scholarly journals A Global View of Direct Access and Patient Self-Referral to Physical Therapy: Implications for the Profession

2013 ◽  
Vol 93 (4) ◽  
pp. 449-459 ◽  
Author(s):  
Tracy J. Bury ◽  
Emma K. Stokes
Keyword(s):  
Physical Therapy ◽  
Online Survey ◽  
Response Rate ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Medical Profession ◽  
Good Practice ◽  
Clinical Effectiveness ◽  
Direct Access ◽  
Policy Makers

BackgroundInternational policy advocates for direct access, but the extent to which it exists worldwide was unknown.ObjectiveThe purpose of this study was to map the presence of direct access to physical therapy services in the member organizations of the World Confederation for Physical Therapy (WCPT) in the context of physical therapist practice and health systems.DesignA 2-stage, mixed-method, descriptive study was conducted.MethodsA purposive sample of member organizations of WCPT in Europe was used to refine the survey instrument, followed by an online survey sent to all WCPT member organizations. Data were analyzed using descriptive statistics, and content analysis was used to analyze open-ended responses to identify themes.ResultsA response rate of 68% (72/106) was achieved. Direct access to physical therapy was reported by 58% of the respondents, with greater prevalence in private settings. Organizations reported that professional (entry-level) education equipped physical therapists for direct access in 69% of the countries. National physical therapy associations (89%) and the public (84%) were thought to be in support of direct access, with less support perceived from policy makers (35%) and physicians (16%). Physical therapists' ability to assess, diagnose, and refer patients on to specialists was more prevalent in the presence of direct access.LimitationsThe findings may not be representative of the Asia Western Pacific (AWP) region, where there was a lower response rate.ConclusionsProfessional legislation, the medical profession, politicians, and policy makers are perceived to act as both barriers to and facilitators of direct access. Evidence for clinical effectiveness and cost-effectiveness and examples of good practice are seen as vital resources that could be shared internationally, and professional leadership has an important role to play in facilitating change and advocacy.

scholarly journals Decision-Making Ability of Physical Therapists: Physical Therapy Intervention or Medical Referral

2006 ◽  
Vol 86 (12) ◽  
pp. 1619-1629 ◽  
Author(s):  
Diane U Jette ◽  
Kerry Ardleigh ◽  
Kellie Chandler ◽  
Lesley McShea
Keyword(s):  
Physical Therapy ◽  
Confidence Interval ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Direct Access ◽  
Medical Conditions ◽  
Musculoskeletal Conditions ◽  
Logistic Regressions ◽  
American Physical ◽  
Medical Referral

Abstract Background and PurposeOpponents of direct access to physical therapy argue that physical therapists may overlook serious medical conditions. More information is needed to determine the ability of physical therapists to practice safely in direct-access environments. The purpose of this study was to describe the ability of physical therapists to make decisions about the management of patients in a direct-access environment. Subjects. Of a random sample of 1,000 members of the Private Practice Section of the American Physical Therapy Association, 394 participated. Methods. A survey included 12 hypothetical case scenarios. For each case, participants determined whether they would provide intervention without referral, provide intervention and refer, or refer before intervention. The percentage of correct decisions for each group of scenarios was calculated for each participant, and participants were classified as having made correct decisions for 100% of cases or less for each group. Three sets of logistic regressions were completed to determine the characteristics of the participants in relation to the decision category. Results. The average percentages of correct decisions were 87%, 88%, and 79% for musculoskeletal, noncritical medical, and critical medical conditions, respectively. Of all participants, approximately 50% made correct decisions for all cases within each group. The odds of making 100% correct decisions if a physical therapist had an orthopedic specialization were 2.23 (95% confidence interval=1.35–3.71) for musculoskeletal conditions and 1.89 (95% confidence interval=1.14–3.15) for critical medical conditions. Discussion and Conclusion. Physical therapists with an orthopedic specialization were almost twice as likely to make correct decisions for critical medical and musculoskeletal conditions.

scholarly journals BACK TO THE GRASS ROOT

2014 ◽  
Vol 3 (2) ◽  
pp. 41-43
Author(s):  
Ali Farhad ◽  
Saad Saleem ◽  
Zainab Abdul Razzak
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Direct Access ◽  
Self Assessment ◽  
Professional Advancement ◽  
Health Networks ◽  
Grass Root

