Future of PTA and Healthcare Reform

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aynna in Mansfield, Ohio

52 months ago

Hi I was cruising through the internet and came upon your question. I am a DPT with a master's degree, a PT specialty (Gerontology), and have published in a professional journal. I am going to answer your question honestly. I think PTA's do a great job. I enjoy working with them and they enable us to provide services to a greater number of patients. However, I do not think their time should be billed the same as that of a PT. Our degree is a minimum of 6 years. (We have a local medical school who is graduating primary care physicians in 7 years.) The PTA degree is a 2 year associate degree. There is a vast gap of knowledge between the physical therapist and the physical therapy assistant. Personally, I do not think they should be able to work unsupervised with the PT off site. I have not seen the knowledge base to substantiate this and I have been a therapist for many years, working in many environments, with numerous PTA's. To make an analogy, do you think your dental assistant has the same degree of expertise as your dentist? Probably not. Nurse practicioners and physician assistants are only 1 year away from a general practicioner MD. I personally think the PTA should be at least a 4 year academic degree. The difference between 2 years of study and 6 years of study is too large of a gap. Logically speaking, reimbursement could not be the same.
Thanks for allowing me to air my opinion.

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Aphex in Falls Church, Virginia

52 months ago

Aynna,

I have to respectfully disagree with you when you say reimbursement for services delivered by PTAs should be less than those delivered by PTs. There is absolutely no difference between treatments delivered by PTAs and those delivered by PTs. PTAs have the professional training and education when it comes to treatment delivery. Studying more courses like history/art/English etc will not make PTAs better at what they do. PTs may have the education to diagnose and evaluate, but when it comes to treatment, PTAs know what they are doing. We get the same clinical training as you do. You can't claim to know more about therapeutic exercise or using other modalities e.g. traction, ultrasound, Estim....etc.. We are not the same as dental assistants; they don't receive training on how to treat, but PTAs do. As a matter of fact it's unfair for PTAs to be called assistants. People don't call LPNs nurse assistants, just because they can do less with their license. We are not asking to be reimbursed for services like evals, as we don't have education nor training in these areas, but we are great in delivering treatments.

Cheers,
Ashraf

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Lee in Cumberland, Maryland

52 months ago

PTs assume the risk of supervision of PTAs, to assume that they should be paid the same is ludicrous. If a PTA (assistant that assists the PT in treatment prescription i.e. appropriate name) injures a patient and gets sued it is the PTs license, one that they spent a whole lot of money and time to get, on the line. The PTs are trained to understand why treatment modalities are to be applied. PTAs are to apply the treatments in a manner which dilutes the service and makes it safe and effective.

I don't see a reason why the minimum educational requirements for the PTA degree should be increased. All this would do is increase the costs of the degree and put pressure on increased salaries aka increased costs for the service. What they have now is adequate for their role. They are essential in diluting the service, but are well compensated for both the length and cost of education. I cannot say the same for the PT degree. This is a long-term problem.

I do think changes are bound to come in the next ten years due to the fiscal insolvency of Medicare, and there will be changes to the payment structure. What these changes will be I don't know. I do think that the payment structures will represent educational disparity levels better than they do now though.

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Marie in Charleston, South Carolina

51 months ago

When I am evaluated by a Physical Therapist, it is awful to be shuffled off to an assistant. I am billed at the rate of the professional Physical therapist but seen by someone with much less experience. I have learned to ask now, if this is the standard practice, to get the patient to come and see the physical therapy group then have the actual physical therapist never available to see you thereafter. and never seem to be available for an appointment. I have recovered much faster from surgery and been more encouraged when seen by a therapist and the therapist sees me for the duration of my treatment. To be shoved off on an assistant or constantly rotate the patient to different therapists is awful for the patient. I have been there and will never again go to a group that utillizes the physical therapy assistant and bills for the higher rate. This is just a way to string the patient along for additional visits, and if the physical therapy assistant gets mad at this observation, then go back to school and get your full degree. Patient's have rights and need to be seen by the professional that they think they are going to see and are being billed to see. I base this on seeing a physical therapist who ended up having an affair with a physician in the same building and pawned me off on her receptionist who had no training whatsoever to assist me. This was the worst experience I ever endured and the therapist ended up losing her husband, almost custody of her child and was a wreck and would cry all the time. Just think at the level of care I received? Just plain awful!

Before anyone disagrees with me, stop a minute and think, if you just had your knee or hip replaced and needed to rely on quality care to enable you to walk again, would you go to someone who uses their receptionist to watch you do exercises or an assistant in which there are all levels of being an "assistant" or would you want the person you paid for,a highly trained therapist that can help you.

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Aphex in Falls Church, Virginia

51 months ago

A Physical Therapist assistant is not a receptionist, but a highly trained/educated therapist who is qualified to treat you under the law (check the laws of your state). You are not being billed for something you don't receive. There is no difference between treatments delivered by PTs and those delivered by PTAs in most cases. PTs will not treat you better than PTAs; the difference is that PTs are trained/educated to do evals/exams, when PTAs are not.

