Steve Karas PT

Tuition, Burnout, and Board Failures: Inside the DPT Crisis ptpintcast.com/tuition-burnou… @KyleCovPT #DPT #DPTeducation #PhysicalTherapySchool #DOE #departmentofeducation #CAPTE #APTA #studentloans #PTstudent

@GregLehman So you took the course & reviewed all the references before disparaging the content? What if people did the same w your course?

Theatre and showmanship.

Physicians who sit at the bedside (compared to standing) are perceived to have spent longer with their patient and have higher patient satisfaction.

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@PhysicalTherapy @DrSethPT podcasts.apple.com/us/podcast/pt-…

PT education is on fire. It’s time to stop the incremental fixes. 🧵 1/ Physical therapy applications are cratering because the "best and brightest" are doing the math—and the numbers don’t work. 2/ The stats: Average DPT debt is $142,489. Starting salaries? $71k–$89k. That is an unsustainable 0.69 debt-to-income ratio. 3/ We’re taking aim at the "sacred cow" of the 7-year track. In the UK, Canada, and Australia, 4–5 year models already produce elite clinicians. 4/ Proposed: A 5-Year DPT Model. 3 years undergrad 2 years immersive graduate training Earlier workforce entry 5/ The survival of the profession depends on design, not duration. Full breakdown here: by @PhysicalTherapy @timothywflynn open.substack.com/pub/physicalth…

Great 🇺🇸 is leaving the @WHO ! This decision is more 🐂 💩 from @RFKJr_Official that will hurt 🇺🇸 & 🌎 health. Total 🤡

@chadcookpt @DrSethPT 50 million ppl take statins and their mechanism is uncertain. So not unique to MT.

@DrSethPT I fully agree. I doubt we will ever fully understand it. It's one reason I find alternative explanations so fascinating

A new CEMMT blog with Damian Keter summarizes our mega-mechanisms paper sponsored by ForceNET and published in PLOS One. It's an easy read with a nice layperson's summary at the end. sites.duke.edu/cemmt/2026/01/…

Old, boring & safe. Made the move to @volvocars this year.

If you get blocked on #PT TWITTER bc u asked about a paper or engaged in discussion, u have to wonder… #goingtolinkedin #AcademicTwitter

@DrDunning @DrSethPT @IvanDodlek95 Thats seems to be a recurring issue w PT RCTs. Lack of treatment fidelity.

Interesting the abstract has no information on what SAPS population (military? subacute, chronic?) the sample was taken from AND not a single word describing the actual DN treatment (how many sessions, how many needles, was it a standardized intervention, time in situ, EDN or DN, any particular tissue targets) or the dosage parameters. Sort of strange to omit this from the abstract. Nevertheless I will read the full text this week and give my specific thoughts at that time.

Dry Needling Plus Manual Therapy and Exercise for Subacromial Pain Syndrome: A Sham-Controlled Randomized Clinical Trial “Adding dry needling to a standard physical therapy program did not result in greater improvements in SPADI scores at one year.” jospt.org/doi/abs/10.251…

@fritdog23 @NickHoopes_ @PaulBliton I agree. Affordability is an issue! Loans are only 1/2 the picture.

@Steven_AK @NickHoopes_ @PaulBliton Community college is now free in my state. I teach in a PTA program at a community college, and our program and the RN and LPN programs are busting at the seams. If it is cheap, they will come.

I keep seeing people upset about this whole “professional degree” thing for federal loans… And how professions like nurses and physical therapists aren’t included… And all I can think is; “Well, yeah, those degrees shouldn’t cost $200k to obtain…that’s a bad investment🤷‍♂️”

@fritdog23 @NickHoopes_ @PaulBliton No. This may affect the # of students able to afford a degree. We have shortages. The WWF 🤡 will hurt patients.

@Steven_AK @NickHoopes_ @PaulBliton Is a plumber a professional? They most certainly are, and if you need validation from the Dept of Education, that is your problem. All that matters is if your patients think you are a professional and I am sure they do. Carry on.

