PT & OT. What’s the difference? Does it matter?
Even physical therapists and occupational therapists can have a hard time explaining the distinction between the two fields because there is significant overlap. When asked, professionals who have been able to formulate any sort of response have explained:
- PT tends to work on large joints (knees, hips, shoulders); OT tends to work on small joints (hands & wrists)
- PTs tend to prescribe formal exercises; OTs are more likely to learn about your daily life and find things you can fit into your normal routine to exercise the joints involved (an OT will tell you that knitting and piano playing are excellent hand exercises).
However, PTs can work on the hands. In fact, they can earn extra “hand” certification. I discovered this (and many other interesting things) because my daughter has decided that her career goal is to become a physical therapist. She has been learning what hoops she’ll need to jump through to make that happen, and one requirement is a certain number of observation hours in a variety of PT settings. Two local PT offices have graciously allowed my daughter to observe in their clinics, so she has been able to compare not just different therapists in a single location, but the differences between how two different clinics are run.
One of the PT clinics where she’s observing is a large chain. An advantage to large chains is that they employ floaters who act like a substitute teacher, travelling from one clinic to another to cover for those who call in sick. Patients can set up a therapy schedule and be confident that they won’t be cancelled if their therapist becomes ill. One disadvantage is that the PTs there are extremely clock-conscious, and ignore the patient part of the time because they’re doing documentation. In case you haven’t discovered it yet, ignoring patients to do documentation means that the therapist doesn’t notice when patients are doing their exercises wrong.
The other place is a small, privately owned clinic. They do not watch the clock as strictly, and tend to be more focused on accomplishing specific goals for each patient each day. If that requires an extra ten minutes, it isn’t a problem. On the down side, if someone is out sick, either another therapist has to pick up extra patients all day, or patients have to be rescheduled.
In the past, PT was an undergrad degree. That has changed, however, and new physical therapists enter the field with a doctorate in physical therapy.1 DPT school is every bit as competitive to enter as medical school, and has stringent entrance requirements: at least one year each of college level biology, human anatomy & physiology, chemistry, physics, and psychology, with a number of other “strongly recommended” courses, as well.
Anyone with RA (or another type of autoimmune arthritis) can benefit from consulting a physical therapist. PTs can test to determine which muscles need to be strengthened, and can then teach the least painful way to strengthen muscles so that joints work as efficiently as possible. The more I learn, I believe there is value in shopping for a PT like we shop for a physician.
1Occupational therapists enter the field with a masters degree, which honestly makes no sense to me, since it takes about the amount of time to earn as a DPT.