Not all are altruistic

Not all are altruistic

 

I want to congratulate this student for getting published before graduation. This is a great feat and kudos to you. Now the student makes great points, but I doubt that this student is at the bottom of his class. Not all can be amazing students. Someone has to be the student that brings the average down. Nothing wrong with that, but unfortunately, anyone lower than the highest-grade earner will be that student. Someone wrote this article on the “awesome-side” of the bell curve. I retort using the “not so awesome side” of the bell curve examples.

 

  1. “There is a way to meet these goals (increased productivity demands), a simple and safe way that bypasses the “high-risk, high-reward” decisions that practice owners face when on the brink of future growth of their company: Add a student into your clinic”

 

This is coming from a student!? Look, I love taking students. I am a credentialed clinical instructor (this means that I have taken a course to learn how to work with students). I completely disagree with the above statement. From a business perspective, we should not be using students as free labor in order to pad our profits. These students are paying for the right to be in the clinic. Our primary objective as clinical instructors is to produce the best therapists that our ability allows. If I treat a student as a therapist, then I am doing the student a disservice by asking them to do the work that I usually do, and then going off to do more work in order to increase the companies bottom dollar. There has to be a line drawn in the sand regarding business ethics.

 

  1. “I have experienced good clinics, bad clinics, and great clinics; and I have noticed certain characteristics that tend to separate one from another”

 

I’m sorry, but as a student, the sample size is very small. To say that one has seen great clinics is a far reach since, in my opinion, they are few and far between. It is rare to be in a clinic in which the bottom dollar is secondary to patient outcomes. This will be changing in the future, but not anytime soon. For additional information, please see: http://www.mechanicalcareforum.com/podcast/97)

 

  1. “…students can be your safe haven for boosting morale”

 

I haven’t seen this as much in my career. There are those “go getters”, but this is just as rare as finding a “great clinic”. When looking at the bell curve of PT classes, there are only so few on the awesome side of the bell curve. Mostly, students coming out of PT school are average in my experience. Every once in a while, we get the student that has the potential to change the profession, but again…few and far between.

 

  1. “…having a student in their second or third year of physical therapy school who can take half or one-fourth of your caseload can save you time to work on documentation while maintaining clinic productivity standards”

 

This is where the shit hits the fan. Most students coming out of school have not mastered biomechanics. If a student can’t step in and do my job, including my clinical rationale, then I should not be using this student to bolster “my productivity” because the student will not be giving “my quality”. Some therapists come out of school and after 3 years are no more than overpaid personal trainers. Again, this doesn’t apply to all, but to believe that a PT student can come out of school and do my job with my experience leads me to believe that I am overpaid. In 8 years of practice and having well over 50 students, I have only had two that could possibly take my job. Again, these two were rock stars. They have the potential to change the profession. All other students needed to be built into clinicians. This does the opposite of improving my productivity because I am now spending time that would have been spent on paperwork in order to teach the future of our profession. I have had very few failures, but also very few rock stars. The rest start as average and become clinicians as the weeks progress.

 

  1. “Another benefit of having a student is that they can keep you up to date with the latest evidence”

 

Again, this is another fallacy. There are clinicians out there that don’t know how to research. I believe that Jensen (many will cite this article about PT’s that don’t research) states it clearly that the longer you are out of school, the less likely you are to perform research. That doesn’t mean that the newer grads coming out of school are much better at interpreting research beyond an abstract. I have encountered many abstract readers, but few students that can break down the article to actually tell me if it will affect my clinical outcomes. As you can see though, I also am spending time making myself better by reading the “latest evidence”.

 

  1. “What better way to create a legacy than to help students practice with the same methods that helped you prosper?”

 

It took the author many pages of writing to get to the heart of why many of us take students. I am looking to create amazing clinicians that feel confident in their abilities. My goal is that for any student that goes through me to become a Doctor…Doctor…Doctor of Physical Therapy, will earn that title. If a student has me as a CI, it will be a rough clinical, but I guarantee that the student will be much better off for it. This is why I do what I do!

 

Quotes taken from:

 

Sinacore A. SIMPLIFY! How adding a student can amplify growth. IMPACT. April 2016:40-46.