If your PT let the receptionist treat you, then you have every right to complain. But if it was a PTA, then what is the problem? PTAs have "full degrees", not half degrees like you think. We don't need/have to go back to school to be PTs.

I hope that helped.

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Gondola in Powder Springs, Georgia

51 months ago

It is understandable when the general public confuses or minimizes the role of an Assistant (as the title itself does not lend itself to giving much confidence to a lay person). It is however quite disheartneing when a PT diminishes the work a PTA does, which to me is not surprising because PTs are completely ignorant as to the academic content of the PTA degree. The PTA degree when compared side by side to the DPT will reveal that PTs and PTAs do learn very similar content. As a matter of fact, my PTA therex class and modalities class used a text book also used by the PT students for the same classes. there is no way to teach anatomy differently to PTAs and to PTs anatomy is anatomy is anatomy same insertions and origins and inervations. And there is no way to provide the interventions to patients differently either, long arc quads are long arc quads are long arc quads whether by a PTA or PT.
So why should reimbursement be different?
And please answer this question: If PTAs are much less than PTs - 4 years less educated - how come we attend the same continuing ed classes with the PTs/DPTs? Could it be because we actually have similar knowledge bases? Is that too incredible to fathom?
Ultimately some PTs are better thatn PTAs and vice versa, sometimes the best does not come with the title but with experience, compassion and empathy. there are lousy PTsout there just as there are some really great PTAs.

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PTA in Lexington, Kentucky

51 months ago

I agree with the above post. There are good PT's and good PTA's. and vice versa.....trust me, I've seen both...

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PTA in Atlanta GA in Jefferson, Georgia

50 months ago

Ok I respect all of your comments and they are all very well spoken exept for one thing. Most PTA schools require you to try to get into a competitive program so before you start you have to take Anatomy and Physiology two times biology human growth and development etc so it ends up being 2 YEARS at some places before you get accepted to be a pta. After that it is usually a 2 years program so all together PTA's go to school about 4 years. So Im sorry to say it but pta degree is associate but also it is not just two years.

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Dannielle in Cottage Grove, Oregon

50 months ago

I agree, technically speaking, by the time you get your pre-reqs done it is about 2 years, then application, then the actual program, voila 4 year degree, and that's if there is no waiting list. I personally find it frustrating that it is not already considered a Bachelor's degree and also think that is very misleading of the schools to say that it is something that can be done quickly. By doing this they are able to get more money out of you for additional pre-req classes and we lose out on the degree title which naturally lends itself to more respect in general.

I am married to a Dr. and I have looked very closely at the PT program- and we both laughed at the idea of spending that kind of money to become a PT when with an additional year you can become and MD, and work in just about any field and earn a considerable amount more.

The APTA is going to have to make a change somewhere in this profession, because as it stands it seems very unbalanced between the two.

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danny-future-OTR in Washington, District of Columbia

49 months ago

Are there any practicing Physical Therapists in this forum? If so, how do you view the field of Occupational therapy? Do you see the field as a valuable field, or one that people can live with out? The reason I ask is because I have been reading many negative remarks about the field, and I wanted to know the views of those who work closely with occupational therapists? Honest responses would be much appreciated.

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danny-future-OTR in Washington, District of Columbia

49 months ago

Also, I am trying to decide which field I can be best effective in helping individuals. I am drawn to both fields but I am more interested in OT because of its room for creativity. I am fully aware of the differences of the two fields but was concerned by the negative comments I read about OT. So, again, your honest view of this field (OT) is much appreciated, as it will help me make my decision.

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Hannah in Westland, Michigan

48 months ago

Why are you a DPT with a Master's Degree??? Doesn't make sense.....

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janice in Winder, Georgia

48 months ago

I am in the dpt program currently. In response to how I feel. About ot....it just seems so scattered with no real purpose. Ten different ot's will give you ten different job descriptions. It just seems very broad.

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roucrumom

45 months ago

Interesting reading here to say the least. I think some of the "posters" consider PTA's "techs" this has become a problem with insurance companies as well. We are licensed by the state in which we practice. One post is correct by the time we graduate from the program we do not lack much from a BS degree. The reason I feel that this has never happened is that the jr. colleges would lose a HUGE amt. of money. Plus the politics of it all. Most PT's are no longer doing RX's they are strickly doing evals and discharges. The PTA's do the "grunt" work. As a practicing PTA of 20 years of which 19 have been in home health let me share some information with the poster that is concerned that PTA's do not have the experience to treat he or she. In most cases my PT's look to me for my input and my experience. Even those PT's that have been out in the field for many many years. In home health your PTA is even more so the go to person. If the PTA's are done away with so be it. This field has never dealt with the issue and it appears the APTA has not done much in the way of addressing the issue.

