Re: role of techs

January 24, 2012

,

All very well said, and I apologize again for how some of my comments came

across. I see how my comment of, " I may as well just be a technician " could have

been construed as degrading. If you read any of my posts from last night, you

will see that I was a veterinary technician (non certified, but was performing

vet tech duties and was very proud of my skills and respected greatly by the

vets that I worked for) for 9 years before pursuing physical therapy school. My

intention was to say, that as far as compensation goes, if I was only getting

21% of $70 an hour, that would be closer to technician pay, and all my schooling

and student loans and expertise that I learned along the way would not have

served me. I highly respect the role of the veterinary technician and they are a

vital part of the team.

As far as the comment about would a veterinarian who takes a two week course in

human therapy techniques and anatomy be able to work on humans even under the

supervision of a PT, seems fairly irrelevant. The therapist is bringing a skill

set and it is our occupation and the skills are needed to add to the team and

supply best practice as a whole. A vet would not be bringing needed skills to

supply physical therapy to the human world. I feel that your comment was

unnecessary. I don't think anyone was trying to say that veterinarians or

veterinary technicians should not be involved or that rehabilitation on animals

is not a part of veterinary medicine. I feel most comments have been positive

regarding the team approach of having everyone involved and respecting each

other for what we can all bring to the table. I for one, had no intention of

presenting any other thought.

>

> Thanks Dr. Wall for your comments, they are greatly appreciated. I feel very

fortunate to work in veterinary medicine and at a facility that supports and

promotes rehabilitation. I am also very proud of the fact that I am a

registered veterinary technician. In veterinary medicine, the term technician

is a broad statement, but to educate those who may not understand, an RVT, LVT,

or a CVT is a graduate of an American Veterinary Medical Association accredited

program. These programs offer an associate degree, which can also lead to a BS

in veterinary technology from many different institutions. These programs offer

in-depth courses in pharmacology, anesthesia and surgery, parasitology, and many

other courses including in-depth anatomy. The anatomy instruction is very

in-depth and is more than a few day course offered in a certification program.

One of my current goals is to work with the American College of Veterinary

Sports Medicine and the National Association of Veterinary Technicians in

America to start a Veterinary Technician Specialty (VTS) certification for those

RVT's who would like to seek additional in depth training in the field of sports

medicine and rehabilitation to increase the knowledge base of RVT's involved

rehabilitation, and to help us earn more professional respect. Please consider

the training of veterinary technicians before labeling them with just the term

" technician " .

>

> With that being said, as I read all of the various posts related to

compensation, I do find the statement that " I'll just go be a technician " to be

very offensive. I have been involved with rehabilitation for several years and

I observe this same mindset all the time. I greatly respect the knowledge base

and techniques that physical therapists bring to the table. They have an

overwhelming amount of knowledge with modalities and manual therapies and other

techniques. At the same time, in most veterinary practices, technicians are a

valuable commodity for the hospital due to their training. Veterinary

technicians will never have the knowledge that PT's do with manual therapies,

but a lot of veterinarians utilize technicians for rehabilitation because on the

slow days, the RVT can run anesthesia, take radiographs, provide restraint for

aggressive animals, give sedation when required, and fulfill a lot of roles in a

veterinary practice that others haven't been trained to do.

>

> From the veterinarian perspective, if a veterinarian took a two week course in

physical therapy techniques and human anatomy, would they be allowed to work on

humans even it was under the supervision of an MD or a PT? Absolutely not. The

point of this statement is to allow everyone to remember that rehabilitation is

a part of veterinary medicine and veterinarians and veterinary technicians will

always be involved. Without question, PT's are a valuable asset to this

profession as well, and instead of everyone pointing fingers about who is the

best care provider, let's think of our patients that we serve and do our best to

better develop our collaborative relationships to improve the quality of their

lives, regardless of who provides the care.

>

> From: VetRehab [mailto:VetRehab ] On Behalf Of

Unifour Referrals Rehabilitation

> Sent: Tuesday, January 24, 2012 8:39 AM

> To: VetRehab

> Subject: re: compensation / role of techs

>

> Thank you . I'm glad an RVT finally stepped into this conversation.

My clinic is not so modernized that the RVT's are fully utilized. But I feel

that being the only RVT that is specialized, I am more utilized then others. I

do 95% of the work in rehab. Including designing the rehab plan for each pet,

doing all the modalities, designing diet plans, and speaking with owners about

the progress of their pets during the process, with a veterinarians supervision.