Profession is, not to squeak like a grateful and apologetic mouse, but to roar like a lion out of pride1. Throughout a professional vocation, professionals change the span of their skill, through becoming more specific, through inspiring into recently emergent areas of professional work, or by taking on administration or enlightening positions. They will also be continually developing the quality of their work in a number of areas, beyond the level of proficiency of one’s ability or skill. Professional advancement inculcates a process of incessant development, long-term knowledge, and augmentation, which allow professionals to get better in their practices so as to better serve patients, clients, associations, the profession, and society2. A physical therapist has an enduring professional accountability for maintaining proficiency through ongoing self-assessment, education, and augmentation of information and skills. Physical Therapy, by 2020, will offer such Physiotherapist who are doctors of Physical Therapy and who may be board–licensed experts3. Clients will have direct access to Physical Therapists in all milieus for patient/client management, expectation, and wellness services. Physiotherapist will be practitioners of choice in clients’/patients’ health networks and will hold all rights of autonomous practice4. Physical Therapists may be assisted by Physical Therapy assistants, who are erudite and qualified to provide Physical Therapist–directed and controlled, components of intervention. Physical Therapy profession in Pakistan is rising with a great pace. Every passing minute brings extraordinary revolution in this field and now it is a high time to have some institution takes the responsibility on its shoulder to curtail the nourishing elements of quackery and bring autonomy and sovereignty to the field.

scholarly journals Dermatomyositis: Evolution of a Diagnosis

2003 ◽  
Vol 83 (10) ◽  
pp. 932-945 ◽  
Author(s):  
Joshua A Cleland ◽  
Jane Walter Venzke
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Short Form ◽  
Exercise Program ◽  
Signs And Symptoms ◽  
Care Physician ◽  
Direct Access ◽  
Home Exercise ◽  
Diagnostic Process

Abstract Background and Purpose. As direct access evolves, physical therapists will increasingly encounter patients with pathology that might have an underlying systemic origin. The purpose of this case report is to describe the diagnostic process that led a patient's physical therapist to recognize signs and symptoms of dermatomyositis. Case Description. The patient was an 18-year-old woman who was referred for physical therapy by her primary care physician on 3 occasions with 3 separate musculoskeletal diagnoses. During the third episode, the physical therapist recognized signs and symptoms that could be indicative of dermatologic disease and referred the patient to a dermatologist. Outcomes. A rheumatologist diagnosed the patient's condition as dermatomyositis and referred her for physical therapy. The physical therapy plan of care focused on strengthening and stretching, with an emphasis on a home exercise program. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) indicated that the patient continually made functional improvements over an 18-month period. Discussion. Although diagnosis of diseases such as inflammatory myopathies is not within a physical therapist's scope of practice, this case demonstrates the role a physical therapist can play in recognition of underlying systemic pathology by using the diagnostic process.

scholarly journals Direct Access to Physical Therapy in the Netherlands: Results From the First Year in Community-Based Physical Therapy

2008 ◽  
Vol 88 (8) ◽  
pp. 936-946 ◽  
Author(s):  
Chantal J Leemrijse ◽  
Ilse CS Swinkels ◽  
Cindy Veenhof
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
The Netherlands ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Information Service ◽  
Direct Access ◽  
Number Of Patients ◽  
Quality Aspects ◽  
Nationally Representative

BackgroundIn 2006, direct access to physical therapy was introduced in the Netherlands. Before this policy measure, evaluation and treatment by a physical therapist were only possible following referral by a physician.ObjectiveThe objectives of this study were to investigate how many patients use direct access and to establish whether these patients have a different profile than referred patients.MethodsElectronic health care data from the National Information Service for Allied Health Care (LiPZ), a nationally representative registration network of 93 Dutch physical therapists working in 43 private practices, were used.ResultsIn 2006, 28% of the patients seen by a physical therapist came by direct access. Patients with non–further-specified back problems, patients with nonspecific neck complaints, and higher-educated patients were more likely to refer themselves to a physical therapist, as were patients with health problems lasting for less than 1 month. Younger patients made more use of direct access. In addition, patients with recurring complaints more often referred themselves, as did patients who had received earlier treatment by a physical therapist. Patients with direct access received fewer treatment sessions. Compared with 2005, there was no increase in the number of patients visiting a physical therapist.LimitationsData came only from physical therapists working on general conditions in general practices. Severity of complaints is not reported.ConclusionsA large, specific group of patients utilized self-referral, but the total number of patients seen by a physical therapist remained the same. In the future, it is important to evaluate the consequences of direct access, both on quality aspects and on cost-effectiveness.

