The Educated Therapist

Let’s face it. Most physical therapists aren’t winning any sales and marketing awards. Most of us have don’t have a business background and typically enter this profession based on a love of health, exercise and helping others. In school, we don’t really have time to cover anything beyond examination and treatment of our soon-to-be patients. We graduate, enter the world of health and wellness as practitioners of physical therapy, and soon realize the competition is fierce. In San Francisco, a city with something for everyone, there are individuals providing health and wellness services that seem in direct competition with everything we offer. There are personal trainers, massage therapists, Muscle Activation Therapists, Sports Therapists, Neurokinetic Therapists, Core Activation Therapists, and more. Have you ever stopped to consider who is best trained to help you heal? While these practitioners may indeed be skilled at the services they offer, based on our level of education and training, physical therapists are in a league of our own.

The other day, I had a pleasant conversation with a gentleman who was interested in learning more about the field of physical therapy. A seemingly intelligent man, he’d also had personal experience as a recent physical therapy patient. At some point in our conversation, he stopped me and asked, “Do you have to have some sort of certificate to be a physical therapist?” My jaw dropped.  It was then and there I realized how physical therapists have done such a terrible job of informing the public of what we do, what we can offer, and why we should be considered the practitioners of choice for musculoskeletal health.

So here’s what you should know: physical therapists go to school for 7-8 years. This includes 4 years of undergraduate education, heavily based in science (physics, chemistry, microbiology, exercise physiology, etc.), and 3-4 years of graduate-level education. Students graduating from physical therapy programs in the United States today earn a Doctor of Physical Therapy. The first Doctorate program in Physical Therapy was started in 1993 at Creighton University in Nebraska and, as of 2015, all accredited and developing physical therapist programs are DPT programs. Often part of a medical school, PT programs teach physical therapy examination and treatment, as well as courses in Anatomy, Neuroanatomy, Pathology, Pharmacology, Radiology and Differential Diagnosis (how I determine if a symptom may be something more serious—and outside of my scope of practice—than run-of-the-mill back pain). In fact, when I attended UCSF in the early 2000’s, the physical therapy students were the only students who performed full cadaveric dissections. Other programs used the cadavers we spent our first foggy summer in San Francisco dissecting. It was also the start of our collaboration with the first year medical students, where we 2nd year PT students helped teach the medical students musculoskeletal anatomy. Most recently, residencies and fellowships after graduation have grown in popularity to provide advanced training for physical therapy school graduates.

Beyond our formal education, physical therapists are licensed by the state in which we practice and are held to a high level of professional conduct that includes requirements for continuing education every year. Most courses are held on the weekends and many physical therapists travel great distances to take courses of interest. This year alone, PT’s from TherapydiaSF will take courses in San Francisco, San Diego, Montana, and Las Vegas. Some physical therapists also opt to enhance their degree and training by completing board certification in different areas of practice, including Orthopaedics, Pediatrics, Women’s Health, Neurology and 4 other areas of specialty practice.

The next time someone suggests physical therapy, please consider our extensive training and education and know that we have the education, expertise and dedication to help you work, play and move without pain.



One size fits all? Part 2: What makes a good PT? Aren’t all therapists the same?

IMG_3930A good physical therapist…

…invests in continuing education- While the majority of states require continuing education credit for continued licensure, some therapists complete only the minimal requirements while others seem to spend every weekend taking courses!  It is reasonable for a patient to inquire about the therapist’s interest in educational topics.  Chances are the PT will be excited to talk about their latest course.

…considers the whole person.  An injury is very rarely limited to the specific joint or muscle that hurts.  A good therapist treats not only the symptoms, but looks for the cause of the injury and understands how dysfunction in one area of the body may contribute to symptoms in a different location.

…draws from a variety of sources and isn’t afraid to learn from others.  Therapists who are willing to collaborate with other practitioners can learn a lot! 

…is directly involved in your care.  Some tasks are acceptable to delegate to a physical therapy aide, but only a physical therapist (PT) or physical therapy assistant (PTA) can perform physical therapy.  If you only see your PT for a few minutes at the beginning or end of your appointment and spend most of your time doing exercises with an aide or independently, you are not receiving quality care.  The foundation of my training and education is my ability to observe dysfunctional patterns of movement and to relate those findings to the patient’s primary complaint.  It has taken me a long time to refine my observational skills and the longer I practice, the better I get.  Guiding a patient through their exercises provides yet another window of observation and completes my assessment of that person’s problem and is not something I’m willing to delegate to someone else.

…revises or progresses your treatment.  If you are not seeing changes in your condition, are doing the same exercises, or receiving the same treatment at every appointment from week one to week six, you need to consider finding a new therapist.