Author: Dr. Vince Gutierrez, PT, cert. MDT

After having dedicated 8 years to growing my knowledge regarding the profession of physical therapy, it seems only fitting that I join the social media world in order to spread a little of the knowledge that I have gained over the years. This by no means is meant to act in place of a one-one medical consultation, but only to supplement your baseline knowledge in which to choose a practitioner for your problem. Having completed a Master of Physical Therapy degree, the MDT (Mechanical Diagnosis and Therapy) certification and currently finishing a post-graduate doctorate degree, I have spent the previous 12 years in some sort of post-baccalalaureate study. Hopefully the reader finds the information insightful and uses the information in order to make more informed healthcare decisions. MISSION STATEMENT: My personal mission statement is as follows: As a professional, I will provide a thorough assessment of your clinical presentation and symptoms in order to determine both the provocative and relieving positions and movements. The assessment process and ensuing treatment will be based on current and relevant evidence. Furthermore, I will educate the patients regarding their symptoms and their likelihood of improving with either skilled therapy, an independent exercise program, spontaneous recovery or if the patient should be referred to a separate specialist to possibly provide a more rapid resolution of symptoms. Respecting the patient’s limited resources is important and I will provide an accurate overview of the prognosis within 7 visits, again based on current research. My goal is to empower the patient in order to take charge of both the symptomatic resolution and return to full function with as little dependence on the therapist as possible. Personally, I strive to be an example for family and friends. My goal is to demonstrate that success is not a byproduct of situations, but a series of choices and actions. I will mentor those, in any way possible, that are having difficulty with the choices and actions for success. I will continue to honor my family’s “blue-collar” roots by working to excel at my chosen career and life situations. I choose to be a leader of example, and not words, all the while reducing negativity in my life. I began working towards the professional aspect of the mission statement while still in physical therapy school. By choosing an internship that emphasized patient care and empowering the patient, instead of the internship that was either closest to home or where I knew that I would have the easiest road to graduation, I took the first step towards learning how to utilize the evidence to teach patients how to reduce their symptoms. I continued this process by completing Mechanical Diagnosis and Therapy courses A-D and passing the credentialing exam. I will continue to pursue my clinical education through CEU’s on MDT and my goal is to obtain the status of Diplomat of MDT. Returning back to school for the t-DPT was a major decision for me, as resources (i.e. time and money) are limited. My choice was between saving money for the Dip MDT course (about 15,000 dollars) and continuing on with the Fellowship of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT) (about 5,000 dollars), as these courses are paired through the MDT curriculum or returning to school to work towards a Doctorate of Physical Therapy degree. I initially planned on saving for the Dip MDT and FAAOMPT, but life changes forced me to re-evaluate my situation. The decision then changed to return for the tDPT, as my employer paid for a portion of the DPT program. My goal for applying to and finishing the Dip MDT and FAAOMPT is 10 years. This is how long I anticipate that it will take to finish paying student loans and save for both programs, based on the current rate of payment. I don’t know if I will ever accomplish what I set forth in the mission statement, but I do know that it will be a forever struggle to maintain this standard that I set for myself.

2 thoughts on “Not all are altruistic”

  1. Wow, it sounds like this student is totally missing the purpose of the clinical experience. As a current PT student I view my CI as someone I can learn from, I want to be a sponge and soak up everything I can from them. I want to see how they interact with patients, how they choose to examine them and how they reach their clinical decisions. In no way do I think I am there to help them with or do their job for them to take a load off or help increase productivity (nor do I think I am anywhere near qualified to do their job!). I think one of my strongest assets going into my clinical experience is knowing that I DON’T know everything (or really much of anything for that matter!) and to take advantage of every learning opportunity I can. My hope is that I end up with a CI who has the same beliefs and good intentions that you express and that their goal is to make me a better clinician, NOT to take some work off their plate! Thank you for sharing.

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    1. Thanks for the comment. That is the attitude that students need to have going into a clinical. I take students almost year round and prior to a student coming to my site, they get a pamphlet of presentations and research articles to read. My goal for every student is for them not to have to waste the 9 years that I spent reading and learning (for the record, my years weren’t a waste for the patient, but if the student can get a head-start from where I started and I don’t give them the head-start then it would be wasted for that student). Good luck and if you have any questions feel free to reach out.

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