Evidence-based Practice regarding knowledge, attitude and perceived barriers of Mangalore Physical Therapists: A Survey

2020 ◽  
Vol 11 (4) ◽  
pp. 7056-7063
Author(s):  
Vineel P ◽  
Gopala Krishna Alaparthi ◽  
Kalyana Chakravarthy Bairapareddy ◽  
Sampath Kumar Amaravadi
Keyword(s):  
Response Rate ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Medical Profession ◽  
Demographic Data ◽  
Perceived Barriers ◽  
Hard Copy ◽  
Evidence Based ◽  
Research Committee ◽  
The Individual

  Evidence-based Practice is defined as usage of current best evidence which is conscientious, explicit and judicious in deciding on the care of the individual. It is one of the vital decision-making processes in the medical profession. Though India is renowned as a center for medical education, there is scarcity regarding the literature on evidence-based practice. The survey aims to identify the prevalence of evidence-based practice among the physical therapists of Mangalore. The study protocol submitted to scientific research committee and Ethical institutional committee, K.M.C. Mangalore Manipal University. On approval, the questionnaire had been distributed among the physical therapists of Mangalore through mails and in the written form. The questionnaire consists of questions divided into eight sections: 1) consent form 2) current practice status; 3) demographic data; 4) behavior; 5) previous knowledge of E.B.P. resources; 6) skills and available resources; 7) Opinions regarding E.B.P.; 8)Perceived barriers regarding E.B.P. The emails were sent through Google forms to all the physical therapists, and hard copies were distributed among the selected physical therapists. The response rate for the emails was 13.1%. The response collected through hard copies was 178, whereas total hard copies distributed was 320, the participants rejected some due to lack of interest. In total, including emails and hard copy questionnaire 205 was the response rate in which all were practicing physical therapy as their primary profession. The findings of the study will pave the way to identify the status of evidence-based practice as well as help in designing promotional programmers for evidence-based practice.

scholarly journals Patient Participation in Physical Therapy Goal Setting

2001 ◽  
Vol 81 (5) ◽  
pp. 1118-1126 ◽  
Author(s):  
Susan M Baker ◽  
Helen H Marshak ◽  
Gail T Rice ◽  
Grenith J Zimmerman
Keyword(s):  
Patient Satisfaction ◽  
Physical Therapy ◽  
Elderly Patients ◽  
Goal Setting ◽  
Patient Participation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Assessment Instrument ◽  
Initial Examination ◽  
Goals And Objectives

Abstract Background and Purpose. An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. Subjects and Methods. Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (X̄=76.4 years of age, SD=7.1, range=65–94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. Results. Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. Discussion and Conclusion. In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

Contributions of Non-professional Local Physical Therapist In the Promotion of Community Health Activities in the Arsi Zone, Southeast Ethiopia (Preprint)

2021 ◽  
Author(s):  
Leta Melaku
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Arsi Zone ◽  
Southeast Ethiopia ◽  
The Impact

BACKGROUND Physical activity is a first-line therapy and secures against persistent illnesses. Essential medical care professionals are obviously situated to advance actual action. Active recuperation mediations focused on advancement and upkeep of wellbeing, personal satisfaction, and wellness. There is, notwithstanding, a deficiency of such examination proof in Ethiopia. OBJECTIVE We planned to assess the degree of KAP of nonprofessional local physical therapists' towards wellbeing advancement in Arsi zone of Oromia, Southeast Ethiopia. METHODS Community based cross sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pre-tested, structured and self-administrative questionnaires. Participants were selected by quota sampling technique. The questionnaire was drafted specifically to test the KAP. Data were double entered and analyzed by SPSS Version 20.0 program. Descriptive statistics were used. The KAP were estimated using proportion. RESULTS In present response rate is 90.0%. Ages of respondents ranged between 24 – 87 years. 57.8% of participants got initial physical therapy knowledge from either of their parents. 53.3% of the respondents hear about health promotion from families and friends. 57.8% of them provided health promotion at their workplace. The overall percentage of all the respondents’ KAP in health promotion was 60.1%. CONCLUSIONS The respondents’ have good KAP towards health promotion. However there is still room for improvement. Also there is a lack of proper guide lines in determining the impact physical therapy.

