"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

Friday, January 30, 2009

Are 'home grown' outcomes measures better than OPTIMAL?

For now, over half the physical therapists in the US can take comfort in their 'informal collection of data' rather than their use of standardized outcome measures.

They are in the majority.

A new study by Dr. Diane Jette in the February Physical Therapy Journal titled Use of Standardized Outcome Measures in Physical Therapist Practice: Perceptions and Applications reveals that only 48% of physical therapists in the United States used standardized outcome measures.

For now, they are in the minority.

Similarly, only 40% of the physical therapists in New Zealand appear to use outcome measures.

For the present, there is no mandate that physical therapists use standardized outcomes measures to assess patients at baseline.

Instead, physical therapists seem to act based on a professional consensus which indicates a lack of solidarity on outcomes measures.

Rather than a mandate, Medicare 'recommends' the use of one of three outcomes measure to assess need and clinical progress in patients.

"Home grown" measures instead

Dr. Jette's study found that 'home grown' outcome measures are used by a surprising 22% of physical therapists.

Why use 'home grown' measures?

Are they better than one of the 'recommended' tools?

Are 'home grown' outcomes measures better than the OPTIMAL?

Physical therapists can use baseline outcome measures to direct the plan of care and increase the thoroughness of their evaluation.

Dr. Jette's article illustrates the essential limitation of all outcome measures:

Most clinicians do not see the value in using standardized outcome measures.

The dilemma of the outcomes measure value proposition leads to this premise:
Outcome measures are a policy-makers' solution to a problem faced by clinical physical therapists, namely:
"How do I know what my patient needs?"
Bottom line, policy-makers need a way to measure value for the $3.06 billion (2006) annually spent on Medicare outpatient physical therapy.

The majority of physical therapists will need to quickly adapt when mandated outcomes measures arrive within five-years time.

Then, it will be time for 'home-grown' to go home.

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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.
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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.