I am not compensated any differently then the other employees in the clinic. The

clinic did pay for my schooling completely to become a CCRP but, there are

employees here that are not registered that make more money then I do. I have my

own clients and case loads. I'm glad your clinic is up to date on it's way of

thinking about the people who have taken the initiative to learn and perfect

their skills!

>

> Veterinary Referrals Hospital of Hickory, Rehabilitation Angie , RVT,

CCRP Find us on Facebook!

>

January 28, 2012

I find all the points of view interesting. As a rehab tech, I can say that

unfortunately we get " stuck " many times. It is not uncommon for a DVM or PT in

the practice to sidestep and leave the tech responsible for way more than they

should be. For example, do the initial consult and the leave everything up to

the technician. Deciding on what modalities,how often,when to modify- pretty

much the entire case. And I know a few that have had the initial consult turned

over to them.

Believe me, no technician wants to be put in the role of the entire rehab

department. And if we object, or heaven forbid stand up for the " best interest

of the patient " and demand more support from the DVM, we get written up,layed

off,or pushed until we resign. And unlike the DVM or PT who can just start their

own practice or go to the next clinic, we have to quit doing rehab or relocate

if there is no other facility close. I have been there!

I am passionate about rehab and find it very unfortunate that in some aspects it

has been more about " be the first to offer rehab in town " or about the bottom

$$$ and that the best interest of the patient is dwindling. Rehab is the most

intense yet most rewarding thing I have ever done in veterinary medicine. And

the benefits are obvious. No tech should have to decide between keeping their

job and doing what is right and no practice has the right to expect that. I find

most rehab techs to be dedicated and passionate and a great asset to the

facility. They should be used to their full capabilities but should have a

support structure as well.

I am very thankful to be in a facility that is passionate about patient care

above anything else and is thankful to have me as part of their TEAM. Now, let's

kick some butt and help these patients!

Sherri Jerzyk,CCRA.

Veterinary Specialty Center of Tucson

>

> Hi to everyone involved in this interesting discussion that has morphed into

something much more emotional. I applaud for finally being the brave one

to acknowledge the elephant in the corner which is the where exactly does the

human physical therapist fit in the veterinary rehab field, what is their status

in veterinary medicine, what is their status compared to the licensed veterinary

technician and what is their status compared to the licensed veterinarian? It

is rather a gray area as both the CCRP and CCRT programs see the PT at the same

level as DVM in their certification but the CCRT program sees the technician as

only an assistant in their program. The ACVSMR does not recognize either the PT

or the licensed veterinary technician (LVT) as a potential member.

>

> The CCRT being only for the DVM or PT has never seemed quite right with me. I

think there are many ways that you can look at the individual roles of the DVM,

PT and LVT. The team approach, such as the team of DVM, PT, LVT all equal or

the team of the DVM and PT as superiors with the LVT as an assistant, or the DVM

as the superior and the PT and LVT as assistants. However I have always

wondered how it is that the non-veterinary but human trained PT got to have the

same status level of the DVM in veterinary medicine. For that matter I also

wonder how it is that human chiropractors, massage therapists and acupuncturists

have come to this same status.

>

> Before I jump into my opinions on these questions, let first give information

about the training of the LVT because I think it is important to identify the

knowledge base that the LVT brings to the team. I have just been part of a

group that has set up the curriculum for a veterinary technician school on the

campus of Central Oregon Community College and OSU-Cascades here in Bend. It is

a 2 year program with three 4 month long terms each year, so two full time

years. The curriculum includes anatomy and physiology (3 terms), veterinary

terminology, hospital management, animal nursing (4 terms), Animal Diseases (2

terms), Clinical Pathology (4 terms – includes microbiology, parasitology,

virology), Pharmacology, Anesthesiology, Surgical techniques and nursing,

Radiology, Dentistry, Public Health and then a total of 360 hours worked in

veterinary clinics spread evenly over Small Animal, Equine, Food Animal and

Emergency Practice. Graduates of this and other LVT programs in O

> regon then go on to take a national exam and then if they pass it they take a

state jurisprudence exam. I think for the benefit of the LVT this is all

important for everyone in veterinary rehabilitation to understand.

