An Analysis Of The Field Of Physical Therapy Sample Paper

The career that interests me is physical therapy. There are many different aspects to physical therapy. It is, defined as the treatment of physical dysfunction or injury by the use of therapeutic exercise and the application of modalities, intended to restore or facilitate normal function or development While doing research for my paper I talked to many people about the field of physical therapy. One woman said that contrary to what all the books say, she thinks that physical therapy isnt the field of work to get into because it is no longer a high paying career because there are so many therapists. On the other hand, a man that I talked to said that I should get into physical therapy because there is money in the field and that I would enjoy it.

Physical therapy puts to use skills that a person has learned to help someone get better. This aspect of helping others attracts me. In an attempt to learn more about this career, I arranged to do job shadow with Louie Greenwald, a physical therapist at Medical Associates Clinic with many years of experience, had lots to say on the topic. When I first went to Medical Associates Physical Therapy wing I was a little shaky. Louie was there waiting for me, he then took me to a nurse who filled out papers with me. After all the legalities were worked out she gave me a nametag and took me to where Louie was working with a patient. This was his favorite patient of the day for one reason. This was the last day of physical therapy for this man. Louie says its the best feeling to watch a patient progress to the point of being completely better. That was an inspiring beginning for me.

Throughout my shadow experience, I was able to see Louie work with a variety of patients. Each experience was unique and helped me to see a slightly different aspect of a physical therapists job. The next patient we went to see had shoulder problems. He was in chronic pain. Louie worked with this patient on a personal basis, which seemed to be greatly appreciated, by the patient. This man received an ultrasound on his shoulder, a machine to use at home for exercises, and therapy from Louie. Louie pulled this mans arm around until he hurt but when the man left he said he felt better. Louie also recommended the Dubuque Orthopedic Chair for the man to sit in to improve his posture.

I realized the level of competency a physical therapist must have to be able to feel confident that the pain they put the patient in is good and necessary. Next Louie and I had a break while his physical therapist assistants were preparing the next patients to see the therapist. Louie took me to his office and let me sit in his chair. The chair makes you sit correctly. He says that if people sat correctly they wouldnt have so many problems with their back, necks, and shoulders. Louie invented this chair; the design is his. He is trying to work out a deal with Flexsteel to build his chairs for him. Until the deal passes he has been assembling them in his basement. The chairs are very expensive. Seeing this surprising invention made me realize that physical therapists may develop other skills related to their job, which could connect them to a sideline secondary career.

While on break Louie told me that therapists couldnt make a patient better; its all up to the patients and how badly they want it. Our next patient was a slacker. She never did her exercises but pretended she did. Louie says the physical therapist always knows when the patient is doing the exercises. She asked Louie why she wasnt getting better and what was he supposed to say? She had a window of opportunity for a limited amount of time for her knee to get better, and the window was about closed. Louie put her in a machine that bent her knee for her. The pain she went through all because she didnt do the exercises was so obvious on her face. When she left I asked Louie if that was the last time that he would see her and he didnt know. All he said was, if a patient wont do their exercises and what I tell them to do, I cant do anything else for them. Another thing I learned from Louie was that in physical therapy there are so many techniques and tools available for treatment. If you dont know the right one to use you could hurt the patient. For instance, for someone who tore their ACL, the first two weeks they put ice on the knee; from then on they use heat. Both ways take the swelling down, but if you use heat first the swelling gets worse.

Louies last patient before his lunch break at 12:00 was late, so we had some time to talk. I asked him how much money he was making. Although he wouldnt tell me directly, he said you only start making a lot when youve been at it a while. Secondly someone who works independently will make more money than someone who works for a hospital. Then I asked him where he went to school. He told me he studied in New York at a small school. He said he liked the small school atmosphere much better than a big one. Next I asked him if all the classes that they make you take in high school and in college are really important. For instance, chemistry is a really hard subject for me and I was wondering if its really important for me to do well in it in order to be a physical therapist. Louie said I need to work really hard on my biology and my anatomy classes. Finally Louie told me that physical therapists never quit learning. They are constantly going to increase their skills.