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SP in Falmouth, Maine

45 months ago

aynna in Mansfield, Ohio said: Hi I was cruising through the internet and came upon your question. I am a DPT with a master's degree, a PT specialty (Gerontology), and have published in a professional journal. I am going to answer your question honestly. I think PTA's do a great job. I enjoy working with them and they enable us to provide services to a greater number of patients. However, I do not think their time should be billed the same as that of a PT. Our degree is a minimum of 6 years. (We have a local medical school who is graduating primary care physicians in 7 years.) The PTA degree is a 2 year associate degree. There is a vast gap of knowledge between the physical therapist and the physical therapy assistant. Personally, I do not think they should be able to work unsupervised with the PT off site. I have not seen the knowledge base to substantiate this and I have been a therapist for many years, working in many environments, with numerous PTA's. To make an analogy, do you think your dental assistant has the same degree of expertise as your dentist? Probably not. Nurse practicioners and physician assistants are only 1 year away from a general practicioner MD. I personally think the PTA should be at least a 4 year academic degree. The difference between 2 years of study and 6 years of study is too large of a gap. Logically speaking, reimbursement could not be the same.
Thanks for allowing me to air my opinion.

Really? You come out of school with your DPT, yet you have no more skill than a PT or MSPT. Going to the DPT was a HUGE mistake for the whole PT industry. Insurance companies and medicare will never allow reimbursement on a large scale for direct access. Think about it...the medical doctors who advise the government will all of a sudden allow people to skip the physician's referral part of the game. I think not.

Continued in another post.

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SP in Falmouth, Maine

45 months ago

To Aynna Continued...
As for your opinion of the PTA in the industry: Your extra schooling is where you learn your evaluation and assessment skills. It is solely the fault of the APTA that you had to achieve a DPT, or was it a Masters...you said both? As for anatomy, pathology, exercise physiology, PT theory and application, modalities...the curriculum is the same between PT and PTA schooling. Of course there are variations with education region to region, but Pennsylvania is the only state where the PTA is not allowed to perform ALL treatments in ALL settings without on-site supervision of a PT. I have actually worked in outpatient clinics where my manual therapy techniques were more advanced than the supervising PT's on staff. Needless to say, I did not stay long, as I was not able to use my advanced skills under the supervision of PT's without the skill set to oversee my techniques and write appropriate goals for my patients.
Sounds to me like someone is insecure about their role in the health care world. If things keep going like they are, PT's will be doing evals and check-ups only. Why would a clinic pay your salary to perform treatments that a PTA is more than qualified to perform? Outside of a few ignorant people (Marie in Charleston included), NO ONE cares who treats them as long as they are getting good competent care. I have traveled around the country and worked in a lot of places. This has given me the opportunity to work with a lot of really good PT's and PTA's, and a lot of really bad PT's and PTA's...our profession is no different than any other. It is all about taking pride in what you do, and staying up on the latest interventions out there.
P.S. Rehab directors and Experienced PT's (BS and MS) laugh at people like you when they show up for interviews and expect a higher starting rate than they get! I know, I used to be one.

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kt linden mi in Fenton, Michigan

45 months ago

I am 47 year old male, interested in PTA....have I missed my window...I have a daughter with CP and so I think I may have the make up for this career ...any input please... thank you

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Greg in Fort Worth, Texas

43 months ago

Boy, you opened up a can of worms. I have been a PTA for 15 years. I to am concerned about the changes coming w/healthcare reform. It will all boil down to who can perform the job w/the fewest dollars spent. Don't think that 3rd party payers will pay you more if the PTAs are gone. The current healthcare system is broke$$$$ The APTA is too worried about vision 2020. Do really think the payment system will improve w/all DPT practicing? Like it or not, PTs will become specalized in Dx and certain types of treatments. The money will not be there for a PT to be in private practice and perform all of the treatments on his/her own. More time should be spent on protecting the profession and stop the egos on who is qualified w/in the field. If you (PT, PTA)provide poor service and outcomes, find another JOB. P.S. I have learned as a PTA that the only way to succeed is to work hard. I make over 100K a year because I work. The majority of PTs I know are not willing to put in the time. They just expect to be paied for their initials PT, MSPT, tDPT, DPT.

Thanks

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roucrumom

43 months ago

Greg in Fort Worth, Texas said: Boy, you opened up a can of worms. I have been a PTA for 15 years. I to am concerned about the changes coming w/healthcare reform. It will all boil down to who can perform the job w/the fewest dollars spent. Don't think that 3rd party payers will pay you more if the PTAs are gone. The current healthcare system is broke$$$$ The APTA is too worried about vision 2020. Do really think the payment system will improve w/all DPT practicing? Like it or not, PTs will become specalized in Dx and certain types of treatments. The money will not be there for a PT to be in private practice and perform all of the treatments on his/her own. More time should be spent on protecting the profession and stop the egos on who is qualified w/in the field. If you (PT, PTA)provide poor service and outcomes, find another JOB. P.S. I have learned as a PTA that the only way to succeed is to work hard. I make over 100K a year because I work. The majority of PTs I know are not willing to put in the time. They just expect to be paied for their initials PT, MSPT, tDPT, DPT.

