Educational Programs' #1 Customer

I got this most unusual request (tounge-in-cheek) today from Dr. Julie Whitman at Regis University, essentially a survey asking for some perspectives on what employers' needs might be when it comes to equipping physical therapists with the best possible education, the results of which will inform their upcoming strategic planning. An educational program asking employers for their opinion? What a concept (again tounge-in-cheek)! Most educational programs have absolutely no appreciation for the fact that employers are their #1 customer and instead arrogantly think that the academic ivory tower knows best, never mind the fact that many faculty in PT academia have never themselves practiced or only in their very distant past (please no one share the results of this survey with me if it's out there lest it ruin my New Year.).

Kudos to Regis for asking it's #1 customer how it might best serve their needs.

Happy New Year to everyone!

John

Comments

[Jason]

I agree with you, John, that major stakeholders such as employers should be consulted in an enterprise as important as professional education--keeping in mind, of course, that employers will not all share the same perspectives. However, your view of educational programs seems unduly dim to me. At the program where I teach, many of the faculty continue to practice and to stay current on the literature in their respective areas, which is no small feat considering the explosion of research that seems to be happening in the health sciences across the board. My concerns--as a counterpoint to yours--are that (1) employers allow physical therapist practice to be too driven by the constantly-changing insurance milieu and that (2) physical therapists tend to exhibit a group mentality in any given workplace in which they don't practice at a very high level, don't engage in evidence-based practice, don't stay current in their knowledge base, and don't know what is going on in their profession. My concerns are the direct result of my 8 years of recent experience as a full-time staff clinician. Hopefully we are both representing extreme points of view and the truth lies somewhere in the middle.

[John Ware]

I concur with Jason that PT practice is driven more by insurance reimbursement policies than research evidence or even practice guidelines.

Practice-owners are in the difficult position of providing a quality service while at the same time getting maximum reimbursement for the service. Meantime, the system is set up to pay you for what you do, not the results you achieve. And there is virtually no reward for making an accurate diagnosis. How many PTs out there have received a referral for PT for LBP that either turned out to be a hip problem entirely or in addition to the lumbar problem (see recent editorial in JOSPT on "regional interdependence")? This happens routinely in my practice.

The group mentality issue is a consequence of poor leadership and marginally ethical practice on the part of the practice entity. For instance, if you work in a practice where the policy is to allow only 30 minutes to evaluate a patient with a spinal problem, then that is insufficient, and the PTs working in that department or clinic should speak up and say so and why. If patient-centered outcomes tools aren't being utilized by the pracice owners/department directors, then the PTs who work in that practice should bring it up at professional staffing meetings.

I applaud Regis' efforts to bridge the gap between the the classroom and the clinics. Unfortunately, the reality of a reimbursement system that does not reward results as much as the provision of a useless procedure tends to promote a sense of "ignorance is bliss" on the part of the practice owners. It's often better for the bottom line to practice inefficiently, i.e. more visits, more procedures.

[Selena Horner]

I would appreciate the abilty to do an online search for literature AND have a greater probability of acquiring full text literature at the click of a button (no cutting and pasting, no going to another website) when I see an abstract I like.

The ivory towers have that information for their graduate students, it would be nice to have a low cost option for employers (remember in the trenches reimbursement sucks), especially for the physical therapists practicing independent of some large corporation that might have access to resources.

Provide me with something of value that I can use on a day to day basis and then when it comes to continuing education, I just might consider your programing - especially if that programming is evidence-based and would be helpful because it targets a larger majority of the patient population walking in my doors.

[Jason]

Selena, as a member of the APTA you already have this ability! Go to the APTA website, then choose "Research" and "Open Door." You'll find access to the same databases that are available to colleges and universities, many offering direct links to the articles. It's a great member benefit.

[Selena Horner]

Jason, the database is there and it is great but more often than not all I can acquire is an abstact. Only a few of the times have I had a full text available to me.