physiotherapist & physical medicine/rehab physicians

[aaaphysio]

i have a chronic problem of conflict between physiotherapist / occupational therapist practice and physical medicine & rehab (PMR )physicians practice at the hospital. The PMR are dominating , directing & managing the rehab services, all outpatients have to be seen by them prior to therapy even if referred from specialists physicians ( Neuro, ortho...etc). The PMR prescripe the plan of care to PT/OT including e.g. list of goals , treatments , frequency of sessions & decision to discharge. They are claiming that this is the system of John Hopkins , Cleavland & many other settings especially in USA. I would like to get your support in providing me with evidence from best practice settings that this is not the case. Physios practice all over autonomus , have direct access at many palces of the world , are managing the rehab services and don't need the PMR to supervise them.

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[gcoe]

Currently we have an entry level training that is the basis of our practice. Our entry level training should prepare us to be able to apply our skills to virtually any area of practice at a basic level. There is debate as to whether entry level courses around the world are succeeding at this. The problem has got a lot to do with the knowledge explosion - entry level graduates need to be proficient in so much more. However it is also based on the observation that more mature students who have undertaken some life experience + more rigorous academic work consistently do better. Some countries and universities have resolved this problem by requiring the student to complete a more basic biomedical science degree that prepares them in topics such as anatomy, physiology, pathology, biomechanics, pharmacology, epidemiology, exercise science and so on. Once graduating from this degree they can then go on to complete a Masters or Doctorate entry level degree. This second qualification can focus on developing clinical knowledge and skills to a much higher level of practice in a variety or areas.

However there is still room for specialisation either through further academic study, or through another prescribed route of specialisation.

I think this model of educating the generalist to a higher level of competence and to also provide room for later specialisation works very well and provides scope for improvement. We have a strong identity as a profession and I would not like to see us becoming excessively medicalised, or another branch of medicine.

[HealthMaster]

Nice thread. Also you have a nice offer. Btw, gcoe what state are you in? I want to see if I can get on that training.

Sorry for the bump.

Thanks

[steveparker]

I read all the replies on this post, some are not so defining to me.

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Hallo...
I also have a chronic problem of conflict between physiotherapist and physician generally in my country, like aaaphysio. Health ministerial decree says that Physician as leader / coordinator in rehabilitation service in every hospital in my country. Physician prescripe the plan of care to physiotherapy including e.g. list of goals , treatments , frequency of sessions & decision to dischargeas. Like other physiotherapist around the world, we want autonomy. I need sugestion: before getting autonomy, how to make an ideal relationship betwen physiotherapist and physician?