>

> Now about that elephant, the frank reality that we are all avoiding is that

the PT has no veterinary training other than what they learned in their

certification course or learned in their practice experience. Either way there

is no formal training. This does not mean that I think that the PT is not an

important asset to the practice of veterinary rehab or that they don't come with

a unique set of manual and modality skills and knowledge. They do and way more

so than I do and my technicians do. This simply means they have minimal if any

training in veterinary medicine and they only have training in one species,

humans. Regardless of whether this is offensive to some, it is the reality and

it is an important point. This is why I have always thought that the DVM should

be the CCRT and the PT and LVT should be the CCRAs or better yet be like the

Tennessee program and have CRI make all three the CCRT. I have always

personally thought that what the PT brings to the veterin

> ary rehab table is a set of hands on skills that can be directed to be used,

to assist in, and consult on, the treatment of the patients of the DVM. Perhaps

being considered a consultant or a collaborator would be a better way to view

it? What the PT is not is a DVM or an LVT. The LVT is trained in veterinary

medicine and that is something that should not be discounted by the rehab

community.

>

> When I read statements like:

> " As far as the comment about would a veterinarian who takes a two week course

in human therapy techniques and anatomy be able to work on humans even under the

supervision of a PT, seems fairly irrelevant. The therapist is bringing a skill

set and it is our occupation and the skills are needed to add to the team and

supply best practice as a whole. A vet would not be bringing needed skills to

supply physical therapy to the human world " ,

> and this statement,

> " It's my understanding that LVTs also are NOT to do manual therapy i.e. joint

mobs. Our (CCRP) tech certainly does not. She IS a certified (human) massage

therapist and she does a lot of massage on the dogs; she has good hands and good

eyes and does a lot on her own and comes up with all kinds of good exercises but

she does not evaluate (except in a general sense of how the dogs are doing) and

does not do manual therapy and so it still falls to me or our PT to evaluate on

first visits and frequently re-eval on the fourth to sixth visit and sometimes I

see them even more frequently and some dogs are seen almost exclusively by our

PT "

>

> I think of several points. First, of course, a DVM or LVT would not be

bringing anything to the human field. But that is not the point. The point is

that the PT is not bringing any veterinary medical skills to the field of

veterinary medicine, yet is being allowed to practice in our field without any

formal training in veterinary medicine. Animals are just as complex as humans

and we have multiple species meaning variation in anatomy, physiology and

disease. I think an analogy might be the engineer that designs the first

artificial heart and is definitely part of the team but would never be the team

member to implant it in a test animal or human. A second point is, that there

is always, at least for me, a feeling of reservation about non-veterinarians

coming to my field and practicing some form of veterinary medicine. I could

make the same argument about the technician that goes out and does a solo rehab

practice. I think the basic thought by many veternarians is, t

> hat they went to veterinary medical school and obtained their DVM, so why

should those that have not be able to come and do the same or even some of the

job. It may not be 100% appropriate to feel that way and the PTs and LVTs may

not like it, but it is a feeling held by many veterinarians. I have had

numerous veterinarians convey to me that they feel the human trained health care

practitioners in veterinary medicine are invited and solicited guests in our

field based on their skill and knowledge set but do not have a right, given by

veterinary training and testing, to practice in our field. Again this does not

mean that the PT is not an important part of veterinary rehab at this point. I

am simply pointing out the opinion held by many DVMs. Point number three is

that a human massage therapist also has no training in veterinary medicine AND

is not a technician in any form. I agree that they should not be doing

evaluations; they should at most be doing the massage that i

> s prescribed by the DVM with input from the PT. And should the human massage

therapist be creating exercises for the patient if they are not the person to do

the evaluations? Point number 4 is, why is the PT doing the evaluations with no

formal veterinary medical training? My opinion is that evaluations should be

done by the DVM (or DVM and PT together) and then the PT should be able to take

that information and recommend what manual and modality therapies should be

used. This is the skill set they bring to the table noted in the first quote

above. Why is it accepted that the PT should be seeing veterinary patients

without the supervision of the DVM? Does a multiple week training program and a

CCRP or CCRT certificate qualify a PT to evaluate a dog or cat with orthopedic

or neurologic disease? Why is the LVT excluded from doing an evaluation? Why

would we not delegate this to the LVT that has 2 years of formal veterinary

education? I think these are important question

> s to ask of the veterinary community.