Thanks

Great point Greg!

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Boo in Central City, Pennsylvania

43 months ago

Greg in Fort Worth, Texas said: Boy, you opened up a can of worms. I have been a PTA for 15 years. I to am concerned about the changes coming w/healthcare reform. It will all boil down to who can perform the job w/the fewest dollars spent. Don't think that 3rd party payers will pay you more if the PTAs are gone. The current healthcare system is broke$$$$ The APTA is too worried about vision 2020. Do really think the payment system will improve w/all DPT practicing? Like it or not, PTs will become specalized in Dx and certain types of treatments. The money will not be there for a PT to be in private practice and perform all of the treatments on his/her own. More time should be spent on protecting the profession and stop the egos on who is qualified w/in the field. If you (PT, PTA)provide poor service and outcomes, find another JOB. P.S. I have learned as a PTA that the only way to succeed is to work hard. I make over 100K a year because I work. The majority of PTs I know are not willing to put in the time. They just expect to be paied for their initials PT, MSPT, tDPT, DPT.

Thanks

If PTAs get paid the same as PTs than why would anyone pursue the PT degree? Wouldn't it be a huge problem if people decided not to pursue the PT degree? How would the APTA react if people decided PTA was a better route than PT?

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Boo in Central City, Pennsylvania

43 months ago

SP in Falmouth, Maine said:
P.S. Rehab directors and Experienced PT's (BS and MS) laugh at people like you when they show up for interviews and expect a higher starting rate than they get! I know, I used to be one.

Well you can't laugh at the fact that just about every new graduate has significant student loans to pay off. At some point, salaries need to start increasing or positions won't be filled.

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Greg in Fort Worth, Texas

43 months ago

Boo:
Do you think anyone has a right to tell you how much money you can make if you work hard and do a good job? If you were to break it down, I do not make what PTs make per hour. Nor do I feel that I should. I just work more. PTAs need PTs in order to practice the same way PTs need MDs writing orders for Physical Therapy. (I do not feel that the AMA will ever allow PTs to practice completely independently)We all have to work together in order to serve our clients. Physical Therapy is a service oriented profession. Poor service yeilds poor results. What matters most: a patient achieving their goals or a patient being seen by a PT?? I am very thankful for the many wonderful Physical Therapist/mentors I have worked w/over the years. PTAs do not learn any different than anyone else. I can learn anything that a PT can, but I may not be able to use that skill in my treatment. We all must walk in the path that we have taken. Why not just walk in that path to the best of your abilities.

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SP from Falmouth. in San Angelo, Texas

43 months ago

Boo in Central City, Pennsylvania said: Well you can't laugh at the fact that just about every new graduate has significant student loans to pay off. At some point, salaries need to start increasing or positions won't be filled.

I am not laughing at people being in debt. The problem with the DPT (main reason for increased debt) is that it is not necessary. It is a ploy by the APTA to try for autonomy, but insurance companies and medicare will never change their policy on not paying for PT without a referral from an MD. Under the current system, or Obamacare, direct access is not a realistic proposition.By the way, salaries have increased. At this point PT salaries are peaking though. The PTA salary will continue to increase for a couple more years, but who knows what will happen after that.

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Boo in Central City, Pennsylvania

43 months ago

Salary's connected with how much revenue can be generated. The reduction in Medicare B due to the MPPR and physician fee schedule look to reduce earning potential from Medicare patients by around 20 percent. This should affect PTA's earning potential as well as the revenue they can generate will decrease as well and Medicare doesn't discriminate for treatment delivered by a PT or PTA. Under the current fee-for-service system, additional PTAs will be required to provide treatment to maintain the prior revenue stream. So overall pressure is for salaries to go down.

One thing to take into account is the current FFS payment construct with Medicare. This is a large reason PTAs are compensated so well. This system is largely considered unsustainable, however, and other payment systems are being discussed such as Pay For Performance. Medicare's projected bankruptcy is 2017. How will the payment structure be after fee-for-service fails? My speculation is that RC15-10 will pass, and that PTs can delegate to a wider range of providers. This would increase competition and decrease salaries for extenders. The pay disparity between PT and PTA will be greater. If not this profession could possibly cease to exist.

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roucrumom

43 months ago

Well on my 42 birtday today and being in this field four years as a PT tech. and 20 as a PTA I am depressed. I never got in this field for the money, but a pay decrease would hurt. Guess I better start thinking if it is time to look for another field.

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Boo in Central City, Pennsylvania

43 months ago

Roucrumom Happy Birthday! First off take what I say as simply speculation based upon information that I've gathered. As the MPPR and physician fee schedule cuts are real (talk to PTs about it) everything else is the point of view from a pre-PT (Me.. I think) So take what I say with a grain of salt and get others opinions/ speculations. I'd like to hear a rebuttal to why I'm wrong. I've been preparing for six years (and lots of $$$ spent on education) to enter the healthcare field with my eyes set on PT. Sometimes I tell myself I should have just gone to the PTA program at home. I'd be better off financially. So be happy your in a better position than most. You could be 60k in the hole with a shiny expensive piece of toilet paper (I mean degree) attempting to find a way to do something with your life. There is no plans for family in my near future. Cheers and enjoy your B-day!

