any candidate must meet our usual

criteria for admission including interviews. Our program has rigor and does

graduate an excellent DPT. Personally I feel that I am in good position to

both

listen to and be understanding of the cultural differences and will assure my

profession that should we continue to admit DCs they will be cultured into

physical therapy. We are calling a meeting and have made no firm decisions

beyond that. We are proceeding slowly and cautiously. Additionally I am aware

of

my position in this profession and I feel my actions are wholly consistent

with that position.

Thank you for your request for information.. Best wishes.

Stanley

Stanley V. Paris PT., PhD., FAPTA

President, University of St. Augustine,

1 University Blvd.,

St. Augustine, FL 32086

USA

Voice

Toll Free

[Guest guest]

Steve,

Thank you for getting clarification from Dr. Paris, please pass along

my personal thanks, and the thanks of others on this forum for that.

No one here is attacking Dr. Paris' integrity or commitment to the

profession, and I for one GREATLY appreciate his clarification. To

paraphrase, I'd agree with what Dr. Paris describes as the potential

to find " diamonds in the rough " among disgruntled DC's willing to

disavow chiropractic philosophy in favor of a clinical philosophy

more consistent with the DPT.

I'd like, again, to try to turn people away from discussion about the

ethics or legality of such a program, and refocus upon the idea

of, " Is this a smart move for the profession? " I'm still not

convinced or reassured by Dr. Paris that it is (But I am reassured

that it doesn't sound as though he's completely convinced either).

While I understand and appreciate the potentially positive vision

that Dr. Paris puts forth, there are several doomsday scenarios that,

in my opinion should be judiciously considered. Not in a panic, and

not with any animosity, but seriously considered in a " profession of

physical therapy business plan " or strategic vision sort of way.

Among them are the following:

1. The majority of DPT's are not seasoned clinicians who have

completed a t-DPT. Most are entry-level novice physical therapists.

As the profession moves forward toward autonomous interdependence, we

must consider the potential perils of admitting DC's to DPT programs,

even entry level. This is not to advocate an anti DC bias, but if

the DPT vision is to succeed, it must be considered that DPT's, not

those with combined degrees, must lead the charge. It must be

considered that the vision and motivation of an individual with

multiple degrees may not be entirely loyal to the profession of

physical therapy. Should such a negative outcome be realized, the

DPT vision may be squashed before it ever gets legs. That, I'm sure

even Dr. Paris would agree, would be a shame.

2. It has been argued that any DC who enters a DC to DPT program

would have to pass the same boards as any DPT. This may not be the

case. There are several states, (I believe, and Steve please correct

me if I'm wrong, that land is an example), where DC's are

permitted to advertise " physical therapy " because the term is not yet

protected. The potential for a DC to complete a DPT program as

described by Dr. Paris, but to NOT take the licensing exam, does

exist in theory. Furthermore, the potential for a DC to complete the

DPT program, sit for the boards, pass them, and advertise oneself as

a Doctor of Chiropractic who, as a DC also has complete mastery of

physical therapy, exists as well. My concern is that as DC's

currently have direct access to directly reimbursable patients, and

DPT's do not, that the public can be quickly and incorrectly skewed

into thinking that a DC is to a DPT, as a lawyer is to a paralegal ---

even those DC's WITHOUT DPT training. That, I'm confident Dr. Paris

would agree, would be a disaster for our profession.

Alarmist? Perhaps, but most bad ideas and unintended consequences

begin with a positive vision, full of hope. As Dr. Paris proceeds

with exploration of his vision --- and make no mistake, I support him

in that exploration --- I believe that we as a profession must

encourage him to tread VERY carefully, and judiciously weigh the

potential benefits and value for the profession with very real, very

plausible dangers. I do not question the commitment nor loyalty that

Dr. Paris has demonstrated to the profession of physical therapy over

the years, but I do request that we as stakeholders have a very real,

non-alarmist debate on the issue, BEFORE decisions are made and a

program of this sort encouraged. Concurrently, I'd like to appeal to

Dr. Paris that as he explores the potential of such a program, he

strongly consider less what alarmist PT's may have to say about such

a program --- and more in a business plan nature, about the full span

of potential positive AND negative consequences of such a program,

constantly asking himself, at every stage in the process, and about

every potential outcome (positive AND negative) " Is this outcome

right for the profession? "

M. Ball, PT, DPT, PhD

[Guest guest]

- in land, a DC can advertise that they do 'Physical

Therapy' if they pass a specific set of questions on their board

exam. They would be DCs with Physical Therapy priveleges.

