Think about the hours you spend choosing babysitters, schools, pediatricians, and sports leagues for your children. Shouldn’t the same thought and attention go into choosing a physical (or occupational, speech, counseling) therapist for your child? Often times we hear that parents go wherever their pediatrician mentions, but is that the best fit for YOUR child? You have the choice to take your physical therapy referral to whomever you choose, it does not have to be the PT your physician mentions. Advocate for your child and make sure the PT you choose for them is the best match! What is best for one child, may not be the best fit for another.
Consider these questions when seeking care for your child:
1. Does the therapist have experience in pediatrics and in your child’s diagnosis?
I love to say Jack of all trade and master of none. Be wary of a physical therapist (or any provider) who says they are a specialist in everything. In the past week I referred out a patient with vestibular needs and another patient with women’s health and pelvic floor needs. To be an expert it takes time, experience, and reading, no one has the time to be a specialist in every area. Ask if the specific therapist you will be working with (not the clinic in general) frequently treats children, has knowledge of your child’s diagnosis, and what percentage of their caseload is pediatrics.
2. At the evaluation talk about goals, make sure your goals and the physical therapist goals align
Nothing is worse than beginning a process and realizing you have opposite views about the end result. Have an open discussion about your expectations and goals for your child. The physical therapist should take that into account in their treatment plan. They may have a different idea of goals and prognosis but should take the time to explain to you how they see your child progressing and what goals they envision they child meeting.
3. As treatment progresses, does your child have a connection with that therapist?
There are a lot of different personalities out there! If you start the process and it just isn’t working for you, don’t be scared to switch therapists. We want what is best for you and your family.
4. Who will be treating my child after the evaluation?
Find out if your child will work with the same therapist weekly and if they will be working with a therapist or therapy assistant.
Physical Therapy is an ongoing process and a puzzle that is put together piece by piece. If your child works with a different therapist each week, it is like you start the puzzle over again every time you are with a new therapist, they may be missing opportunities for growth. Additionally, having a consistent therapist gives the child a sense of comfort and safety when they come to therapy.
At many clinics, therapists evaluate and re-evaluate the patients while PTAs (assistants) carry out all treatments. Often times parents are not aware that the person they working with most frequently is not a physical therapist, but an assistant. Here is the difference between a PTA and DPT:
A PTA program is a 2 year associate degree which can include up to 18 weeks of clinical experience with no required pre-requisite work. The state practice act limits which manual interventions they can perform.
A Doctor of Physical Therapy Program requires a 4-year bachelors degree with pre-requisite courses relating to the body and how the body works before beginning formalized PT education. The formalized DPT program is at least 2.5 years post graduate work including up to 36 weeks of clinical experience before entering the field (twice as much!). In addition, many current physical therapists now continue through residencies, fellowships, or further certifications (for example mine is Schroth for Scoliosis) in addition to their Doctorate degree.
5. What type of continuing education has the therapist attended in the past 3 years? Was it in person or online?
I saw a quote the other day that said “Continuous Learning is a minimum requirement for success in any field.” This could not be truer for physical therapy; we consistently have new evidence and new tools being presented to our field. You want your physical therapist to be up to date and not practicing techniques that have since been proven ineffective.
Your physical therapist should be performing at least some of their continuing education in person. This field includes manual therapy, hands on facilitation, and an in depth understanding of the body. This just can’t be taught online, though unfortunately many therapists go through the motions of doing all required continuing ed hours the easy route, in front of a screen.
You are your child’s best advocate.
Physicians have a lot to stay current on while simultaneously fighting pressures to see increased patient caseloads. There may be a better match waiting for your child that your physician is not aware exists. Unfortunately, physicians are pushed to encourage referrals within their own system (Providence to Providence PTs, Scott & White to Scott & White PTs ect). They may be referring to their system because of administrative pressures to keep patients in the system, even when there is another therapist in town who is more experienced with your child’s specific diagnosis. Or referring to the clinic that recently gave them marketing materials because that is the pamphlet on top. We don’t want to think of our physicians and medical system in this light, but it is a reality. Often times the providers with the largest marketing budgets or within the same system get the nod from the physician. Your child deserves the best and you are their advocate.