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jan in Upland, California

43 months ago

So PT's and PTA's would you advise people to still go into PTA programs? Where else do PTA's make decent money other than home health?

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RS2010 in Irving, Texas

43 months ago

Greg in Fort Worth, Texas said: Boy, you opened up a can of worms. I have been a PTA for 15 years. I to am concerned about the changes coming w/healthcare reform. It will all boil down to who can perform the job w/the fewest dollars spent. Don't think that 3rd party payers will pay you more if the PTAs are gone. The current healthcare system is broke$$$$ The APTA is too worried about vision 2020. Do really think the payment system will improve w/all DPT practicing? Like it or not, PTs will become specalized in Dx and certain types of treatments. The money will not be there for a PT to be in private practice and perform all of the treatments on his/her own. More time should be spent on protecting the profession and stop the egos on who is qualified w/in the field. If you (PT, PTA)provide poor service and outcomes, find another JOB. P.S. I have learned as a PTA that the only way to succeed is to work hard. I make over 100K a year because I work. The majority of PTs I know are not willing to put in the time. They just expect to be paied for their initials PT, MSPT, tDPT, DPT.

Thanks

Greg, I will be graduating in a few weeks with a BS in Kinesiology. I applied for PT school for the Fall of 2011, but i dont think ill be accepted into the school of my choice. I dont feel its time worthy to wait another year to re-apply for PT school so I was looking into the field of PTA. Greg, since you have been in the field for 15 years, what would you suggest I do about this issue? If not PT or PTA, what other careers can I continue my education in?

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SP in San Angelo, Texas

43 months ago

jan in Upland, California said: So PT's and PTA's would you advise people to still go into PTA programs? Where else do PTA's make decent money other than home health?

What do you consider "decent money?" After all, PTA is only a 2 year Associate of Applied Sciences degree. I can't think of many other 2 year degrees that have an entry level median starting wage of over 45k nationwide. Get in the right place, and you can make a fair amount more than that. Don't do your research, and you will end up with less. If you want to bust your hump like Greg, you can earn a well above average living.

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Greg in Arlington, Texas

43 months ago

Physical Therapy is a wonderful field to be in. I was in out patient orthopedics for 12 year prior to going to home health full time. It is very rewarding to see the progress that people make and know that you are apart of that. I graduated college w/a BS in Biology. I did not have the grades to get in to PT school at that time, 3.0 GPA. AVG was a 3.8 GPA then. Many friends of mine were wasting time and money retaking classes w/no certainty that they would get into PT school. I decided on PTA school. No regrets. In todays market, you have to be looking at what is out there for you when you are finished w/school. A BS in Biology does no make you a biologist. PTA school was a sure fire way to know that I would have a job after school. No one knows what the future holds. Things do not look great for health care but there will always be a need. Follow what you love and you should be able to make a living at it.

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George in Yakima, Washington

42 months ago

Lee in Cumberland, Maryland said: PTs assume the risk of supervision of PTAs, to assume that they should be paid the same is ludicrous. If a PTA (assistant that assists the PT in treatment prescription i.e. appropriate name) injures a patient and gets sued it is the PTs license, one that they spent a whole lot of money and time to get, on the line. The PTs are trained to understand why treatment modalities are to be applied. PTAs are to apply the treatments in a manner which dilutes the service and makes it safe and effective.

I don't see a reason why the minimum educational requirements for the PTA degree should be increased. All this would do is increase the costs of the degree and put pressure on increased salaries aka increased costs for the service. What they have now is adequate for their role. They are essential in diluting the service, but are well compensated for both the length and cost of education. I cannot say the same for the PT degree. This is a long-term problem.

I do think changes are bound to come in the next ten years due to the fiscal insolvency of Medicare, and there will be changes to the payment structure. What these changes will be I don't know. I do think that the payment structures will represent educational disparity levels better than they do now though.

As a DPT you should be well aware of that PTA's in several states are actually licensed under their own credentialling number thus desolving a PT of any repercution of action if a patient should be injured under the care of a PTA. I agree what does the study of history and other meaningless classes accomplish nothing but the ability to increase the initial behind a degree. I work with several PTA's who first got their bachelors and then went back to school and became a PTA. Now the questions begs do they have less knowledge to treat patients only now that they can't evaluate a patient?

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Lee in Somerset, Pennsylvania

42 months ago

George in Yakima, Washington said: As a DPT you should be well aware of that PTA's in several states are actually licensed under their own credentialling number thus desolving a PT of any repercution of action if a patient should be injured under the care of a PTA. I agree what does the study of history and other meaningless classes accomplish nothing but the ability to increase the initial behind a degree. I work with several PTA's who first got their bachelors and then went back to school and became a PTA. Now the questions begs do they have less knowledge to treat patients only now that they can't evaluate a patient?