Thankfully, very few have passed these questions, which do not in any

way reflect the knowledge base of the entry level PT of this era.

As many may know, the beloved Florence Kendall passed this weekend,

and at many land state meetings, she would tell and retell the

story of how the DC 'got' this tapped into both the DC and PT

practice act. She claimed that it was a sleight of hand, slipped

into legislation in the dark of night, back in the 50s. There have

been several meetings to try and adress this, and eventually, perhaps

in my life time, this issue will be confronted. In the mean time, a

DC who has passed this test, can claim in advertising to do 'PT.' If

this makes your heart sink, and you are from land, maybe now is

the time to work on it! The spring meeting will be coming, and maybe

the momentum will be there this year?

What will become interesting is this: a DC becomes a DPT by any

means, and then fails the traditional PT board exam, but takes the

DC 'PT privelges' portion of the test... and passes. Interesting.

Dr. Paris did explain his rationale, and have done my DPT through the

USA, clearly In understand why he thinks it might be a good idea to

perhap$ try and recruit $ome new $tudents. There exists lots of

competition for DPT students, less people are applying to PT schools,

there are only so many ATCs looking for the PT degree, and like all

corporations, the bills need to be paid. Like all schools, they need

more applicants than slots. This is a sort of untapped resource, a

new population to sell the product to. ly, with a high rate of

disgruntled DCs that are 'hungry' and looking for their next step,

maybe they ought to consider this profession. There will be

licensure and board related issues... very interesting!

As for the DC becoming a PT by the conventional means:

We cannot deny any adult (or child for that matter) the right to

pursue education in this country. If they are willing to make their

tuition payments, take the course work, and pass the board, then we

cannot in good conscience deny anyone that chance. Insert the term

farmer for DC and the phrase is equally applicable. Even, if you

just, insert the term MBA, and the phrase still reluctantly can ring

true, does it not?

This has been great. Thanks so much for all who contributed to this.

- Simonetti

land

[Guest guest]

Hi Steve!

Thanks you for posting this interesting discussion! I was talking to

a University of St. Augustine alumni friend this afternnon when I

first heard about this topic. To be honest, I was shocked at first so

I tried to do some checking on the topic. I am so glad to read the

position of Dr. Paris on your posting. It was quite a relief.

It is nice to realize that the program provided by Univeristy of St.

Augustine is not a t-DPT but a 12 Semester DPT Post Baccalaureate -

an entry level degree. This makes a lot of difference for those who

were alarmed like me.

I think the main issues here are: DC earning a DPT degree, billing,

and licensing.

I don't have much conern with the the first 2 issues but I am

concerned on the licensing.

DC earning a DPT degree? The program USA offers is a post BS DPT

degree. I don't see a problem with that. It's like offering the

program to anyone who has a BS degree. It's open for anyone eligible

to apply for the program. Therefore, chiropractors can pursue their

degree in physical therapy like anyone else. I think it just more

sensationalized because of the fact that chiropractors are in the

program or could be in the program. Really, no problem with that!

Just like PTs becoming MDs or vice-versa. I am a graduate of

University of St. Augustine so I know how rigorous the program is and

anyone who is in program would know.(let the chiropractors experience

it, too, smilin).Who knows, the best DPT can be a DC? Nothing wrong

with that, it would benefit our physical therapy profession.

The billing situation. Not a problem if they become physical

therapists. This is my very main concern: they have to be a state

licensed physical therapists. I believe that these chiropractors

becoming a physical therapists should also be licensed physical

therapists before they can practice our profession and bill for the

services. If this happens, still, not a problem. If this is not the

case, then it is a concern.

There will be a lot of opinions on this issue and it is a good topic

to discuss since it will affect our profession now and in the future.

I respect Dr. Paris highly and I am sure he would not do anything to

hurt our profession.I thank him for his vision. I thank you Steve for

posting this interesting topic.

