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.

8 comments:

Ed said...

Absolutely true and just not in the medical profession but other professions as well.

geri said...

Ayayay... thanks for the heads up, this should make me more cautious and questioning and less reliant on pharmacists.

You know, as Ed says, this is true for all professions here in the states, even with graphic artists. I too have contemplated on getting a masters but what another officemate said about not understanding why a lot of graphic artists spending more money and energy on masters when they should be working on putting together an impressive portfolio. And I believe this too. BUT I think this is an advantage only applicable to the creative field where you can show what you can do right away - it's different for the other fields I guess.

malor said...

I wrote this more than a month ago but unable to post it because of computer problem which I still have and unable to fix.

Anyway, Ed, I fee; good that you agree with me. I did not know that they keep on raising the educational requirments on other profession.

At Geri, You are absolutely right regarding creative field. It is difficult for people like us to prove our worth outside the title. Thanks for sharing...

malor said...

@Geri, I just want to clarify that not all pharmacists are bad. However, bad pharmacists do exist. We need to be in charge of our own healthcare.

Ed said...

In the engineering field, in which I work, there is a big push to get professionally licensed for all engineers. When I graduated, it was only for civil engineers building bridges, buildings and such. Also, the push isn't necessarily always to increase the education for little reward but to dilute the responsibilities of those in the field. An example of what I mean is that when I graduated, I spent 90% of my day doing hard core engineering. As the years have gone by, I end up doing less of that and more project management, people management, paper management, etc. Now I probably spend less than 20% of my time doing what I would call hard core engineering. Most of this latter thing I attribute to just the shift global markets and the U.S. shifting from a manufacturing giant to service oriented. As manufacturing companies have moved overseas and reduced in size, fewer employees means we have to take on more duties and engineers just seem to inherit a lot of them in a manufacturing climate.

To summarize, your post struck a chord with me because all I ever wanted to do was to become an engineer and now it is a profession that I probably wouldn't recommend to a person.

PhilippinesPhil said...

I've been insulated from this kind of thing, but it seems to spotlight at least one more reason why US healthcare costs continue to spiral upward. Instead of trying to find ways to make the costs less, all these health specialist oversight groups seem to be finding ways to justify even HIGHER prices for services. Its why a lot Americans now go overseas for operations and procedures where prices can be a fraction of what US hospitals and clinics charge. Dental is a perfect example for here in the Philippines. I pay for ALL my family's dental here out of pocket; it rarely takes more than a $25 for an extraction or a filling. A cleaning is less than $10. A root canal is about $150 or less. Even other procedures: my buddy just had a hip replaced for $9K, very affordable. American culture going down the tubes aside, healthcare costs alone make me wonder why I should ever go home again!

malor said...

@Ed, Thanks for the info. We thought engineering would be a good profession for our little boy. We do not want want him to be a P.T.

Anyway, in P.T., I would say the same thing too. Most of the things we learned in school and continue to learn from continuing ed as well literature cannot be appled due to Medicare restriction. We also spend a lot of time doing paperwork.

@Phil, I agree. My mother went home last April to have her dental work and cataract surgery. She has a big deductible in her insurance ($5,000. Insurance does not cver her needed denatal work which will cost her about 1500 dollars. She went back to RP and only spent about 1000 dollars for everything.

After reading your comment, I am thinking of maybe having my father go back home. He was diagnosed with pancreatic cancer stage 4. He has insurance but has a big deductible. The doctor is thinking he will just live 6 mos but they will do aggressive treatments for 2 to 3 mos. Then, I don't know. I will research more about these. I write about my father's illness in this blog really soon. I am just too busy with work right now. I have tons of paperwork. I have to do them accdg. to Medicare standard so we get paid...

PhilippinesPhil said...

Well, there are SOME procedures that are best not done here. Those that aren't done very often and those not done at the same high standards or with the latest technology. If he's stage 4, I think if the "aggressive treatment" is not a success I think I'd go for comfortability, and THAT can be a problem here. I've noticed about this place is that they let folks suffer, Chintzy on the pain meds, you know? You are right to research it first. If only the Philippines had Thailand's complete medical capabilities and standards! Now THAT would be awesome. Another issue for me about this country is that virtually everything is done on the cheap, even when they charge full price.