>

> I think that there is a trend now which may be somewhat different from when

veterinarians first began to solicit the input and help of the PT in their

practices. The trend now seems to be that it has somehow become acceptable for

the PT to set up their own stand-alone practices, for the PT to render diagnoses

based on their exams, to discuss anatomic structure and function/dysfunction

with clients, to have discussions with clients about veterinary medical and

surgical conditions and procedures and to render prognoses. This is essentially

practicing an area of veterinary medicine. I read it every day on the Rehab

ListServ. The relevancy to the above quote is that other than the PT skill set,

the PT does not bring the skills to justify doing these aforementioned actions,

which it seems they are doing more and more commonly. Once again, I am not

suggesting that the PT does not have a place in veterinary medicine, but I am

suggesting that the PT should be under the supervisi

> on of the licensed DVM. In Oregon the practice act allows the stand alone

clinic of a PT or DC but the PT or DC can only see cases that have been referred

by a DVM. They cannot take on non-referred appointments. Is this correct? I

think whether correct or not correct according to the law, what it creates is

the situation where the PT, DC, Acupuncturist or Massage Therapist is doing

exams, evaluations, rendering treatment plans, monitoring progress and

establishing prognosis without veterinary medical training and without DVM input

and supervision. Is this correct? Another relevancy to the previous quote is

that I would not attempt to do this in the human field and even I had some skill

to contribute to human health care I would not be allowed to practice that skill

unsupervised. These are all important questions and I think we all should think

them over, if for nothing else than the goal of providing the best, most

complete, most appropriate care for the veterinary reha

> b patient.

>

> I am sure I have stirred the pot quite a bit with this dissertation but we

have sort of danced around it for a long time and like most cross field

relationships that have occurred in veterinary medicine, we crossed the field

before establishing clear boundaries and rules. I don't want to exclude the PT

from veterinary medicine but I think it is important for all of us on the rehab

" team " , the DVM, the PT and the LVT to all know our roles and limits. I

sincerely believe that the PT is an important addition to the field of

veterinary rehabilitation! I do not and would never presume to think because I

have a CCRT that I am the equal of the PT in physical rehabilitation ( " therapy "

-- still ridiculous it cannot be called that), nor would I presume to think that

I can handle a patient, draw blood, trim nails, etc… like that of an LVT. But

nor should the PT or LVT presume that they should function in the role of the

DVM. Sorry ahead of time if this angers anyone but I have nev

> er been very good at sitting on my hands. If you believe this is

inappropriate for the rehab list, please feel free to hurl insults directly to

me on my email: mbparchman@...

> Have a great day!

> Mark B. Parchman, DVM, DACVS, CVA, CCRT

>

January 28, 2012

I think an important point is missed in your below commentary. DVMs, PTs, or

licensed techs, none are qualified to perform a physical rehabilitation

evaluation on animals. Just as a human medical doctor is not qualified to

perform a physical therapy evaluation, a DVM is not qualified to perform a

rehabilitation evaluation. While a physical therapist is qualified to perform a

physical therapy evaluation, they are not qualified to perform one on animals.

And a tech is not qualified to perform a physical therapy evaluation on animals

or on people. That is where the certificate programs come in. They take each of

our lacking areas and attempt to " qualify " us.

One of the problems, I as a physical therapist see, is that veterinarians seem

to " own " all treatments and work performed on any animal. While the human model

is very different in that, there are many different practitioners qualified to

practice on humans. They understand that it is impossible and even if attempted,

would result in subpar care, for a medical doctor to provide care for all areas

of human health. I as a physical therapist, am not practicing " human medicine " ,

I am practicing physical therapy. And a person would not go to their medical

doctor for physical therapy. But as it stands now, it seems like any person who

works on an animal, is considered to be performing veterinary medicine. Humans

as well as animals are best served by those who are trained and educated in

specific disciplines. That brings me back around to the education point. The

certificate programs are trying to educate the lacking areas in each of our

disciplines. In a couple week program, can this be done? Maybe, maybe not, but

it is what is available at this point. It would be better if there were a degree

program in animal physical rehabilitation as a complete separate program. But

this is not available.

As far as the examination on the animals, there is a difference between a

medical (or veterinary) exam and a rehab exam. All of the patients that I see,

have a veterinary exam and diagnosis first to rule in/out specific pathology and

decide whether or not the animal is a rehab candidate. I always get a written

and signed referral from the veterinarian. Then I perform a physical rehab exam,

where physical impairments are identified and a treatment protocol and plan of

care is set forth. This not the same as the veterinary, or medical exam. I would

never suppose to take the place of a veterinarian.

Again, no one is the qualified practitioner here. We all come from our own

backgrounds and fill in the holes in our education with the certification

programs, continuing ed when we can find it, and self study and clinical

experience. We all share a common interest and goal, we wish to help and serve

the pet population in a way that was unheard of in the not too distant past. We

have passion to help the animals. We are all in a ground breaking phase as this

field changes and morphs and I am very excited to be a part of it.

Thanks to everyone who is making and creating this field of animal health!

Day, MPT, CCRP-pending