Awareness and Perception of Physical Therapy Education, Role in Patient Management and Health Promotion Held by Senior Medical Practitioners

2020 ◽  
pp. 13-17
Author(s):  
OJS Admin
Keyword(s):  
Health Promotion ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Well Being ◽  
Physical Therapy Education ◽  
Health Providers ◽  
Medical Practitioners ◽  
Therapy Education

Physical therapists are integral part of health care system. In collaboration with other health providers, physical therapist can play an effective role in patient handling and well-being of individuals. The awareness and perception of senior medical practitioners is less known regarding physical therapy education, role in patient management and health promotion.

scholarly journals Value-Based Care for Musculoskeletal Pain: Are Physical Therapists Ready to Deliver?

2019 ◽  
Vol 100 (4) ◽  
pp. 621-632 ◽  
Author(s):  
Trevor A Lentz ◽  
Adam P Goode ◽  
Charles A Thigpen ◽  
Steven Z George
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Musculoskeletal Pain ◽  
Clinical Decision Making ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Great Promise ◽  
Health Care Environment ◽  
Early Physical Therapy ◽  
Analytical Approaches

Abstract Early physical therapy models hold great promise for delivering high-value care for individuals with musculoskeletal pain. However, existing physical therapist practice and research standards are misaligned with value-based principles, which limits the potential for growth and sustainability of these models. This Perspective describes how the value proposition of early physical therapy can be improved by redefining harm, embracing a prognostic approach to clinical decision making, and advocating for system-wide guideline-adherent pain care. It also outlines the need to adopt a common language to describe these models and embrace new, rigorous study designs and analytical approaches to better understand where and how early physical therapy delivers value. The goal is to define a clear path forward to ensure physical therapists are aligned within health care systems to deliver on the American Physical Therapy Association’s vision of high-value care in a rapidly changing health care environment.

scholarly journals The Revised APTA Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant: Theory, Purpose, Process, and Significance

2010 ◽  
Vol 90 (5) ◽  
pp. 803-824 ◽  
Author(s):  
Laura Lee Swisher ◽  
Peggy Hiller ◽  
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Code Of Ethics ◽  
Codes Of Ethics ◽  
Ethical Conduct ◽  
Vision 2020 ◽  
Deliberative Process ◽  
Physical Therapist Assistant ◽  
Physical Therapist Assistants

IntroductionIn June 2009, the House of Delegates (HOD) of the American Physical Therapy Association (APTA) passed a major revision of the APTA Code of Ethics for physical therapists and the Standards of Ethical Conduct for the Physical Therapist Assistant. The revised documents will be effective July 1, 2010.PurposeThe purposes of this article are: (1) to provide a historical, professional, and theoretical context for this important revision; (2) to describe the 4-year revision process; (3) to examine major features of the documents; and (4) to discuss the significance of the revisions from the perspective of the maturation of physical therapy as a doctoring profession.Process of RevisionThe process for revision is delineated within the context of history and the Bylaws of APTA.Format, Structure, and Content of Revised Core Ethics DocumentsThe revised documents represent a significant change in format, level of detail, and scope of application. Previous APTA Codes of Ethics and Standards of Ethical Conduct for the Physical Therapist Assistant have delineated very broad general principles, with specific obligations spelled out in the Ethics and Judicial Committee's Guide for Professional Conduct and Guide for Conduct of the Physical Therapist Assistant. In contrast to the current documents, the revised documents address all 5 roles of the physical therapist, delineate ethical obligations in organizational and business contexts, and align with the tenets of Vision 2020.SignificanceThe significance of this revision is discussed within historical parameters, the implications for physical therapists and physical therapist assistants, the maturation of the profession, societal accountability and moral community, potential regulatory implications, and the inclusive and deliberative process of moral dialogue by which changes were developed, revised, and approved.

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