Updated: Aug 26, 2020
Here’s a typical scenario.
Someone: “So I hear you’re a PT” Me: “ I am” Someone: “I have this pain right here (points to body part). Can you give me some stretches for this?” Me: “Well you see, you should really see someone for a proper evaluation and prescription.” Someone: “How do I know if they are any good?”
This conversation has played out in some version many times before. I can certainly understand why people may be unsure how to proceed. Many years ago, when one experienced pain or discomfort, they would simply see their internist or family doctor. They would give them a diagnosis, sometimes prescribe some stretches and send them on the way. Rarely would they refer to a physical therapist. These days, healthcare consumers have many choices when selecting a provider to help their aches and relieve their pain. Some see a Physical Therapist or a personal trainer (some of whom also use the acronym “PT”), while others visit massage therapists, chiropractors and others who fall under the category of “bodywork practitioner.” On top of that, each occupation has its own certifications, licenses, and various alphabet soups. It’s beyond the scope of this paper to review every single kind of practitioner/provider, so I will just focus on how to choose the best physical therapist.
So, how does one choose the best PT on the planet? Read on and follow these steps below!
Step 1: Evaluate Education and Experience
The first step is to understand and evaluate your PT’s credentials and educational background. Physical therapy was previously a Baccalaureate or Masters level field, but as of about five years ago, virtually all physical therapists in the United States receive Doctorate of Physical Therapy (DPT) degrees. No, it’s not a PhD (although some PTs are PhDs). It’s a clinical doctoral degree, similar to a PsyD for psychologists. The programs typically last 3 years and the curriculum includes courses on Anatomy, Physiology, Kinesiology, Exercise Science, and other courses with a narrower focus on various fields PTs specialize in. A major part of our training is completed in the clinic. We are mentored and evaluated by practicing therapists while we treat patients with a variety of conditions from sprains, pain and stiffness after surgery, stroke or cancer. However, the amount of time in practice and additional learning PTs undertake is a more reliable indicator of expertise than the academic degree. Which brings us to Step 2.
Step 2: Evaluate Post-Degree Education
The second step in finding the best PT on the planet is to evaluate the practitioners’ post-degree education. (Your PT, at minimum, will be licensed by the state.) Post-degree education can include continuing education, certifications, specializations, and/or residency programs. Certifications indicate that the physical therapist has specialized in particular conditions, and has passed post-degree written and practical exams. For example, many physical therapists choose to complete a certification in manual therapy.
Also, PTs can complete a residency program in a particular specialization. The residency programs are designed to further enhance our knowledge in an area of specialty practice. They are typically 12–18 months long and involve additional didactic and mentored learning. While this system has been around for at least 20 years, recently there’s been an increase in the number of therapists who complete the residency programs. Unlike physicians who are required to complete residency training to practice, for PTs it’s optional. Once the residency is completed (although it’s not mandatory), PTs take a Board Certification exam in a particular area of practice, for example Orthopedics or Women’s Health. You can find a Board Certified PT here: http://aptaapps.apta.org/DirectoryofCertifiedSpecialists/default.aspx .
There are additional ways to further one’s education like fellowships, which some PTs pursue. Thus, evaluating your PT’s post-degree education will help you choose the best PT for you and your needs. For example, if you injured your knee playing sports, it would be great to find a PT who specializes in sports or orthopedics and holds a certification in either specialty.
Step 3: Evaluate Their Interaction With You
It is no secret that face-time with health care practitioners have shortened over the last few years http://www.statista.com/statistics/250219/us-physicians-opinion-about-their-compensation/. It is a reality that many healthcare providers face increasing pressures including lower reimbursement rates, higher patient volume, and more documentation requirements . Similar pressures face physical therapists. However, these pressures are no excuse for low-quality care. Once you have selected a PT (after completing steps 1 and 2), you should proceed to the third step: evaluating how your PT interacts with you. A great PT will take the time to listen to your concerns, involve you in the treatment process, set reasonable goals, and dedicate time to making sure that you are working on something relevant to you and your lifestyle. This therapist will adjust your treatment, if it’s not working and tell you if you need another specialist to complete your care.
Step 4: Evaluate Your Physical Therapy Treatment Program
Your physical therapy will begin with a comprehensive exam, including asking you what brings you to therapy and what you would like to get out of it. Your treatment will often involve active techniques like exercise, which you perform with guidance and supervision, and passive techniques which the therapist will administer to you. Passive techniques can be anything from stretches to your muscles and joints and modalities like heat and ultrasound. While the passive techniques feel a lot better, most often it’s the active techniques that produce more lasting results. Even if your program begins with a lot of passive techniques, you should be progressing to an active program as soon as possible. Also keep in mind while modalities like heat, ultrasound and some electrical stimulation may feel like they are effective in short term, most of the recent evidence supports exercise over other techniques for long term changes and relief http://www.apta.org/PTinMotion/News/2014/9/15/ChoosingWiselyRelease/. Your PT should prescribe you program that is individualized to your body, goals, and lifestyle, and leans heavily on active modalities. I encourage you to give your PT feedback about the relevance of any treatment you receive. If your PT reacts negatively, this could be a sign that you may need to find another provider.
In summary, you can follow these four easy steps to find the best physical therapist on the planet. This therapist will be one that is educated, experienced, and dedicated to working with you to provide effective care.