Yes George I've come to a concussion after 3 or so years preparing for the DPT as a pre, that it is absolutely ridiculous for anyone wishing to do PT to go for the DPT. The cost to benefit of a DPT vs PTA tells the whole story. PTAs have the best deal going since sliced bread. Go for PTA people. Don't waste you're money and time going for the DPT. Factor in the years you could be working as a PTA in the three years you're in school for the DPT. Then factor in experience. Get you're technical degree at a cc and enjoy a wonderful career as a professional as a PTA. DPT will put you in debt for life. You'll even have DPTS defending how good their PTAs are, slowly pushing PTs out of the picture. Their strength simply lies in politics. Sad reality.

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SP in Rusk, Texas

42 months ago

How does a DPT "push a PT out of the picture," They do the same thing. To some of the others on here wondering why the PTA salary is getting closer to the PT, think about it...Except for Part B and private insurance, which is not a big slice of the pie, evaluations are not paid for by Medicare part A in skilled care. Since skilled care is where most of the dollars go, why would salaries for PT's go up if the big clinical separation is evaluation skills and that doesn't bring in any money to the facility?
George, you are spot on: PTA's do have the knowledge to understand when, why (or why not), or how any treatment or modality can/ should be used. They also know the appropriate settings/ parameters for any given treatment, as well as potential risks and signs to watch for if things are not going as expected. PTA's carry the same malpractice insurance that PT's do, and if a PTA were to injure someone during the course of a treatment, they would be held responsible.

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Lee in Somerset, Pennsylvania

42 months ago

Basically PTAs are equivalent to PTs from a Medicare reimbursement perspective. In the eyes of govt, they are basically the same entity.

"How does a DPT "push a PT out of the picture,"?

Easy. They have overpriced themselves. It's only a matter of time before most pre-DPTs become pre-PTAs because it is simply not worth it. The dependence of both PTs and PTAs on social programs which are failing (see "government shutdown", MPPR, and Medicare cuts.) SP in Rusk, Texas; you're statement confirms the concept that PTAs are basically equivalent to PTs at a lower cost... thus pushing the DPTs out of the picture. You've helped prove my point.

DPT would only be beneficial in outpatient settings. Since orthopedics require the most skill and this is the most desirable setting for therapy, DPTs will flock here. As was mentioned, this is also where Medicare Part B is cutting. Part A is still doing alright, for now at least. I find it amusing more people don't see the PT / PTA relationship more of a problem than they do. Not my problem anymore though. The sand is deep with heads stuck in it, and the sand keeps piling on with no attempt to pull it out.

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SP in Rusk, Texas

42 months ago

Lee, I completely agree. I misunderstood your comment. I thought you were saying that someone with a DPT would be pushing someone with a BSPT or MSPT out of a job...though I have encountered plenty of new-grad DPT's with an entitlement complex ;-)

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mjf in Santa Monica, California

42 months ago

Greg in Fort Worth, Texas said: Boy, you opened up a can of worms. I have been a PTA for 15 years. I to am concerned about the changes coming w/healthcare reform. It will all boil down to who can perform the job w/the fewest dollars spent. Don't think that 3rd party payers will pay you more if the PTAs are gone. The current healthcare system is broke$$$$ The APTA is too worried about vision 2020. Do really think the payment system will improve w/all DPT practicing? Like it or not, PTs will become specalized in Dx and certain types of treatments. The money will not be there for a PT to be in private practice and perform all of the treatments on his/her own. More time should be spent on protecting the profession and stop the egos on who is qualified w/in the field. If you (PT, PTA)provide poor service and outcomes, find another JOB. P.S. I have learned as a PTA that the only way to succeed is to work hard. I make over 100K a year because I work. The majority of PTs I know are not willing to put in the time. They just expect to be paied for their initials PT, MSPT, tDPT, DPT.

Thanks

I am looking for PTA schools, hopefully starting soon. Can you tell me how your able to make such a high salary? Do you travel? In home care?

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mjf in Santa Monica, California

42 months ago

SP in Rusk, Texas said: Lee, I completely agree. I misunderstood your comment. I thought you were saying that someone with a DPT would be pushing someone with a BSPT or MSPT out of a job...though I have encountered plenty of new-grad DPT's with an entitlement complex ;-)

Can anyone tell me the difference between a technical career school vs. community college vs. private school? When looking for a job, is the school considered? Even if there all accredited?

