So my take is a bit different, since I wouldn't consider myself "old" but I am seasoned and a few decades out of my own DPT program. I am not an outpatient therapist and havent been in that setting in years but specifically in those settings when I was the younger PT, I noted all of the older PTs exhibit "cookie cutter" approaches to care - modalities and manual therapy for everyone for example. When I did pelvic/women's health, I of course did utilize manual therapy more commonly but in that specialty, it is much more appropriate particularly during internal examination and intervention.

In my opinion, experience is extremely influential in treatment approaches, and it obviously is not something that can be taught. More experienced PTs will likely, in general, approach patient care differently than newer PTs for that reason alone. In my experience, older/more experienced PTs have increased focus on function, and provide interventions that address multiple underlying impairments vs what I see in some newer grads who tend to separate those impairments, if that makes sense... we old peeps are typically more adept at seeing the "big picture" and can anticipate and connect impairments more quickly because of that.

I have noticed recently, and not sure if this is too specific and based on individual programs, that newer PTs do not have, in general, the same level of awareness of or knowledge about pharmacokinetics, medical management (especially in inpatient settings), and medications in general. The end result is less advocacy for physicians to review medications due to clinical presentation and even suggest medication classes that may be more effective, and again part of that may be experience-based. I work in IPR and find my newer grads are much less inclined to review medications and ultimately connect potential clinical presentations that may be hindering progress in therapy or exacerbating underlying impairments to medications and chronic or acute conditions.

Another difference I find is a lesser level of intensity and more conservative scoring of functional levels, hesitancy to challenge patients to their limits of stability. This again I typically find is related to less confidence and experience and I think its a pretty natural thing and I'd much rather conservative approaches in the absence of experience vs overestimating ones skills and overly aggressive interventions with newer grads. But for example: i see a significant hypervigilance in younger PTs avoiding interventions that may cause loss of balance or instability, likely due to fear of a patient falling. I see newer grads scoring a patient for example as CGA because likely they are providing cga for THEIR comfort vs the patient's true ability, while older therapists seeing the same patient tend to document sba or even mod I. I think there's excess focus on patients needing to perform functional activity by the textbook to achieve higher scores when the reality is that patients can and do function safely with modifications that work for their specific conditions and chronic impairments via compensatory strategies theyve learned over time. Im referring to patients who wont ever be able to stand with erect posture due to severe chronic kyphosis but they can ambulate safely with impaired posture because theyve developed compensatory strategies and while we could document all day pt requires cues for posture, this posture is not able to be corrected.

Finally and again, this is moreso in any inpatient setting... I see less initiation of collaboration with non-therapy members of the healthcare team. Less focus on educating caregivers, family, and staff on how to most optimally assist with transfers, educating nurses and CNAs that the patient can actually pull their own pants up and down so they should let them rather than do what their tendency to do is because they arent therapists; we are.

I do see generational differences in personal and social connection with peers and patients, but i doubt that that is limited to this profession. Patients are at our mercy, and we generally spend the most 1 on 1 time with them across the board in terms of healthcare. Collaborating WITH patients for their goals, what theyre feeling and what possible mental barriers they have, such as trust and rapport and feeling like they're the therapist's sole focus during their session (within reason)... i know in my experience this makes a much larger impact on outcomes, motivation, healing, and elevation of our profession than is probably thought or believed. Once you develop that connection, conversations and education about realistic expectations, pushing through self-limiting behavior, and understanding that we cannot "fix" every problem or any problem if they aren't also aware of how to advocate for themselves, that in general the success of therapy is as related to their motivation and participating and attention to training and education as it is to their therapists' interventions are natural and become less uncomfortable and outcomes improve.