The learning never ends. Overall I was very impressed with the impressions gained through my shadow experience. (Job Shadowing with Louie Greenwald, Medical Associates West) Physical therapists must go through lots of academic and clinical training. A bachelors degree is the minimum requirement. Clinical training includes rotations at physical therapy departments to gain hands-on experience. After graduation from a program therapists must pass an exam to become licensed. Some therapists pick a specialty area and receive a specialist certification. Therapists assistants train patients in how to use devices and equipment. Examples of this equipment are canes, crutches, and wheelchairs. They also apply, remove, care for, and cope with splints, braces, and artificial body parts. (Career Discovery Encyclopedia page 51, Internet Arkansas State University Physical Therapy Programs page 6,7, Internet Physical Therapist Online page 2, From high school to work pages 448449. Reference: Encyclopedia of careers and Vocational guidance pages 109.)

Physical therapists work in hospitals, clinics, and private offices. They treat patients in rooms, homes, and schools. Most therapists work 40 hours a week. The job can be demanding on the body with stooping, kneeling, crouching, lifting, and standing for long periods of time. Sessions with patients could be brief or last one hour or more. (Occupational Outlook Handbook page 170, Career Information Center fifth edition page 118, From high school to work page 450, Encyclopedia of careers and vocational guidance page 109.) Physical therapists help people who have been injured. Since they treat people of all backgrounds they should be outgoing, caring, energetic, and unafraid of close contact. A physical therapist first evaluates new patients to decide what treatment would best help them. Therapy can last from a few weeks to months or even years.

As treatment continues, physical therapists document progress, have evaluations, and sometimes change treatments. Some days a therapist works with outpatients (patients who are released from the hospital), and some days they work with inpatients (patients who are still in the hospital). Some days they work with both of them. (Career Discovery Encyclopedia page 50, Occupational Outlook Handbook pages 169-170, Internet Arkansas State University Physical Therapy Programs page 1, Internet Robl, Stacie page 5, From High School to work page 447, Reference Encyclopedia of careers and vocational guidance pages 107, 109.) A therapist cant forget that the patient has feelings too. Patients feel hopelessness and lack of confidence. Assistants sometimes need to improve the emotional state of patients and prepare them psychologically for treatments. Assistants also have to work with families to help them cope with reality.

In physical therapy there are many devices used in therapy. Parallel bars, stationary bicycles, and weightlifting equipment are all used. Heat is used in a variety of ways; whirlpool, paraffin bath, infrared lamp, heating pad, or electrical currents are all used also. Wheelchairs, canes, crutches, orthotic devices (braces and splints), and prosthetic devices (artificial limbs and body parts) are all helpful equipment used in physical therapy treatment. (From high school to work page 448.) Employment for physical therapists looks good. Hospitals employed 1/3 and therapists working in offices employed of all salaried therapists in 1994. Physical therapy is expected to be one of the fastest growing careers through the year 2005. You can gain experience while still in school. Students may get experience by volunteering or part-time work at a physical therapy department in a hospital or clinic. (Occupational Outlook Handbook pages 170-171, Career Information center fifth edition page117, From High School to Work page 449, Encyclopedia of careers and vocational guidance page 109.)

Physical therapy doesnt only stay in the hospitals and in clinics, but branches out to the army as well. Primary responsibility is rehabilitation of patients. In the Army youre involved in all phases of treatment. Your practice could involve an amputee care as one part of your many responsibilities as compared to the field of sports medicine, where cases are not usually so severe. In the Army, physical therapists are respected and considered as equals to other disciplines because everyone works toward the same goal of helping the patient. Some helpful characteristics for those in military careers are the desire to help others, interest in developing detailed plans and treatment, patience to work with people whose injuries heal slowly, and the ability to communicate effectively.