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Lee in Somerset, Pennsylvania

42 months ago

SP in Rusk, Texas said: Lee, I completely agree. I misunderstood your comment. I thought you were saying that someone with a DPT would be pushing someone with a BSPT or MSPT out of a job...though I have encountered plenty of new-grad DPT's with an entitlement complex ;-)

Well the reality is that the new DPTs will be struggling due to their overpriced education. This is not a DPT problem, however, it is a PT problem as it is now the entry-level requirement. I think there are only 7 or so MPT programs left, and these are quickly transitioning to the DPT for obvious reasons - more money. So DPT it is. A PT is a PT regardless of degree. Any BsPT or MPT will be quick to state this fact. This reality, is in fact a very big problem. If PTs by and large due not accept the transition, how to they expect everyone else to? Like I said I'm done with worrying about it. The DPT is now looked at as a joke. Who wants to spend 7+ years in school to get a degree which is laughed upon and regarded as inflated in a climate of decreasing reimbursement? I know someone who doesn't. 35k/year for a three year program in tuition alone?! Or 10k tuition for an entire PTA program at a community college. Easy decision really. ATCs and LMTs are also looking to obtain more market share from DPTs. Add to this and the fact that you can get PTs (not PTAs) from overseas, and all of the sudden the govt could flood the market. I could go on and on. From all you pre-PTAs, you are not in the clear either. Remember your pay is dependent on social/government funds. These funds are becoming nonexistant. Think about your target consumer/patient and their discretionary income. Sure many people could use PT, but if govt funds go away, who's going to pay for it? A poor old lady collecting retirement benefits? Sure there is private insurance. Consider the fact that they generally follow payment trends from govt payors. They are also merging. I'm out!

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T in San Diego, California

42 months ago

mjf in Santa Monica, California said: Can anyone tell me the difference between a technical career school vs. community college vs. private school? When looking for a job, is the school considered? Even if there all accredited?

I dont think there is a difference really besides the cost of tuition. Comm colleges are cheapest but you will have to deal with waitlists
Schools like PIMA dont have a waitlist and ARE accredited but they are like 3x the price of a commm college and Ive heard and read so many complaints about PIMA.

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mjf in Santa Monica, California

42 months ago

Thank you so much!! I'm in Los Angeles, Ca. Concorde career college now offers the program, $41,000 stupidly exspensive! But, no pre-req's and you test out of math. This will save me 1 yr and the possible hassle of waiting list. They should be accredited by May, if not I'll take the long route :( What is PIMA?

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greymatter in Shawnee, Kansas

41 months ago

Hannah in Westland, Michigan said: Why are you a DPT with a Master's Degree??? Doesn't make sense.....

There is a transitional doctorate for those PT"s practicing with a bachelors or masters of PT.

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SP in Fort Worth, Texas

41 months ago

greymatter in Shawnee, Kansas said: There is a transitional doctorate for those PT"s practicing with a bachelors or masters of PT.

Yes, there is. If you complete it you are a DPT, not a DPT with a masters degree who also has a transitional DPT degree...That would be like your college professor saying he/ she is an educator with a B.S. and a masters in foreign literature and a PhD in english literature. They just go by PhD.

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SP in Fort Worth, Texas

41 months ago

PTA in Atlanta GA in Jefferson, Georgia said: Ok I respect all of your comments and they are all very well spoken exept for one thing. Most PTA schools require you to try to get into a competitive program so before you start you have to take Anatomy and Physiology two times biology human growth and development etc so it ends up being 2 YEARS at some places before you get accepted to be a pta. After that it is usually a 2 years program so all together PTA's go to school about 4 years. So Im sorry to say it but pta degree is associate but also it is not just two years.

It can be done in 2 years from start to finish. I did it fall 2006-spring 2008, passed boards 3 weeks after graduation. Have been practicing all over the country for the last two and a half years. I am not a traditional student (started at 29), and had to work 30 hours a week in a restaurant to pay tuition...It can be done, I think a lot of people on here make it harder than it is!

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teejei in Ocala, Florida

41 months ago

Coming from a PT family (father & stepmom) and also from working in the field as a PT Aide & Admin Assistant, I've seen the highs & lows. After migrating from the Philippines and receiving my green card, I was talked out of continuing my PT education by my father (I only finished the first 2 required years in a university), citing the high expense vs. number of years needed to break even, and the current trend in insurance reimbursements affecting salaries.

I'm a recent graduate (2010) and a newly licensed PTA. From the discussion my parents & I have had during the course of my program, PTs and PTAs have the same basic knowledge base - anatomy, physiology, kinesiology, modalities, data collection, ortho/neuro management, orthotic/prosthetic training, thera ex, manual techniques, wound care, hydro/aquatic therapy, etc. The main difference is that only PTs can evaluate, diagnose, and discharge the patient. There's nothing different going on during a treatment whether it's a PT or PTA doing it...unless of course, the PT and/or PTA is not using their critical thinking and problem-solving skills.

I think one of the most important things to keep in mind is the obligation/responsibility to educate the public on our respective professions. "Assistant" does carry the impression of less or lack of knowledge/expertise, but if we explain it well, the public would then know better. And the same goes to the public, too; do your research! In this age of computers, anything can be looked up in the Internet. Be discerning, be critical, but also be open-minded.

All in all, this was a very good thread to read while waiting for callbacks from the hospitals to which I applied.

