Do You Need a Degree to be a Therapist?

Aren’t you a little young to be my therapist?

Too often, as a young therapist fresh out of school, I get the question “How long have you been practicing?” Initially, this statement frustrated me, as I saw it as doubt in my level of patient care and suggested that I was not an adequate provider for my patients. I also struggled with the best way to answer the question – should I directly answer it and allow the patient to jump to conclusions, skirt around it and mention that I have had several years of clinical experience (considering time in school), or take an evidence-based approach and note that the literature suggested that there was not a positive correlation between therapist experience and patient outcomes? Generally, my explanation has involved a combination of all three, but it still bothers me at times that the question is even asked. Thankfully, I don’t look as young as my wife – also a Doctor of Physical Therapy – who has been asked if she needed a college degree to work as a therapist…

Therapy is an evolving field, and those who do not keep up with the latest best evidence and monitor current concepts in the treatment of particular conditions tend to fall behind in patient outcomes. This is similar to any medical profession, where practitioners are constantly shifting towards specialization to allow them to stay current with the influx of new research and techniques. Often, you are very safe in the hands of new graduates, who just received several years of instruction in the latest research and have put these skills to use over the past few years in clinical rotations. Jette and colleagues1 reported younger therapists tended to have better training, familiarity with search strategies, use of databases, and critical appraisal skills than their older counterparts, making it easier for recent graduates to access current literature.

Another article, by Resnik and Jensen2, suggested that “expert[s] were not distinguished from participants classified as average by years of experience, continuing education, or specialty training”.  Overall, they concluded that physical therapy experts utilized patient-centered care (YOUR goals matter) through collaborative problem solving, patient education, and maintained a good working relationship with their patients. While the clinical experience of senior therapists should not be undervalued (this is obviously a big advantage), it is important for this knowledge to be balanced with treatments that have been proven by research to have significant effects.

When you initiate treatment with a physical therapist, look at their comfort level when taking you through the history and physical exam, their confidence and eye contact during questioning, and the information they provide as you are receiving treatment. Don’t measure your therapist by the number of months/years they have been out of school, but instead take a look at what really matters – how confident they are in their approach and how familiar they are with the best available evidence on your condition. Any therapist who does not take the time to get to know you, take your unique situation and presentation into account, and factor your personal goals into treatment outcomes should be a warning sign of potential sub-optimal treatment.

Contributed by Dr. John Sauer, PT, DPT

edit: This used to bother me as well, everyone has to start somewhere. Now I miss being young, no one asks me that anymore - Dr. E

1Jette DU, Bacon K, Batty C, et al. Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists. PHYS THER. 2003;83(9):786–805.

2Resnik L, Jensen GM. Using Clinical Outcomes to Explore the Theory of Expert Practice in Physical Therapy. PHYS THER. 2003;83(12):1090–1106.


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