"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

Saturday, June 7, 2008

Physical Therapy Decisions

Are physical therapists drowning in an ocean of medical information?

Journals, articles, continuing educations courses, new textbooks, government regulations and professional position statements are just a few of the complex reading requirements that physical therapists must digest.

Selena Horner posts at www.MyPhysicalTherapySpace.com in a post titled Overwhelmingly Complex

She asks the following...

"Is there a way to move from overwhelmingly complex to simple?"

Selena Horner

Joel Bialosky, Stephen George and Mark Bishop ask How Spinal Manipulative Therapy Works: Why ask Why? in the guest editorial of the June Journal of Orthopedic and Sports Physical Therapy.

Somewhat paradoxically, Bialosky et al state the following:

"More information on how and why spinal manipulative therapy
works may lead to higher utilization rates because there would be less skepticism
about rationale for its effectiveness and less mysticism surrounding its use."

Finally, in 2006 the Orthopedic Section of the APTA began a project called...
Use of the International Classification of Functioning and Disability to Develop Evidence-Based Practice Guidelines for Treatment of Common Musculoskeletal Conditions

The authors, Joseph Godges, DPT, MA, OCS Coordinator, ICF-Based Clinical Practice Guidelines and James J. Irrgang, PT, PhD, ATC Orthopaedic Section President state the following:

"It is believed that these guidelines will advance orthopaedic physical therapist practice and could be used to guide professional and postprofessional education and to establish an agenda for future clinical research."

Ultimately, the goal of academic research should be to improve clinical physical therapy.

Ms. Horner's original question asked how to make the complex into the simple.

I think each of these examples, in its own way, seeks to do one thing - improve physical therapist clinical decision making.

For the practicing physical therapist clinician (and the lab researcher) better physical therapy decisions come down to one thing:


Take better measurements of your patients to make better treatment decisions.

I recommend a simple system for management of lower quarter and lumbar dysfunction, interestingly called SIMPLE for Summary of Impairments of the Lumbar Spine and the Lower Extremity.

Take a look at it at the SIMPLE website.

I also recommend an excellent textbook on Physical Therapy Diagnosis which you can get here...

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"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.