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huh in Stanton, Texas

39 months ago

aynna in Mansfield, Ohio said: Hi I was cruising through the internet and came upon your question. I am a DPT with a master's degree, a PT specialty (Gerontology), and have published in a professional journal. I am going to answer your question honestly. I think PTA's do a great job. I enjoy working with them and they enable us to provide services to a greater number of patients. However, I do not think their time should be billed the same as that of a PT. Our degree is a minimum of 6 years. (We have a local medical school who is graduating primary care physicians in 7 years.) The PTA degree is a 2 year associate degree. There is a vast gap of knowledge between the physical therapist and the physical therapy assistant. Personally, I do not think they should be able to work unsupervised with the PT off site. I have not seen the knowledge base to substantiate this and I have been a therapist for many years, working in many environments, with numerous PTA's. To make an analogy, do you think your dental assistant has the same degree of expertise as your dentist? Probably not. Nurse practicioners and physician assistants are only 1 year away from a general practicioner MD. I personally think the PTA should be at least a 4 year academic degree. The difference between 2 years of study and 6 years of study is too large of a gap. Logically speaking, reimbursement could not be the same.
Thanks for allowing me to air my opinion.

To Aynna I just graduated from PTA school last May so I'm replying with limited experience. First I do agree with you that if I went to dentist's office I would not expect to be charged the same if I saw the dental assistant and not the dentist. But what about the dental hygienist? Considering that is who our equivalent would be in that field. And why is that you count your pre-requisites to get into your program but ignore those for PTA school? Just curious.

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jj in Virginia Beach, Virginia

39 months ago

I have 15+ years experience as a PTA, 8 years experience as a LMT and 3 years experience as a Podorthist. I believe that once you understand the human body, you have the ability to treat it accordingly whether you are a PT or PTA. One problem that I have been noticing a lot with PT's is that they are consumed with paper work. This is a problem since they tend to use a more cook book approach with treatments to save time. This is causing the "use it or loose it" problem with PT's and treatments. Whereas, PTA's have more time to constantly challenge patients with new exercises and manual treatments. Therefore, I would except a treatment by a PTA any day of the week. No disrespect to PT's.

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valerie in Buford, Georgia

38 months ago

Wow! I can't believe what I just read. I have worked 14 years in this field and let me tell you that the letters behind someones name doesn't make them good at what they do as a profession.

I have worked with PT's, MPT's, and DPT's and also assistants. Trust me when I say that there have been some DPT's I would not want working on me. A title is just that, a title. There are many things that make a therapist or therapist asst. good at what they do besides the letters behind their name.

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mrp in Middletown, Ohio

38 months ago

Very interesting thread! I have to point out that I once was trying to get into PT school, a really long time ago when it was still a BS!! However, my grades were not wonderful (3.2 not the 3.8 they wanted), so I pursued becoming a PTA at the suggestion of a PT I was volunteering with. My third year of school was my first year in the program so with gen eds, and pre-reqs it took my 4 years to finish. But the great thing was I had a job before I graduated and paid my school loans off very early! I have worked with some wonderful PT's and PTA's and we can learn so much from one another. I did ortho-sports medicine for 11 years and now am working with special needs children. There are so many differnt areas to work in our field and so much to learn I feel we could never get bored!
On a differnt note, the hospital I used to work for is eliminating PTA's in the out-patient setting because the healthcare corporation that "owns" the hospital brought a consultant in and they determined the ratio of PT to PTA was not cost effective! It was one on one team based treatment but the kicker is the price the corporation charges for an evaluation...$542.00!! Yes, for one eval whether the PT spends an hour or 30 minutes with the patient. The bean counters have seen that is the way to bring the most money in but they neglected to figure out who was going to be treating all of the evaluations when they come back for follow-ups! I loved ortho and am truly sad for my friends who all have 14+ years of experience and are very knowledgable PTA's, most educating the PT's that would come into the clinic and who the patient asks for when they come back for another surgery/injury. I hope this is one of the downslopes for PTA's like in the late 90's with PPS and soon the bean counters who have no knowledge of patient care will step back and see who is really going to suffer. I'm glad I left when I did.

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jjjs in Dayton, Ohio

38 months ago

This is am interesting discussion but I do fear that the future for PTA's is not good. I also work for a hospital health system that eliminated 3 PTA's yesterday and I know that I have a target on my back and will be the next to go. They will no longer hire anymore PTA's only PT's. The reasons I was given is the coming changes in reimbursement, only for PT and not PTA, declining reimbursement that we do get, higher co-pays etc. I have witnessed the job listing for PTA's evaporate. One problem is everybody wants physical therapy but nobody is willing to pay for it. All the financial risk for patients are going to move from Medicare & insurance to the patients. They will need the services but will be unable to pay, so they will bypass Rx. This will hurt PT's but PTA's will fare far worse.

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mrp in Middletown, Ohio

38 months ago

Jim-bob- is that you? I heard you were safe so I'm hoping that's true...hang in there buddy! You are way too valuable to lose!

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