"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Tuesday, May 13, 2008

Virginia Chiropractors can't make a Physical Therapy Diagnosis

You can read this discussion about Virginia chiropractors practicing physical therapy that was 'born' on the Physical Therapist Manager Yahoo Groups and can be read here . You will need to sign in to Yahoo Groups to contribute to the discussion.

It's too bad 'physical therapy privileges' can be awarded to
chiropractors who probably can't do a physical therapy evaluation on a
patient prior to performing treatment.

This letter from the acting Virginia Attorney General states that chiropractors can 'practice physical therapy' when performing techniques and modalities.

Here is last paragraph of letter posted on site:

“Based on the above, I am of the opinion that the statutory changes enacted
by the General Assembly in 2000 were not intended to change, and did nothing
to change, the scope of practice of chiropractors, and I am further of the
opinion that chiropractors may lawfully provide physical therapy modalities
as part of a treatment program for patients and, therefore, practice
physical therapy.

With kindest regards, I am
Very truly yours,

Randolph A. Beales

Acting Attorney General”

I wonder if the Virginia state practice act required a 'physical therapy
diagnosis' prior to any profession administering physical therapy
treatments if that would slow the chiropractors down.

The 'physical therapy diagnosis' would require specific measurement of
impairments in ROM, strength and other physical patient
characteristics and also measurement of functional limitations
(perhaps with the OPTIMAL).

The physical therapist would then hypothesize the 'physical therapy
diagnosis' - the link between the impairments and the functional

The physical therapist would then treat the patient using any
combination of techniques - exercise, manipulation, education,
whatever it takes.

The physical therapist would then re-measure the patient
characteristics (ROM, strength, OPTIMAL) to see if any improvement

If improvement did occur, the physical therapist could attribute the
benefit to the treatment and render a 'discharge physical therapy

I've developed a decision-making process called SIMPLE Physical Therapy Diagnosis with 'how-to' videos, data-collection templates and extensive references at www.SimpleScore.com .

If most physical therapists followed this decision-making process I
bet most chiropractors would hesitate mightily before advertising
their services as anything akin to physical therapy.

The problem is that most physical therapists don't follow this
decision-making process prior to administering physical therapy on a
patient and most chiropractors know this.

If chiropractors thought that physical therapy diagnosis was 'over
their heads' then we would be safe from professional infringement.

Physical Therapy Diagnosis is the only sustainable competitive position that physical therapists have in the rehabilitative marketplace.

The only way to protect that position is by practicing Physical Therapy Diagnosis.

Legislative solutions wont work because economic forces drive legislation. Deeper pockets will prevail.

Physical therapists can beat chiropractors not with better laws but by being better physical therapists.

Free Tutorial

Get free stuff at BulletproofPT.com

Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

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No reproduction without authorization.

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