Physical Therapist, Chad Kofoed, explains how the physical therapy profession has evolved and what it means for patient.
Each spring, members of the Minnesota Physical Therapy Association gather at the Minnesota State Capitol in St. Paul for “Day on the Hill.” We discuss key topics with our legislators that impact patients and physical therapists in today’s healthcare climate.
Our main focus over the past few years has been updating our lawmakers on the evolving nature of our profession. The lack of understanding about the physical therapy profession extends beyond our representatives on the hill, to our friends, family, and even some of our patients. With this said, let’s dive into a few big points encompassing today’s physical therapy.
Changes in Education
The profession of physical therapy was first developed in the early 1900’s. Physical therapists helped patients recover from polio and assisted in rehabilitating soldiers returning from the first World War. In 1936, students only needed two years of education to practice physical therapy. The requirements increased to a four year baccalaureate degree in the 1960’s. By the 1990’s it increased again as all programs evolved to a Master’s degree.
The role of the physical therapist has become more important throughout the healthcare system for a wide variety of patients, and the educational demands of the profession grew. Over the past 20 years, the role of physical therapists has grown to include working in:
- acute care
- pelvic health
- chronic pain
This has resulted in the evolution of the profession, which now requires a clinical doctorate degree for all new graduates. Surprising to many, the path to practice physical therapy now requires a four year bachelors degree followed by three years in an accredited program to get a Doctor of Physical Therapy (DPT) degree.
Following the entry level DPT degree, three primary opportunities exist for post graduate education or specialization within the field:
Clinical Residency: Includes at least 1,500 hours of post professional education/mentoring in a specific field after a therapist has achieved their license to practice. In addition to gaining specialized experience in a certain area of practice, residents then sit for the associated board certified clinical specialist exam.
Board Certified Clinical Specialist: Clinical specialist exams are offered in eight specialty areas. Most outpatient therapists seek specialization in either “Orthopedics” or “Sports.” Over half of TRIA’s physical therapy department has achieved these specialties, compared to that of under 10% nationally.
Fellowship: After completing a board certified clinical specialist exam, some therapists choose to progress their education further with a clinical fellowship. This involves the most in depth training, knowledge of treatment and clinical decision making. This is the pinnacle of our profession.
If you see a few extra letters following someone’s name and PT degree, they may be referring to this advanced post graduate education.
Driving the continued evolution of physical therapy is the term “evidence based practice.” This means incorporating the most up to date research to provide the highest quality of care possible for our patients. Research often involves establishing normative values for ranges of motion, strength, and healing times, but also includes how movement patterns, rehabilitation protocols, and even patient education can affect outcomes. Here at TRIA we have monthly departmental education meetings, have published dozens of peer reviewed articles, and the physical therapy department is currently involved in five formal research studies to ensure we are bringing the best possible evidence and care to our patients.
Direct Access (First Line Providers)
Few individuals are aware that all 50 states allow patients to seek treatment from a licensed physical therapist without first seeing a physician for a referral. Currently in Minnesota, patients who do not have a federal insurance plan such as Medicare or Tricare can be treated by a physical therapist without a physician referral for up to 90 days. Studies have shown repeatedly that for certain injuries, take acute low back pain for example, early physical therapy can significantly reduce overall medical costs and help to avoid unneeded opioid usage, injections, or surgeries. Direct access to physical therapy additionally helps avoid unnecessary delays in getting services that can expedite your recovery. Next time you have a musculoskeletal issue that needs addressing, consider seeing a physical therapist first to help you get back on the field, back to work, or playing with your kids as soon as possible.
What we bring to the table
The field of physical therapy is incredibly broad and includes treatment of patients with neurologic, cardiac, athletic, and orthopedic deficits, amongst many others. Listed below are just a few highlights of the outpatient orthopedic offerings here at TRIA: