If you have been active in social media for a while, you may have noticed that DPT students are participating in discussions about the current and future state of our profession. I am so encouraged by this passionate group, and really enjoy watching them think critically about important issues. One student that has impressed me for quite some time is Matt De Bole. I had the pleasure of participating in an APTA Roundtable discussion with Matt a few months ago: http://bit.ly/UzgfmM and we got to meet in person recently when Matt was in town over his Spring Break. He agreed to answer some questions I had regarding current DPT student education and the profession in general. He is bright, well spoken, passionate, and a sharp dresser (always in a bow tie). I look forward to seeing his career take off after he graduates. You can find Matt on Twitter at @MattDeBole and you can follow the #DPTstudent chat on Twitter every Wednesday night at 9pm EST.
Interview with Matt DeBole, SPT
1) Give readers a brief bio – where you go to school, when you will graduate, what you did prior to PT school
Having suspicions I would one day become a physical therapist, in 2008, I received my Psychology degree from Georgetown University with a concentration in pre-medicine. After earning a birth in the 2008 Olympic Track and Field Trials in the 1500 meters, I continued to pursue a professional running career for several more years. In the summer of 2011, I hung up the racing spikes and entered into the Doctor of Physical Therapy program at the University of Pittsburgh. I currently serve as class president as well as the 2012-2013 Director of the APTA Student Assembly.
2) What setting would you like to work in upon graduation?
To me, the most intriguing clinical setting I could join after graduation would be an orthopaedic outpatient facility that blends my understanding of athletes with my professional values.
3) What has surprised you the most about PT school?
That’s easy – I never knew I could work this hard. Yes, the curriculum is demanding, but I’ve been most surprised to find a passion for the physical therapy profession that prevents me from going to sleep at night and makes me wake up early in the morning. I’m surprised that I could enjoy and believe in my path so much!
4) Do you feel that your education has prepared you well for your future career?
While it’s been just shy of two years, with one more remaining before graduating, I could not have asked for a better experience at the University of Pittsburgh. Learning from a faculty that includes five Fellows of the APTA allows not just preparation for the NPTE but gives an incredible perspective on the profession in terms of the latest research, involvement opportunities and developing healthcare system. I’m excited to have a year of full-time clinical affiliations ahead of me to fine tune my practice before entering the workforce.
5) If you could improve one aspect of the education process for PTs, what would it be?
The cost of our tuition must come down. On the whole, it’s unrealistic to expect future physical therapists to accrue such incredible debts and not be persuaded to ‘follow the money’ when searching for jobs. Hopefully we can find ways to leverage technology in the classroom to help make this become a reality and allow new grads to focus on their outcomes and not their debts.
6) Have you received any business education in your program which would prepare you to own/operate a PT clinic?
As a part of our Leadership and Personal Development series, the final project involves working in groups tasked with developing strategies to address strategic planning, marketing, quality assurance, policy and procedures, staffing, asset acquisition, budgeting, facility layout, and rules and regulations. Each group has a particular practice setting such as acute care, skilled nursing facility, rehab facility, long-term care facility, nursing home, home health, or outpatient facility. So, while it might not be a formal business class, we are taught by a professor with their MBA and learn to apply business principals to real-world scenarios.
7) Did you find your CI’s to be up to date on research, dedicated to the profession, good mentors?
All of my CIs have been dedicated to the profession and good mentors, which has given me the chance to develop my very basic clinical skills. But, I personally feel as though I’ve experienced the spectrum in terms of their ability to be up to date on the research. Many CIs are clearly updating their practice habits based on the literature and expect their students to be as well. In these situations, there is a mutual respect when research from the CI is given to the student and the student gives the latest from the classroom back to the CI. Other times, I’ve encountered CIs stuck in their practice habits, viewing the latest research as a fad and resort to practice habits they feel most comfortable delivering. They’re resistant to using outcome measures, putting down the ultrasound wand or trying treatments not mentioned in a textbook.
8) What did you find most surprising when you were doing your clinical rotations?
Across the board, I was most surprised by how long it took patients to finally reach a physical therapist for the care they needed, and it seemed to happen for multiple reasons. Sometimes the patient delayed seeking any medical care and decided after months of pain that enough is enough; this speaks to the need to educate the public. Sometimes there was a delay to schedule with physician and an additional delay to schedule with a physical therapist; this speaks to the need to improve access in our system. And sometimes it took visits with multiple physicians to finally find one who would refer to physical therapy; this speaks to the need to educate other health professionals on our scope of practice.
9) What has been your favorite affiliation so far? Least favorite?
My favorite experience has been working in the University of Pittsburgh’s Student Health Service Physical Therapy Clinic alongside three classmates and with the program faculty serving as CIs. My least favorite setting was the skilled nursing facility even though the therapists and patients were both amazing!
10) Were you told in your program that the DPT was the key to gaining autonomy as a healthcare provider? Do you still believe this to be true?
Actually, very early into my time within the program, we were told that the word ‘autonomy’ was incredibly misleading. Yes, the advancement in degree will aid physical therapists in being considered by the public and other health care professionals to be experts who can make autonomous decisions within our scope of practice. However, this autonomy does not mean we can practice in silos, removing the collaborative nature of health care, which as a system provides care for the whole patient. I absolutely believe we need to pursue the DPT to gain this respect.
11) What is your (and your classmates) feeling toward non DPT clinicians (BS, MSPT, MPT)? Do you respect their years of experience as an asset or do you feel that they are inferior because they are not doctorate level practitioners?
Regardless of degree, whether it is a BS, MSPT, MPT or DPT, years of experience are an asset so long as they’re used for personal development. A year of bad experience repeated 25 times over isn’t the same as 25 years of learning, refining, tuning and improving. I can honestly say I have never thought or heard others consider those clinicians without a DPT as inferior. But, seeing the advancement in our profession over the past several decades, it does make me wonder why there is a hesitation of many clinicians to seek the transitional-DPT. Yes, there is the cost and time commitment in addition to possibly not seeing the proportional bump in salary, but shouldn’t all physical therapists be trained in medical screening, health promotion and wellness, pharmacology and diagnostic imagining? What happened to being life-long learners and the importance of public perception?
12) Over the past few years many of my colleagues have reported that they are shocked by the arrogance of DPT students in the clinic. Have you noticed this in your classes? In your rotations? Do you think that this is an accurate perception, or is there some sort of “communication generation gap” going on that experienced therapists are unaware of?
Though I haven’t noticed this shift in student behavior in the clinic over the years since I haven’t been around long enough, I hope that our physical therapy programs are producing more confident, knowledgeable, and progressive students than ever before. We ought to be getting our money’s worth! While I certainly won’t defend arrogance and believe we must continue to be respectful and professional, I will support those students who continually think critically and challenge the status quo. Opinions formed from sound clinical reasoning and biologic plausibility should produce good debates in the clinical setting, as we should all be looking to improve our patient-centered approaches. In this profession, we all must become comfortable with ambiguity and open to other perspectives. Rarely is there an absolute truth in physical therapy.
13) Some DPT students have made comments in social media that they “can’t wait until all the non DPT therapists retire.” I find this to be a rather shocking thing for a student to say. Have you heard other students make comments like this? Do you think they are making comments like this because they had a bad experience on a rotation or do they have a perception of all non DPT therapists as lacking in education and skills?
Yet have I seen or heard other students make comments similar to the one you describe. I would guess anyone making these comments is using the level of degree to reference a style of thinking. ‘Jurassic Park’ physical therapy practices aren’t going to survive in this emerging health care landscape and those who have failed to maintain best practices will either evolve or become extinct.
14) If you could say one thing to experienced therapists about current DPT students, what would you want them to know?
As DPT students, haven’t seen all of the changes you have seen take place in the profession of physical therapy. Some of the tenants of your practice may never have been taught or explained to us. Know that science and technology are rapidly advancing, and we have spent the past three years studying the most current information. Rather than seeing us as your career’s biggest threat, see us as physical therapy’s best hope. Use us as a resource so that we can both share our strengths and better our weaknesses to improve the entire profession.
Thanks to Matt for taking the time to answer my questions! I would love to hear the thoughts of other DPT students as well as thoughts from licensed PT’s on these topics. What have your experiences been?
Ann
Great post here! I definitely think it’s something we can all learn from–regardless of profession! So many professions seem to have a hatred for each other, but we must all learn to work together. That collaboration is so important for the patient!
One thing Matt noted was the time it took for individuals to make it to PT. And that is just so true! It’s amazing to me how long it can take for a patient to go from injury to the doctor and finally start rehab.
Mike,
Thanks for commenting. I agree that we have to think in terms of collaboration, both within the rehab profession (PT’s, PTA’s, ATC’s, MD’s)and outside of our area of expertise (psych, pharmacology,etc).
I also agree that we need to educate the public (and other healthcare professionals) about rehabilitation and physical therapy. This requires all of us working together!
Ann
Thanks for taking the time to answer these questions Matt and thanks Ann for providing a platform! I have a few random thoughts whose clarity and flow will be largely based on exhaustion and copious amounts of expresso.
I agree that the cost issue needs to be addressed – PT is not the wisest financial decision if your going into healthcare at this point.
One thing I wanted to mention is that I really don’t see students as either the “biggest threat” or the “best hope” we should look at PT students for what they are: individuals who will continue the work that many great PT’s currently in the trenches are doing. It is a continuum that started long ago and will continue through the time that the last PT ceases practicing (if that ever happens). To me both terms are slightly off putting. Obviously the issues with threat are implied in the term but the idea of students being the hope of PT conjures images of a last ditched stand in the face of overwhelming odds (cue up the idea of Frodo, Rand al Thorn, or any other hero) This could just be me however. We must continue to move forward but it is not all on our shoulders we are hear to assist those already out there in bearing the load.
On the topic of the DPT I want to be careful since this has been a very hot button topic. I do believe it is a move that has potential for leveraging our profession. I also think that the benefits that are inherent to it may have been oversold to a generation of students in order to ease the acceptance of a burdening debt in the face of shrinking returns. Much like you still have to have the requisite skill set and train hard to see benefits with the use of performance enhancing drugs, I see the DPT as an ergogenic aid that is useless alone but can accelerate our growth as a profession.
Finally I do believe that respect must be shown to those who have walked this path before us. However every generation should strive stand on the shoulders of these giants and leave the profession better than they came into it. So move forward confidently but maintain an eye to the past.
Scot,
Thanks for commenting! I agree with your statement: “Finally I do believe that respect must be shown to those who have walked this path before us. However every generation should strive to stand on the shoulders of these giants and leave the profession better than they came into it.”
I think that most reasonable people (including us old physical therapists!) are more than willing to listen to our student’s ideas, opinions, presented research, etc…it’s all in the way it’s presented. Students who come into clinical rotations with a chip on their shoulder make the experience difficult (I have seen this first hand). There is a time and place, as well as a technique, to present ideas in a non-threatening, collaborative way. I love having students, and really enjoy learning what they have to share; however, mutual respect needs to underlie all of these communications.
Ann
Absolutely Ann! I think as a student it is easy to focus on the fact that your CI may use modalities more than you like, or can’t quote your favorite guru verbatim, or any other specific issue. This becomes the focus instead of being placed into perspective. One of the best things I have done for myself is stepping back and trying to learn the decision making process instead of focusing on individual little areas I may disagree with.
I find that both in exercise and PT often the lack of key terminology is associated with being “wrong” “outdated” or “not getting it” which is a mistake. Step back, learn the system, learn the thought process, understand why the intervention was chosen. Then plug in whatever “modern” approach you like (PRI, DNS, SFMA, etc).
The key is to respect the system by taking the time to learn the process, language, and culture. Then make your decisions.
Very well stated. You can learn something from everyone – learn how that therapist develops relationships with their patients, watch how they demonstrate a caring nature, how they listen with empathy, how they manage to stay passionate after 15 years of treating 14 patients (or more) a day… I place a lot of importance on being up to date with research, yet there is a whole human component that goes into the work we do, both with patients, and with colleagues.
