"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

Wednesday, March 12, 2008

What is Skilled Physical Therapy?

What do you do?

What do you do better than anyone else?

What can you do better than an athletic trainer, a massage therapist or a kinesiotherapist?

Can you progress your patient to a new level of exercise intensity, frequency or duration? Can you back down the intensity, frequency or duration?

Can you assess some new finding or physical sign not in the initial plan of care?

Will the patient leave your care better off than when they arrived?

Was their outcome more certain?

Physical therapists are paid more than athletic trainers, massage therapists or kinesiotherapists precisely because we do bring a greater level of certainty to each patient encounter.

Physical therapists produce better outcomes because risky patients don’t get worse with exercise interventions.

Physical therapists are paid more than athletic trainers, massage therapists or kinesiotherapists because the physician can expect that patients would otherwise not be safe.

An example of a post-surgical total knee replacement will help to illustrate this point.

Even an athletic trainer is qualified to show the patient how to do leg lifts for a weak quadriceps muscle.

But what if the patient came to therapy with a swollen calf, red, tender skin and radiating pain into the groin? Would the athletic trainer recognize a blood clot? Would the massage therapist use a standardized scale like the Well’s score to quantify the risk, document the findings and call the doctor?

Quantify the risk using standardized scales so that terms like better, risky and more are not just superlative adverbs but can be used as measurements for goal setting.

An impairment goal of therapy would be to reduce a Well’s score from 2/9 to 0/9.

A Well’s score of ‘3’ is a high risk for a blood clot.

See also the Medicare Benefit Policy Manual Section 220.2.C (page 20) for a definition and examples of skilled therapy.


References: Journal of Family Practice Online, December 2007. Web Accessed 3/12/08

http://www.jfponline.com/Pages.asp?AID=5728&issue=December_2007&UID=

Comments (5)

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As an undergrad AT student we actually learned how to use the Well's score in assessing level of impairment. While ATC's are very much specialized healthcare providers, I decided to pursue PT due take on a more clinical role. There is a good article here http://www.exercise-science-guide.com/degrees/phy... for prospective students interested in pursuing rehabilitation therapy.
Yes its true that physical therapy provides best outcomes and assists in rehabilitation of body.
Also Our clinic Prorehab Occupational Health West Sussex is the most prefered in the area, so call us for appointment to get excellent health services. www.prorehab.co.uk
Always always try physical therapy first and bracing, taping, and other conservative treatments. You have not done enough physical therapy for results. You need to concentrate on VMO strengthening and give it several months efforts. Physio Hillarys, Physiotherapy Hillarys, Physio Sorrento, Physio Padbury, Physio Kallaroo, Physio Joondalup, Physiotherapy Joondalup, Physio Wanneroo, Physiotherapy Wanneroo
After my first dislocation, I did physical therapy from August to November and had a patella tracking brace and my physical therapist taped my knee. physio bicton, physiotherapy bicton, physio east freo, physiotherapy east freo, physio east fremantle, physiotherapy east fremantle, physio Melville, physiotherapy Melville, physio fremantle, physiotherapy fremantle
I agree that physiotherapists have a strong foundation for their skills, based in the scientific literature. It's a time tested way to treatment MSK injuries with efficiency.

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