Gerry Catapang, PT, DPT

President

Missouri Medical Private Practice Consultants, LLC

www.myownclinicinoneweek.com

-- In PTManager , MDTepper@... wrote:

>

> Hello,

>

> I asked Dr. Stanley Paris to comment on this discussion and I

received the

> following email from him which he asked me to share with all of

you. I

> apologize if this is not the usual way to post information.

>

> Thanks,

> Steve Tepper

>

>

>

> In a message dated 1/30/2006 2:38:52 PM Eastern Standard Time,

> sparis@... writes:

>

>

> Steve,

>

> WHAT MIGHT NOT HAVE BEEN CLEAR IS THAT THIS IS NOT A T-DPT BUT A

12 SEMESTER

> DPT FOR POST BACCALAUREATE - AN ENTRY LEVEL PROGRAM

>

> I would appreciate this response being posted to anyone who has

heard of the

> meeting that we are planning to have with chiropractors interested

in

> transitioning to a DPT degree. For a start we are not the only

school looking at

> this issue and the other program has been looking at it longer

than us. While I

> have historically fought chiropractic, no doubt more than any

other

> therapist, and have spent quite a few dollars and much time in the

process being sued

> by them etc. both in New Zealand and the United States, I have

always felt

> that out best defense was to strengthen our own profession and

defend against

> incursions by them while at the same time not speaking ill of them.

>

> Basically chiropractors are of three groups. The super straight,

straight

> and those using EBP. Most schools are tending towards the straight

to EBP model

> but most students are in the super straight and straight schools.

There is a

> growing realization in chiropractic that EBP is the way

reimbursement and

> practice is going and that where they need to be. The schools

might be less

> concerned than the clinicians. But today's EBP chiropractor, is at

least in the

> musculoskeletal area, not too far removed from physical therapy

practices.

> Given that five years after graduation only 50% are practicing as

chiropractors

> there are a great number that have left the profession for

whatever

> reason(s).

>

> We already have one DC in our 12 semester online and weekend lab

DPT program

> based in Boca Raton. He is taking all the courses and not clepping

out or

> transferring credits in any way. He is a student in every sense.

We are calling

> the meeting to which you refer to look at all the issues involved

in

> allowing these persons to become PTs. Culture is foremost and so

is EBP. Paying

> attention to those aspects I b believe we will find many a

candidate that will

> make an ideal DPT. Today, sociologists predict that most young

people will have

> three careers. I am sure that if a DC wishes to become a DPT such

a career

> move will serve them well and serve well those in need of their

services.

>

> Do consider that if the likes of Erhard PT., DC who has

worked and

> researched with Tony Delitto as well as being a founding member of

AAOMPT and

> the first president of IFOMT (International Federation of

Orthopaedic

> Manipulative Therapists), then while there might not be other Dr.

Erhards there are

> still many fine DC's that would make excellent DPTs. We are just

considering

> the process in reverse. Likewise both chiropractors and physical

therapists

> have applied to and be accepted into medical schools. So I have

difficulty in

> seeing what the problem is. We certainly are not teaching them

seminars. We

> have never knowingly admitted a chiropractor to our seminars.

>

> There is no political agenda here but I am sure some will read

such into

> it. There certainly is no " selling out. " Any candidate must meet

our usual

> criteria for admission including interviews. Our program has rigor

and does

> graduate an excellent DPT. Personally I feel that I am in good

position to both

> listen to and be understanding of the cultural differences and

will assure my

> profession that should we continue to admit DCs they will be

cultured into

> physical therapy. We are calling a meeting and have made no firm

decisions

> beyond that. We are proceeding slowly and cautiously. Additionally

I am aware of

> my position in this profession and I feel my actions are wholly

consistent

> with that position.

>

> Thank you for your request for information.. Best wishes.

>

> Stanley

>

>

> Stanley V. Paris PT., PhD., FAPTA

> President, University of St. Augustine,

> 1 University Blvd.,

> St. Augustine, FL 32086

> USA

> Voice

> Toll Free

>

>

>

>

>

>

>

>

[Guest guest]

Yes, the program would be an advanced standing entry-level program for

DC's. My personal concern is that some states allow DC's to

practice " physical therapy " without having a PT license. How would

DC/DPT's be regulated. Better yet, would the practice lattitude

afforded to DC/DPT's be politically extended to all DC's? Furthermore,

would DC/DPT's use their creditials to try to limit the scope of less

experienced, DPT only novice clinicians?

Drew