I wanted to share my 2 cents on a question that Matt raises in the interview. Matt asks: “seeing the advancement in our profession over the past several decades, it does make me wonder why there is a hesitation of many clinicians to seek the transitional-DPT. Yes, there is the cost and time commitment in addition to possibly not seeing the proportional bump in salary, but shouldn’t all physical therapists be trained in medical screening, health promotion and wellness, pharmacology and diagnostic imagining? What happened to being life-long learners and the importance of public perception?”
I can only speak for myself, but my reasons for not pursuing the t-DPT to date include exactly the reasons that Matt brings up: the cost and time commitment in addition to not seeing the proportional bump in salary. Current DPT students can NOT underestimate these reasons for some of us not pursuing the t-DPT. They are valid reasons. In my case, I am still paying back my undergraduate loans (I graduated in 1992), my loans for my MPT (graduated in 1998), and a mortgage. Additionally, I have two children who are very active in sports and school activities – one of whom is off to college herself in 3 years. At the same time, I started a business 1 1/2 years ago…you get my point – I went through 10 years of schooling to get my MPT (4 yrs undergrad, 3 years of working full time while taking a few more pre-requisites (physics, upper level stats..)and a 3 year MPT program. After 10 years of schooling and 21 years in this profession (ATC since 1992, MPT since 1998), the idea of going back into debt for more schooling for a degree that will not increase my earning potential is ludicrous.
I have been “trained in medical screening, health promotion and wellness, pharmacology and diagnostic imagining” through my MPT and through continuing education courses – in fact, in order to attain a direct access certification in Virginia, I had to take a course on these topics through the APTA (not a single thing in the entire course was new to me).
As far as being a life long learner, I have chosen to spend my money on continuing education courses that directly affect my earning potential, as I come away from each course with new skills and ideas, which allow me to set myself apart from other physical therapists, and provide quality care for patients.
Additionally, there is not a single state in the continental US that has gained true, unrestricted direct access since the inception of the DPT level degree. Not one. There are currently 17 states with true Direct Access and ALL had DA prior to 1990. HI gained DA in 2010.(And, even in states with unrestricted direct access to physical therapy, most patients AND their physicians do not know about it or understand what it means. We need to start there.
Ann
There are so many factors that will influence whether one chooses to invest time and money into something. Honestly the APTA and it’s vision hasn’t been successful at showing current practitioners without DPT the value of having one. The benefits must outweigh the costs and that’s the root of this ongoing conflict. Branding and marketing is important and if private practice owners are not going to have any true direct access and autonomy there’s no use flushing hard earned dollars down the toilet.
My choice to pursue DPT was primarily for marketing of my business & at the time last year the price was right. I’m fortunate that Maryland has direct access which made the bitter pill of going back to school to earn the DPT degree easier to swallow.
I agree, Monique, there are many factors that influence how people spend time and money, and the benefits need to outweigh the costs.
Something has to be done with the cost of tuition for DPT grads. As a new grad, my goals are to own my own facility with the visions and passions I want to focus on. As of right now I can’t even see the light at the end of the tunnel secondary to my loans at this point in my career. Less and less companies are offering tuition reimbursement depending on location. I have talked to fellow grads who wanted to do outpatient which is where our passion lies but we often thought of working in a SNF because that is where the money is right now. We shouldn’t have to go to the money or be hindered in our dreams as PTs.
Ryan,
I agree, tuition is a major issue. Did you know that you can sign a petition regarding loan forgiveness for physical therapists?
http://1.usa.gov/146Iw8V
Something that I failed to bring up by answering these questions is how much I believe in and the importance of membership within the APTA. The APTA exists so that we, as PTs and PTAs, can guide the direction of our profession as a unified group. While APTA is predominantly lead by PTs, it has an amazing staff who is equally as passionate in our mission to provide the best care possible for our patients and specializes in things such as PR, fundraising, lobbying, IT, communications, law, policy, insurance, research, finance etc. etc.. As a member, these resources exist so that you don’t have to be an expert in everything outside of PT and so you have a full time staff working toward the long term goals you have for this profession.