Earnings and benefits for a physical therapist range a lot. A salary for entry-level physical therapists is $33,000 to $35,000. More experienced therapists earn as much as $48,000. Therapists who work for government earn less; the starting wage is $20,000 per year; the average is $26,400. On the opposite end of the pay range, the top 10% of therapists averaged $61,776, a year. Therapists who have a private practice earn considerably higher wages. Benefits for salaried therapists are paid holidays, and vacations, health insurance, and pension plan. Self-employed therapists must provide their own benefits.

The practice of physical therapy has developed as knowledge of medicine and human bodies have grown. The war accepted the use of physical therapists to treat war victims. The polio epidemic in the 1940s led to a demand for therapists also. The American Physical Therapists Association now serves 67,000 members. (Career Discovery Encyclopedia page 51, Encyclopedia of careers and vocational guidance pages 107-108.) Physical therapy is one of the fastest growing occupations in the U.S. due to the population getting older. More people in sports create a demand also. There are not enough physical therapists to keep up with the demand. Being a physical therapist definitely has its benefits. You get to work with people all day, you dont have to sit at a desk all day in front of a computer, and you dont have homework to take home at night. You also get paid well and get good benefits. While writing this paper I have learned that being a physical therapist will be fun, but also will be challenging. It takes a lot of work to become a therapist and a lot of school and money. If you want to become a physical therapist you need to be serious about what you do and always be thinking ahead. Doing this paper has made me excited about my being a physical therapist. I hope that in the future things stay how they are now so I have the advantages that people have had ahead of me. My future plans are to attend the University of Iowa and study there to become a physical therapist.

The Many Benefits Of Physical Therapy

Physical therapy, by definition, is the treatment of a disease, deformity, or injury by physical exercise rather than the use of drugs or surgery. Physical therapy can help enhance a person’s mobility and body thus improving their health altogether. It is incredibly useful for those who suffer from arthritis, muscle strain, back pain, tendon or ligament issues, or want to promote post operative healing. Ways physical therapy can improve one’s ability to live a healthy lifestyle is by reducing or eliminating their pain, recovering from certain injuries faster due to past strengthening of muscles, and improving one’s mood. Physical therapy reduces or eliminates a person’s pain by a physical therapist teaching their patient proper exercises to increase their mobility and improve their overall lifestyle. PTs can achieve this by identifying which part of the body seems to be the weakest or most stiff and create treatments to reduce or eliminate that pain. Treatments can include aerobic exercise like cycling, jogging, swimming and strengthening exercises like squats, push ups, and lunges. Cycling improves your joint mobility and cardiovascular fitness, jogging strengthens your bones, and swimming reduces stress levels and improves your mood.

Squatting helps build your leg muscles, push ups can help create stability and balance, and lunges can effectively work your leg and glute muscles which can strengthen them and can increase hip flexibility. These all have been shown to have a very positive effect on the human body both physically and mentally. Another way physical therapy can help a person live a healthy lifestyle is by strengthening one’s muscles so that they can recover from injuries faster. Let’s say that you’re an adolescent athlete, for example, a baseball player in high school. Baseball is known for its repetitive throwing movements and if you’re an adolescent, you’re in the time period of your life where your bones are rapidly growing and those constant, repetitive movements can lead to painful injuries.

According to an article written by Ellen Shanley, PhD, and Chuck Thigpen, PhD, in the International Journal of Sports Physical Therapy, “The combination of repetitive throwing, weak physeal cartilage at growth centers, muscle tightness associated with rapid long bone growth, increased laxity of soft tissue structures, and decreased development of neuromuscular movement patterns may place the adolescent athlete at increased risk of upper extremity injury.”(1) With the help of a physical therapist who can identify the weak spots of the arms and shoulders in an adolescent baseball player, with proper exercises and movements to strengthen these areas like for example, your elbows, you’ll be getting fewer injuries or at least recovering a lot quicker from those injuries. Then, soon enough, you can be back out on the field playing with the rest of the team. The last way physical therapy can make a difference in someone’s ability to live a healthy lifestyle is that their mood can drastically improve. With the exercises your physical therapist recommends you to do, studies have shown that exercise can drastically improve how you feel overall.

