Misconception of the Physical Therapist

I have practiced Physical Therapy both in the US and the UK, and in both cases I have found that patients often do not have a good understanding of what PT is or what to expect from it. Misconceptions are common; sadly, this can deter patients from seeking and obtaining treatment from a PT when needed, because they do not realize what PTs have to offer.

My Physical Therapist is…

I have heard people say that they have gotten a massage by a PT, or given some exercise by a PT, and unfortunately they are not always impressed with their experience. As people further explain their experiences, I can see that they cannot differentiate between Physical Therapy and other professions such as massage therapists and personal trainers. Now, I do believe these other professions offer good service and value to their clients, but I feel that PT is in a unique position to offer solutions to many problems. To explain my stance, let’s consider what constitutes a PT, which in turn should help you know what you should expect to experience.

1. PTs have a detailed understanding of human anatomy. Many people do not realize that PT is a postgraduate degree program and includes full dissection of a human cadaver. We have a detailed and intimate knowledge of human anatomy and more importantly functional anatomy, or biomechanics. The anatomy we learn is not dry book learning; it is real and applied. It is all well and good that I can tell you the anatomy of the knee joint, but it is far more important that I can then tell you how it should function, and the problems that can occur when it is dysfunctional.
2. We are taught how to watch and test for pathology. For example, I am taught how to test for an ACL, meniscal, or labral tears. We are taught what “red flags” to look for that might indicate cancer or other disease. This knowledge helps me to know when to appropriately progress or stop therapy. It helps me to know when to contact your MD and discuss your care – which might necessitate a further physician visit, referral, or imaging.
3. We learn about physiology, medical conditions, and how to understand lab work and drug interactions. We learn about imaging so we can look at your MRIs, X-rays, CT scans, etc. These pieces of information further help us formulate and individualize our plan of care.
4. We learn how to read, understand and conduct scientific research. This way, our practice is fluid and adaptable as there is always new research being produced (sometimes by us in our clinics) which should alter our framework of practice and care. Your experience of PT should not be cookie-cutter but instead well thought out and evidenced.
5. We learn about communication skills and strategies which help us to better understand our patients and effectively communicate with them. This way we can hopefully ensure that we are meeting your goals of therapy, rather than some arbitrary way-point.

So when you see a PT, you should expect a high depth of knowledge and thinking. You should expect a thorough examination, well thought-out plan of care, and well-evidenced treatment. At this point, some people look confused and ask why their experience was not like this. There may be many reasons for this, but I feel a major reason is that billing and reimbursement of insurance-based care leads to providers having less time and feeling rushed. You may have experienced short appointments, overlapping patients, frazzled staff, seeing multiple providers and having to tell each one your story. For this reason, when I formed PhysioWorks, I decided our services will be out-of-network. We can spend 60 minutes one-to-one, you will see the same therapist, and we can tailor your follow-ups to both meet your therapy needs and your schedule. Better still, most insurances do provide reimbursement, so for many this level of care does not necessarily cost more in the long run!

Having reviewed what constitutes a PT, you might think there are a lot of similarities between us and medical doctors. There are certainly similarities, but there are differences and both professions should work together to create great care. Medical doctors operate under what we call the “medical model”, which in itself is very focused and diagnostic, looking for a pathology. In contrast, PTs operate under the “biopsychosocial model”, which means that we follow a more functional, holistic model of care. A PT is not unconcerned by the pathology but is more concerned with the client’s function and how all aspects, pathology, diagnosis, personality interact. With our differences, there are obviously different situations where care by a medical doctor or a PT is most appropriate and beneficial. A good PT or good medical doctor realizes this and will refer the patient to each other as appropriate.

The medical doctors and PTs that I observe to have the best results are those who:

1. Care about representing their profession at a high level with well-founded thought and application.
2. Want to understand what, and how other, professions get results rather than just knowing their own jobs.
3. Work well with and respect the other professionals they work with.

The best doctors and PTs will more likely reproduce the findings of research in their care.

For the above reasons, I, as a Physical Therapist, continue to seek to expand my knowledge by review of recent research, quality continued education courses, as well as talking to and understanding what other professionals do. Throughout my career, I have taken time to discuss patient care and current issues with orthopedic doctors. Where opportunity arose, I even observed surgery. These relationships have helped me better understand the way doctors treat and perform surgery. It has also created a relationship where many of them asked questions about how I cared for patients and I hope and believe a mutual respect was formed.

If you read the above and feel that you have not had this experience with a Physical Therapist, I hope from reading this you would consider trying PT again.  If you have not considered PT before, not realizing our background, I would ask you to consider us! Many people want a magic pill or fix to recover and sadly that doesn’t happen. Neither PT or orthopedic surgery are easy treatments. If you chose to try Physical Therapy, I would be happy to help you and make your experience a positive one. With this we are now offering Discovery Consultation.