@CorKinetic Id say the evidence shows there is no ‘cure’ for periodic nslbp.

IMO one of the big issues in back pain is the focus on the 'cause' not the 'cure' I think the evidence shows you can do the latter without knowing everything about the former

@DocBorelli @DrDiGiorgio @CharlieRuland MRI r overused. Irrelevant most of the time and abused by MDs who own MR machines. Its a scam ay worst and unneeded lazy or defensive medicine at best. Data supports this!

See what kind of MRI scan you get for $95 total (facility payment + physician payment). That is the current Medicare global reimbursement for millions of MRI procedures performed in the US today. 😮 Can anyone show me a break-even pro forma that includes a $2.5 million+ MRI scanner (the cost of a state-of-the-art 3T machine) at this level of reimbursement?

Let's have a serious conversation about Medicare for All. Medicare physician reimbursement has gone down 50% since the 1990's. This has led to shortages. Ask anyone who has tried to get a primary care appointment using Medicare. Almost 10% of primary care doctors are now in Direct Primary Care models outside off Medicare. Medicare has favored hospitals over independent physician practices. It pays them more with facility fees. It keeps their reimbursement high. It clearly favors these large institutios over independent doctors. Medicare banned physician ownership of hospitals. Medicare gave us quality metrics, cumbersome electronic medical records, and appropriate use criteria. Meanwhile, Medicare takes money from every American's paycheck every month. What do you get in exchange? 80% coverage for hospital services. You still need to pay out of pocket for the remaining 20% or pay out of pocket for a supplemental insurance plan. You still need to pay premiums for physician services or drug coverage. Medicare for all would completely eliminate private insurance. It would put 100% of healthcare spending under direct control of the secretary of Health and Human Services. So, tell me, why would we want to impose this on all Americans?

@adamdobson123 Ive always wondered why walking is advised w cpgs, but yet often is associated with w le complaints 🤔

Lumbar spinal stenosis is primarily a clinical diagnosis rather than a radiographic one. In the Wakayama Spine Study by Ishimoto et al (see illustration), only ten percent of the cohort were symptomatic despite 77.9 percent having either moderate or severe canal stenosis. pubmed.ncbi.nlm.nih.gov/22796511/ Terming it neurogenic claudication, in the same way that we use painful radiculopathy as a clinical presentation would make more sense. Even in the presence of radiographic changes, considerable uncertainty remains regarding whether laminectomy +/- fusion provides benefit for people with neurogenic claudication, and if so for whom, and when. These operations are lengthy and carry non trivial risk, usually in a maturing population. pubmed.ncbi.nlm.nih.gov/26824399/ As is usually the case, treat the (Wo)Man, not the Scan.

@SenFettermanPA Be well Senator. Heal quick!

Statement from Sen. Fetterman’s Spokesperson: “During an early morning walk, Senator Fetterman sustained a fall near his home in Braddock. Out of an abundance of caution, he was transported to a hospital in Pittsburgh. Upon evaluation, it was established he had a ventricular fibrillation flare-up that led to Senator Fetterman feeling light-headed, falling to the ground and hitting his face with minor injuries. Senator Fetterman had this to say: ‘If you thought my face looked bad before, wait until you see it now!’ He is doing well and receiving routine observation at the hospital. He has opted to stay so doctors can fine-tune his medication regimen. Senator Fetterman is grateful for the EMTs, doctors, and nurses who are providing his care.”

@DrDunning @DrEscaloniPT Thoughts on this? @Retlouping @CorKinetic @AdamMeakins @GregLehman @marklaslett_NZ Pretty good effect size.

Which patients with knee #osteoarthritis are most likely to experience a successful outcome to periosteal & intra-articular electrical dry needling (PIEDN)? The results on 586 patients presented in Reno #AAOMPT2025 facebook.com/share/v/1BT1fG…

@AAOMPT great talk by Ken Olson former @IFOMPT pres. Awesome take home