According to James Blumenthal, PhD, “There’s good epidemiological data to suggest that active people are less depressed than inactive people. And people who were active and stopped tend to be more depressed than those who maintain or initiate an exercise program.”2) Blumenthal conducted an experiment to explore the connection exercise had to one’s mood. Through a series of randomized trials, he took sedentary adults and separated them into four groups: one group that will do supervised exercise, one that will do home based exercise, one that will take antidepressant therapy, and one that will receive a placebo pill. After following up with the patients after one year, the active subjects reported having lower depression at the one-year follow up than the less active groups did. This shows that while the exercises can make you stronger and healthier physically, it can also help you feel better also. The exercises seemed to have served as a form of physical therapy to those with major depressive disorder, making them feel better than they did before the exercise. Physical therapy can help tremendously if we abide by the doctor’s orders and our exercise regimen. It can help us physically by strengthening our bones and muscles, eliminate or reduce any pain, and improve our mood for the better. Physical therapy can be one of the great ways to live a healthier lifestyle, especially if you’re one who doesn’t like the idea of going under the knife or being on so many prescription medications. With more people opening their eyes to the benefits of physical therapy, there would be more people exercising and, as a bonus, possibly a lower number of surgery bills in the future.

The Problem Of Ethics In The Physical Therapy Profession

One of the most rapidly growing occupations in the United States today is Physical Therapy. The United States Department of Labor has projected 23,000 unfilled physical therapist positions in the year 2000 and a lack of qualified physical therapists to fill them (www.apta.org). While Physical Therapy grows rapidly, questions of ethics in this field have also grown in large quantities. Physical therapy is the treatment of disease through physical means, including light, heat, sound waves, electricity, magnetic fields, and exercise (www.byu.edu). This means that therapists use many different forms to treat people, and treating people can be a large challenge because of all the different possibilities that could occur with the different treatments. Physical Therapy is a very rewarding and lucrative profession if the problems that come along with the job are dealt with in a capable manner.

The main problem with Physical Therapy is the problem of the ethics of the profession. There are many ethical conflicts such as how to charge based on your services, and what types of services to give to each individual patient. To guide physical therapists in their decision making the American Physical Therapy Association came up with a code of ethics for its members to set their standards to work by. Their members are required to work by this code and are also required to maintain ethical practices. The first principle in their code is to respect the rights and dignity of all individuals. This includes all patients, employees, and co-workers. The second principle is to comply with all of the laws and regulations governing the practice of physical therapy. Physical therapists learn these laws in school before becoming a therapist. The third principle is that they must accept responsibility for their actions and exercise sound judgment. Every therapist must own up to their mistakes, and take responsibility for their patients. 

The fourth principle is that they must maintain and promote high standards for physical therapy practice, education, and research. No therapist should ever compromise his or her beliefs for any reason. The fifth principle is that they must seek remuneration for their services that is deserved and reasonable. This means that they should be paid for the work that they do, but that the pay should be a reasonable amount. The sixth principle is that they must provide accurate information to the consumer about the profession and about those services they provide. This includes a thorough explanation of what they will be doing while servicing a patient. The seventh principle is that they must accept the responsibility to protect the public and the profession from unethical, incompetent, or illegal acts. This means that if they are aware of any unethical acts, they are obligated to report them. The eight and final principle is that they must participate in efforts to address the health needs of the public (Code of Ethics).

These principles have been addresses, but there are still many problems in the system. To assess some of the problems that therapists feel are important, many surveys are conducted. One survey by the United Kingdom National Health Service wanted to compare ethical contexts and themes, so they sent a structured questionnaire to many different physical therapy groups around the country. The therapists filled out the questionnaires and the results found that the most common ethical problems among therapists in the United Kingdom were dangerous behaviors in patients and unprofessional staff behavior. Their second biggest concern was resource limitations and treatment effectiveness. These findings suggested that educators of future physical therapists need to make students aware of work settings and the interdisciplinary nature of employment as well as principles held by individual therapists (Barnitt).

