Every year, around this time I start hearing questions about if it is worth pursuing clinical specialization. Recently, I even saw a forum post asking if the specialization warranted a raise. It's a highly debatable topic, but absolutely worth discussing. As you know, the APTA offers clinical specialization in various fields, like pedicatric, orthopaedic, sports, and more. To become a certified specialist, one must past the specialization exam for the respective field which is offered once a year. To qualify for the test, one must either complete a residency in the field or a certain number of hours (1-2 years worth usually) treating the appropriate field and apply for sitting for the test.
Now, whether or not clinical specialization actually changes practice patterns or represents a true expert knowledge is a debate by itself; however, the question that comes more frequently is does it (or should it) translate to a raise. I think what is key to help justify a raise is how does it benefit your clinic. One might initially think improved outcomes, however, I believe that studies have shown little change in outcomes compared to non-specialists. It's not that specialization isn't worth it, but I believe it is not being marketed properly. My current clinic has done very little to market it. It is not labeled on our website, in our office or on my cards. Part of it may be to keep therapists appearing on the same level (to facilitate sharing patients), but it may be due to lack of knowledge of how to market it. I honestly do not know.
While I did get a raise with specialization, I believe there are more benefits to pursuing specialization than just financial incentive. There are definitely aspects of evidence-based practice that are presented in each monograph for the OCS that are beneficial to clinical practice. Also, I think there is definitely something to be said about knowing a standard of orthopaedic knowledge and recognizing that level of knowledge with specialization. It is rewarding and can help identify clinicians with that knowledge. Additionally, it may open up opportunities that may otherwise have been closed. Recently, I interviewed with two companies that were looking to hire a clinical specialist as their staffs are primarily made up of specialists. While I did accept an offer from one of the companies, I cannot for certain say I would have had the opportunity to interview for either or both companies if I weren't a specialist. The potential benefits for clinical specialization lie beyond immediate financial improvements.
-Dr. Chris Fox, PT, DPT, OCS
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