Thursday, June 9, 2011

Over-education for nothing?

When I first came here in the U.S., most Physical Therapists that I worked with just have their Bachelor's degree. Then, after few years, they required it to be Master's Degree. Now, it is a Doctoral Degree which means it requires to have 3 years of Graduate education to become a Physical Therapist. New grads call themselves doctors.

My husband and I think it is a ridiculous and unnecessary way to raise the cost of health care. The title holds so much promise but delivers so little. We cannot prescribed any medications nor diagnostic test. Medicare still requires physician's order before we can start P.T. treatments. RN's who only needs 2 years (4 years to have BSN) actually have more responsibilities than P.T.'s. The only draw is that insurance companies pay more for P.T. services compared to other allied health services, hence, pay is better. Average P.T. in the State of Iowa makes more than $70, 000 annually compared to RN which pay about $50, 000.

I admit to toying this idea of getting my Post-professional Doctor Of Physical Therapy Degree which many schools offer online. What stopped me going with it is that it will not really benefit me professionally. It will not raise my salary nor position. Nor my confidence which seems to be lacking. Nor make me several inches taller so many patients will be comfortable of me lifting them. Nor make me a better and happier therapist (I think).

Anyway, I am ranting about this because it's not just P.T.'s who are over-educated but also Pharmacists. I think they keep on raising the educational standard to keep the supply low and demand high. Purely capitalistic intention, in my opinion.

The other day, I called a pharmacist to clarify if my patient's new Fentanyl patch is a new dose prescription or an added dose to the existing patch he already has. The wife reports that she applied both patches which caused too much sleepiness. The wife refused for me to contact the primary physician who prescribed the patch because she is not very happy with that physician. So, to clarify the dosage, I called the pharmacist who filled the prescription. She (the pharmacist) told me that she doesn't know and that I should call the physician to clarify. I was disappointed by her response. I am a Physical Therapist( my medication knowledge is limited) and ,for Pete's sake, it's her responsibility to clarify the order, or, at least, know the answer to my simple question. Is she incompetent or just lazy? Maybe, she just doesn't care. Anyhow, this kind of mediocrity or indifference is not only annoying but downright dangerous. A non-professional person (pharmacy technicians) can dispense medications but what separates a professional from non-professional is the knowledge that they should impart to the clients, and their intermediary role between the prescriber and the client. The latter she clearly neglects. Anyway, I did the calling to the physician myself, going against the wife's request.

The same situation happens to me many times over working in home health. So many occasions, I found out that many pharmacists are not checking drug interactions despite the fact that they have the list of client's other medications. At one time, when I was working as a nurse in Dallas, a new pharmacist asked me what solution she's supposed to dilute the medication with. What in the world! Isn't she supposed to know this? She's the pharmacist. Or, at least, she should call the doctor or ask another pharmacist!

My point is people who are in charge in setting standards should evaluate their motives. I think the best education for healthcare professionals is the clinical experience. I don't deny the need for strong academic background but there are times you don't need to be in school for such a long time burdening students with astronomical loan when a bachelor's or master's degree sufficed.