Not all PTs and PTAs feel the need to join an organization like the APTA and that’s a personal choice. However, if you choose to sit on the sidelines, you cannot affect the outcome of the game. So, when people ask me what the benefits to membership are, I don’t mention the access to latest evidence or networking opportunities. I’m more inclined to say that it gives them an important position on the field. As an APTA member, you become part of the team playing for the future of physical therapy. You might even have the chance to be a team captain and lead us. But, if you instead elect to not join the team, you are subject to being only as powerful as your one voice can be screaming from the grandstands.
I doubt most people realize that the leadership within the APTA is volunteer-based. They have electively committed their time and energy to play the game to the best of their ability for the sake of all- members and non-members alike. They aren’t omniscient and rely on the opinion and guidance of the team members to make decisions. With only 40% of our profession on the field its incredibly difficult to accurately represent the other 60% either in the stands or not even at the stadium.
The least we can do is contribute membership dues to join the team. Yes, they are expensive, but maybe we have to make some personal choices- like skipping a couple fancy dinners a year- to make it happen financially.
Imagine if we were all in one place, having these same frank discussions about the issues that get us fired up. Imagine what impact we could make by discussing these things in a forum where our leadership was listening and could be directed by our conclusions. Imagine what we could accomplish with a 200,000 member strong organization that is focused on building the profession.
If you aren’t an APTA member, I’d love the chance to hear why and help gain a better understanding of what I can do to get you on the field.
Thanks for posting this Ann (and Matt of course for being brave enough to answer these questions!).
You make very good points and are definitely ahead of the game in my opinion. I did not have any of these insightful answers when I was still a student. Not sure if it is different out there now (I’m only 5 yrs out), or if social media has definitely helped spread the word and allow Matt to be ahead of his time. Or, he is just smart like that 🙂
I do say as a CI, I strive to be up on evidence and address the newest information. I don’t nor plan to practice jurassic park style, but there is something to say about experience. I just had a student who was going for an interview (he is graduating in May) and wanted to know if he should ask about evidence they use at the clinic. I thought about it for a second but definitely pushed against this question. I haven’t had any arrogant DPT students or anything, but I can imagine this could be fretting to therapists who have been practicing for many years, or even yet, ones who do not keep up with evidence and participate under social media.
Overall great comments from Matt. I’ll be sharing with my interns.
Harrison
Thanks, Harrison! Good to hear from you! I agree that we can all learn from each other! Good communication and an open mind help the discussions.
Ann
The beauty of this Post (thanks Matt!) and replies is the PASSION for OUR Profession! That to me is the single most important component to moving this forward. What I love most about the engaged #DPTstudent(S) is their PASSION. When they challenge my beliefs or make statements I dont agree with I see that as an opportunity to have a discussion., not arguement. After 22 years in the Profession it is many times the PASSION of the #DPTstudent(s) that keeps me inspired and involved in things such as the APTA and #advocacyPT. So, yes I do see you “kids” as a BIG HOPE for my future.
Overall I agree with Matt’s comments. As far as respect for the past I have personally seen Matt “respect the past” I would say dont confuse his PASSION for disrespect. It happens frequently to all of us here.
I dont have a DPT and will not be getting one…..With that I believe the DPT is a very important component in Moving Forward PT! I respect Monique’s comment alot. She acknowledges why she got the DPT. That comes with incredible self awareness and being comfortable with who you are and who you aren’t.
And yes….join the APTA and your state chapter and you might actually be surprised by the POSITIVE change that occurs!!
Jerry,
I have also seen Tucker (formerly known as Matt)”respect the past” while looking forward to the future. I too enjoy the discussions and the sharing of different viewpoints. And, I love the PASSION!
Ann
Thanks for sharing this, Ann. And thank you, Matt, for taking the time to sit down to discuss this with her. While it is often the job of the therapist to motivate the student, I once again find that the roles can be reversed. Please continue displaying this passion for what you do; it will greatly improve your patient outcomes, improve your relationships with co-workers, and give you great satisfaction with your work.