The American Physical Therapy Association also conducted a study to identify current ethical issues and also issues that may be faced in the future by therapists. They used a technique called the Delphi technique, where a panel of experts was selected and the experts responded to questionnaires stating their concerns with ethics. The experts narrowed their concerns down to three categories: patient rights and welfare, professional issues, and business factors. The experts chose six patient rights and welfare issues, five professional issues, and five relating to business factors to be the most important. The first issues addressed, the patients’ rights and welfare issues, were the primary concern of the panel of experts. The issues at hand focused on interactions, confidentiality, sexuality, and consensual issues between doctors and patients. Any interaction between a doctor and patient should be understood and clear. Sexual activities between doctor and patient should be prohibited, and all interactions should be ensured as confidential.

The second issues faced were professional ones. These issues dealt primarily with policies and relations between health professionals. Some issues listed in this category were maintaining clinical competence, supervising personnel, taking care of the environment, and reporting any misconduct of others. Therapists should be competent in their work, their personnel should be supervised at all times, their environment should be sanitary and clean, and they should feel obligated to report and wrong doing of their peers. The third and final category discussed was business and economics. The issues outlined in this category included appropriate fees, advertising, endorsement of equipment, exploitive business relationships, and billing fraud. Physical therapists are expected to charge appropriate fees for their services, they are expected to advertise fairly and truthfully, they should endorse equipment without exploiting themselves or others, and they should bill fairly and justly for their services (Triezenberg and Purtilo).

A few of the future ethical problems they outlined are the over-utilization of services, the protection of the patientis rights, the justification of the appropriate fees for the services rendered, the ethical guidelines for the use of human subjects in research, and responsibilities of physical therapists. The over-utilization of services would be using the service too much. The protection of the patientis rights includes privacy issues. The justification of the appropriate fees for the services rendered would be proper billing. The ethical guidelines for the use of human subjects in research includes making sure the human subjects are not harmed in any way, and are treated fairly. The responsibilities of physical therapists include their duty to respond to environmental issues, as well as social issues (Triezenberg and Purtilo).

Since one of the main problems addressed by the therapists surveyed was the behavior among their co-workers and patients, some of these behaviors should be examined and explained. The elderly are one of the largest groups of people that partake of the care of Physical Therapists. Sometimes, though, their care is not quality service and they can often be cheated out of money. One study on Physical and Occupational Therapy in Nursing found that even though patients received the therapy needed and their wellness improved because of it, 13% of the patients were not properly billed, and 4% were not documented properly in the patientis medical records. Some reasons for being billed improperly were that the people providing the services were not qualified to do so, therefore they were charging for a job that they were not authorized to do. Another report, “Physical and Occupational Therapy in Nursing Homes: Cost of Improper Billings to Medicare,” estimated amounts of money that were billed or documented improperly during a one year period ending June 30, 1998. They estimated that $1 billion for improperly billed physical and occupational therapy and $331 million for improperly documented physical and occupational therapy was paid by Medicare to these workers (How to Fix Therapy Services).

The government has taken many steps to fix these problems. The main government agency for these problems, Medicare, has done many evaluations and reviews to ensure things are being done right, especially in nursing homes. Medicare is now requiring more documentation regarding health care and is also making sure that all employees are aware of the guidelines that they set. Medicare is also making sure that therapists and assistants clearly know their job role, and do not do work that they are not authorized to do (How to Fix Therapy Services). Any unauthorized work would be done a physical therapistis assistant. The American Physical Therapists Associationis Guide to Physical Therapists Practice outlines the role of an

assistant to a physical therapist, and states what they can and cannot do. First of all, any kind of therapy should always be lunder the direction or supervision of a physical therapist.l Therefore, if any sort of therapy is done by the assistant and is not under supervision of the therapist, then nothing in the prognosis should be represented as actual physical therapy (Guide to Physical Therapist Practice). These sorts of practices are also being investigated and fixed by Medicare services. These are just some ethical problems that Physical Therapists deal with every day. Therapists can help prevent any problems by conducting their practices following the guidelines set by them, and by avoiding any problems that have been foreshadowed for the future. There will always be ethical problems in businesses, but by working together therapists can help improve conditions and eventually fix them.

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