training of physicians

[MarathonRunner]

She does not want the legal liability for prescription writing, but she certainly thinks she could fully do so in this sort of case (and unambiguously ought to have been allowed to write the prescription for the CircAid tvelcro compression garments she used).   But rather than fight over whose judgment is correct in the meds case for PTs, why do you think the DOD allows PT military folks to do so?

Only in the Army/Air Force are PTs allowed to prescribe medicines, and it's in a very limited capacity with extra training. Good article on it and the impacts here, https://pubmed.ncbi.nlm.nih.gov/7732082/ and on the AF here, https://www.jba.af.mil/News/Article-Display/Article/769378/physical-medicine-flight-implements-direct-access-for-physical-therapy/

Reminds me that for many years (decades) in Canada, only the military had PAs (unlike the US). Now we have a few provinces recognizing PAs or having PA programs. The military has always been different. Engineering officers in the CAF, for instance, don't need a PEng or an engineering degree, as the military context is so different from the civilian one.

[kaysixteen]

1) eigen, you do realize that the Army article you linked to was from 1995, right?  And the USAF one was marked 'unavailable' as well.

2) Marathon_Runner, it does not make a difference, whether in Canada or the USA, what the context is, civilian or military-- if a military engineer can engineer a perfectly safe and usable bridge, he is capable of doing that, even if his level of education may well be considered inadequate in a civilian context, something which seems to make the civilian ed requirements not exactly necessary, but rather credentialism designed to perhaps boost engineer salaries.  The Canadian Army no more needs or wants unsafe construction on its bases than our army does.

[eigen]

1) eigen, you do realize that the Army article you linked to was from 1995, right?  And the USAF one was marked 'unavailable' as well.

Yes? Still a good article. Why would it being from 1995 be an issue when it appropriately covers the practice and outcomes?

The other article works fine for me, not sure why it isn't working for you.

[eigen]

She does not want the legal liability for prescription writing, but she certainly thinks she could fully do so in this sort of case (and unambiguously ought to have been allowed to write the prescription for the CircAid tvelcro compression garments she used).   But rather than fight over whose judgment is correct in the meds case for PTs, why do you think the DOD allows PT military folks to do so?

Only in the Army/Air Force are PTs allowed to prescribe medicines, and it's in a very limited capacity with extra training. Good article on it and the impacts here, https://pubmed.ncbi.nlm.nih.gov/7732082/ and on the AF here, https://www.jba.af.mil/News/Article-Display/Article/769378/physical-medicine-flight-implements-direct-access-for-physical-therapy/

Reminds me that for many years (decades) in Canada, only the military had PAs (unlike the US). Now we have a few provinces recognizing PAs or having PA programs. The military has always been different. Engineering officers in the CAF, for instance, don't need a PEng or an engineering degree, as the military context is so different from the civilian one.

Not sure if the history is the same in Canada, but PAs mostly came from military service in the US and then it got more common. It was intended for corpsman/medics with experience but lacking training to get an in depth didactic education. It's why the schooling for PAs has relatively little practical clinical training and most schools require hundreds to thousands of hours of paid clinical experience before admission.

[namazu]

And the USAF one was marked 'unavailable' as well.

Here you go!

NEWS | Oct. 8, 2015
Physical Medicine Flight implements direct access for physical therapy

By Capt. Chase Hamilton 779th Medical Operations Squadron
JOINT BASE ANDREWS, Md.  –  Over three of the last five years, musculoskeletal injuries, such as knee sprains, have been the number one reason for active-duty Airmen seeking care at a military treatment facility. They are also the largest reason for limited-duty profiles in the Air Force.

On May 5, 2015, the Air Force Medical Operations Agency directed all Air Force military treatment facilities to establish direct access for physical therapy care.

"Air Force physical therapists (PTs) have the ability to prescribe medications, order diagnostic imaging, issue profiles, and refer to advanced levels of care when appropriate. They are uniquely trained to act as physician extenders," said Physical Medicine Flight Commander Maj. Lance Mabry.

Malcolm Grow Medical Clinics and Surgery Center (MGMCSC) began offering "direct access" for patients seeking physical therapy treatment on Oct. 15, 2015. Direct access allows active duty service members who have musculoskeletal injuries to be evaluated and treated by a PT without requiring a referral from a physician.

"By allowing PTs to serve as front line musculoskeletal providers, we free our primary care managers to evaluate and treat more life-threatening conditions. PTs play an essential role in the healthcare delivery system, assuming leadership roles in rehabilitation, prevention and health maintenance," said Mabry.

At MGMCSC, active duty members can be evaluated by a physical therapist, without a referral, by calling 1 (888) 999-1212 to schedule an appointment. All other beneficiaries seeking physical therapy must obtain a referral from their Primary Care Manager.

For more information on physical therapy and direct access, contact the MGMCSC, Physical Medicine Flight at (240) 857-4074.

(Source)

[kaysixteen]

Thanks for sending me the air force article, namazu.   I do suppose ten years old is better than thirty.

eigen, would you really accept, in a science term paper, an article that was thirty yeaers old, if the student did not supplement this with,er, current references?  To not do this in a scientific field, actually in many other fields as well, is more or less Bibliographic Instruction 101 or Intro to Reference Librarianship, for MLS students.   Or am I missing something?  As the army article from 1995 tells me a great deal about army practice in, ahem, 1995, as well as the 1995 rationale for such practices, I would certainly read it if I were researching the history of whether, when, and why PTs get or do not get prescription-writing authority.  I did, however, not bother to read it to shed insight on current army practice or research/best practices now, since I could learn nothing about those things from reading this piece.

[eigen]

Yes? Papers from the 60s are still viable. Science doesn't "age out". Good work is often still good work.

What is your issue with this particular study and its conclusions? What do you feel has changed in the intervening time that makes them inaccurate?

Did you even read it before looking at a date and deciding it was a waste?

[kaysixteen]

No.  I did not read it, any more than I would give it to a patron researching the current state of military duties and privileges for PTs today, if approached with such a query at a reference desk.   It may well contain valuable information but it would not be necessarily currently accurate information.  Obviously either of us could google information which would definitively relate information on current DOD practices here across all services, but I am going to stick with my current PT's knowledge of this, which certainly postdates 1995.

I get that science does not always change, and there are loads of classic papers which would reflect the still-current best thinking/ research/ practices with which they are dealing-- the same is even more obviously true wrt papers in Latin grammar, clearly.  But when all one cites is thirty years old, one had best be sure that the old stuff is still the gold standard. This is perhaps even more important when seeking information about public or other policies, moreover.

[eigen]

I like how you're criticizing my sources for not being good enough when your source is "this person I met told me".

I'm getting pretty clearly that this was a thread for you to vent or complain rather than learn, so I think I'm going to stop wasting my time explaining things to you.

[kaysixteen]

I could say something like, 'and I am tired of explaining to a college professor, esp a tenured one, why sole reliance on a thirty year old reference is unacceptable in most cases, and it would be up to him to demonstrate why this is not one of those cases', and, 'guy on social media citing "someone I know" is not at all the same as citing a 20+ year veteran doctorate-holding working in-field professional, who is commenting now, in real time, to said citer'.  But maybe I should stop wasting my time, as well.

[MarathonRunner]

1) eigen, you do realize that the Army article you linked to was from 1995, right?  And the USAF one was marked 'unavailable' as well.

2) Marathon_Runner, it does not make a difference, whether in Canada or the USA, what the context is, civilian or military-- if a military engineer can engineer a perfectly safe and usable bridge, he is capable of doing that, even if his level of education may well be considered inadequate in a civilian context, something which seems to make the civilian ed requirements not exactly necessary, but rather credentialism designed to perhaps boost engineer salaries.  The Canadian Army no more needs or wants unsafe construction on its bases than our army does.

As the spouse to a CAF engineer officer who is not a PEng, let me just say you know nothing about the CAF military context. Zero.

[kaysixteen]

I could come from the far side of the moon, distinguished colleague, and I suspect that this would not change the fact that the Canadian Army no more wants unqualified personnel to be building bridges on its bases than the Martian one does, which certainly means that the personnel it assigns to this task are soldiers it deems qualified for this task, irrespective of their level of formal education.   Which is pretty much exactly what I said.

[kaysixteen]

I suppose I did not really have to devote any time to this task, but I had some time to kill and something to prove (you will especially note the dates in the links provided):

https://www.prnewswire.com/news-releases/physical-therapists-positioned-to-serve-as-primary-care-providers-throughout-the-us-military-302049661.html

https://www.adventhealth.com/hospital/adventhealth-winter-park/blog/physical-therapists-take-lead-militarys-team-based-care-approach

[eigen]

Did you read either of those articles? All they say is that patients wont need a referral to see a PT and that PTs can order imaging for patients. Both of those are quite reasonable and common even outside of the military, depending on your insurance provider.

I'm not sure what either has to do with prescribing medications or the discussion at hand though. In fact they pretty much exactly agree with the articles I provided that you didn't want to read.

No one disagrees with PTs taking a primary role in neuromusculoskeletal care. That's what they're trained for. But they don't have the breadth of medical training to provide care outside of that.

I'm guessing you don't understand what "primary care" means in the context of this article? Primary care just means a provider someone can see without a referral, or in other words: not a specialist you only see after someone general.

[kaysixteen]

I did think of this interpretation, actually, being, well, at least as intelligent as others here, despite the contempt shown for me.   I understand that maybe 'primary care' could mean as you think it does, except, perhaps, that:

1) the article explicitly says that the new policy is a reversal of older policies that required one to go to a primary care provider to get a lot of stuff that now they have decided, upon evaluation of, ahem, well, actual research, PTs have been shown to be able to do.

2) that PT of mine, whose knowledge of her field's current rules and policies is broadbased and vastly exceeds yours, explicitly has told me, and did so again last week, that PTs in the services can prescribe meds.

3) therefore it is logical for me to conclude I am right, and you are engaging in special pleading.